Radiographic Examination Research Articles

Complete Remission of Acute-onset Autoimmune Hepatitis Following Transcatheter Splenic Arterial Embolization and Splenectomy for Spontaneous Splenic Rupture.

A 62-year-old woman presented with jaundice and fatigue. A blood examination revealed markedly elevated serum transaminase and bilirubin levels and negative hepatitis virus markers. A radiographic examination revealed no bile duct abnormalities. Serum transaminase levels decreased and normalized without immunosuppression after transcatheter arterial embolization and splenectomy for spontaneous splenic rupture, respectively. The pathological findings of the liver biopsy specimens were consistent with those of acute-onset autoimmune hepatitis (AIH), despite normal serum IgG levels. The clinical course of the present case suggests that pathogenic immune responses associated with acute-onset AIH may arise in the spleen, but not in the liver.

Deep learning-assisted comparison of different models for predicting maxillary canine impaction on panoramic radiography.

Deep learning-assisted comparison of different models for predicting maxillary canine impaction on panoramic radiography.

Effectiveness of triple osteotomy in correcting severe hallux valgus with the first metatarsal pronation deformity

To explore the effectiveness of triple osteotomy in correcting severe hallux valgus with the first metatarsal pronation deformity. A retrospective analysis was conducted on the clinical data of 29 patients (40 feet) with severe hallux valgus accompanied by the first metatarsal pronation deformity, who were admitted between January 2022 and December 2023 and met the selection criteria. There were 8 males (10 feet) and 21 females (30 feet), with an average age of 50.0 years (range, 44-62 years). The disease duration ranged from 5 to 9 years (mean, 6.5 years). All patients underwent triple osteotomy to correct the deformity. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score were used to evaluate joint function and pain before and after operation. Based on pre- and post-operative X-ray films, hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured to evaluate the correction of hallux valgus; the shape classification of the lateral edge of the first metatarsal and the pronation of first metatarsal angle (PFMA) were observed to assess the correction of the first metatarsal pronation deformity. A superficial infection occurred in 1 foot and the incison healed after dressing change; the remaining incisions healed by first intention. All patients were followed up 12-18 months (mean, 12.6 months). Three cases (4 feet) experienced limited movement of the metatarsophalangeal joint after operation, and the joint function recovered after strengthening functional exercises. During follow-up, no recurrence of deformity or secondary metatarsal pain occurred. Compared with preoperative scores, the AOFAS score increased and the VAS score decreased at last follow-up, and the differences were significant ( P<0.05). Radiographic examination showed that the osteotomy achieved bony healing, with the healing time of 2.5-6.2 months (mean, 4.1 months). The hallux valgus deformity was corrected, and the IMA, HVA, and DMAA were significantly smaller at last follow-up when compared with those before operation ( P<0.05). The first metatarsal pronation deformity was also corrected; there was no R-type (R-type for pronation deformity) on the lateral edge of the first metatarsal at last follow-up, and the PFMA decreased compared with preoperative levels ( P<0.05) and was corrected to the normal range. Triple osteotomy can achieve good effectiveness for correcting severe hallux valgus with the first metatarsal pronation deformity. The functional training of the first metatarsophalangeal joint needs to be strengthened.

Evaluation of the radiopacity of single-shade composite restorative materials using a digital radiography system

ObjectivesRecently, single-shade universal composite resins have been introduced to the market to simplify restorative procedures. The inorganic structures of dental composites may influence several properties, including radiopacity. Radiopacity plays a crucial role in clinical dentistry as it enables the detection of recurrent caries, marginal defects, and restoration overhangs through radiographic examination. The aim of this investigation was to assess the mean gray value and compare the radiopacity of different single-shade composite resins using digital image analysis.Materials and methodsSeven single-shade universal composite resins (Omnichroma, Charisma Topaz One, Vitra Aps Unique, Admira Fusion x-tra universal, X-tra Fill, Essentia Universal and ZenChroma) and one multi-shade universal composite resin (Optishade) were used. The enamel-dentin segment, a typical aluminum (Al) step-wedge (1–10 mm), and the samples were placed on a phosphor imaging plate. For each image, the MGV and the standard deviation of the grey values for three different regions were calculated and the mean of these three values was recorded.ResultsmmAI measurements of the study groups were found to be statistically significant different (p < 0.05). The differences were found between Charisma one and Voco xtrafil groups and between Enamel, Dentin and Zenchroma groups. Also, differences were observed between Dentin and Vittra aps unq groups. The radiopacity values of all materials tested were found to meet the requirements of ISO.ConclusionsIt is found that Glass particles containing composites have similar radiopacity as enamel due to their low atomic weight. Zirconium particles containing composites are more radiopaque than glass particles containing composites because of their higher atomic weight.

Enhancing patient safety through radiograph rejection analysis: Insights from a diagnostic imaging department audit

Objective: Assessment of actual radiograph rejection was the primary goal of this investigation in the imaging facility of a public sector hospital, which was noticeably high during the pandemic as staff members were afraid of infection. Methods: This retrospective study was carried out in the department of Radiology, LRH from July 2023 to March 2024 during which a total of 47,300 radiographic examinations were conducted. Analysis was performed for the rejected radiographs and their causes respectively. Results: Our rate of 11% is comparable to the global range of 3.4-14.1% respectively. Of the total rejection, 46.1% rejection was observed in males and 53.9% in females while 69.5% &amp; 30.5% rejection was noticed in adults and pediatric age group respectively. Artifacts (26.2%) was the prime cause of rejection followed by motion (18.8%), positioning (14%), improper collimation (11.7%), exposure errors (8.4%), wrong labeling (6.6%), machine faults (5.7%), detector errors (4.5%), PACS issues (2.5 %) and re-requests from referring physician (1.6%). The highest rejection with respect to anatomical body parts was observed in chest radiography (29.9%), followed by extremities (28.8%), spine (11.4%), KUB (9.9%), skull (8.4%), abdomen (5.5%), pelvis (4.4%), and neck (1.7%) respectively. Conclusion: Radiograph rejection has reduced considerably but still is a common problem within the facility due to many contributing factors. Implementation of rejection analysis as an integral part of the quality assurance program as well as focusing on staff-centered skill and knowledge upliftment training programs can result in a significant reduction enhancing patient safety. doi: https://doi.org/10.12669/pjms.41.7.11441 How to cite this: Yaseen M, Nishtar T, Ajaj R, Ali A. Enhancing patient safety through radiograph rejection analysis: Insights from a diagnostic imaging department audit. Pak J Med Sci. 2025;41(7):2052-2059. doi: https://doi.org/10.12669/pjms.41.7.11441 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effects on heat-exposed teeth in relation to forensic identification — a pilot study

BackgroundUnderstanding dental alterations at different temperatures is crucial in forensic odontology. Analyzing the effects of extreme heat on teeth provides critical information for victim identification in fire investigations. This study explores structural changes in dental tissues under varying thermal conditions. To analyze and document the changes in teeth subjected to various heat treatments using forensic imaging techniques, and to determine the applicability of these changes in forensic dental investigations. The study involved 24 freshly extracted healthy permanent teeth (12 anterior and 12 posterior), exposed to temperatures of 200 °C, 400 °C, 600 °C, and 800 °C for 15 min using a muffle furnace. Both pre- and post-heat teeth underwent macroscopic and radiographic examinations at various settings. Qualitative changes in dentition were analyzed and calculated as percentages.ResultsThere were no significant radiographic changes in teeth at 200 °C and 400 °C, but a noticeable reduction in radiopacity was revealed in enamel only at 600 °C and in both enamel and dentin at 800 °C at the 80 kV, 11 mA radiographic exposure settings.ConclusionThe study found notable radiopacity changes in enamel and dentin above 600 °C. Radiographic analysis of burnt dental remains has potential for improving victim identification and advancing forensic odontology.

Multimodal Analysis of Giant Anteater (Myrmecophaga tridactyla) Femorotibiopatellar Joint Anatomy: Macroscopic, Radiographic, and Ultrasonographic Findings.

The giant anteater (Myrmecophaga tridactyla) is an endangered species, and further studies on its morphology are essential for conservation efforts. These animals adopt a bipedal posture on their pelvic limbs for defense and foraging. This study aimed to evaluate the femorotibiopatellar joint, that is, the stifle joint (SJ), in M. tridactyla, and to describe its anatomical characteristics using macroscopic, radiographic, and ultrasound approaches. A total of 18 joint evaluations were conducted using five specimens fixed in 10% formalin (six joints) and six thawed carcasses (12 joints). Radiographic examinations, both simple and contrast-enhanced, were performed, alongside joint ultrasound. Anatomical assessments included macroscopic dissection and frozen sectioning using a band saw. Radiographic evaluation was conducted with mediolateral and caudocranial views, focusing on bone elements in simple radiographs and joint capsule distension and meniscal contouring in contrast radiographs. Ultrasound allowed for the evaluation of articular and periarticular soft tissues, including ligaments, tendons, menisci, articular capsule, cartilage, and the infrapatellar fat body. The anatomical assessment revealed several particularities, such as a long medial collateral ligament and patellar ligament, as well as the presence of a supratrochlear fat pad and synovial folds in proximal suprapatellar region. Additionally, the absence of femoropatellar ligaments was noted, along with the presence of a large, rectangular sesamoid bone in the m. popliteus tendon (also known as cyamella). Furthermore, no communication was found between the joint cavity and the tendon sheath of the m. long digital extensor. In conclusion, the anatomical peculiarities of the SJ in M. tridactyla should be considered in the diagnosis, clinical evaluation, and surgical procedures for conditions affecting this species.

Healing beyond the apex: Nonsurgical management of a periapical lesion with esthetic rehabilitation using direct composite veneers

Abstract Discoloration of nonvital anterior teeth, often resulting from pulpal necrosis and associated periapical pathology, poses both functional and esthetic challenges. Conservative management that addresses both biological healing and esthetics is essential in such cases. A 45-year-old female presented with pain and discoloration in the maxillary anterior region. Clinical and radiographic examination revealed a nonvital, discolored tooth 11 with a large periapical lesion and initial periapical changes in tooth 12. Root canal treatment was performed on both teeth using HyFlex EDM files and ultrasonically activated irrigation protocol. Obturation was completed using a bioceramic sealer. Intracoronal bleaching of tooth 11 was attempted using sodium perborate and hydrogen peroxide, but minimal improvement in shade necessitated direct composite veneers for teeth 11 and 12. Tooth 13 was also veneered upon the patient’s request. The patient was followed up at 3, 6, 9, and 12 months, with satisfactory clinical and radiographic outcomes. A combination of conservative endodontic treatment and minimally invasive esthetic rehabilitation can effectively manage nonvital, discolored anterior teeth, ensuring both functional success and patient satisfaction.

Patient-size based dose optimization in projection radiography examinations: A BMI-guided approach.

The increasing prevalence of obesity poses challenges for dose optimization in projection radiography due to greater anatomical thickness in overweight and obese patients worldwide. Diagnostic reference levels (DRLs) alone may not adequately account for variations in body habitus, potentially leading to suboptimal patient protection. This study aimed to explore benchmark doses (BMDs) based on patient body mass index (BMI) for projection radiography examinations of major anatomical regions in Sri Lanka, providing a complementary approach for dose optimization alongside DRLs. This prospective study included 1989 adult patients (≥18 years) undergoing abdomen anteroposterior (AP), chest posteroanterior (PA), kidney-ureter-bladder (KUB) AP, lumbar spine AP, lumbar spine lateral (LAT), and pelvis AP examinations at six major tertiary care hospitals. For each examination, patient demographics (age, weight, height, and BMI) and exposure parameters (kilovoltage peak [kVp] and tube current-exposure time product [mAs]) were recorded, and the patient doses in terms of kerma-area product (PKA) were measured using a PKA meter. DRLs (achievable doses) were proposed at the median of the median PKA distribution across hospitals for a standard-sized patient group (58±20kg). For BMI-based BMDs, patients were classified into four standard BMI categories: underweight, normal weight, overweight, and obese. The median PKA distributions across hospitals were used to formulate BMI-based BMDs, which were then compared with the proposed DRLs for the standard-sized patient group. The results showed a progressive increase in BMI-based BMDs across BMI categories for all examinations studied. BMI-based BMDs (in Gy.cm2) for underweight, normal weight, overweight, and obese patients were as follows: 1.46, 1.94, 2.88, 3.00 (abdomen AP); 0.17, 0.21, 0.22, 0.25 (chest PA); 1.70, 1.76, 2.30, 3.60 (KUB AP); 1.00, 1.03, 1.29, 1.48 (lumbar spine AP); 1.94, 2.09, 2.57, 2.56 (lumbar spine LAT); and 0.60, 1.85, 1.86, 2.24 (pelvis AP). Compared to normal weight patients, underweight patients exhibited percentage reductions in BMI-based BMDs of 24.7%, 3.4%, 2.9%, 7.1%, 4.5%, and 67.6% for abdomen AP, KUB AP, lumbar spine AP, lumbar spine LAT, chest PA, and pelvis AP, respectively. Conversely, overweight patients demonstrated percentage increases of 48.5%, 30.7%, 25.2%, 23.0%, 4.8%, and 0.5% across the same examinations, while obese patients showed increases of 54.6%, 104.5%, 51.5%, 22.5%, 19.0%, and 21.1%, respectively. DRLs for the standard-sized patient group were 1.82, 0.22, 2.03, 1.27, 2.21, and 1.90Gy.cm2, respectively. These findings underscore the importance of BMI-based BMDs as an effective tool for personalized dose optimization, accounting for variations in patient body habitus. Their integration into clinical practice, alongside DRLs, could enhance patient protection and promote good radiographic practices. Furthermore, the findings underscore the need for the introduction of international guidelines for DRLs in intervals of BMI to ensure standardized implementation across countries.

Evaluation of the effectiveness of photodynamic disinfection on the cytokine profile of oral fluid in patients with chronic generalized periodontitis

INTRODUCTION. An emerging and promising direction in dentistry is the use of photodynamically activated disinfection as part of comprehensive therapeutic and preventive protocols. This method contributes to the improvement of clinical periodontal status, enhances immune function, and positively influences the outcomes of periodontal treatment. However, the pathogenetic mechanisms underlying the effectiveness of this therapy remain insufficiently understood and require further investigation. AIM. To evaluate the effectiveness of laser-assisted photodynamic disinfection on the clinical condition of periodontal tissues and the cytokine profile of oral fluid in patients with moderate chronic generalized periodontitis. MATERIALS AND METHODS. A total of 62 patients aged 35 to 45 years with moderate chronic generalized periodontitis were examined. They were randomly assigned to two groups: a control group (receiving standard periodontal treatment) and a main group (receiving photodynamically activated disinfection in combination with standard treatment). Clinical and radiographic examinations were performed, along with the measurement of cytokine levels in oral fluid (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-α, and IFN-γ) before treatment, and at 14 days, 3 months, and 6 months after treatment initiation. RESULTS. Photodynamically activated disinfection led to a significant improvement in the clinical condition of periodontal tissues and normalization of periodontal and hygiene indices. In addition, patients in the main group demonstrated a restoration of cytokine balance in periodontal tissues, with a marked reduction in proinflammatory cytokines IL-1β, IL-6, IL-8, TNF-α (p &lt; 0.01), and IFN-γ (p &lt; 0.001), as well as an increase in antiinflammatory cytokines IL-4 (p &lt; 0.05) and IL-10 (p &lt; 0.05), compared to baseline levels. CONCLUSIONS. In patients with moderate chronic generalized periodontitis, therapeutic and preventive measures contribute to improved clinical periodontal conditions, as reflected in the periodontal and hygiene indices. However, patients in the main group receiving photodynamically activated disinfection exhibited significantly greater improvements in periodontal indices and normalization of the cytokine profile (p &lt; 0.001).

Clinical, Radiological and Hematological Evaluation in Cats with Tooth Resorption

This study aimed to investigate tooth resorption (TR), a common dental disease in cats. Conducted on 35 cats admitted to Selçuk University Faculty of Veterinary Medicine Animal Hospital for oral health issues or castration, the study evaluated the prevalence of TR, the distribution of affected teeth, and the relationship between resorption types and stages. Clinical and radiographic examinations were performed, and blood parameters were analyzed. The findings indicated that TR prevalence increases with age and is most commonly observed in mandibular third premolars and first molars. Blood analyses revealed sodium and phosphorus levels outside the reference ranges in many cases, suggesting electrolyte and metabolic imbalances. A significant relationship was observed between TR stages and types; Type 1 lesions were predominant in early stages, while Type 3 lesions increased in advanced stages. In conclusion, TR is not solely a localized periodontal condition but also has systemic effects. A multidisciplinary approach is recommended for the early diagnosis and prevention of TR progression. Further investigation of environmental, genetic, and metabolic factors may contribute to the development of effective management strategies for this disease.

Assessment of radiation effects on apoptosis in parotid gland acinar cells during radiographic examination

Radiographic examination plays a crucial role in dentistry for establishing diagnoses and developing treatment plans. Dental X-rays utilize ionizing radiation, which can induce ionization in exposed tissues. The salivary glands, particularly the parotid gland composed of serous acinar cells, are commonly affected during exposure. These parotid acinar cells are highly sensitive to radiation, making them susceptible to DNA damage and triggering programmed cell death (apoptosis). This in vivo study was conducted using male rats as animal models. Eighteen rats, each weighing between 200–250 grams, were divided into three groups: a control group, a group exposed to a periapical radiation dose, and a group exposed to a panoramic radiation dose targeted at the parotid region for approximately one second. Parotid gland tissues were collected on the third day following radiation exposure and prepared for histological examination using hematoxylin-eosin staining. The apoptotic index was evaluated under a light microscope at 400x magnification by two independent observers. A statistically significant increase in apoptotic index was observed in the irradiated groups compared to the control group (p &lt; 0.05). Thus, radiation exposure during dental radiographic procedures leads to an elevated rate of apoptosis in the parotid acinar cells of male Wistar rats.

CURRENT RECOMMENDATIONS FOR THE MANAGEMENT OF TRAUMATIC DENTAL INJURIES

Introduction: Traumatic dental injuries (TDIs) are a significant concern, especially in children and adolescents, as they often result in complex injuries to the teeth, supporting bone, and surrounding soft tissues. The increasing prevalence of such trauma in younger populations makes it a crucial subject in contemporary dental practice. These injuries can range from mild enamel fractures to serious luxations and avulsions, with long-term implications for oral health, function, and aesthetics. Methods: This narrative review analyzes current evidence and clinical recommendations for the management of TDIs, focusing on the latest updates from the International Association of Dental Traumatology (IADT). The study involved an in-depth review of the types of dental injuries, clinical and radiographic examination protocols, pulp vitality assessment tools, and intervention strategies such as splinting, replantation, and antibiotic administration. Results: Proper diagnosis and timely management are crucial for preserving dental structures and preventing long-term complications, particularly in young patients with developing dentition and immature root structures. The management approach depends on the type and severity of the injury, with a special focus on pulp vitality preservation and the appropriate use of splints and antibiotics. Clinical techniques, such as sensibility and vitality tests, assist in monitoring pulp status, while interventions like partial and full pulpotomy are increasingly used to maintain pulp health. Additionally, adherence to IADT guidelines ensures standardized care across various types of injuries, including fractures, luxations, and avulsions. These guidelines emphasize not only initial management but also the necessity of long-term follow-up and patient compliance. Conclusion: Through proper adherence to these guidelines, dental professionals can mitigate complications like pulp necrosis, root resorption, and tooth loss, ultimately improving long-term outcomes for patients. The integration of evidence-based protocols into clinical practice supports optimal healing and reduces the burden of trauma-related sequelae in both pediatric and adult populations.

Management of Traumatic Brain Injury in Juvenile Golden Jackal (Canis aureus)

A juvenile male Golden Jackal was rescued from a village. Anamnesis suggested possible injury due to automobile accident. Initial observation and physical examination revealed lateral recumbency and hindlimb stiffness along with dorsal curvature of the back. A thorough neurological as well as orthopedic examination led to neuro-localization of the lesion approximately in the cerebellar region. Radiographic examination concluded that there was no detectable skeletal abnormality. Leucocytosis, neutrophilia and significant elevation in the SGPT and ALP values were noticed. Defecation and urination were voluntary. Initial therapeutic management included administration of a combination of steroidal drugs and supportive therapy which was continued for three days along with supportive fluid therapy. Additionally, infrared therapy was initiated to improve the ambulatory response, coupled with physiotherapy. The pup was fed a protein rich diet along with oral Syrup containing mecobalamin vitamins and lycopene for the duration of rehabilitation. Appropriate ambulation with reduced incoordination was exhibited by the puppy. After a rehabilitation period of around 45 days, the puppy was released back in to the wild.

Evaluation Of Radiographic Skills Of Radiographers During Patient Load And Their Behavior Towards Patients

A valid necessity for performing a radiographic examination in the radiological department is presented here. The study aims to educate radiographers on medical diagnostic imaging and technologies. These days, X-rays and many other advanced ionizing radiation-based diagnostic technologies are utilized daily and are believed to be the best ways to diagnose various diseases and ailments. Their understanding of radiation safety is, therefore, crucial. Since the general public is unaware of the negative effects of ionizing radiation exposure, medical professionals who work directly with patients must take the necessary precautions to safeguard both themselves and the public. This qualitative observational study was conducted in the Department of Radiodiagnosis, SGT Hospital, and Gurugram, where a minimum of 8 radiographers were taken in this study, in which both male and female radiographers were included from 2021 to 2023 and will demonstrate how radiographers behave in the workplace. Study data was received from the Department of Radiodiagnosis, SGT Hospital, Gurugram, where all the radiography was carried out. Both male and female radiographers were included during the study and observed on their communication skills, attitude, and behavior towards patients during heavy and low patient loads following the ALARA principle. Only 50% of radiographers were aware of the ALARA principle. As a result, individuals are more likely to experience an ionizing radiation-related problem. To keep up a high level of radiation protection, hospital management should be concerned with regular training programs that will help their personal development.

Endodontic management of a maxillary premolar with a rare anatomical variation: Case report

The success of endodontic treatment depends on the quality of cleaning and obturation of the Root Canal System (RCS), which are challenged by morphological variations such as isthmuses, polar areas, and accessory canals. Failure to locate all root canals can result in persistent infections or reinfections, significantly contributing to treatment failure. Upper premolars with three roots represent a rare anatomical variation, requiring a meticulous approach to achieve therapeutic success. This study aims to report the endodontic treatment of a left upper premolar with three roots and three canals, with independent foraminal exits. A 38-year-old male, Caucasian patient, was referred for endodontic treatment of the left second upper premolar. Upon clinical examination, tooth 25 showed an exaggerated response to the vitality test, and the radiographic examination revealed an atypical anatomy with three roots and three canals. The first session was dedicated to locating and performing complete chemical-mechanical preparation of the three canals using stainless steel files (C-pilot®), rotary instruments (Bondent Platinum®). An intracanal medication containing calcium hydroxide combined with 2% chlorhexidine gel was placed for 21 days. In the second visit, the root canal system was obturated with Endofill® sealer. The endodontic treatment of teeth with complex anatomy, such as tooth 25 with three independent canals, emphasizes the need for meticulous planning and the use of advanced technologies for clinical success.

Prevalence of musculoskeletal injuries associated with lameness in Australian campdraft horses.

Campdrafting is a unique Australian cow horse sport, which evolved from mustering cattle and is one of Australia's fastest growing equine sports. This discipline is associated with its own unique set of musculoskeletal injuries yet to be reported. To describe the prevalence, anatomical location, and diagnostic modality used to localise lameness in campdrafting horses to better assist efficient orthopaedic management of the campdraft horse. Retrospective case series. Medical records were examined from one private practice equine group and one university veterinary hospital between 2017 and 2024. Lameness examinations conducted by 5 veterinarians were included. Data were collected regarding signalment, history, findings on physical and lameness examinations, results of diagnostic procedures performed, and final diagnoses. Two hundred and sixty-seven horses were observed; the most common lameness grade was 2/5 (AAEP; 116; 43%), and the most common breed was Australian stock horses (109; 40%). Forelimb lameness was observed in 53% (143/267) and hindlimb lameness in 41% (112/267) of horses. Forelimb lameness was bilateral in 36 (13%) horses, and bilateral hindlimb lameness was observed in 19 horses. Diagnostic anaesthesia was utilised in 187 (70%) of the 267 horses, with anaesthesia of the abaxial sesamoid nerve block rendering most commonly a positive response (43; 22%). Diagnostic anaesthesia followed by radiography sufficed to obtain a final diagnosis in 110 (41%) cases. Diagnostic anaesthesia, radiographic, and ultrasonographic examination was used to achieve a final diagnosis in 67 (25%) cases. Lameness associated with the distal interphalangeal joint was the most common finding (23%; 63/267), followed by the metacarpus and metatarsus (19%; 53/267). Responses to diagnostic anaesthesia and lameness were evaluated subjectively. In the study sample of campdraft horses, lameness was more commonly observed in the distal forelimb compared with samples from other disciplines in cow horse sports.

Management of an Endo-Periodontal Lesion with Guided Tissue Regeneration in a Maxillary Lateral Incisor: One-Year Follow-Up: A Case Report

Introduction: Periodontitis is a multifactorial disease primarily associated with biofilm accumulation, leading to progressive loss of periodontal support and the formation of bone defects. Although traditionally considered independent entities, clinical and anatomical evidence has demonstrated a close relationship between periodontal and pulpal pathologies, particularly in endo-periodontal lesions. According to recent classifications, these lesions may have a primary endodontic, periodontal or combined etiology and are characterized by anatomical communication between the pulp and the periodontium through apical foramina, dentinal tubules and lateral canals. Disease progression facilitates the migration of bacteria and toxins between the tissues, exacerbating their destruction. Therefore, differential diagnosis is essential for defining an appropriate treatment, which must be comprehensive and include both root canal disinfection and periodontal regeneration. Guided Tissue Regeneration (GTR), using collagen membranes and bone substitutes, has proven to be an effective technique for promoting healing and restoring functionality in areas affected by bone and soft tissue destruction, enabling the regeneration of damaged periodontal tissues. Case Report: A 51-year-old female patient presented to the Postgraduate Program in Periodontics and Implantology at UJED seeking to preserve tooth 1.2. Clinical and radiographic examination revealed a defective restoration with intraosseous crater-type root exposure and deep probing depth. The diagnosis was generalized periodontitis, stage III, grade B. Additionally, the endodontic diagnosis was previously treated tooth with asymptomatic apical periodontitis and an endo-periodontal lesion type V according to Simon, Glick and Frank. Nonsurgical retreatment and guided tissue regeneration were indicated to improve the prognosis of the tooth. Objective: To evaluate the clinical and radiographic outcomes of guided tissue regeneration in the treatment of endo-periodontal lesions with infraosseous defects through a detailed analysis of the therapeutic response. The aim is to determine whether this technique significantly enhances bone regeneration and periodontal health, contributing to improved prognosis in affected patients. Conclusion: At 6 months postoperatively, satisfactory bone and soft tissue regeneration was observed in the treated tooth, with significant clinical and radiographic improvement. There was evidence of bone level gain, reduction in probing depth and decreased tooth mobility, indicating favorable periodontal recovery.

Bilateral rostral mandibulectomy in case of a complete fracture of the pars incisiva in a Simmental fattening bull

Abstract A 9‐month‐old Simmental fattening bull with a history of anorexia, severe salivation and marked bilateral swelling of the mandible was referred to the clinic. The physical examination and radiographs revealed a bilateral complete displaced mandibular fracture involving the symphysis. Treatment consisted of rostral mandibulectomy, including the symphysis, which resulted in a loss of integrity and therefore instability of the hemi‐mandibulae. To promote early food intake and to ensure appropriate analgesia, a multimodal analgesic plan was implemented, and repeated pain scoring was initiated immediately following surgery. The bull was discharged 16 days after surgery, at which point the bull was able to eat normally. The bull showed sufficient weight gain at the end of the fattening period. At slaughter, physical examination showed a stable connection between both sides of the mandibles, and a radiographic examination of the head revealed osseous fusion of both hemi‐mandibulae through a renewal of the symphysis.

A Deep Learning-Based Clinical Classification System for the Differential Diagnosis of Hip Prosthesis Failures Using Radiographs: A Multicenter Study.

Accurate and timely differential diagnosis of hip prosthesis failures remains a major clinical challenge. Radiographic examination remains the most cost-effective and common first-line imaging modality for hip prostheses, and integrating deep learning has the potential to improve its diagnostic accuracy and efficiency. A deep learning-based clinical classification system (Hip-Net) was developed to classify multiple causes of total hip arthroplasty failure, including periprosthetic joint infection (PJI), aseptic loosening, dislocation, periprosthetic fracture, and polyethylene wear. Hip-Net employed a dual-channel ensemble of 4 deep learning models trained on 2,908 routine dual-view (anteroposterior and lateral) radiographs for 1,454 patients (Asian) across 3 medical centers. An interpretive subnetwork generated spatially resolved disease probability maps. Discrimination performance and interpretability were tested in external and prospective cohorts, respectively. The correlation between model-generated individual PJI risk and inflammatory biomarkers was assessed. Hip-Net demonstrated strong generalizability across different settings, effectively distinguishing between 5 common types of hip prosthesis failures with an accuracy of 0.904 (95% confidence interval [CI], 0.894 to 0.914) and an area under the receiver operating characteristic curve (AUC) of 0.937 (95% CI, 0.925 to 0.948) in the external cohort. The spatially resolved disease-probability maps for PJI closely aligned with intraoperative and pathological findings. The model-generated individual PJI risk scores exhibited a positive correlation with the C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR). Hip-Net provided a clinically applicable strategy for accurately classifying and characterizing multiple etiologies of hip prosthesis failure. Such an approach is highly beneficial for providing interpretable, pathology-aligned probability maps that enhance the understanding of PJI. Its integration into clinical workflows may streamline decision-making and improve patient outcomes. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.