Chairs:
rubens spin-neto
raluca roman
268: BILATERAL VESSEL-OUTLINING CAROTID ARTERY CALCIFICATIONS IN PANORAMIC RADIOGRAPHS – STRONGER INDICATOR FOR RISK OF VASCULAR EVENTS THAN PLAQUEAREA
M. Garoff1,2, J. Ahlqvist1, E. Levring Jäghagen1, P. Wester3, E. Johansson4
1Umeå University, Oral and Maxillofacial Radiology/ Umeå University, Umeå, Sweden, 2Umeå University, Oral and Maxillofacial Radiology/ Odontology, Umeå, Sweden, 3Umeå University, Department of Public Health and Clinical Medicine/Umeå University, Umeå, Sweden, 4University of Gothenburg, Department of Clinical Neuroscience, Gothenburg, Sweden
Aim: Carotid artery calcification (CAC) can incidentally be identified in panoramic radiographs (PR). Bilateral vessel-outlining (BVO) CACs represent a specific feature of CAC and constitute an independent risk marker for future vascular events. We aimed to investigate the correlation between BVO CACs and vascular events, as well as their association to carotid ultrasound plaque area.
Material and method: We prospectively enrolled 212 consecutive participants with PR-detected CACs, performed for dental purposes. BVO CACs were identified in 43/212 (20%) participants and ultrasound was utilized to assess plaque area at baseline. The primary outcome was the occurrence of major adverse cardiovascular events (MACE) during the follow-up period, including transient ischemic attack, stroke, angina pectoris, myocardial infarction, heart failure, revascularization, peripheral artery disease, and vascular death.
Results: Vessel-outlining CAC was significantly associated with larger plaque area on the same side (p<0.05) and BVO CACs were associated with larger total plaque area compared to other CAC features (p<0.01). Mean follow-up was 7.0 years and one third of the participants had more than one MACE. In bivariable analyses, both BVO CACs (HR 2.5, p<0.001) and total plaque area (HR 1.8 per cm2, p<0.01) were associated with MACE. When entering BVO CACs, plaque area and other relevant co-variates in a multivariable model, BVO CACs were close to unchanged, whereas total plaque area was no longer significant (HR 1.0, p>0.9).
Conclusion: The present results point to that BVO CACs is a stronger predictor for future MACE than plaque area.
75: THE RADIATION DOSE IN THE CONE BEAM COMPUTED TOMOGRAPHY EVALUATION OF MAXILLARY IMPACTED CANINES IN PEDIATRIC PATIENTS
M. Çağlar1, S. Gökşin1
1Ankara University, Faculty of Dentistry, Ankara, Turkey
The Aim: The aim of the study is to investigate the effect of radiation dose from different imaging protocols on the visualization of maxillary impacted canine teeth in 10 and 15-year-old patients using cone beam computed tomography.
Material and Methods: PCXMX 2.0 software was utilized to calculate organ absorbed doses. Images were simulated in 360 degrees using Newtom7G and Newtom GO devices with 8X6 cm2 FOV in best, regular, and low resolution modes.
Results: It has been observed that the total absorbed organ dose is highest in images taken in the best mode of Newtom 7G, followed by regular and low modes. When comparing the total absorbed organ dose between the two devices, the highest value belongs to the best mode of Newtom 7G, while the lowest is associated with the low mode of Newtom GO. The most affected tissues are oral mucosa and salivary glands.
Conclusion: It has been observed that patients aged 10 receive a higher radiation dose in total absorbed radiation doses compared to those aged 15. When comparing radiation doses from images obtained in all modes of the two devices, Newtom 7G is found to cause more radiation exposure in tissues than Newtom GO. Oral mucosa is identified as the most affected tissue in terms of radiation exposure.
109: PET CT SCAN OF MULTIPLE INVASIVE EXTERNAL CERVICAL ROOT RESORPTION IN DENOSUMAB TREATED METASTATIC BREAST CANCER PATIENT- A CASE REPORT
M.M. Ariel Nahalon1, M. Findler1, N. Yarom1,2, S. Friedlander-Barenboim1
1Sheba Medical Center, Oral Medicine Unit, Tel Hashomer, Israel, 2Tel Aviv University, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Health and medical sciences, Tel Aviv, Israel
Multiple invasive external cervical root resorption (ICCR) is arare, idiopathic, and aggressive form of dental hard tissue lossat the cemento-enamel junction. Denosumab is an anti-RANKL antibody that suppresses clastic cell activity and hard tissue resorption. RANKL/RANK signaling system is essential in breast cancer primary oncogenesis, and contributes to migration and colonization of cancer cells in the bones. RANKL/RANK inhibitors are essential to minimize metastatic spread, reduce fracture risk and pain. ICCR in a single tooth was reported in patients under denosumabtreatment and multiple ICCR was documented in cases of denosumab discontinuation.
Case summary: A 52 Y.O. female presented with three months facial edema, eating and speaking dificulties. Breast cancer diagnosed in 2014 following recurrence in 2017, she was treated withchemotherapy, immunomodulatory agents, and daily prednisone. Denosumab treatment lasted four years thendiscontinued prior to dental treatment to minimize MRONJ risk.
Clinical and radiographic examination showed rapidly progressive generalized ICCR. PET-CT scan showed FDG uptake at the resorption areas. To minimize MRONJ risk, no extractions were performed.Tissue biopsies demonstrated inflammatory cells andmultinucleated giant cells. Second PET-CT scan following a month of Ibuprufen treatment demonstrated FDG uptakereduction.
Conclusion: Due to the high prevalence of breast cancer world-wide and the frequent use of this novel therapeutic strategy, the potential side effects of denosumab treatment/discontinuationincluding ICRR are of great importance to the practitioners.
136: PATIENTS WITH CROWDING AND PARTIAL EDENTULOUS SPACES: THE INFLUENCE OF INTRAORAL SCANNING TECHNOLOGY ON TRUENESS OF DIGITAL IMAGES
B.N. Freitas1,2, C.P. Capel2, M.A. Vieira2, G.F. Barbin2, C. Tirapelli2
1Aarhus University, Department of Dentistry and Oral Health, Aarhus, Denmark, 2School of Dentistry of Ribeirão Preto, University of São Paulo, Department of Dental Materials and Prosthodontics, Ribeirao Preto, Brazil
Aim: To evaluate the trueness in meshes obtained by two intra-oral scanning (IOS) technologies from patients presenting crowding and bilateral posterior edentulous space with tilted molars.
Material and Methods: conventional impressions and casts of two patients with the aforementioned dental arch conditions were produced and digitized on a desktop scanner to be used as the reference meshes. Then, the patients were scanned using confocal microscopy (CM; iTero Element 2) and blue laser-multiscan imaging IOS (BLM; Virtuo Vivo), totalling thirty scans. Meshes were exported in Standard Tessellation Language format and analysed using Geomagic Control X. Root mean square (RMS) error was calculated and presented in a colour map. Differences in IOS technologies were evaluated with paired t-tests (α=0.05).
Results: Meshes from BLM showed greater discrepancy compared to CM in both dental arch conditions (p= 0.0084 and 0.0025 for crowding and partial edentulous space, respectively). The colour map showed discrepancies in buccal surface of crowding teeth when scanned using BLM, and in lingual surface using CM. For edentulous spaces with tilted molar, it showed similar discrepancy pattern at molars posterior to edentulous spaces for both IOS technologies.
Conclusion: Trueness of IOS scans of dental arches presenting crowding and edentulous spaces with tilted molars can be affected by the IOS technology.
223: COMPARISON ON ASSESSMENT OF CARIES ON THREE DIGITAL RADIOGRAPHIC IMAGE TYPES: INTRAORAL BITEWING, CBCT, AND DIGITAL TOMOSYNTHESIS. IN-VITRO STUDY.
O. Svystun1, B. Del Negro2, S. Kreiborg1, C. Dirckx3, K. Renforth3, N. Vibe Hermann1, T.A. Darvann1, A. Bakhshandeh1
1Copenhagen University, Department of Odontology- School of Dentistry, København N, Denmark, 2University Sao Paulo, School of Dentistry, Sao Paolo, Brazil, 3Centre for Innovation & Enterprise, Oxford, United Kingdom
Aim: to assess the presence and extension of caries lesions on bitewing, CBCT and digital tomosynthesis images.
Material and Method: Sixty-eight extracted permanent teeth (48 molars and 20 premolars) were included in the study. Teeth were mounted in putty to the level of enamel-cement junction in rows of 3-4 teeth, simulating a natural position in the jaw. Bitewing (BW) images were acquired with a Soredex Minray (70kV, 8mA, 0.16sec). CBCT images were acquired with a Planmeca Viso (90kV, 14mA, 8.92sec, 500×500 mm, and resolution of 0.08mm). Digital tomosynthesis (DT) images were acquired with an Adaptix prototype device (60kV, ~50µA, 0.1sec per emitter position, and slice spacing 0.25mm). Histologic standard samples were made by slicing teeth in antero-posterior direction. Caries lesions were evaluated according to presence of demineralization (yes/no), and extension of demineralization (≤1/2 in enamel, >1/2 in enamel, <1/3 in dentin, 1/3-2/3 in dentin, >2/3 in dentin, in the pulp). The assessments were performed by two trained and calibrated observers. Descriptive statistics summarized the findings.
Results: K ranged from moderate to good. Accuracy, sensitivity, and specificity of the assessments of images compared to the histological assessments were statistically similar. For presence of caries the range of errors varies between 7-16% for BW, and 7-15% for both CBCT and DT. For the extent of the caries lesions, DT was characterized by the fewest errors 23%, followed by CBCT 25%, while BW led to 36% errors.
Conclusion: The accuracy of caries diagnosis is substantially affected by the radiographic imaging modality used.