Radiology Centers Research Articles

Кислотно-щелочное состояние крови у пациентов с мочекаменной болезнью. Исследование II. Роль pH крови.

Introduction. We will try to show the place of acid-base balance (ABB) study in urolithiasis patients. There is the second article in a series of works devoted to the study of ABB in urolithiasis patients. This work is devoted to the study of the level of basic acid base indicators: blood pH, pCO2, pO2, BE. Materials and methods. The study was conducted prospectively at the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation. We analyzed data of 83 urolithiasis patients (39 men and 44 women). All patients underwent an analysis of the urinary stones chemical composition, biochemical analysis of blood and daily urine, blood acid-basic balance, blood parathyroid hormone. Urine pH morning was determined for all patients. Results. Patients with acidemia (blood pH <7.32) had significantly higher concentrations of chlorine, creatinine and ionized calcium in the blood than in the group of patients with 7.32 <blood pH <7.42. The BE indicator is significantly lower than in the comparison group. There is a higher level of total blood calcium (p<0.05) and magnesium excretion, a lower level of serum concentration of creatinine (p<0.05), urea (p<0.05) and chlorine (p<0.05) in the group of patients with hypercapnia (pCO2 >51 mmHg) than in patients with 41< pCO2 <51 mmHg. Patients with a BE level <-2.5 had significantly higher levels of creatinine, urea and chlorine in the blood, and higher urine pH (p<0.05) compared to patients with BE>2.5. Patients with BE < -2.5 also had significantly lower level of blood pH, pCO2 and ionized calcium compared to the group of patients with BE >2.5. Conclusion. Normalization of blood pH is capable to correct the metabolism of the main lithogenic substances in urolithiasis patients.

Combined vertebroplasty and pedicle screw insertion for vertebral consolidation: feasibility and technical considerations.

To assess the feasibility and technical accuracy of performing pedicular screw placement combined with vertebroplasty in the radiological setting. Patients who underwent combined vertebroplasty and pedicle screw insertion under combined computed tomography and fluoroscopic guidance in 4 interventional radiology centers from 2018 to 2023 were retrospectively assessed. Patient demographics, vertebral lesion type, and procedural data were analyzed. Strict intra-pedicular screw positioning was considered as technical success. Pain score was assessed according to the Visual Analogue Scale before the procedure and in the 1-month follow-up consultation. Fifty-seven patients (38 men and 19 women) with a mean age of 72.8 (SD = 11.4) years underwent a vertebroplasty associated with pedicular screw insertion for the treatment of traumatic fractures (29 patients) and neoplastic disease (28 patients). Screw placement accuracy assessed by post-procedure CT scan was 95.7% (89/93 inserted screws). A total of 93 pedicle screw placements (36 bi-pedicular and 21 unipedicular) in 32 lumbar, 22 thoracic, and 3 cervical levels were analyzed. Mean reported procedure time was 48.8 (SD = 14.7) min and average injected cement volume was 4.4 (SD = 0.9) mL. A mean VAS score decrease of 5 points was observed at 1-month follow-up (7.7, SD = 1.3 versus 2.7, SD = 1.7), p < .001. Combining a vertebroplasty and pedicle screw insertion is technically viable in the radiological setting, with a high screw positioning accuracy of 95.7%.

Association of mandibular canine impaction and anatomical factors: A multicentre retrospective panoramic study in Latin America

Mandibular canine impaction is infrequent in dental eruption anomalies and treatment is very challenging. The aim of this multicenter retrospective panoramic study in Latin America was to evaluate panoramic radiographic imaging characteristics of mandibular canine impaction (impaction area, mandibular base contact, transmigration, impaction height and sex) and their associations. This cross-sectional study evaluated 212 digital panoramic radiographs from three radiological centres in Tingo Maria (Peru), Bogota and Tunja (Colombia). The study included children of both sexes with impacted mandibular canines. Mandibular alpha angle, contact with mandibular basal bone (MBB), impacted sector according to 10 sectors with an adaptation of the Ericson and Kurol method, presence of transmigration and the impacted height were measured and the relationship among these measures was analyzed. Fisher's exact test, Chi-square and binary logistic regression were used. (P<0.05). The mandibular canine impaction showed contact with the MBB (32.08%), dental transmigration (36.79%), mainly located at an apical (40.09%) and sub-apical (36.79%) level. Transmigration mainly occurred in sectors 6 (33.30%) and 10 (25.60%) (P<0.001). It was found that for each year of increase in age, the possibility of contact with the MBB decreased (β=0.89, P=0.010), and as the alpha angle increased by one degree the probability of contact with the MBB decreased (β=0.97, P=0.001) and the probability of transmigration increased (β=1.05, P<0.001). One third of the impacted canines were in contact with the MBB, while another third presented dental transmigration and were mainly located apically and subapically of the incisor roots. These imaging features should be taken into account when planning orthodontic treatment.

COVID-19 and cancer risk arising from ionizing radiation exposure through CT scans: a cross-sectional study

BackgroundThe surge in the utilization of CT scans for COVID-19 diagnosis and monitoring during the pandemic is undeniable. This increase has brought to the forefront concerns about the potential long-term health consequences, especially radiation-induced cancer risk. This study aimed to quantify the potential cancer risk associated with CT scans performed for COVID-19 detection.MethodsIn this cross-sectional study data from a total of 561 patients, who were referred to the radiology center at Imam Hossein Hospital in Shahroud, was collected. CT scan reports were categorized into three groups based on the radiologist’s interpretation. The BEIR VII model was employed to estimate the risk of radiation-induced cancer.ResultsAmong the 561 patients, 299 (53.3%) were males and the average age of the patients was 49.61 ± 18.73 years. Of the CT scans, 408 (72.7%) were reported as normal. The average age of patients with normal, abnormal, and potentially abnormal CT scans was 47.57 ± 19.06, 54.80 ± 16.70, and 58.14 ± 16.60 years, respectively (p-value < 0.001). The average effective dose was 1.89 ± 0.21 mSv, with 1.76 ± 0.11 mSv for males and 2.05 ± 0.29 mSv for females (p-value < 0.001). The average risk of lung cancer was 3.84 ± 1.19 and 9.73 ± 3.27 cases per 100,000 patients for males and females, respectively. The average LAR for all cancer types was 10.30 ± 6.03 cases per 100,000 patients.ConclusionsThis study highlights the critical issue of increased CT scan usage for COVID-19 diagnosis and the potential long-term consequences, especially the risk of cancer incidence. Healthcare policies should be prepared to address this potential rise in cancer incidence and the utilization of CT scans should be restricted to cases where laboratory tests are not readily available or when clinical symptoms are severe.

Assessment of Ambient X-ray Pollution and its Health Effects in the Medical Diagnosis Centers in Kabul City

One of the most common pollutants in healthcare facilities is X-ray radiation, which can seriously injure patients as well as staff members in the corresponding department if safety precautions are not taken and the risks are not sufficiently understood. To look at X-ray radiation pollution in radiology centers in Kabul, measurements were taken with Poly-Master detectors in several radiology center locations, including the control room, hallways, behind the gates, and in more than 12 radiology facilities. The dose data was then analyzed. The SPSS program was used to assess background, X-ray devices worker equivalent doses, ambient pollution, and surface pollution. The results demonstrate that, there is no surface pollution following exposure and that the background dose is typically normal. The X-ray device used by employees' equivalent dose was found to be slightly greater than the specified threshold in places where radiology criteria was not taken into account, but overall it was near to normal. The equivalent dose estimate for radiation workers indicates that, in terms of health impacts, the dosage is typically not more than the established limit and does not pose a significant risk to health. As can be seen from the spatial distribution, radiation risks are higher at sites with a higher volume of radiology services. However, these risks can be mitigated by having adequate knowledge and information about how the device operates.

First experience of using Pembroria® medication in patients with disseminated renal cell carcinoma

Background. According to the clinical guidelines from the leading Russian and international societies, treatment of patients with metastatic renal cell carcinoma is based on combination use of immune and targeted drugs. In December of 2022, the first Russian analogue of immune-oncological drug pembrolizumab with trade name Pembroria® was registered in Russia.Aim. To evaluate safety of the biosimilar, as well as register its effectiveness in the form of objective response estimation in accordance with the RECIST v.1.1 (Response Evaluation Criteria in Solid Tumors version 1.1) criteria. The article presents the results of the first experience of using Pembroria® in real clinical practice. Two clinical observations are presented demonstrating effectiveness and safety of the biosimilar.Materials and methods. At the clinic of the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiology Center, 21 patients with clear cell renal cell carcinoma who did not previously receive systemic antitumor treatment underwent immunotarget therapy with Pembroria® and a targeted agent: lenvatinib (20 mg/day orally) or axitinib (10 mg/day orally).Results. The analysis of effectiveness considering short follow-up periods was performed in 18 patients. Median follow-up period was 6 (2–13) months and objective response rate was 50 %, in 28 % of cases stable disease was observed. Survival rates were not evaluated due to short observation time.Conclusion. Use of Pembroria® medication in patients with metastatic renal cell carcinoma in real clinical practice showed high objective response rate with acceptable toxicity level. No new, previously not described adverse events were registered during Pembroria® administration.

Comparing the Levels of Total Plasma Antioxidant Capacity in Hamadan Hospitals Between Radiographic Technologists and Non-radiographic Technologists

Background: Changes in the plasma total antioxidant capacity (TAC) are considered an important prognosis in the formation and progression of many atherogenic diseases, the TAC, carcinogenesis, and inflammation. In this study, plasma TAC values were measured in radiographic and non-radiographic technologists. Methods: The present study was conducted on 75 people exposed to radiation in the radiology centers of Hamadan hospitals and 75 non-radioactive people working in the other non-radiology departments of Hamadan hospitals. The people in the studied population were matched in terms of age and gender. After preparing their blood samples, the plasma of each was separated, and then, the plasma TAC values were measured by the calorimetric method. Results: The results showed that the antioxidant capacity of total plasma was lower in radiographic technologists compared to individuals working in other non-radiology departments, so that in the two studied groups, it was 5.32±0.66 and 6.70±0.95 μmol/L, respectively (P&lt;0.0001). Conclusion: The findings of this research revealed that the plasma TAC was lower in radiographic technologists than in individuals working in other non-radiology departments. Therefore, people exposed to radiation are more exposed to risks caused by changes in plasma TAC, and the use of antioxidant substances is recommended for these people.

Dental Caries diagnosis from bitewing images using convolutional neural networks

BackgroundDental caries, also known as tooth decay, is a widespread and long-standing condition that affects people of all ages. This ailment is caused by bacteria that attach themselves to teeth and break down sugars, creating acid that gradually wears away at the tooth structure. Tooth discoloration, pain, and sensitivity to hot or cold foods and drinks are common symptoms of tooth decay. Although this condition is prevalent among all age groups, it is especially prevalent in children with baby teeth. Early diagnosis of dental caries is critical to preventing further decay and avoiding costly tooth repairs. Currently, dentists employ a time-consuming and repetitive process of manually marking tooth lesions after conducting radiographic exams. However, with the rapid development of artificial intelligence in medical imaging research, there is a chance to improve the accuracy and efficiency of dental diagnosis.MethodsThis study introduces a data-driven model for accurately diagnosing dental decay through the use of Bitewing radiology images using convolutional neural networks. The dataset utilized in this research includes 713 patient images obtained from the Samin Maxillofacial Radiology Center located in Tehran, Iran. The images were captured between June 2020 and January 2022 and underwent processing via four distinct Convolutional Neural Networks. The images were resized to 100 × 100 and then divided into two groups: 70% (4219) for training and 30% (1813) for testing. The four networks employed in this study were AlexNet, ResNet50, VGG16, and VGG19.ResultsAmong different well-known CNN architectures compared in this study, the VGG19 model was found to be the most accurate, with a 93.93% accuracy.ConclusionThis promising result indicates the potential for developing an automatic AI-based dental caries diagnostic model from Bitewing images. It has the potential to serve patients or dentists as a mobile app or cloud-based diagnosis service (clinical decision support system).

Multilayer radiation shields for nuclear and radiological centers using free-lead materials and nanoparticles

We prepared two types of lead-free shielding materials consist of double and triple layered with different thicknesses and reported the radiation shielding performance of the developed concrete samples. The linear attenuation coefficient (LAC) of microcomposites was calculated theoretically by XCOM-software and compared with experimental results and less than 4 % difference was observed at all discussed energies. We measured the half and tenth value layers (HVL and TVL) of the single, double and triple layered samples and evaluated the radiation shielding efficiency (RSE) at different energies. The experimental data showed that the inclusion of nanoparticles into the composites reduced the TVL. The triple layered sample, composed of a 3 cm IM-2 layer, a 15 cm CON-2 layer, and a 2 cm IM-2 layer, exhibited exceptional radiation shielding performance, with an RSE of 97.5 % at 0.662 MeV, and an RSE of approximately 92 % for energies greater than 1 MeV. Comparing our samples to pure lead, we found that our double and triple layered samples could replace lead in practical applications, with the triple layer exhibiting superior performance at energies greater than 0.662 MeV. The RSE of our triple layered sample was 100 % for energies less than 0.06 MeV and 97.5 % at 0.662 MeV, and the RSE of our double layered sample with a thickness of 18 cm was 93.5 % and 92.3 % for energies of 1.173 and 1.33 MeV, respectively.

Abstract TMP38: Enhancing Door-In-Door-Out Time in a Rural Primary Stroke Center: Early Activation of a Large Vessel Occlusion Alert/Bundle of Care Utilizing EMS Pre-Alert, Parallel System Processing and Auto-Launch of Transfer Resources

Background: Thrombectomy has become the primary treatment in the management of acute stroke Large Vessel Occlusions (LVO). For a rural primary stroke center that does not have in house thrombectomy services, expedited transfer to a Comprehensive Stroke Center is imperative. The purpose of this quality improvement initiative is aimed at optimizing the Door-In-Door-Out (DIDO) time for stroke patients at a Rural Primary Stroke Center, with a specific goal of DIDO time of &lt;90 minutes, 50% of the time and &lt;120 minutes, 75% of the time. Methods: System inefficiencies in serial event processing, radiology interpretation, teleneurology application and activation of transferring Emergency Medical Services (EMS) were identified. We implemented several systematic changes utilizing multiple Plan Do Study Act cycles. The final implementation was an “LVO-Alert” process, which utilized parallel event processing of emergency medicine, teleneurology, radiology, and transfer center auto-lance of EMS transfer resources. This process is activated based on a positive prehospital modified Rapid Arterial Occlusion Evaluation score prior to the patient’s hospital arrival rather than a positive Computed Tomography Angiogram and can be cancelled in the case of negative imaging or declination of transfer. Pre and post metrics were compared. Results: Pre LVO-Alert implementation, DIDO time averaged 184 minutes (n=21) over 2 years, and anterior circulation LVO’s achieved a &lt;90-minute DIDO time 5% of the time. Post implementation, DIDO averaged 109 minutes (n=21) and anterior circulation LVOs achieved a &lt;90-minute DIDO 48% of the time. Post implementation, anterior circulation LVOs went from 19% to 90% transferred in &lt;120 minutes. Pre implementation, posterior circulation LVO’s achieved a &lt;120-minute DIDO time 0% (n= 2) of the time while post implementation, posterior circulation LVOs achieved a &lt;120-minute DIDO 50% (n=4) of the time. Among LVO alert activations over the post-implementation period, 27.4% resulted in transfer for thrombectomy. Conclusion: The application of a parallel process bundle of care model with early activation from a prehospital positive LVO scale may help to improve DIDO times in this patient population.

Evaluation of Hemodynamic Alterations after Flow Diverter Placement using the AneurysmFlowTM tool.

AneurysmFlow (Phillips Healthcare) is the flow measurement tool, utilizing an optical flow-based algorithm from DSA, lacks sufficient published studies. This study aimed to assess the significance of flow velocity changes and the Mean Aneurysm Flow Amplitude (MAFA) ratio in evaluating outcomes following flow-diverting treatments. Between June 2021 and October 2022, 41 patients with 42 aneurysms underwent FDS treatment with AneurysmFlow measu-rement at the Bach Mai Radiology Center. The tool achieved a 90.5% success rate in 38 out of 42 patients. Most aneurysms (89.5%) were small to medium-sized (<10 mm), and a decrease in flow velocity post-stent deployment was ob-served in 78.9% of cases. Conversely, 21.1% showed increased flow, mainly in aneurysms smaller than 5 mm. No significant association was found between flow changes or MAFA ratio and aneurysm size characteristics. Twenty-two patients (59.5%) underwent re-examination at 6 months, revealing no correlation in MAFA ratio between completely and incompletely occluded aneurysms. Our current investigation, primarily centered on small and medium-sized aneurysms, did not uncover any link between quantitative flow changes assessed using the AneurysmFlow software and the occlusion status of aneurysms at the 6-month follow-up post-flow diverter treatment. Larger case series with extended follow-up imaging are necessary to further explore these findings.

Frequency of pre-eruptive intracoronal resorption in panoramic radiographs of peruvians: a cross-sectional study

To determine the frequency of Preeruptive Intracoronal Resorption (PIR) in a sample of digital panoramic radiographs of Peruvian patients between 3 to 21 years of age who attended an oral and maxillofacial radiology center between 2013 and 2021. This observational study was descriptive, retrospective and cross-sectional. A sample of 1897 digital panoramic radiographs was evaluated to determine the frequency of PIR and its covariates of location, depth, and inclination of the affected teeth. The authors' calibration was performed before the study. The intraoperator agreement was determined by calculating the Kappa coefficient (0.72, CI 0.67-0.76). The radiographs were evaluated by the study's principal author (IEP), and the data were collected in a form designed for the study. The statistical association was determined using the Chi-square test, with a confidence level of 95%, and a p-value of less than 0.05 was considered significant. The frequency of PIR was 3.95%, with no statistically significant difference between sexes (p>0.05). The most common findings were PIR in the lower right second molar (32.5%), a singular defect (89.3%), central location (44.5%), and superficial dentinal involvement (83.1%). These results aligned with existing literature. Our results describe the epidemiological profile of PIR in the present sample as a single radiolucent and small (grade I) defect located centrally in the coronal dentin, often affecting posterior lower teeth with a frequency lesser than 5%. These findings provided valuable insights for clinicians and researchers regarding the frequency and characteristics of PIR in Peruvian patients.

EVALUATION OF THE CONDYLAR POSITION IN RELATION TO THE DIFFERENT MALOCCLUSIONS OF A STUDENT POPULATION

Studying the position of the condyle in the glenoid cavity is an important aspect of achieving the diagnosis and the treatment plan in dentistry. The posterior position of the condyle in the glenoid cavity is not a completely reliable predictor of the lack or appearance of disc displacement, although they are related (1). The TMJ is a small joint with a complex morphology surrounded by bony tissues that create a superimposition of images, especially in the petrous region of the temporal bone, the mastoid process and the articular eminence (1). Studies on the ideal position of the condyles have shown that the healthiest condyle-fossa relationship in which the condyle is centered anteriorly in the mandibular fossa. The following research aims to evaluate the condylar position in relation to different malocclusions of thirty-two students of the Faculty of Dentistry of the University of Cuenca.The research has a quantitative approach, carried out by means of numerical analysis. The population used was thirty-two students from the Faculty of Odontology in the University of Cuenca, aged between 21 and 29 years, who underwent cone beam computed tomography. The research was carried out as a descriptive retrospective sample and provides systematic information. The research used is of a primary source, using CBCT scans obtained from an image bank at the CERIOM Radiology Centre in the city of Cuenca, and the tomographic examination will be imported in DICOM format into the RadiAnt DICOM Viewer software (64-bit).

Features of the systemic influence of cervical cancer on peripheral blood and hemostasis according to the tumor histological subtype

Aim. To identify the features of the systemic effect on hematopoiesis and the blood coagulation system of different histological subtypes of cervical cancer (CC).Materials and methods. A single-center retrospective cohort study of 428 patients (61 patients with high grade squamous intraepithelial lesion (carcinoma in situ) and 367 patients with CC) examined from 1997 to 2022 in the Polyclinic of P. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia. The age of patients was from 18 to 90 years (median age – 42 [34; 51] years). Patients were divided into 4 groups: group 1 – patients with high grade squamous intraepithelial lesion and 3 groups depending on tumor’s histological subtype (squamous cell, glandular squamous cell, adenocarcinoma). Demographic and clinical data were analyzed including laboratory tests (general blood count, biochemical blood test and iron metabolism and coagulograms (total 32 variables)) compared to clinical and surgical stages of CC.Results. High grade squamous intraepithelial lesion does not have a systemic effect on the parameters of general, biochemical blood tests and hemostasis (p &gt;0.05). On the other hand, statistically significant changes were found in the parameters of routine laboratory blood tests, which correlate with the results of microinvasive analysis of CC, thus revealing the systemic effect of a malignant tumor: at p ≤0.001 for thrombin time, total protein, alkaline phosphatase levels; at p ≤0.05 for alanine aminotransferase, aspartate aminotransferase, C-reactive protein, serum iron and urea levels. Among patients with CC, statistically significant (p&lt;0.001) correlations were obtained between hematological, hemostasiological and biochemical blood parameters. Of statistical significance, the presence of the glandular component in the tumor increases the systemic effect of CC on blood parameters, hemostasis, markers of inflammation and iron metabolism: leukocytosis and maximum erythrocyte sedimentation rate values compared to CC, high fibrinogen and the level of soluble fibrin-monomer complexes which increased activation of coagulation hemostasis along the common coagulation pathway (thrombin time) (p&lt;0.001). It leads to an increase in the risk of venous thromboembolic complications in this category of patients.Conclusion. The identified changes in blood parameters made it possible to reveal the unique biological characteristics of each histological subtype of CC, including biochemical ones, which will help in developing an improved diagnosis of CC depending on the histological subtype and stage of the disease, along with developing preventive measures and treatment methods adapted to each specific case.

Cone-Beam Computed Tomography Analysis of the Root Canal Morphology of Lower Second Molars in the Croatian Subpopulation

The aim of this study was to investigate the root canal morphology of lower second molars in the Croatian subpopulation of the Zagreb region using cone-beam computed tomography (CBCT). We analyzed 3212 CBCT scans from the two radiology centers in Zagreb. The number of roots and root canals, the occurrence of C-shaped canals and additional roots were recorded. “C”-shaped roots were classified according to Melton classification. Canals in the mesial root were classified according to Vertucci. Lower second molars were found on 608 CBCT scans from a total number of 859. Among them, 78 (9.1%) had a “C”-shaped form. In the mesial roots, the frequencies of Vertucci types were: Type I in ninety-four cases (12.0%), Type II in three hundred and twenty cases (41.0%), Type III in six cases (0.8%), Type IV in three hundred and fifty-two cases (45.1%), Type V in three cases (0.4%), Type VI was found in four cases (0.5%) and Type VIII was found in one case (0.1%). Radix entomolaris and paramolaris were found in 29 (3.4%) lower second molars. The lower second molars in the Zagreb population show significant diversity in internal anatomy with a relatively high prevalence of “C”-shaped root canals and merged root canals in the mesial root.

National survey to update the diagnostic reference levels in interventional radiology procedures in Italy: working methodology.

Interventional Radiology (IR) deals with the diagnosis and treatment of various diseases through medically guided imaging. It provides unquestionable benefits to patients, but requires, in many cases, the use of high doses of ionizing radiation with a high impact on radiation risks to patients and to overall dose to the population. The International Commission on Radiological Protection introduced Diagnostic reference levels (DRLs) as an effective tool to facilitate dose verification and optimize protection for patients undergoing radiological procedures. In addition, EURATOM Council Directive 2013/59 and its Italian transposition (Legislative Decree 101/2020) have reiterated that DRLs must be established for many common radiological diagnostic procedures to compare the radiation dose delivered for the same diagnostic examination. Within this framework, Istituto Superiore di Sanità-Italian National Institute of Health (ISS)-, in collaboration with relevant Italian Scientific Societies, has provided documents on DRLs in radiological practices such as diagnostic and IR and diagnostic nuclear medicine. These reference documents enable National Hospitals to comply national regulation. The implementation of DRLs in IR is a difficult task because of the wide distribution of doses to patients even within the same procedure. Some studies have revealed that the amount of radiation in IR procedures is influenced more by the complexity of the procedure than by the weight of the patient, so complexity should be included in the definition of DRLs. For this reason, ISS promoted a survey among a sample of Italian Centers update national DRL in IR procedures with related complexity factors than can be useful for other radiological centers and to standardize the DRLs values. In the present paper the procedural methodology developed by ISS and used for the survey will be illustrated.

The association of endodontic prognostic factors with the presence of periapical lesion, its volume, and bone characteristics in endodontically treated molars: a cross-sectional study

BackgroundThis study intended to evaluate the association between several endodontic prognostic factors with the presence of periapical lesions (PLs), their volume, and bone characteristics including cortical bone destruction (CBD) and buccal plate bone height (BPBH) in root-filled molar teeth using cone-beam computed tomography.MethodsA collection of 143 scans of endodontically treated maxillary/mandibular first or second molars recorded over 8 years, were obtained from a specialized radiology center. Data on prognostic factors including tooth number, gender, jaw type, the status and number of missed canals, obturation length, restoration type, presence of a separated instrument, presence of a post or screw in the canals, and presence of perforation were collected. The assessed outcomes included PL presence, PL volume, CBD, and BPBH. The association between prognostic factors and outcomes was evaluated using multiple logistic regression models with adjusted covariates and multifactorial ANOVA at a significance level of 0.05.ResultsA total of 282 molars from 82 women and 50 men with a mean age of 40.6 ± 12.27 were included. Among those, 139 teeth presented PL with a mean volume of 18.68 mm3. CBD was prevalent in 137 teeth and the mean BPBH appeared to be 9.45 mm. The presence of a missed canal (OR = 10.022, P < .05), underfilled canal (OR = 3.725, P < .05), overfilled canal (OR = 15.859, P = .018), and perforation (OR = 15.261, P = .013) was significantly associated with PLs. None of the prognostic factors could considerably contribute to the CBD (P > .05). The presence of a missed canal was positively associated with the PL volume (P < .05). Similarly, missed canals (P < .05), perforation (P < .05), and separated instruments (P = .004) were associated with a significantly reduced BPBH.ConclusionsOverfillings, perforations, missed canals, and underfillings were identified as remarkable predictors of PL, arranged in descending order of their respective impact. The only factor capable of significantly increasing the PL volume was the missed canal. In brief, obturation length errors, perforations, missed canals, and separated instruments were robustly correlated with endodontic failure, which highlights the importance of mitigating the potential for errors by following the fundamentals of endodontics.

Morphometry and Significance of Collodiaphyseal Angle among Bini Tribe in Southern Nigeria

Abstract Introduction: The collodiaphyseal angle (CDA) is an angle formed between the femoral neck and femoral shaft axes. It is a vital determinant of femoral neck fracture as narrower angle is often used as a predictor of stress fracture. It is also important in orthopedic treatment planning, especially hip replacement surgery. Aim: This study was carried out to evaluate the CDA values among the Bini tribe and elucidate its significance. Methodology: This study employed 200 anterior-posterior pelvic radiographs of the Bini tribe (100 males and 100 females) aged between 25 and 55 years obtained from selected radiological diagnostic centers in Benin City, Nigeria, after obtaining the Institutional Ethical Approval. They were used to evaluate the right and left CDA as an angle formed by intersection of the femoral neck and shaft axes and measured using the goniometer. Data were statistically analyzed using IBM-SPSS (version 20) with the mean, standard deviation, and range evaluated, and side and gender comparisons were done using t-test, and P &lt; 0.05 was set as statistically significant level. Results: The average CDA was 135.56° ± 5.75° and 131.67° ± 6.15° in males and females, respectively. This angle showed significant gender differences bilaterally (P &lt; 0.05). However, the bilateral differences in the CDA were not statistically significant among either male or female Binis (P &gt; 0.05). Conclusion: The CDA can be employed as a morphometric indicator of sexual differences and for other clinical applications.

The prevalence of pulp stones in the Kurdish population as a diagnostic tool in endodontic prognosis using Digital Orthopantomograph

Background:Pulp stones (PSs) are calcified masses, found commonly in dental pulps of healthy, diseased, and even unerupted teeth.Objectives:Our study aims to determine the prevalence of PS in Kurdish adults using an orthopantomograph (OPG) and investigate the relationships between PSs with sex, age, tooth type, and dental arch/side.Patients and Methods:We examined 1,170 digital OPGs from Kurdish patients at the private Maxillofacial Radiology Center in Sulaimaniyah City, Iraq, were taken for various purposes between January and July 2023. A total of 31,598 teeth were examined to identify PSs. We collected patient data and determined correlations between the presence of PSs and various patient variables.Results:About 242 (20.68%) patients and 471 (1.49%) teeth had at least one stone. The prevalence of PS in the Kurdish population was 20.68% based on the total number of patients examined and it was 1.49% based on the total teeth examined. The PS frequently was found in those aged 45 years and more (50%) and the PS prevalence was higher in females (61%) than males (39%). The maxillary dental arches and molar teeth had the highest frequency of PS (p=0.000).Conclusions:In the Kurdish population, the prevalence of PSs was moderately high, particularly among females. PSs were most frequent in the maxillary arch and first molars, with incidence increasing with age.

The prevalence of dental agenesis among children with cleft lip and palate patients in Lahore, Pakistan.

This retrospective, cross-sectional analytical study investigated the incidence of tooth agenesis in cleft lip and palate (CLP) patients. Cone Beam Computed Tomography (CBCT) radiographs of the CLP children were examined for congenitally missing teeth. This study was conducted at three radiology centers in Lahore, namely, the Pakistan Jinnah MRI and Body Scan Centre, the University of Lahore Radiology Centres, and Fatima Memorial Hospital, from September 2021 to August 2022. The CLP patients were divided into four groups based on the location of the cleft: Cleft Lip and Palate Right (CLPR), Cleft Lip and Palate Left (CLPL), Bilateral Cleft (CLPB), and Midline Cleft (CLPM), inside and outside the cleft region. Two-way ANOVA was employed to compare the means of agenesis. Tukey's test was utilized to ascertain where the difference lies. The significance level was set at p ≤ 0.05. Moreover, a significant number of missing teeth were found inside the cleft. This study observed the CLPL (42.3%) and CLPR (13.6%) types more in number. Maxillary first premolars were found more missing outside the cleft region in CLPL and CLPB types. Although CLPB and CLPM types revealed a pattern of missing teeth, only a few cases were found in this study. Moreover, mean tooth agenesis was highest (4.5 SD.71) in the CLPM group, followed up by CLPB (2.75 SD 2.49), CLPR (1.23 SD 1.27), and CLPL Group (1.15 SD 1.12). Unilateral cleft lip and palate patients reported significant agenesis patttern compared to bilateral and median cleft cases.