RESUMO
Introducción: A pesar de que actualmente la radiografía panorámica es un instrumento auxiliar de diagnóstico de uso común, desafortunadamente sus beneficios no se aprovechan en su totalidad y su empleo se limita al uso en determinadas áreas de la odontología y en ocasiones se omiten hallazgos que pueden tener un significado clínico importante. Material y métodos: Estudio transversal y descriptivo de una muestra aleatoria de 500 estudios de imagen (radiografías panorámicas) durante el periodo de enero a mayo de 2018 analizadas por expertos estandarizados y empleando estadística descriptiva básica mediante el paquete estadístico Excel. Resultados: Se incluyeron 500 estudios, 67% correspondió a mujeres en un rango de cinco a 91 años de edad con una mediana de 43 años, 48% presentó alteraciones siendo las más frecuentas pérdida del proceso alveolar 45%, alteraciones en articulación temporomandibular 34%, y calcificación del ligamento estilohioideo 31%. Conclusión: Se reportaron hallazgos clínico-radiográficos significativos, resaltando la necesidad de un análisis cuidadoso de los métodos auxiliares de diagnóstico que permitan visualizar de manera contextual el tratamiento odontológico de los pacientes y/o reportar al especialista correspondiente otro tipo de hallazgos (AU))
Introduction: Although panoramic radiography is currently a commonly used diagnostic auxiliary instrument, unfortunately its benefits are not fully exploited and its use is limited to use in certain areas of Dentistry and eventually findings that may have important clinical significance are omitted. Material and methods: Crosssectional and descriptive study of a random sample of 500 imaging studies (panoramic radiographs) during the period from January to May 2018, analyzed by standardized experts and using basic descriptive statistics using the Excel statistical package. Results: 500 studies were included corresponding to 67% women and an age range from five to 91 years of age with a median of 43 years, 48% presented alterations, the most frequent being loss of the alveolar process 45%, alterations in the temporomandibular joint 34%, and calcification of the hyoid ligament 31%. Conclusion: In this study significant clinical-radiographic findings are reported, highlighting the need for a careful analysis of auxiliary diagnostic methods that allow visualize the dental treatment of the patients and / or report other findings to the corresponding specialist (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Previdência Social , Radiografia Panorâmica , Doenças Maxilomandibulares/diagnóstico por imagem , Epidemiologia Descritiva , Estudos Transversais , Estudos Retrospectivos , Doenças da Boca/diagnóstico por imagemRESUMO
Vitiligo is the most common depigmenting, chronic acquired disease of the skin and mucosa. However, vitiligo of an unclassified type and mucosal subtype affecting only one area of the mucosa is considered quite uncommon. The diagnosis of vitiligo, regardless of its type, is clinical. Nonetheless, a device that allows the visualization of the tissue fluorescence may be useful for confirming the diagnosis. We present the use of wide-field optical fluorescence device for complementary examination and diagnosis of unusual cases of mucosal vitiligo located only in angles of the mouth.
Assuntos
Doenças da Boca/diagnóstico por imagem , Mucosa Bucal/diagnóstico por imagem , Imagem Óptica/métodos , Vitiligo/diagnóstico por imagem , Fluorescência , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/patologia , Mucosa Bucal/patologia , Imagem Óptica/instrumentação , Vitiligo/patologiaRESUMO
SUMMARY Vitiligo is the most common depigmenting, chronic acquired disease of the skin and mucosa. However, vitiligo of an unclassified type and mucosal subtype affecting only one area of the mucosa is considered quite uncommon. The diagnosis of vitiligo, regardless of its type, is clinical. Nonetheless, a device that allows the visualization of the tissue fluorescence may be useful for confirming the diagnosis. We present the use of wide-field optical fluorescence device for complementary examination and diagnosis of unusual cases of mucosal vitiligo located only in angles of the mouth.
RESUMO O vitiligo é a doença crônica adquirida despigmentante mais comum da pele e/ou da mucosa. Entretanto, o vitiligo do tipo não classificado e subtipo de mucosa afetando apenas uma área da mucosa é considerado bastante incomum. O diagnóstico de vitiligo, independentemente do seu tipo, é clínico. No entanto, o uso de um dispositivo que permite a visualização da fluorescência tecidual pode ser útil para a confirmação do diagnóstico de vitiligo. Apresentamos o uso do dispositivo de exame complementar de fluorescência óptica de campo amplo para o diagnóstico de um caso incomum de vitiligo de mucosa localizado apenas em ângulos da boca.
Assuntos
Humanos , Masculino , Vitiligo/diagnóstico por imagem , Imagem Óptica/métodos , Doenças da Boca/diagnóstico por imagem , Mucosa Bucal/diagnóstico por imagem , Vitiligo/patologia , Imagem Óptica/instrumentação , Fluorescência , Pessoa de Meia-Idade , Doenças da Boca/patologia , Mucosa Bucal/patologiaRESUMO
Whole slide imaging (WSI) systems are being increasingly used in educational and professional settings, highlighting the value of digital microscopy and favouring its acceptance for use in primary diagnosis. There has been a reluctance to introduce diagnostic applications due to a lack of validation and regulation of these devices. This study aims to provide information regarding the performance of WSI and to validate it for use in the diagnosis of oral diseases, using the intraobserver variability as the primary form of analysis. Seventy (n = 70) H&E-stained glass slides of oral biopsies were scanned using the Aperio Digital Pathology System at a magnification of × 20. Two experienced oral pathologists blindly analysed all H&E-stained sections with a conventional light microscope (CLM) and, after 3-month washout, with WSI. Clinical information was provided along with the cases in both analyses. The intraobserver agreement between CLM and WSI was 97% (κ = 0.9) for both pathologists. The majority of preferred diagnoses were by CLM. Both pathologists had the same discordances in different cases. Challenging cases and cases with insufficient quantity of tissue for analyses were considered the main reasons for disagreement rather than the diagnostic methods. Median time taken to make a diagnosis was higher only in CLM for one pathologist. Time outliers occurred in discordant cases and in other difficult cases. This study provides evidence of a high performance of WSI for diagnostic purposes in clinical practice, routine pathology and primary diagnosis in the field of oral pathology.
Assuntos
Microscopia/métodos , Doenças da Boca/diagnóstico por imagem , Estudos Transversais , Humanos , Doenças da Boca/patologia , Variações Dependentes do Observador , Estudos RetrospectivosRESUMO
OBJECTIVE: The diagnosis of oral lesions is often challenging for primary healthcare providers, which explains the high number of referrals to specialist care. This favors increases in waiting lines and delays in diagnosis, contributing to high mortality rates from oral cancer. This study aimed to summarize the experience of the EstomatoNet, a telediagnosis program catering to primary care dentists and physicians from southern Brazil. STUDY DESIGN: This exploratory study included all queries received by EstomatoNet from June 2015 to December 2016. Health providers (71 dentists and 18 physicians from primary care) submitted requests including clinical information and photographs of oral lesions by means of a cloud-based platform. Specialized oral medicine teleconsultants received the data, conveyed a diagnostic hypothesis, and conveyed management recommendations. RESULTS: Actinic cheilitis (n = 41, 15.8%), squamous cell carcinoma (n = 22, 8.5%), and inflammatory hyperplasia (21, 8.1%) were the most frequent diagnoses. Teleconsultants recommended referral to specialists in 42.9% of the cases, total biopsy in 23.6%, and follow-up in 16.2%. After the EstomatoNet use, the intention to refer the patients to face-to-face consultation reduced from 96.9% to 35.1%. CONCLUSION: Telediagnosis for oral lesions is feasible and has potential to improve the quality of primary health care by bridging the gap between primary and specialized health care.
Assuntos
Odontologia/métodos , Doenças da Boca/diagnóstico por imagem , Atenção Primária à Saúde/métodos , Telemedicina , Adulto , Idoso , Atitude do Pessoal de Saúde , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação , Encaminhamento e Consulta/estatística & dados numéricos , Adulto JovemRESUMO
A termografia infravermelha consiste em um exame de imagem complementar aplicada na avaliação da temperatura corporal com base na emissão de radiação infravermelha através da pele, podendo auxiliar no diagnóstico ou monitoramento das intervenções terapêuticas. Trata-se de uma técnica não ionizante e não invasiva que capta e registra a distribuição térmica da superfície cutânea avaliada por meio das alterações na microcirculação dos pacientes frente a diferentes condições patológicas. Dentre as aplicações na Odontologia, a termografia pode complementar o exame físico anatômico, visto que apresenta em tempo real condições fisiológicas, de acordo com a temperatura. Esta técnica pode auxiliar no diagnóstico e planejamento do tratamento de alterações orofaciais, como processos inflamatórios e infecciosos na região orofacial, acompanhamento pós-cirúrgico e na avaliação de pacientes com desordens temporomandibulares (DTM). A termografia ainda é pouco utilizada na Odontologia, e protocolos para avaliação de alterações na região de cabeça e pescoço ainda devem ser testados e estabelecidos. Porém, já mostra ser um exame complementar de boa performance na detecção de pontos gatilho da dor, acompanhamento de pacientes de forma não invasiva e como documentação médico-legal.
Infrared thermography consists of a complementary imaging test applied to the assessment of body temperature based on the emission of infrared radiation through the skin, which may aid in the diagnosis or monitoring of therapeutic interventions. It is a non-ionizing and non-invasive technique that captures and records the thermal distribution of the cutaneous surface evaluated by means of the changes in the patients' microcirculation in face of different pathological conditions. Among the applications in Dentistry, thermography can complement the anatomical physical examination, since it presents in real time physiological conditions according to temperature. This technique can help in the diagnosis and planning of the treatment of orofacial alterations, such as inflammatory and infectious processes in the orofacial region, post-surgical follow-up and in the routine evaluation of patients with temporomandibular disorders (TMD). Thermography is still poorly used in Dentistry and protocols for the evaluation of head and neck disorders have yet to be tested and established. However, it already shows up as a good complementary examination for the detection of pain trigger points, follow-up of patients in a non-invasive way, and as medical-legal documentation.
Assuntos
Humanos , Masculino , Feminino , Termografia/métodos , Doenças Maxilomandibulares/diagnóstico por imagem , Face/diagnóstico por imagem , Doenças da Boca/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagemRESUMO
La radiología odontológica ha jugado un rol fundamental en el diagnóstico odontológico. El avance en la adquisición y procesado de la imagen digital produjo el desarrollo de nuevas tecnologías que han revolucionado el manejo del intercambio de la información en odontología. Las radiografías intraorales y extraorales se han adaptado a esa revolución digital. La búsqueda automatizada, el acceso a la literatura en formato electrónico y el intercambio de texto, imágenes y sonido en tiempo real son algunas de las características que lo hacen un elemento imprescindible dentro de la práctica en salud y los actuales estándares de la atención odontológica. El reciente desarrollo de la tomografía computada de haz cónico ha reemplazado el uso de la tomografía computada médica en odontología. En este artículo se hace una introducción en los métodos actuales y en cómo han cambiado el diagnóstico radiológico en odontología.
Dental radiology has played a fundamental role in the dental diagnosis. The advance of the acquisition and processing of the digital image produced the development of new technologies that have revolutionized the management of the information exchange in dentistry. Intraoral and extraoral radiographies have adapted to this digital revolution. The automated search, access to literature in electronic format and the interchange of text, images and sound in real time, are some of the features that make an essential element within the practice in health and the standard of dental care. The recent development of cone beam computerized tomography has replaced the use of computed tomography in dentistry. This article is an introduction to the current methods employed and how they have changed the radiological diagnosis in dentistry.
Assuntos
Humanos , Diagnóstico por Imagem , Radiografia Dentária , Tomografia Computadorizada de Feixe Cônico/métodos , Consultórios Odontológicos , Doenças da Boca/diagnóstico por imagem , Equipamentos Odontológicos/normas , Radiografia Panorâmica/métodos , Especialidades Odontológicas , Tecnologia OdontológicaRESUMO
INTRODUCTION: The aim of this article is to present a rare case of myiasis caused by Dermatobia hominis. Myiasis is a disease caused by invasion of tissues of animals and humans by larval stages of dipterous (2-winged) flies. There are few reports of oral myiasis in the literature, mostly related to Cochliomyia hominivorax larvae. We present a case of a 53-year-old man with painful swelling of the left lower lip that was confirmed to be myiasis caused by D. hominis. Though more common in tropical and subtropical regions of North and South America, myiasis should be considered in the differential diagnosis of subcutaneous masses among residents or travelers in endemic areas.