Metallic objects, such as intracanal posts and restorations, may produce severe interference, thus diminishing the quality of CBCT imaging. Objective: The purpose of this study was to analyze the influence of conventional and bioceramic gutta-percha points on the production of artifacts in CBCT images. Methods: Extracted single- -rooted premolar teeth (n=20) were instrumented and scanned with a CBCT device to create three groups: the Control group, the Gutta-Percha group and the Bioceramic Gutta-Percha group. Two types of analysis were executed: an objective one, using the Region of Interest (ROI) to measure the pixel density of each tooth, and a subjective one, to compare the groups’ images. For the statistical analysis, Student’s t-test, descriptive statistics and the frequency distribution analysis were used for both objective and subjective analyses. Results: The agreement between the observers ranged from moderate to excellent. Similar grayscale values were obtained in both the GP and BCGP groups. These results were endorsed by the p-values obtained with Student’s t test. For the subjective analysis, the observers indicated the BCGP group as the one that developed the highest number of artifacts. Conclusions: Both materials produced artifacts in the CBCT images. However, in the subjective analysis, the BCGP group showed higher levels of artifact production than the GP group, which could result in the misdiagnosis of root fracture and in a worse prognosis for that tooth.
Response of peripheral blood mononuclear cells to conditioned medium from cultured oral squamous cell carcinomas Abstract: The current study investigated the capacity for tumor factors secreted by head and neck squamous cell carcinoma (HNSCC) cell lines, KB, KB16, and HEP, to induce the secretion of various cytokines from peripheral blood mononuclear cells (PBMCs). PBMCs were isolated from blood samples collected from six healthy volunteers and these cells were incubated for 6, 24, 48, or 72 hours in the presence of 50% conditioned medium collected from cultured cell lines pretreated with, or without, stimulants such as phytohemagglutinin (PHA) or lipopolysaccharides (LPS). Aliquots of each supernatant were then assayed for levels of IFN-γ, vascular endothelial growth factor (VEGF), TNF-α, and IL-4 using enzyme linked immunosorbent assays (ELISAs). Data collected were analyzed using Student's t-test, an ANOVA test followed by Tukey's test, and tests of Pearson's Correlation. PBMCs cultured with KB16-conditioned medium produced the highest levels of IFN-γ. VEGF was also detected in conditioned media collected from all of the squamous cell carcinoma (SCC) cell lines used, and a significant difference in VEGF levels between control and KB-or KB16-conditioned media was observed. TNF-α was secreted by all PBMC groups within 6 hours of receiving conditioned media, and these levels increased up to the 24 hour timepoint, after which levels of TNF-α stabilized. In contrast, none of the supernatant samples contained detectable levels of IL-4. In combination, these data suggest that direct contact between fresh human PBMCs and conditioned media from tumor cells induces the secretion of TNF-α and VEGF by PBMCs, and this represents an initial angiogenic response.
A síndrome de Rubinstein-Taybi é uma doença multissistêmica genética rara caracterizada por dimorfismo facial típico, retardo de crescimento, deficiência mental e múltiplas anormalidades dentárias. Este relato de caso descreve os achados orofaciais da síndrome de Rubinstein-Taybi que afetou um menino brasileiro de onze anos de idade e uma menina de dez anos. As descobertas orais dos pacientes, tais como lábios superiores finos, retenção prolongada dos dentes decíduos e hipodontia são relatados, e o manejo clínico é discutido.
The aim of this study was to compare the influence of endodontic sealers artifacts on the detection of vertical root fracture in cone beam computed tomography (CBCT). Premolars and central incisors were assigned into five different groups: Control, Pulp Canal Sealer, AH Plus, Sealer 26, and BC Sealer (n= 10, per group). VRFs were mechanically induced and the teeth were inserted into an image phantom. Subsequently, CBCT (Cranex 3Dx, Soredex, Tuusula, Finland) images were obtained and two observers were asked separately to identify root fracture, by visual analysis. For both premolar and central incisors, kappa coefficients of intraobserver agreement varied from good to excellent (K: 80% - 87%), and the values for interobserver agreement varied from fair to moderate (K: 30% - 35%). As follows, the area under the curve (AUC) of receiver operating characteristic (ROC) values for VRFs highlighted that the use of BC sealer reduced the observers’ ability to discriminate VRFs relative to other sealers. Moreover, sensitivity values for premolars teeth ranged from 20% to 60%, and specificity ranged from 60% to 100%; while sensitivity values for central incisors ranged from 30% to 70%, and specificity ranged from 70% to 100%. In conclusion, the low sensitivity values, mainly for premolars, demonstrated the difficulty in VRF diagnosis. Furthermore, BC Sealer induced significantly more imaging artifacts than other sealers. These results highlighting that endodontic sealers may interfere with the diagnosis of VRFs.
Objetivo: O presente estudo avaliou a influência de materiais obturadores endodônticos na produção de artefato de imagens de tomografia computadorizada de feixe cônico (TCFC), por meio da análise de densidade de imagem em incisivos centrais e dentes pré-molares unirradiculares. Métodos: Os dentes foram submetidos a instrumentação endodôntica e divididos em cinco grupos: um grupo controle (sem preenchimento endodôntico) e quatro grupos teste, cada um preenchido por um material obturador endodôntico diferente (PulpCanal Sealer, AHPlus, Sealer26 e BCSealer). Após a aquisição da TCFC, as imagens foram avaliadas para determinar variações de tons de cinza nos três terços da raiz (análise objetiva). A segunda análise (subjetiva) comparou o grupo controle com dois dos grupos teste, em um processo randomizado. Resultados: Na análise objetiva, o Sealer26 e o BCSealer mostraram diferença estatística para valores mínimos, em comparação com outros materiais obturadores endodônticos, para dentes anteriores e posteriores. Para valores máximos, apenas o grupo controle diferiu estatisticamente dos grupos teste. Ao comparar os valores dos pré-molares e dos incisivos centrais em tons cinza pelo teste de Kruskal-Wallis, foi encontrada diferença estatisticamente significativa para os valores mínimos. Na análise subjetiva, para dentes anteriores e posteriores, o PulpCanal Sealer foi o material mais frequentemente apontado pelos observadores como aquele que produziu mais interferência de artefato. Conclusões: Os materiais obturadores endodônticos nos dentes posteriores apresentaram comportamento semelhante; somente o PulpCanal Sealer no terço apical apresentou diferenças estatísticas em relação aos demais grupos. Para os dentes anteriores, o BCSealer apresentou valores mínimos maiores em relação aos outros materiais obturadores endodônticos, o que poderia representar maior interferência do artefato.
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