Optical coherence tomography to evaluate variance in the extent of carious lesions in depth.

PubMed

Park, Kyung-Jin; Schneider, Hartmut; Ziebolz, Dirk; Krause, Felix; Haak, Rainer

2018-05-03

Evaluation of variance in the extent of carious lesions in depth at smooth surfaces within the same ICDAS code group using optical coherence tomography (OCT) in vitro and in vivo. (1) Verification/validation of OCT to assess non-cavitated caries: 13 human molars with ICDAS code 2 at smooth surfaces were imaged using OCT and light microscopy. Regions of interest (ROI) were categorized according to the depth of carious lesions. Agreement between histology and OCT was determined by unweighted Cohen's Kappa and Wilcoxon test. (2) Assessment of 133 smooth surfaces using ICDAS and OCT in vitro, 49 surfaces in vivo. ROI were categorized according to the caries extent (ICDAS: codes 0-4, OCT: scoring based on lesion depth). A frequency distribution of the OCT scores for each ICDAS code was determined. (1) Histology and OCT agreed moderately (κ = 0.54, p ≤ 0.001) with no significant difference between both methods (p = 0.25). The lesions (76.9% (10 of 13)) _were equally scored. (2) In vitro, OCT revealed caries in 42% of ROI clinically assessed as sound. OCT detected dentin-caries in 40% of ROIs visually assessed as enamel-caries. In vivo, large differences between ICDAS and OCT were observed. Carious lesions of ICDAS codes 1 and 2 vary largely in their extent in depth.

Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis.

PubMed

Ornellas, Pâmela Oliveira; Antunes, Leonardo Dos Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

2016-09-01

This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration’s tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis

NASA Astrophysics Data System (ADS)

Ornellas, Pâmela Oliveira; Antunes, Leonardo Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

2016-09-01

This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration's tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

Selective laser ablation of carious lesions using simultaneous scanned near-IR diode and CO2 lasers

NASA Astrophysics Data System (ADS)

Chan, Kenneth H.; Fried, Daniel

2017-02-01

Previous studies have established that carious lesions can be imaged with high contrast using near-IR wavelengths coincident with high water absorption, namely 1450-nm, without the interference of stains. It has been demonstrated that computer-controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, a point-to-point scanning system was developed integrating a 1450-nm diode laser with the CO2 ablation laser. This approach is advantageous since it does not require an expensive near-IR camera. In this pilot study, we demonstrate the feasibility of a combined NIR and IR laser system for the selective removal of carious lesions.

Selective Laser Ablation of Carious Lesions using Simultaneous Scanned Near-IR Diode and CO2 Lasers.

PubMed

Chan, Kenneth H; Fried, Daniel

2017-01-28

Previous studies have established that carious lesions can be imaged with high contrast using near-IR wavelengths coincident with high water absorption, namely 1450-nm, without the interference of stains. It has been demonstrated that computer-controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, a point-to-point scanning system was developed integrating a 1450-nm diode laser with the CO 2 ablation laser. This approach is advantageous since it does not require an expensive near-IR camera. In this pilot study, we demonstrate the feasibility of a combined NIR and IR laser system for the selective removal of carious lesions.

Effect of oxalic acid pre-treatment in restorations of non-carious cervical lesions: A randomized clinical trial.

PubMed

de Souza, André Mattos Brito; Colares, Regina Claudia Ramos; Mendonça, Juliano Satori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

2014-09-01

Non-carious cervical lesions are usually associated with dentin hypersensitivity. The use of oxalic acid in restorations of these lesions could be beneficial in relieving pain. To evaluate the use of oxalic acid in restorations of non-carious cervical lesions. A randomized clinical trial. One operator placed 90 restorations in 20 volunteers of both sexes, with at least two lesions to be restored with the techniques: Control - Restoration with total-etch technique and Experimental - Restoration with pretreatment with oxalic acid followed by application of adhesive system. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners using a modified United States Public Health Service (USPHS) method at baseline, 6 and 12 months, taking into account the following criteria: Retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). The data were statistically analyzed using the Fisher exact and McNemar tests. The level of significance was set at 5%. After 1 year, the results of restorations clinically satisfactory obtained for the control and experimental group respectively were: R (97% / 89%), MI (100% / 100%), MD (100% / 100%), S (100% / 100%), C (100% / 100%), and AF (100% / 100%). The use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in non-carious cervical lesions after 1 year.

Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions.

PubMed

Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A

2014-01-01

Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Dental plaque from children (N=20; aged 3-6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10-20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1-6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric potential of these strains may influence susceptibility in the

The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique.

PubMed

Kemoli, A M; van Amerongen, W E

2011-03-01

To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from 30 rural schools in Kenya participated in the study. Three examiners selected a total of 1,280 suitable proximal carious lesions in primary molars after examining 6,002 children from 30 schools randomly selected out of 142 schools in two divisions. Seven operators randomly paired on a daily basis with eight assistants restored the lesions. An explanation was provided for any cavity that was not restored. Pre-and post-operative radiographs of the cavities were also taken for evaluation. The examiner's choice of suitable proximal cavities restorable using the ART approach was related to the decision made to either restore or not during the operative stage. The radiographic findings of the selected cavities were also compared to the decision made by the operator. The results obtained were used to determine the examiner's accuracy in selecting suitable proximal cavities for restoration using the ART approach. The majority of the children recruited in the study were excluded due to absenteeism, pulpal-exposure or anxiety during the operative stage. Only 804 children received one restoration in their primary molars. The examiner's accuracy in selecting suitable ART-restorable cavities clinically was 94.9% and based on radiographic analysis was 91.7%. A trained and diligent examiner has a very good chance of selecting proximal carious lesions restorable with the use of ART approach, without the threat of dental pulpal-involvement during the excavation of caries.

Remineralization efficiency of bioactive glass on artificially induced carious lesion an in-vitro study.

PubMed

Narayana, Sai Sathya; Deepa, Vinoth Kumar; Ahamed, Shafie; Sathish, Emmanuel Solomon; Meyappan, R; Satheesh Kumar, K S

2014-01-01

The objective of this study is to investigate the efficacy of bioactive glass containing product on remineralization of artificial induced carious enamel lesion and to compare its efficiency with other remineralization products using an in-vitro pH cycling method. The null hypothesis tested was bioactive glass has no effect on enamel remineralization. A total of 20 enamel samples of human molar teeth were subjected to artificial caries lesion formation using pH cycling method and was verified using high resolution scanning electron microscope (HRSEM). Each demineralized sample was then divided into five test groups each containing twenty. Group A - Bioactive glass (SHY-NM), Group B - Fluoride tooth paste (Amflor), Group C - CPP-ACP (Tooth mousse), Group D - CPP-ACPF (Tooth mousse plus), Group E - control. All the test groups were exposed to the pH cycling regime, the remineralizing agents were applied for 10 min except control. After 10 days period, the entire test groups were evaluated with HRSEM and quantitative assessment by energy dispersive X-ray spectroscopy. The obtained data was analyzed statistically using one-way ANOVA, Student's t-test and Tukey's multiple comparison tests. P ≤ 0.05 was considered to be significant. Rejection of the null hypothesis and highlights the concept of biomimetic bioactive glass as an effective remineralizing agent. To focus on the importance of minimal invasive treatment on incipient carious lesion by remineralization.

Randomized in vivo evaluation of photodynamic antimicrobial chemotherapy on deciduous carious dentin

NASA Astrophysics Data System (ADS)

Steiner-Oliveira, Carolina; Longo, Priscila Larcher; Aranha, Ana Cecília Corrêa; Ramalho, Karen Müller; Mayer, Marcia Pinto Alves; de Paula Eduardo, Carlos

2015-10-01

The aim of this randomized in vivo study was to compare antimicrobial chemotherapies in primary carious dentin. Thirty-two participants ages 5 to 7 years underwent partial caries removal from deep carious dentin lesions in primary molars and were subsequently divided into three groups: control [chlorhexidine and resin-modified glass ionomer cement (RMGIC)], LEDTB [photodynamic antimicrobial chemotherapy (PACT) with light-emitting diode associated with toluidine blue solution and RMGIC], and LMB [PACT with laser associated with methylene blue solution and RMGIC]. The participants were submitted to initial clinical and radiographic examinations. Demographic features and biofilm, gingival, and DMFT/DMFS indexes were evaluated, in addition to clinical and radiographic followups at 6 and 12 months after treatments. Carious dentin was collected before and after each treatment, and the number of Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Fusobacterium nucleatum, Atopobium rimae, and total bacteria was established by quantitative polymerase chain reaction. No signs of pain or restoration failure were observed. All therapies were effective in reducing the number of microorganisms, except for S. sobrinus. No statistical differences were observed among the protocols used. All therapies may be considered as effective modern approaches to minimal intervention for the management of deep primary caries treatment.

Effects of Remineralization Agents on Artificial Carious Lesions.

PubMed

Savas, Selcuk; Kucukyilmaz, Ebru; Celik, Esra Uzer

2016-11-15

The purpose of this study was to evaluate the remineralization potentials of different agents on demineralized enamel surfaces. Four hundred and sixty extracted human molars with artificial carious lesions were divided into six groups: (1) control; (2) acidulated phosphate fluoride (APF); (3) Curodont Repair (CR); (4) silver diamine fluoride (SDF); (5) ammonium hexafluorosilicate (SiF); and (6) SiF plus cetylpiridinium chloride (SiF+CPC). They were subdivided according to immersion periods (seven out of 30 days). After demineralization and remineralization procedures, microhardness test (VHN), energy-dispersive X-ray spectroscopy analysis, and confocal laser scanning microscopy evaluation were performed. The data were statistically analyzed. By the 30-day remineralization, the mean differences in VHN values were ranked as follows, in order: (1) CR; (2) APF; (3) SiF; (4) SiF+CPC; (5) SDF; and (6) control (P<0.05). The calcium (Ca) content and calcium/phosphate ratio for all groups were significantly higher after 30 days (P<0.05). The greatest lesion depth changes were observed in the CR, APF, SiF, and SDF groups (P<0.05), while the greatest fluorescence changes were observed in the APF, SiF, and CR groups (P<0.05). The remineralization was most successful in the CR, APF, and SiF groups, with higher values than for those of the other treatments.

Enamel Carious Lesion Development in Response to Sucrose and Fluoride Concentrations and to Time of Biofilm Formation: An Artificial-Mouth Study

PubMed Central

Arthur, Rodrigo Alex; Kohara, Eduardo Kazuo; Waeiss, Robert Aaron; Eckert, George J.; Zero, Domenick; Ando, Masatoshi

2015-01-01

The aim of this study was to evaluate both sucrose and fluoride concentrations and time of biofilm formation on enamel carious lesions induced by an in vitro artificial-mouth caries model. For Study 1, biofilms formed by streptococci and lactobacilli were grown on the surface of human enamel slabs and exposed to artificial saliva containing 0.50 or 0.75 ppmF (22.5 h/d) and broth containing 3 or 5% sucrose (30 min; 3x/d) over 5 d. In Study 2, biofilms were grown in the presence of 0.75 ppmF and 3% sucrose over 3 and 9 days. Counts of viable cells on biofilms, lesion depth (LD), and the integrated mineral loss (IML) on enamel specimens were assessed at the end of the tested conditions. Counts of total viable cells and L. casei were affected by sucrose and fluoride concentrations as well as by time of biofilm formation. Enamel carious lesions were shallower and IML was lower in the presence of 0.75 ppmF than in the presence of 0.50 ppmF (P < 0.005). No significant effect of sucrose concentrations was found with respect to LD and IML (P > 0.25). Additionally, deeper lesions and higher IML were found after 9 d of biofilm formation (P < 0.005). Distinct sucrose concentrations did not affect enamel carious lesion development. The severity of enamel demineralization was reduced by the presence of the higher fluoride concentration. Additionally, an increase in the time of biofilm formation produced greater demineralization. Our results also suggest that the present model is suitable for studying aspects related to caries lesion development. PMID:25664342

Selective ablation of carious lesions using an integrated near-IR imaging system and a novel 9.3-μm CO2 Laser

NASA Astrophysics Data System (ADS)

Chan, Kenneth H.; Fried, Nathaniel M.; Fried, Daniel

2018-02-01

Previous studies have shown that reflectance imaging at wavelengths greater than 1200-nm can be used to image demineralization on tooth occlusal surfaces with high contrast and without the interference of stains. In addition, these near-IR imaging systems can be integrated with laser ablation systems for the selective removal of carious lesions. Higher wavelengths, such as 1950-nm, yield higher lesion contrast due to higher water absorption and lower scattering. In this study, a point-to-point scanning system employing diode and fiber lasers operating at 1450, 1860, 1880, and 1950-nm was used to acquire reflected light images of the tooth surface. Artificial lesions were imaged at these wavelengths to determine the highest lesion contrast. Near-IR images at 1880-nm were used to demarcate lesion areas for subsequent selective carious lesion removal using a new compact air-cooled CO2 laser prototype operating at 9.3-μm. The highest lesion contrast was at 1950-nm and the dual NIR/CO2 laser system selectively removed the simulated lesions with a mean loss of only 12-μm of sound enamel.

Clinical evaluation of flowable resins in non-carious cervical lesions: two-year results.

PubMed

Celik, Cigdem; Ozgünaltay, Gül; Attar, Nuray

2007-01-01

This study evaluated the two-year clinical performance of one microhybrid composite and three different types of flowable resin materials in non-carious cervical lesions. A total of 252 noncarious cervical lesions were restored in 37 patients (12 male, 25 female) with Admira Flow, Dyract Flow, Filtek Flow and Filtek Z250, according to manufacturers' instructions. All the restorations were placed by one operator, and two other examiners evaluated the restorations clinically within one week after placement and after 6, 12, 18 and 24 months, using modified USPHS criteria. At the end of 24 months, 172 restorations were evaluated in 26 patients, with a recall rate of 68%. Statistical analysis was completed using the Pearson Chi-square and Fisher-Freeman-Halton tests (p < 0.05). Additionally, survival rates were analyzed with the Kaplan-Meier estimator and the Log-Rank test (p < 0.05). The Log-Rank test indicated statistically significant differences between the survival rates of Dyract Flow/Admira Flow and Dyract Flow/Filtek Z250 (p < 0.05). While there was a statistically significant difference between Dyract Flow and the other materials for color match at 12 and 18 months, no significant difference was observed among all of the materials tested at 24 months. Significant differences were revealed between Filtek Z250 and the other materials for marginal adaptation at 18 and 24 months (p < 0.05). With respect to marginal discoloration, secondary caries, surface texture and anatomic form, no significant differences were found between the resin materials (p > 0.05). It was concluded that different types of resin materials demonstrated acceptable clinical performance in non-carious cervical lesions, except for the retention rates of the Dyract Flow restorations.

Polymerization shrinkage stresses in different restorative techniques for non-carious cervical lesions.

PubMed

de Oliveira Correia, Ayla Macyelle; Tribst, João Paulo Mendes; de Souza Matos, Felipe; Platt, Jeffrey A; Caneppele, Taciana Marco Ferraz; Borges, Alexandre Luiz Souto

2018-06-20

This study evaluated the effect of different restorative techniques for non-carious cervical lesions (NCCL) on polymerization shrinkage stress of resins using three-dimensional (3D) finite element analysis (FEA). 3D-models of a maxillary premolar with a NCCL restored with different filling techniques (bulk filling and incremental) were generated to be compared by nonlinear FEA. The bulk filling technique was used for groups B (NCCL restored with Filtek™ Bulk Fill) and C (Filtek™ Z350 XT). The incremental technique was subdivided according to mode of application: P (2 parallel increments of the Filtek™ Z350 XT), OI (2 oblique increments of the Filtek™ Z350 XT, with incisal first), OIV (2 oblique increments of the Filtek™ Z350 XT, with incisal first and increments with the same volume), OG (2 oblique increments of the Filtek™ Z350 XT, with gingival first) and OGV (2 oblique increments of the Filtek™ Z350 XT, with gingival first and increments with the same volume), resulting in 7 models. All materials were considered isotropic, elastic and linear. The results were expressed in maximum principal stress (MPS). The tension stress distribution was influenced by the restorative technique. The lowest stress concentration occurred in group B followed by OG, OGV, OI, OIV, P and C; the incisal interface was more affected than the gingival. The restoration of NCCLs with bulk fill composite resulted in lower shrinkage stress in the gingival and incisal areas, followed by incremental techniques with the initial increment placed on the gingival wall. The non-carious cervical lesions (NCCLs) restored with bulk fill composite have a more favorable biomechanical behavior. Copyright © 2018. Published by Elsevier Ltd.

Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine): a case report

PubMed Central

Grosgogeat, Brigitte; Seux, Dominique; Farge, Pierre

2013-01-01

The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth. PMID:24303363

Remineralization effects of two pediatric dentifrices and one regular dentifrice on artificial carious lesion in primary teeth: An in vitro study

PubMed Central

Advani, Shweta; Sogi, Suma; Hugar, Shivayogi; Indushekar, K. R.; Kiran, K.; Hallikerimath, Seema

2014-01-01

Aim: The aim of the following study is to know the efficacy of remineralization of two pediatric dentifrices and one regular dentifrice on artificial carious lesions in primary teeth. Materials and Methods: A total of 21 teeth coated with nail varnish leaving a window of 1 mm were subjected to demineralization for 72 h. These 21 teeth were then sectioned into two equal parts with a diamond disc. The 42 sections obtained were then evaluated under the stereomicroscope and the demineralization values were noted. The 42 sections were divided into three groups: Group 1: Kidodent, Group 2: Cheeriogel, Group 3: Colgate Total and subjected to remineralization respectively for 7 days. The specimens were again evaluated under the stereomicroscope for the remineralisation values. Results: All the three dentifrices showed remineralization with artificial carious lesions. Colgate Total showed higher remineralization rates compared with the other two pediatric dentifrices. Kidodent showed a slightly higher remineralisation rate compared with Cheeriogel which was not significant. Conclusion/Hypothesis: The pediatric dentifrices also showed remineralization with artificial carious lesions. Hence, we conclude that, this amount of remineralization was more or less, when compared to the regular dentifrice which showed higher remineralization rates, which could lead to adverse effects, like fluorosis if not used judiciously. On basis of which we hypothetize: Pediatric dentifrices have an appropriate fluoride content, as required by the children, and also does not minimize the cariostatic effects. PMID:25254193

The Study of Carious Teeth by Laser-Induced Breakdown Spectroscopy

NASA Astrophysics Data System (ADS)

Hamzaoui, S.; Nouir, R.; Jaidene, N.

2017-03-01

The aim of this work is a multi-component analysis of the element composition of the enamel and carious parts of teeth and the quantification of enamel demineralization using laser-induced breakdown spectroscopy (LIBS). For each tooth the P/Ca ratios of the emission line intensities in the enamel part and those in the carious regions were compared. Since zinc is a trace element, the same procedure was performed for Zn/Ca ratios in the enamel and carious parts. These comparisons showed that the mineral loss from carious lesions occurs at different rates for the studied elements. Calcium has the highest casualty rate. On the other hand, the zinc level diminishes also in the carious region but at a lower rate. The lines were obtained from plume plasma emission generated on the enamel and carious regions.

Laser-scanned fluorescence of nonlased/normal, lased/normal, nonlased/carious, and lased/carious enamel

NASA Astrophysics Data System (ADS)

Zakariasen, Kenneth L.; Barron, Joseph R.; Paton, Barry E.

1992-06-01

Research has shown that low levels of CO2 laser irradiation raise enamel resistance to sub-surface demineralization. Additionally, laser scanned fluorescence analysis of enamel, as well a laser and white light reflection studies, have potential for both clinical diagnosis and comparative research investigations of the caries process. This study was designed to compare laser fluorescence and laser/white light reflection of (1) non-lased/normal with lased/normal enamel and (2) non-lased/normal with non-lased/carious and lased/carious enamel. Specimens were buccal surfaces of extracted third molars, coated with acid resistant varnish except for either two or three 2.25 mm2 windows (two window specimens: non-lased/normal, lased/normal--three window specimens: non-lased/normal, non-lased carious, lased/carious). Teeth exhibiting carious windows were immersed in a demineralizing solution for twelve days. Non-carious windows were covered with wax during immersion. Following immersion, the wax was removed, and fluorescence and laser/white light reflection analyses were performed on all windows utilizing a custom scanning laser fluorescence spectrometer which focuses light from a 25 mWatt He-Cd laser at 442 nm through an objective lens onto a cross-section >= 3 (mu) in diameter. For laser/white light reflection analyses, reflected light intensities were measured. A HeNe laser was used for laser light reflection studies. Following analyses, the teeth are sectioned bucco-lingually into 80 micrometers sections, examined under polarized light microscopy, and the lesions photographed. This permits comparison between fluorescence/reflected light values and the visualized decalcification areas for each section, and thus comparisons between various enamel treatments and normal enamel. The enamel specimens are currently being analyzed.

Comparing natural and artificial carious lesions in human crowns by means of conventional hard x-ray micro-tomography and two-dimensional x-ray scattering with synchrotron radiation

NASA Astrophysics Data System (ADS)

Botta, Lea Maria; White, Shane N.; Deyhle, Hans; Dziadowiec, Iwona; Schulz, Georg; Thalmann, Peter; Müller, Bert

2016-10-01

Dental caries, one of the most prevalent infectious bacterial diseases in the world, is caused by specific types of acid-producing bacteria. Caries is a disease continuum resulting from the earliest loss of ions from apatite crystals through gross cavitation. Enamel dissolution starts when the pH-value drops below 5.5. Neutralizing the pH-value in the oral cavity opposes the process of demineralization, and so caries lesions occur in a dynamic cyclic de-mineralizing/remineralizing environment. Unfortunately, biomimetic regeneration of cavitated enamel is not yet possible, although remineralization of small carious lesions occurs under optimal conditions. Therefore, the development of methods that can regenerate carious lesions, and subsequently recover and retain teeth, is highly desirable. For the present proceedings we analyzed one naturally occurring sub-surface and one artificially produced lesion. For the characterization of artificial and natural lesions micro computed tomography is the method of choice when looking to determine three-dimensional mineral distribution and to quantify the degree of mineralization. In this pilot study we elucidate that the de-mineralized enamel in natural and artificially induced lesions shows comparable X-ray attenuation behavior, thereby implying that the study protocol employed herein seems to be appropriate. Once we know that the lesions are comparable, a series of well-reproducible in vitro experiments on enamel regeneration could be performed. In order to quantify further lesion morphology, the anisotropy of the enamel's nanostructure can be characterized by using spatially resolved, small-angle X-ray scattering. We wanted to demonstrate that the artificially induced defect fittingly resembles the natural carious lesion.

Bond strength to dentin with artificial carious lesions: influence of caries detecting dye.

PubMed

Palma, R G; Turbino, M L; Matson, E; Powers, J M

1998-06-01

To evaluate the influence of dyes for caries detection on tensile bond strength of adhesive materials to artificial carious dentin. Buccal and lingual enamel of human molars were removed leaving intact dentin surfaces. The entire surface of each specimen was covered with nail varnish, keeping a window area of 4 x 4 mm. Artificial carious lesions were induced with acidified gel. Three dyes (0.5% basic fuchsin; Caries Finder and Cari-D-Tect) were used according to manufacturers' recommendations. Specimens were etched with 35% phosphoric acid for 20 s, washed and dried, leaving a wet dentin surface. The adhesive system (Prime & Bond 2.0) was applied in two layers and light-cured. Restorative materials (TPH Spectrum, Dyract, Advance) were bonded using a 3-mm diameter inverted-cone mold. Control groups were made without dye. Eight samples were tested for each group. After 24 hrs of storage in distilled water, the samples were debonded using a testing machine at 0.5 mm/min crosshead speed. ANOVA and Tukey-Kramer test showed that TPH Spectrum (0.73 MPa) and Dyract (0.74 MPa) had similar bond strengths, and both were higher than Advance (0.0 MPa), which was statistically different (P < 0.01). The use of the dyes did not cause any changes in tensile bond strength for any tested materials.

Non-surgical management methods of noncavitated carious lesions.

PubMed

Tellez, Marisol; Gomez, Juliana; Kaur, Sundeep; Pretty, Iain A; Ellwood, Roger; Ismail, Amid I

2013-02-01

To critically appraise all evidence related to the efficacy of nonsurgical caries preventive methods to arrest or reverse the progression of noncavitated carious lesions (NCCls). A detailed search of Medline (via OVID), Cochrane Collaboration, Scielo, and EMBASE identified 625 publications. After title and abstract review, 103 publications were selected for further review, and 29 were finally included. The final publications evaluated the following therapies: fluorides (F) in varying vehicles (toothpaste, gel, varnish, mouthrinse, and combination), chlorhexidine (CHX) alone or in combination with F, resin infiltration (I), sealants (S), xylitol (X) in varying vehicles (lozenges, gum, or in combination with F and/or xylitol), casein phosphopeptide amorphous calcium phosphate (CPP-ACP) or in combination with calcium fluoride phosphate. All included studies were randomized clinical trials, were conducted with human subjects and natural NCCls, and reported findings that can yield outcomes measures such as caries incidence/increments, percentage of progression and/or arrest, odds ratio progression test to control, fluorescence loss/mean values, changes in lesion area/volume and lesion depth. Data were extracted from the selected studies and checked for errors. The quality of the studies was evaluated by three different methods (ADA, Cochrane, author's consensus). Sample size for these trials ranged between 15 and 3903 subjects, with a duration between 2 weeks and 4.02 years. More than half of the trials assessed had moderate to high risk of bias or may be categorized as 'poor'. The great majority (65.5%) did not use intention to treat analysis, 21% did not use any blinding techniques, and 41% reported concealment allocation procedures. Slightly more than half of the trials (55%) factored in background exposure to other fluoride sources, and only 41% properly adjusted for potential confounders. Fluoride interventions (varnishes, gels, and toothpaste) seem to have the

Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions.

PubMed

Mohd Said, Siti N B; Ekambaram, Manikandan; Yiu, Cynthia K Y

2017-05-01

To compare remineralization potential of topical fluoride varnishes with added calcium phosphate-based delivery systems on artificial enamel caries. Human enamel specimens (n = 60) were randomly divided into six groups: Group 0: Control (no varnish), Group 1: Duraphat ® , Group 2: MI Varnish ™ , Group 3: Embrace ™ Varnish, Group 4: Enamel Pro ® Varnish, and Group 5: Clinpro ™ White Varnish. Specimens were immersed in demineralizing solution for 96 h to create artificial caries lesion. Each specimen was then immersed in artificial saliva for 6 h after fluoride varnish application and pH cycling was performed for 8 days. Specimens were evaluated using Knoop surface microhardness (KHN) and transverse microradiography (TMR). One-way anova test was performed to examine the effect of fluoride varnishes on change in percentage of surface hardness recovery (%SHR), change in lesion depth (ΔLD), and change in mineral loss (ΔΔZ) with the significance limit set at 5%. %SHR of enamel following treatment with Group 1 was significantly higher than Group 3 and Group 4. Conversely, ΔLD and ΔΔZ of Group 1 were significantly higher than Group 2, Group 3, and Group 4. No significant differences in %SHR, ΔLD, and ΔΔZ were found between Group 1 and Group 5. Duraphat ® alone achieves significant remineralization of enamel carious lesions. Clinpro ™ White Varnish had similar enamel remineralization effect as Duraphat ® . © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Microstructural features of carious human enamel imaged with back-scattered electrons.

PubMed

Pearce, E I; Nelson, D G

1989-02-01

We have used back-scattered electrons (BE) in the scanning electron microscope to produce mineral density images of enamel. Flat surfaces of artificially-carious enamel, softened in an intra-oral experiment, and naturally-carious (white spot) enamel were polished to a high gloss with diamond lapping compound, rendering them almost featureless by secondary electron scanning electron microscopy. They were then examined at 10 to 30 kV in a Philips 505 instrument fitted with a 4-quadrant BE detector. Study of surfaces prepared approximately parallel to the natural surface showed that mineral was lost from both prism core and the interprismatic region, leaving a thin mineral-rich rim at the prism periphery. The same lesions viewed longitudinally on a surface prepared perpendicular to the natural surface showed mineral-rich bands at the prism margins in the outer enamel. Near the advancing front of the lesion, the prism junctions were widened and the prism cores sometimes hypermineralized. Natural lesions sectioned in the prism long axis showed features previously seen with other techniques, e.g., cross-striations and striae of Retzius, but in much greater detail. Mineral enrichment at the prism periphery in the lesion body and a widening of the prism junction at the advancing fronts of lesions in permanent teeth were most obvious. Calculations showed that with an accelerating voltage of 30 kV, the images reflected mineral density up to 4 microns beneath the surface. BE microscopy produces a high-resolution image of mineral loss or gain in carious enamel, with relatively easy sample preparation.

Carious lesions and maize consumption among the Prehispanic Maya: an analysis of a coastal community in northern Yucatan.

PubMed

Cucina, Andrea; Cantillo, Cristina Perera; Sosa, Thelma Sierra; Tiesler, Vera

2011-08-01

Patterns of carious lesions were analyzed in the Classic period coastal Maya population of Xcambó, a salt production and administration center in northern Yucatan. To this end, the study investigated caries in the permanent dentitions of 163 adult skeletons, 23 from the Early Classic (AD 250-550) and 140 from the Late Classic period (AD 550-750), equally distributed between sexes. The archaeological and bioarchaeological evidence indicates a wealthy and socially homogeneous population dedicated to salt production and administration in the Early Classic that switched to pure administrative functions in the Late Classic. The results indicate an increase in caries from 7.4% and 21.2% (males and females respectively) from the Early Classic to 14.0% in males and 27.4% in females from the Late Classic period. The rate of caries in the Early and in the Late Classic phases of continuous occupation is not consistent with a simple interpretation of a heavier reliance on maize during the latter phase, characterized by a sedentary lifestyle, particularly for the male segment of the society now dedicated completely to the administration of the salt mines. Rather, the increase in caries rates in both sexes is best explained within a broader context of overall food habits, new cariogenic foods for both sexes, and the changes in lifestyle imposed by the increased socioeconomic role of the site. Our conclusions stress the limitations imposed by interpreting carious lesions solely in terms of single dietary components, such as maize consumption, without taking into account broader aspects of cultural and socioeconomic relevance. Copyright © 2011 Wiley-Liss, Inc.

Correlation of Streptococcus mutans and Streptococcus sanguinis colonization and ex vivo hydrogen peroxide production in carious lesion-free and high caries adults.

PubMed

Giacaman, Rodrigo A; Torres, Sebastián; Gómez, Yenifer; Muñoz-Sandoval, Cecilia; Kreth, Jens

2015-01-01

This study was conducted to estimate oral colonization by Streptococcus mutans and Streptococcus sanguinis in adults with high and without any caries experience. Furthermore, differences in the amount of hydrogen peroxide (H2O2) produced by S. sanguinis isolated from both groups were assessed. Forty adults were divided into: (i) carious lesion-free, without any carious lesion, assessed by the International Caries Detection and Assessment System (ICDAS), or restoration, (CF) and (ii) high caries experience (HC). Saliva samples were collected and seeded on respective agar-plates for enumeration of total streptococci, S. mutans and S. sanguinis (CFU/mL) and compared between groups. Additionally, S. sanguinis colonies obtained from both groups were inoculated on Prussian blue agar for H2O2 detection. Production of H2O2 was quantified and compared between the two groups. S. sanguinis counts were significantly higher in CF than HC individuals (p<0.05). Conversely, S. mutans showed significantly higher levels in HC than CF subjects (p<0.001). S. sanguinis colonies from CF individuals produced significantly larger H2O2 halos compared with HC subjects. S. sanguinis predominates over S. mutans in saliva of adults without caries experience. In those people, S. sanguinis produces more H2O2ex vivo. Copyright © 2014 Elsevier Ltd. All rights reserved.

White spots on enamel: treatment protocol by superficial or deep infiltration (part 2).

PubMed

Attal, Jean-Pierre; Atlan, Anthony; Denis, Maud; Vennat, Elsa; Tirlet, Gilles

2014-03-01

In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures. Copyright © 2014 CEO. Published by Elsevier Masson SAS. All rights reserved.

Diagnostic yield of ink-jet prints from digital radiographs for the assessment of approximal carious lesions: ROC-analysis.

PubMed

Schulze, Ralf K W; Grimm, Stefanie; Schulze, Dirk; Voss, Kai; Keller, Hans-Peter; Wedel, Matthias

2011-08-01

To investigate the diagnostic quality of different quality, individually calibrated ink-jet printers for the very challenging dental radiographic task of approximal carious lesion detection. A test-pattern evaluating resolution, contrast and homogeneity of the ink-jet prints was developed. 50 standardized dental radiographs each showing two neighbouring teeth in natural contact were printed on glossy paper with calibrated, randomly selected ink-jet printers (Canon S520 and iP4500, Epson Stylus Photo R2400). Printing size equalled the viewing size on a 17″ cathode-ray-tube monitor daily quality-tested according to German regulations. The true caries status was determined from serial sectioning and microscopic evaluation. 16 experienced observers evaluated the radiographs on a five-point confidence scale on all prints plus the viewing monitor with respect to the visibility of a carious lesion. A non-parametric Receiver-Operating Characteristics (ROC-) analysis was performed explicitly designed for the evaluation of readings stemming from identical samples but different modality. Significant differences are expressed by a critical ratio z exceeding ±2. Diagnostic accuracy was determined by the area (Az) underneath the ROC-curves. Average Az-values ranged between 0.62 (S520 and R2400) and 0.64 (monitor, iP4500), with no significant difference between modalities (P=0.172). Neither significant (range mean z: -0.40 (S520) and -0.11 (iP4500)) nor clinically relevant differences were found between printers and viewing monitor. Our results for a challenging task in dental radiography indicate that calibrated, off-the-shelf ink-jet printers are able to reproduce (dental) radiographs at quality levels sufficient for radiographic diagnosis in a typical dental working environment. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Performance of Universal Adhesive in Primary Molars After Selective Removal of Carious Tissue: An 18-Month Randomized Clinical Trial.

PubMed

Lenzi, Tathiane Larissa; Pires, Carine Weber; Soares, Fabio Zovico Maxnuck; Raggio, Daniela Prócida; Ardenghi, Thiago Machado; de Oliveira Rocha, Rachel

2017-09-15

To evaluate the 18-month clinical performance of a universal adhesive, applied under different adhesion strategies, after selective carious tissue removal in primary molars. Forty-four subjects (five to 10 years old) contributed with 90 primary molars presenting moderately deep dentin carious lesions on occlusal or occluso-proximal surfaces, which were randomly assigned following either self-etch or etch-and-rinse protocol of Scotchbond Universal Adhesive (3M ESPE). Resin composite was incrementally inserted for all restorations. Restorations were evaluated at one, six, 12, and 18 months using the modified United States Public Health Service criteria. Survival estimates for restorations' longevity were evaluated using the Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty to assess the factors associated with failures (P<0.05). Estimated survival rates of the restorations were 100 percent, 100 percent, 90.6 percent, and 81.4 percent at one, six, 12, and 18 months, respectively. The adhesion strategy did not influence the restorations' longevity (P=0.06; 72.2 percent and 89.7 percent with etch-and-rinse and self-etch mode, respectively). Self-etch and etch-and-rinse strategies did not influence the clinical behavior of universal adhesive used in primary molars after selective carious tissue removal; although there was a tendency for better outcome of the self-etch strategy.

Effect of resin infiltration and microabrasion on the microhardness, surface roughness and morphology of incipient carious lesions.

PubMed

Yazkan, Basak; Ermis, R Banu

2018-02-15

The effects of resin infiltration and microabrasion on incipient carious lesions by surface microhardness, roughness and morphological assessments, and resistance to further acid attack of treated lesions were evaluated. Eighty artificially-induced incipient lesions were randomly divided into five groups (n = 16): resin infiltration with an adhesive resin (Excite F, Ivoclar Vivadent, Schaan, Liechtenstein), resin infiltration with a resin infiltrant (Icon, DMG, Hamburg, Germany), microabrasion without polishing (Opalustre, Ultradent, South Jordan, UT, USA), microabrasion with polishing (Opalustre, Ultradent, Diamond Excel, FGM, Joinville, SC, Brazil), and distilled water (control group). All specimens were exposed to demineralization for another 10 d. Microhardness, roughness and morphological assessments were done at baseline, following initial demineralization, treatment and further demineralization. Data were analysed by the Kruskal-Wallis, Friedman's and Bonferroni tests (p < .05). Enamel lesions treated with resin infiltrant and microabrasion demonstrated similar hardness values, with a nonsignificant difference compared with sound enamel. Resin infiltration demonstrated lower roughness values than those of microabrasion, and the values did not reach the values of sound enamel. Further demineralization for 10 d did not affect the hardness but increased the roughness of infiltrated and microabraded enamel surfaces. Polishing did not influence the roughness of microabraded enamel surfaces. After resin infiltration, porosities on enamel were sealed completely. The surface structure was similar to that of the enamel conditioning pattern for microabraded enamel lesions. Within the limitations of this study, the icon infiltration and microabrasion technique appeared to be effective for improving microhardness. Icon appeared to provide reduced roughness, although not equal to sound enamel. Further research is needed to elucidate their clinical relevance.

Comparison of reflectance spectra of sound and carious enamel

NASA Astrophysics Data System (ADS)

Analoui, Mostafa; Ando, Masatoshi; Stookey, George K.

2000-03-01

Development of dental caries is associated with the loss of minerals and change in the enamel structure. In this study, we have measured and compared reflectance spectra of sound and carious enamel, to investigate its utility in detection and analysis of dental caries. One hundred twenty, 3-mm diameter human enamel cores, with no sign of fluorosis, tetracycline stain, hypoplasia, fracture and restorations, were prepared. The enamel surfaces then were ground and polished. Specimens were placed on a fitted holder with either black or white color for background, with no fluorescence. The baseline spectra were measured using a spectrophotometer with enclosed diffused illumination. Spectra measured from 380 to 780 nm at 5 nm intervals. All measurements were corrected to compensate for the spectrum of illumination. The specimens were divided into two groups and exposed to a demineralizing solution, for 48 and 96 hours, respectively. Reflectance spectra of specimens were measured following lesion induction. All specimens were sectioned and analyzed by transverse microradiography (TMR), where lesion depth and mineral loss ((Delta) Z) were measured. Dimensionality of multi-spectral data was reduced through its conversion to L*a*b* color coordinates and principal component analysis (PCA). Multiple linear regression analysis showed low correlation between L*a*b* and lesion depth and mineral loss. PCA analysis showed higher correlation coefficient, compared to L*a*b*. Preliminary results of this study suggest that multi-spectral measurement and analysis of the tooth surface could be useful in predicting the depth and severity of an early carious lesion.

Detection of intaoral lesions using a fluorescence camera

NASA Astrophysics Data System (ADS)

Thoms, Michael

2006-02-01

Optical methods for the detection of carious lesions, calculus and plaque have the advantage of being minimally invasive. The use of endogeneous fluorescence markers like porphyrins could simplify the application of fluorescence techniques in the dental practice. It is known that porphyrins are produced by some of the bacterial species that are present in the oral cavity. Since porphyrins have an excitation band at about 400nm they have the potential to be used as fluorescent markers of locations in the oral cavity where the production of bacteria is out of the limits of healthy regions. Further, modern and efficient GaN-based semiconductor diodes emit light in this spectral range and thus make the implementation of fluorescence sensors with excitation at this wavelength easy. Carious lesions, calculus and plaque have been measured using a self build fluorescence camera using GaN-diodes for illumination at 405nm. Further, emission spectra under this excitation were recorded. For the latter purpose freshly extracted teeth were used. It has been found that already in the case of an initial carious lesion red porphyrin-fluorescence is emitted whereas it is absent in healthy enamel. In already brown coloured carious lesions the emission bands of porphyrin are present but the observed overall fluorescence intensity is lower, probably due to the absorption of the fluorescence by the carious defect itself. In dental calculus, dental plaque and subgingival concrements porphyrin originated luminescence was found as well. Since in these cases the emission spectra differ slightly it can be concluded that they originate from different types of porphyrins and thus also from different bacteria. These results show that this fluorescence technique can be a promising method to diagnose carious lesions, calculus and plaque.

Laser treatments of deep-seated brain lesions

NASA Astrophysics Data System (ADS)

Ward, Helen A.

1997-06-01

The five year survival rate of deep-seated malignant brain tumors after surgery/radiotherapy is virtually 100 percent mortality. Special problems include: (1) Lesions often present late. (2) Position: lesion overlies vital structures, so complete surgical/radiotherapy lesion destruction can damage vital brain-stem functions. (3) Difficulty in differentiating normal brain form malignant lesions. This study aimed to use the unique properties of the laser: (a) to minimize damage during surgical removal of deep-seated brain lesions by operating via fine optic fibers; and (b) to employ the propensity of certain lasers for absorption of dyes and absorption and induction of fluorescence in some brain substances, to differentiate borders of malignant and normal brain, for more complete tumor removal. In the method a fine laser endoscopic technique was devised for removal of brain lesions. The results of this technique, were found to minimize and accurately predict the extent of thermal damage and shock waves to within 1-2mm of the surgical laser beam. Thereby it eliminated the 'popcorn' effect.

Effectiveness of fluoride sealant in the prevention of carious lesions around orthodontic brackets: an OCT evaluation

PubMed Central

Pithon, Matheus Melo; Santos, Mariana de Jesus; de Souza, Camilla Andrade; Leão, Jorge César Borges; Braz, Ana Karla Souza; de Araujo, Renato Evangelista; Tanaka, Orlando Motohiro; Oliveira, Dauro Douglas

2015-01-01

Abstract Objective: This article aimed to evaluate in vitro the efficiency of Pro Seal fluoride sealant application in the prevention of white spot lesions around orthodontic brackets. Material and Methods: Brackets were bonded to the buccal surface of bovine incisors, and five groups were formed (n = 15) according to the exposure of teeth to oral hygiene substances and the application of enamel sealant: G1 (control), only brushing was performed with 1.450 ppm fluoride; G2 (control) brushing associated with the use of mouthwash with 225 ppm fluoride; G3, only Pro Seal sealant application was performed with 1.000 ppm fluoride; G4 Pro Seal associated with brushing; G5 Pro Seal associated with brushing and mouthwash. Experimental groups alternated between pH cycling and the procedures described. All specimens were kept at a temperature of 37 °C throughout the entire experiment. Both brushing and immersion in solutions were performed within a time interval of one minute, followed by washing in deionized water three times a day for 28 days. Afterwards, an evaluation by Optical Coherence Tomography (OCT) of the spectral type was performed. In each group, a scanning exam of the white spot lesion area (around the sites where brackets were bonded) and depth measurement of carious lesions were performed. Analysis of variance (ANOVA) was applied to determine whether there were significant differences among groups. For post hoc analysis, Tukey test was used. Results: There was statistically significant difference between groups 1 and 2 (p = 0.003), 1 and 3 (p = 0.008), 1 and 4 (p = 0.000) and 1 and 5 (p = 0.000). The group in which only brushing was performed (Group 1) showed deeper enamel lesion. Conclusion: Pro Seal sealant alone or combined with brushing and/or brushing and the use of a mouthwash with fluoride was more effective in protecting enamel, in comparison to brushing alone. PMID:26691968

The prevalence and severity of non-carious cervical lesions in a group of patients attending a university hospital in Trinidad.

PubMed

Smith, W A J; Marchan, S; Rafeek, R N

2008-02-01

Non-carious cervical lesions (NCCLs) are often encountered in clinical practice and their aetiology attributed to toothbrush abrasion, erosion and tooth flexure. This paper aims to determine the prevalence and severity of NCCLs in a sample of patients attending a university clinic in Trinidad and to investigate the relationship with medical and dental histories, oral hygiene practices, dietary habits and occlusion. Data were collected via a questionnaire and clinical examination. Odds ratios were used to determine the association of the presence of lesions and the factors examined. One hundred and fifty-six patients with a mean age of 40.6 years were examined of whom 62.2% had one or more NCCLs. Forty five per cent of the lesions were sensitive to compressed air. Younger age groups had a significantly lower correlation with the presence of NCCLs than older age groups. Other significant factors included patients who reported heartburn, gastric reflux, headaches, bruxism, sensitive teeth and swimming or had a history of broken restorations in the last year. There was also significant correlation of NCCLs in patients who brushed more than once a day or used a medium or hard toothbrush. Patients with vegetarian diets and those who reported consuming citrus fruits, soft drinks, alcohol, yoghurt and vitamin C drinks were associated with the presence of lesions. Significant associations were also found in patients with group function, faceting, clicking joints or those who wore occlusal splints.

First-time isolation of Candida dubliniensis from plaque and carious dentine of primary teeth.

PubMed

Kneist, S; Borutta, A; Sigusch, B W; Nietzsche, S; Küpper, H; Kostrzewa, M; Callaway, A

2015-08-01

To determine those organisms of the genus Candida associated with dental caries by investigating samples from active carious lesions. Within the genus Candida, the species Candida albicans and Candida dubliniensis are capable of forming chlamydospores and germ tubes. Until it became possible in 1995 to differentiate between the two species taxonomically, C. dubliniensis was falsely identified as C. albicans. Whilst the importance of C. albicans for rapidly progressing early childhood caries (ECC) has been recognised, so far there have been only reports about C. dubliniensis in connection with children/mothers who have been infected with HIV or already developed AIDS. In the present study, C. dubliniensis was for the first time isolated from plaque and carious dentine of a healthy five-year-old boy. As part of the investigation, a number of samples were collected from individual children affected by active dental caries. Amongst the samples, one in particular indicated that Candida species might be involved. The patient was a five-year-old boy with ECC of the primary dentition, scheduled for restorative treatment under general anaesthesia. Before treatment, a salivary, plaque (region of 54/55) and soft carious dentine sample from the tooth 51 was taken before extraction. The counts of yeasts, lactobacilli (LB) and mutans streptococci were determined in the samples. The boy's dmft was 11, which was dominated by the d component. In the saliva of the boy, LB and mutans streptococci (MS) were detected. In plaque and carious dentine, MS and most interestingly C. dubliniensis were present. The yeasts were visualised in carious dentine by means of scanning electron micrographs. Plaque and carious dentine may be a further habitat of C. dubliniensis.

Microbiological Evaluation of Ozone on Dentinal Lesions in Young Permanent Molars using the Stepwise Excavation.

PubMed

Safwat, Osama; Elkateb, Mona; Dowidar, Karin; Salam, Hala Abdel; El Meligy, Omar

To assess the microbial effect of ozone gas on dentinal lesions in young permanent molars using the stepwise excavation. An experimental, controlled clinical trial was performed. The sample included 80 immature first permanent molars, showing deep occlusal carious cavities that were indicated for stepwise excavation. Following first step of dentin excavation, the sample was divided into test (ozone gas) and control (calcium hydroxide (Ca(OH) 2 ) base material) groups. One half of the cases in each group were evaluated for microbiological changes after 6 months, and the other half after 12 months. Mutans streptococci (MS), Lactobacilli, and Candida counts were significantly reduced immediately after ozone application in the test group (P ≤0.05). At the final assessment period, MS and Lactobacilli were significantly reduced in the test group (P ≤0.05). Meanwhile, the Candida counts were significantly reduced only in the test group of the 6 and 12 month-cases (P ≤0.05). Regarding the control group, the significant reduction in microbial count was observed with MS after 6 and 12 months (P ≤0.05). No significant differences were observed between test and control groups at different evaluation periods (P >0.05). Ozone gas had a significant antimicrobial effect in deep class I carious lesions.

Proteomic Analysis of Mesenchymal Stem Cells from Normal and Deep Carious Dental Pulp

PubMed Central

Gao, Jie; Yan, Wenjuan; Liu, Ying; Xu, Shuaimei; Wu, Buling

2014-01-01

Dental pulp stem cells (DPSCs), precursor cells of odontoblasts, are ideal seed cells for tooth tissue engineering and regeneration. Our previous study has demonstrated that stem cells exist in dental pulp with deep caries and are called carious dental pulp stem cells (CDPSCs). The results indicated that CDPSCs had a higher proliferative and stronger osteogenic differentiation potential than DPSCs. However, the molecular mechanisms responsible for the biological differences between DPSCs and CDPSCs are poorly understood. The aim of this study was to define the molecular features of DPSCs and CDPSCs by comparing the proteomic profiles using two-dimensional fluorescence difference gel electrophoresis (2-D DIGE) in combination with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Our results revealed that there were 18 protein spots differentially expressed between DPSCs and CDPSCs in a narrow pH range of 4 to 7. These differently expressed proteins are mostly involved in the regulation of cell proliferation, differentiation, cell cytoskeleton and motility. In addition, our results suggested that CDPSCs had a higher expression of antioxidative proteins that might protect CDPSCs from oxidative stress. This study explores some potential proteins responsible for the biological differences between DPSCs and CDPSCs and expands our understanding on the molecular mechanisms of mineralization of DPSCs in the formation of the dentin-pulp complex. PMID:24809979

Antimicrobial Photodynamic Therapy as an Adjunct for Clinical Partial Removal of Deciduous Carious Tissue: A Minimally Invasive Approach.

PubMed

Ornellas, Pâmela O; Antunes, Leonardo S; Motta, Paula C; Mendonça, Caroline; Póvoa, Helvécio; Fontes, Karla; Iorio, Natalia; Antunes, Lívia A A

2018-06-20

This study aimed to evaluate the use of antimicrobial photodynamic therapy (aPDT) as an adjunct for minimally invasive treatment (partial removal of carious tissue - PRCT) of deciduous carious tissue evaluating its efficacy in reducing microorganisms. For that, a clinical study was design including children with deciduous molars with active deep caries lesions (DCL). PRCT was performed and remaining dentin was treated with 100 μg/mL methylene blue solution (5 min) and than irradiated with a low power laser emitting red light (InGaAIP - indium gallium aluminum phosphide; λ = 660nm; 100mW; 300 J/cm²; 90s; 9J). The colony forming units (CFU) count after PRCT and after PRCT + aPDT/mg of dentin were compared for total microorganisms, including Candida spp., the mutans streptococci group, Streptococcus spp. and Lactobacillus spp. The dentin was classified (color, consistency and humidity). The microbial reduction varied from 69.88% to 86.29% and was significantly observed for total microorganisms, mutans streptococci, Streptococcus spp. and Lactobacillus spp (p<0.001). The dentin type did not influence reduction of microorganisms (p>0.05). The aPDT presents a promising future for clinical use as an adjunct for the reduction of microorganisms in PRCT of DCL in all kinds of dentin. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network

PubMed Central

2018-01-01

Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1), lesion dermoscopic feature extraction (task 2) and lesion classification (task 3). A deep learning framework consisting of two fully convolutional residual networks (FCRN) is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU) is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved. PMID:29439500

Skin Lesion Analysis towards Melanoma Detection Using Deep Learning Network.

PubMed

Li, Yuexiang; Shen, Linlin

2018-02-11

Skin lesions are a severe disease globally. Early detection of melanoma in dermoscopy images significantly increases the survival rate. However, the accurate recognition of melanoma is extremely challenging due to the following reasons: low contrast between lesions and skin, visual similarity between melanoma and non-melanoma lesions, etc. Hence, reliable automatic detection of skin tumors is very useful to increase the accuracy and efficiency of pathologists. In this paper, we proposed two deep learning methods to address three main tasks emerging in the area of skin lesion image processing, i.e., lesion segmentation (task 1), lesion dermoscopic feature extraction (task 2) and lesion classification (task 3). A deep learning framework consisting of two fully convolutional residual networks (FCRN) is proposed to simultaneously produce the segmentation result and the coarse classification result. A lesion index calculation unit (LICU) is developed to refine the coarse classification results by calculating the distance heat-map. A straight-forward CNN is proposed for the dermoscopic feature extraction task. The proposed deep learning frameworks were evaluated on the ISIC 2017 dataset. Experimental results show the promising accuracies of our frameworks, i.e., 0.753 for task 1, 0.848 for task 2 and 0.912 for task 3 were achieved.

Guided fluorescence diagnosis of childhood caries: preliminary measures correlate with depth of carious decay

NASA Astrophysics Data System (ADS)

Timoshchuk, Mari-Alina; Zhang, Liang; Dickinson, Brian A.; Ridge, Jeremy S.; Kim, Amy S.; Baltuck, Camille T.; Nelson, Leonard Y.; Berg, Joel H.; Seibel, Eric J.

2014-02-01

The current rise in childhood caries worldwide has increased the demand for portable technologies that can quickly and accurately detect and diagnose early stage carious lesions. These lesions, if identified at an early stage, can be reversed with remineralization treatments, education, and improvements in home care. A multi-modal optical prototype for detecting and diagnosing occlusal caries demineralization in vivo has been developed and pilot tested. The device uses a 405-nm laser as a scanned illumination source to obtain high resolution and high surface contrast reflectance images, which allows the user to quickly image and screen for any signs of demineralized enamel. When a suspicious region is located, the device can be switched to perform dual laser fluorescence spectroscopy using 405-nm and 532-nm laser excitations. These spectra are used to compute an auto-fluorescence (AF) ratio of the suspicious region and the percent difference of AF ratios from a healthy region of the same tooth. The device was tested on 7 children's teeth in vivo with clinically diagnosed carious lesions. Lesion depth was then visually estimated from the video image using the 405-nm scanned light source, and within a month the maximum drill depth was assessed by a clinician. The researcher and clinicians were masked from previous measurements in a blinded study protocol. Preliminary results show that the ratiometric percent difference measurement of the AF spectrum of the tooth correlates with the severity of the demineralization as assessed by the clinician after drilling.

Large deep neural networks for MS lesion segmentation

NASA Astrophysics Data System (ADS)

Prieto, Juan C.; Cavallari, Michele; Palotai, Miklos; Morales Pinzon, Alfredo; Egorova, Svetlana; Styner, Martin; Guttmann, Charles R. G.

2017-02-01

Multiple sclerosis (MS) is a multi-factorial autoimmune disorder, characterized by spatial and temporal dissemination of brain lesions that are visible in T2-weighted and Proton Density (PD) MRI. Assessment of lesion burden and is useful for monitoring the course of the disease, and assessing correlates of clinical outcomes. Although there are established semi-automated methods to measure lesion volume, most of them require human interaction and editing, which are time consuming and limits the ability to analyze large sets of data with high accuracy. The primary objective of this work is to improve existing segmentation algorithms and accelerate the time consuming operation of identifying and validating MS lesions. In this paper, a Deep Neural Network for MS Lesion Segmentation is implemented. The MS lesion samples are extracted from the Partners Comprehensive Longitudinal Investigation of Multiple Sclerosis (CLIMB) study. A set of 900 subjects with T2, PD and a manually corrected label map images were used to train a Deep Neural Network and identify MS lesions. Initial tests using this network achieved a 90% accuracy rate. A secondary goal was to enable this data repository for big data analysis by using this algorithm to segment the remaining cases available in the CLIMB repository.

Depth and activity of carious lesions as indicators for the regenerative potential of dental pulp after intervention.

PubMed

Bjørndal, Lars; Demant, Sune; Dabelsteen, Sally

2014-04-01

Studies on dental regeneration involving interventions for pulp therapy such as regeneration and revascularization procedures are promising for the injured tooth; however, a complete replication of the original pulp tissue does not seem to take place. In cases in which we wish to preserve or maintain parts of the pulp during treatment, it is apparent that the effectiveness of healing or biological regeneration is dependent on the degree of inflammation of the pulp tissue. Thus, the control or prevention of a pulp infection is still a major issue for the clinicians. Data indicate that the typical reason for performing endodontic treatment is deep caries. The biological concept of vital pulp therapy associated with deep caries takes the treatment and evaluation of the unexposed as well as the exposed pulp into account. Interestingly, the clinical diagnosis is typically the same. Deep caries with reversible pulpitis may receive differing treatments such as excavation procedures aiming to avoid pulp exposure or more pulp invasive treatments such as pulp capping or pulpotomy. This should not be the case. Consequently, huge treatment variation is noted among clinicians based on the same caries diagnosis. Which treatment should be selected? High-quality trials are needed, and it is important to obtain information on the actual lesion depth and an estimate of the lesion activity before treatment. These may be basic indicators for the regenerative potential of dental pulp. Recent clinical trials dealing with the treatment of deep caries lesion are discussed, including pulp invasive and noninvasive concepts, to attempt to solve the task of getting the best clinical outcome for adult patients. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

In Vivo Effect of Calcium Hydroxide and Resin-modified Glass Ionomer Cement on Carious Dentin in Young Permanent Molars: An Ultrastructural and Macroscopic Study.

PubMed

Opal, Shireen; Garg, Shalini; Sharma, Deepak; Dhindsa, Abhishek; Jatana, Isha

2017-01-15

The purpose of this study was to evaluate macroscopically and ultrastructurally the effect of calcium hydroxide cement (CH) and resin-modified glass ionomer cement (RMGIC) compared with gutta percha (control) as a lining material on carious dentin after partial caries removal and sealing. Twenty-seven permanent molars with deep carious lesions underwent partial caries removal with the application of CH, RMGIC, or gutta percha (control) and were then sealed for three months. After a partial caries removal and sealing period, the dentin was macroscopically assessed (for color, consistency, and humidity) and further analyzed by scanning electron microscope to assess the ultrastructural changes in dentin (lumen size, mineralization of tubules, occlusion of tubules by cements, and bacterial ingress). The effect of treatment in each group was statistically analyzed. Dentin darkening and hardening were observed after the sealing period in all groups. However, there was no difference in the color after treatment among the three groups. It was observed that RMGIC showed a significant reduction in the size of the lumen compared to CH and the control. Partial caries removal and sealing resulted in dentin hardening, darkening, and dentin remineralization, irrespective of the dentin protection used.

[Preventive and remineralization effect over incipient lesions of caries decay by phosphopeptide-amorphous calcium phosphate].

PubMed

Juárez-López, María Lilia Adriana; Hernández-Palacios, Rosa Diana; Hernández-Guerrero, Juan Carlos; Jiménez-Farfán, Dolores; Molina-Frechero, Nelly

2014-01-01

INTRODUCTION. Dental caries continues to affect a large percentage of Mexican children and currently advises that if diagnosed at an early stage can be reversed with minimally invasive treatments. The casein phosphopeptide amorphous calcium phosphate known as CPP-ACP is a phosphoprotein capable of releasing calcium and phosphate ions in the oral environment promoting remineralization. OBJECTIVE. To evaluate the effect of CPP-ACP with fluoride added in a scholar preventive program. MATERIAL AND METHODS. A cuasi- experimental study was conducted in 104 schools of six years old. The children were classified into three groups and received six months biweekly applications of different treatments: casein phosphopeptide amorphous calcium phosphate added fluoride (CPP-ACPF), sodium fluoride (NaF) and a control group. Clinical evaluation was performed with the laser fluorescence technique (Diagnodent model 2095). 1340 teeth were included: 294 teeth with incipient lesions and 1,046 healthy teeth. Statistical tests of χ2 y Mc Nemar were used. RESULTS. In the group that received the application of CPP-ACPF, 38% of incipient carious lesions were remineralizing compared with 21% in the group receiving the NaF (p < 0.001) and 15% in the control group (p < 0.0001) The percentage of teeth free of caries were preserved in the therapy group phosphoprotein was the biggest. This group also showed the lower proportion of deep carious lesion development (p < 0.0001). CONCLUSION. The application biweekly for six months of CPP-ACPF showed a protective and remineralizing effect on incipient carious lesions. His action was better than the application of NaF. However, to reduce the impact from dental caries in schoolchildren is important to have a comprehensive preventive approach that includes promoting self-care, as well as the application of sealants.

Near-IR multi-modal imaging of natural occlusal lesions

NASA Astrophysics Data System (ADS)

Lee, Dustin; Fried, Daniel; Darling, Cynthia L.

2009-02-01

Reflectance and transillumination imaging show demineralization with high contrast in the near-IR. The objective of this study is to use lesion size and contrast acquired in reflectance and transillumination near-infrared imaging modes to estimate the severity of natural occlusal caries lesions. Previous studies have shown that near-infrared (NIR) light can be used to effectively image artificial carious lesions. However, its efficacy on natural lesions requires further exploration. Fifty extracted teeth with varying amounts of occlusal decay were examined using a NIR imaging system operating at 1310-nm. Image analysis software was used to calculate contrast values between sound and carious tooth structure. After imaging, teeth were histologically sampled at 1-mm intervals in order to determine lesion depth. Lesion contrast in transillumination mode significantly increased with lesion depth (p<0.001), while lesion contrast in reflectance mode did not increase. The lesion area demonstrated a significant increase with lesion severity in both imaging modes. These results suggest that lesion contrast and area can be used to estimate lesion severity in NIR images.

Efficacy of removal of cariogenic bacteria and carious dentin by ablation using different modes of Er:YAG lasers

PubMed Central

Baraba, A.; Kqiku, L.; Gabrić, D.; Verzak, Ž.; Hanscho, K.; Miletić, I.

2018-01-01

The primary objective of this in vitro study was to evaluate the efficiency of removal of cariogenic bacteria and carious dentin by ablation using two lasers: fluorescence-feedback controlled (FFC) Er:YAG laser and different pulses of Er:YAG laser based on variable square pulse technology (VSPt). The secondary objective was to measure the temperature during laser ablation of carious tissue. Seventy-two extracted human molars were used in this study. Sixty teeth with carious dentin were randomly divided into four experimental groups according to the treatment for caries removal: group 1: 400 µs (FFC group); group 2: super short pulse (SSP group, 50 µs pulse); group 3: medium short pulse (MSP group, 100 µs pulse); group 4: short pulse (SP group, 300 µs pulse) and one positive control group with no treatment. Twelve teeth without carious lesion were used as a negative control group. After caries removal, swabs were taken with cotton pellets and real-time PCR analysis was performed. During caries ablation, a thermal infrared camera was used to measure the temperature changes. In all experimental groups, specimens were free of bacterial contamination after the treatment. In the SSP, MSP and SP groups, temperatures measured during caries ablation were significantly higher compared to temperatures in the FFC group (P<0.001). In this in vitro study, laser treatment for removal of carious dentin and cariogenic bacteria was an efficient treatment modality without causing excessive temperatures that might adversely affect pulp vitality. PMID:29340524

Efficacy of removal of cariogenic bacteria and carious dentin by ablation using different modes of Er:YAG lasers.

PubMed

Baraba, A; Kqiku, L; Gabrić, D; Verzak, Ž; Hanscho, K; Miletić, I

2018-01-11

The primary objective of this in vitro study was to evaluate the efficiency of removal of cariogenic bacteria and carious dentin by ablation using two lasers: fluorescence-feedback controlled (FFC) Er:YAG laser and different pulses of Er:YAG laser based on variable square pulse technology (VSPt). The secondary objective was to measure the temperature during laser ablation of carious tissue. Seventy-two extracted human molars were used in this study. Sixty teeth with carious dentin were randomly divided into four experimental groups according to the treatment for caries removal: group 1: 400 µs (FFC group); group 2: super short pulse (SSP group, 50 µs pulse); group 3: medium short pulse (MSP group, 100 µs pulse); group 4: short pulse (SP group, 300 µs pulse) and one positive control group with no treatment. Twelve teeth without carious lesion were used as a negative control group. After caries removal, swabs were taken with cotton pellets and real-time PCR analysis was performed. During caries ablation, a thermal infrared camera was used to measure the temperature changes. In all experimental groups, specimens were free of bacterial contamination after the treatment. In the SSP, MSP and SP groups, temperatures measured during caries ablation were significantly higher compared to temperatures in the FFC group (P<0.001). In this in vitro study, laser treatment for removal of carious dentin and cariogenic bacteria was an efficient treatment modality without causing excessive temperatures that might adversely affect pulp vitality.

Clinical Evaluation of Ozone on Dentinal Lesions in Young Permanent Molars using the Stepwise Excavation.

PubMed

Safwat, Osama; Elkateb, Mona; Dowidar, Karin; El Meligy, Omar

To evaluate the clinical changes in dentin of deep carious lesions in young permanent molars, following ozone application with and without the use of a remineralizing solution, using the stepwise excavation. The sample included 162 first permanent immature molars, showing deep occlusal carious cavities that were indicated for indirect pulp capping. Teeth were divided into 2 main groups according to the method of ozone treatment. Each group was further subdivided equally into test and control subgroups. Following caries excavation, color, consistency and DIAGNOdent assessments of dentin were evaluated after 6 and 12 months. Regarding dentin color and consistency, no significant differences were observed following ozone application, with and without a remineralizing solution. There were no significant differences between ozone treatment, and calcium hydroxide during the different evaluation periods, except in group I cases after 6 months, concerning the dentin color. The DIAGNOdent values were significantly reduced following ozone application, with or without a remineralizing solution, as well as between test and control cases in group I after 6 months. Ozone application through the stepwise excavation had no significant effect on dentin color and consistency in young permanent molars. DIAGNOdent was unreliable in monitoring caries activity.

Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing.

PubMed

Heasman, Peter A; Holliday, Richard; Bryant, Andrew; Preshaw, Philip M

2015-04-01

To identify the best available evidence for the effect of toothbrushing on the initiation and progression of gingival recession and non-carious cervical lesions (NCCLs). A protocol was developed for the questions: Does traumatic toothbrushing, compared to normal toothbrushing, lead to an increased prevalence of non-inflammatory gingival recession? [FQ1] and NCCLs? [FQ2]. The search covered four electronic databases. Bibliographies of review articles, relevant texts, World and European Workshops were screened. Hand searches were performed of the Journals of Clinical Periodontology, Periodontology, Periodontal Research and IADR abstracts. A meta-analysis included 159 subjects and showed that subjects who used MTBs (manual toothbrush) had greater gingival recession after 12 months when compared with those using PTBs (powered toothbrush). Thirteen cross-sectional studies identified the most frequent toothbrushing factors associated with gingival recession as being toothbrushing frequency, a horizontal or scrub toothbrushing method, bristle hardness, toothbrushing duration and the frequency of changing a toothbrush. The principal toothbrushing factors associated with NCCLs were toothbrushing method and frequency. The data to support or refute the association between toothbrushing and gingival recession and NCCLs remain largely inconclusive. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Atraumatic Restorative Treatment: Restorative Component.

PubMed

Leal, Soraya; Bonifacio, Clarissa; Raggio, Daniela; Frencken, Jo

2018-01-01

Atraumatic restorative treatment (ART) is a method of managing dental caries based on 2 pillars: sealants for preventing carious lesions in pits and fissures, and restorations for cavitated dentine carious lesions. ART uses only hand instruments for opening/enlarging the cavity and for removing carious tissue. The amount of carious tissue that should be removed depends mainly on the cavity depth. In cavities of shallow and medium depth, carious tissue is removed up to firm dentine. In deep/very deep cavities, in which there is no sign of pulp exposure, pulp inflammation and/or history of spontaneous pain, some soft dentine can be left in the pulpal floor/wall with the aim of avoiding pulp exposure. The ART restorative method is indicated for treating single-surface cavities in primary and permanent teeth, and in multiple-surface cavities in primary teeth. Insufficient information is available to conclude on its use for treating multiple-surface cavities in permanent teeth. © 2018 S. Karger AG, Basel.

Environmental lead pollution and its possible influence on tooth loss and hard dental tissue lesions.

PubMed

Cenić-Milosević, Desanka; Mileusnić, Ivan; Kolak, Veljko; Pejanović, Djordje; Ristić, Tamara; Jakovljević, Ankica; Popović, Milica; Pesić, Dragana; Melih, Irena

2013-08-01

Environmental lead (Pb) pollution is a global problem. Hard dental tissue is capable of accumulating lead and other hard metals from the environment. The aim of this study was to investigate any correlation between the concentration of lead in teeth extracted from inhabitants of Pancevo and Belgrade, Serbia, belonging to different age groups and occurrence of tooth loss, caries and non-carious lesions. A total of 160 volunteers were chosen consecutively from Pancevo (the experimental group) and Belgrade (the control group) and divided into 5 age subgroups of 32 subjects each. Clinical examination consisted of caries and hard dental tissue diagnostics. The Decayed Missing Filled Teeth (DMFT) Index and Significant Caries Index were calculated. Extracted teeth were freed of any organic residue by UV digestion and subjected to voltammetric analysis for the content of lead. The average DMFT scores in Pancevo (20.41) were higher than in Belgrade (16.52); in the patients aged 31-40 and 41-50 years the difference was significant (p < 0.05) and highly significant in the patients aged 51-60 (23.69 vs 18.5, p < 0.01). Non-carious lesions were diagnosed in 71 (44%) patients from Pancevo and 39 (24%) patients from Belgrade. The concentrations of Pb in extracted teeth in all the groups from Pancevo were statistically significantly (p < 0.05) higher than in all the groups from Belgrade. In the patients from Pancevo correlations between Pb concentration in extracted teeth and the number of extracted teeth, the number of carious lesions and the number of non-carious lesions showed a statistical significance (p < 0.001, p < 0.01 andp < 0.001, respectively). According to correlations between lead concentration and the number of extracted teeth, number of carious lesions and non-carious lesions found in the patients living in Pancevo, one possible cause of tooth loss and hard dental tissue damage could be a long-term environmental exposure to lead.

Heat Shock70 Protein Genes and Genetic Susceptibility to Apical Periodontitis

PubMed Central

Maheshwari, Kanwal; Silva, Renato M.; Guajardo-Morales, Leticia; Garlet, Gustavo P.; Vieira, Alexandre R.; Letra, Ariadne

2016-01-01

Introduction Heat shock proteins (HSP) protect cells under adverse conditions such as infection, inflammation, and disease. The differential expression of HSPs in human periapical granulomas suggests a potential role for these proteins in periapical lesion development, which may contribute to different clinical outcomes. Therefore, we hypothesize that polymorphisms in HSP genes leading to perturbed gene expression and protein function may contribute to an individual’s susceptibility to periapical lesion development. Methods Subjects with deep carious lesions, with or without periapical lesions (≥ 3 mm) were recruited at the University of Texas School of Dentistry at Houston and at the University of Pittsburgh. Genomic DNA samples of 400 patients were sorted into 2 groups: 183 cases with deep carious lesions and periapical lesions (cases), and 217 cases with deep carious lesions but without periapical lesions (controls). Eight single nucleotide polymorphisms in HSPA4, HSPA6, HSPA1L, HSPA4L and HSPA9 genes were selected for genotyping. Genotypes were generated by endpoint analysis using Taqman chemistry in a real-time polymerase chain reaction assay. Allele and genotype frequencies were compared among cases and controls using chi-square and Fisher Exact tests as implemented in PLINK v.1.07. In silico analysis of SNP function was performed using Polymorphism Phenotyping V2 and MirSNP softwares. Results Overall, SNPs in HSPA1L and HSPA6 showed significant allelic association with cases of deep caries and periapical lesions (P<0.05). We also observed altered transmission of HSPA1L SNP haplotypes (P=0.03). In silico analysis of HSPA1L rs2075800 function showed that this SNP results in a glutamine to lysine substitution at position 602 of the protein and might affect the stability and function of the final protein. Conclusions Variations in HSPA1L and HSPA6 may be associated with periapical lesion formation in individuals with untreated deep carious lesions. Future

Carious Dentine Provides a Habitat for a Complex Array of Novel Prevotella-Like Bacteria

PubMed Central

Nadkarni, Mangala A.; Caldon, C. Elizabeth; Chhour, Kim-Ly; Fisher, Ilana P.; Martin, F. Elizabeth; Jacques, Nicholas A.; Hunter, Neil

2004-01-01

Previous analysis of the microbiology of advanced caries by culture and real-time PCR emphasized the high incidence and abundance of gram-negative anaerobic species, particularly Prevotella-like bacteria. The diversity of Prevotella-like bacteria was further explored by analyzing pooled bacterial DNA from lesions of carious dentine. This was achieved by amplification of a region of the 16S ribosomal DNA with a Prevotella genus-specific forward primer and a universal bacterial reverse primer, followed by cloning and sequencing. Cultured Prevotella species commonly associated with oral tissues constituted only 12% of the Prevotella clones isolated from advanced carious lesions. The remaining 88% consisted of a diverse range of phylotypes. These included five clusters of previously recognized but uncultured oral Prevotella spp. and a major cluster containing Prevotella-like bacteria most closely related to uncharacterized rumen bacteria. Cluster-specific primers were designed, and the numbers of bacteria within clusters were quantified by real-time PCR, confirming the abundance of these organisms. The data indicated that advanced dental caries provides a unique environment for a complex array of novel and uncultured Prevotella and Prevotella-like bacteria which, in some cases, may dominate the diverse polymicrobial community associated with the disease. PMID:15528720

The management of deep-seated, lowgrade lipomatous lesions.

PubMed

Al-Ani, Zeid; Fernando, Malee; Wilkinson, Victoria; Kotnis, Nikhil

2018-06-01

Deep-seated, low-grade lipomatous lesions detected on imaging often cause uncertainty for diagnosis and treatment. Confidently distinguishing lipomas from well-differentiated liposarcomas is often not possible on imaging. The approach to management of such lesions varies widely between institutions. Applying an evidenced-based approach set around published literature that clearly highlights how criteria such as lesion size, location, age and imaging features can be used to predict the risk of well-differentiated liposarcomas and subsequent de-differentiation would seem sensible. Our aim is to review the literature and produce a unified, evidence-based guideline that will be a useful tool for managing these lesions.

One-step partial or complete caries removal and bonding with antibacterial or traditional self-etch adhesives: study protocol for a randomized controlled trial.

PubMed

Villat, Cyril; Attal, Jean-Pierre; Brulat, Nathalie; Decup, Franck; Doméjean, Sophie; Dursun, Elisabeth; Fron-Chabouis, Hélène; Jacquot, Bruno; Muller Bolla, Michèle; Plasse-Pradelle, Nelly; Roche, Laurent; Maucort-Boulch, Delphine; Nony, Patrice; Gritsch, Kerstin; Millet, Pierre; Gueyffier, François; Grosgogeat, Brigitte

2016-08-15

Current concepts in conservative dentistry advocate minimally invasive dentistry and pulp vitality preservation. Moreover, complete removal of carious dentin in deep carious lesions often leads to pulp exposure and root canal treatment, despite the absence of irreversible pulp inflammation. For years, partial caries removal has been performed on primary teeth, but little evidence supports its effectiveness for permanent teeth. Furthermore, the recent development of new antibacterial adhesive systems could be interesting in the treatment of such lesions. The objectives of this study are to compare the effectiveness of partial versus complete carious dentin removal in deep lesions (primary objective) and the use of an antibacterial versus a traditional two-step self-etch adhesive system (main secondary objective). The DEep CAries Treatment (DECAT) study protocol is a multicenter, randomized, controlled superiority trial comparing partial versus complete caries removal followed by adhesive restoration. The minimum sample size required is 464 patients. Two successive randomizations will be performed (allocation ratio 1:1): the first for the type of excavation (partial versus complete) and the second (if no root canal treatment is required) for the type of adhesive (antibacterial versus traditional). For the two objectives, the outcome is the success of the treatment after 1 year, measured according to a composite outcome of five FDI criteria: material fracture and retention, marginal adaptation, radiographic examination (including apical pathologies), postoperative sensitivity and tooth vitality, and carious lesion recurrence. The study will investigate the interest of a conservative approach for the management of deep carious lesions in terms of dentin excavation and bioactive adhesive systems. The results may help practitioners achieve the most efficient restorative procedure to maintain pulp vitality and increase the restoration longevity. Clinical

Lesion Detection in CT Images Using Deep Learning Semantic Segmentation Technique

NASA Astrophysics Data System (ADS)

Kalinovsky, A.; Liauchuk, V.; Tarasau, A.

2017-05-01

In this paper, the problem of automatic detection of tuberculosis lesion on 3D lung CT images is considered as a benchmark for testing out algorithms based on a modern concept of Deep Learning. For training and testing of the algorithms a domestic dataset of 338 3D CT scans of tuberculosis patients with manually labelled lesions was used. The algorithms which are based on using Deep Convolutional Networks were implemented and applied in three different ways including slice-wise lesion detection in 2D images using semantic segmentation, slice-wise lesion detection in 2D images using sliding window technique as well as straightforward detection of lesions via semantic segmentation in whole 3D CT scans. The algorithms demonstrate superior performance compared to algorithms based on conventional image analysis methods.

Neonatal deep white matter venous infarction and liquefaction: a pseudo-abscess lesion.

PubMed

Ruess, Lynne; Dent, Carly M; Tiarks, Hailey J; Yoshida, Michelle A; Rusin, Jerome A

2014-11-01

Deep white matter hemorrhagic venous infarction with subsequent cavitation due to necrosis and liquefaction has been described in neonates and may be associated with infection and meningitis. In our experience, the MRI pattern of these lesions is confused with the pattern seen with cerebral abscesses. The purpose of our study was to characterize the MRI findings of post infarction necrosis and liquefaction after hemorrhagic deep white matter venous infarction in infants and to distinguish these lesions from cerebral abscesses. An institutional review board approved a retrospective review of imaging records to identify all patients with cerebral venous infarction at a children's hospital during a 10-year period. Nine infants had deep white matter hemorrhagic venous infarction with white matter fluid signal cavitary lesions. A diagnosis of cerebral abscess was considered in all. The imaging and laboratory findings in these patients are reviewed and compared to descriptions of abscesses found in the literature. There were six female and three male infants. The mean age at presentation was 20 days (range: 0-90 days), while the corrected age at presentation was less than 30 days for all patients. Seven patients presented with seizures and signs of infection; one infant presented with lethargy and later proved to have protein C deficiency. MRI was performed 0-12 days from presentation in these eight patients. Another patient with known protein C deficiency underwent MRI at 30 days for follow-up of screening US abnormalities. There were a total of 38 deep cerebral white matter fluid signal cavitary lesions: 25 frontal, 9 parietal, 2 temporal, 2 occipital. Larger lesions had dependent debris. All lesions had associated hemorrhage and many lesions had evidence of adjacent small vessel venous thrombosis. Lesions imaged after gadolinium showed peripheral enhancement. Three lesions increased in size on follow-up imaging. Three patients, two with meningitis confirmed via

Multispectral near-infrared reflectance and transillumination imaging of occlusal carious lesions: variations in lesion contrast with lesion depth

NASA Astrophysics Data System (ADS)

Simon, Jacob C.; Curtis, Donald A.; Darling, Cynthia L.; Fried, Daniel

2018-02-01

In vivo and in vitro studies have demonstrated that near-infrared (NIR) light at λ=1300-1700-nm can be used to acquire high contrast images of enamel demineralization without interference of stains. The objective of this study was to determine if a relationship exists between the NIR image contrast of occlusal lesions and the depth of the lesion. Extracted teeth with varying amounts of natural occlusal decay were measured using a multispectral-multimodal NIR imaging system which captures λ=1300-nm occlusal transillumination, and λ=1500-1700-nm cross-polarized reflectance images. Image analysis software was used to calculate the lesion contrast detected in both images from matched positions of each imaging modality. Samples were serially sectioned across the lesion with a precision saw, and polarized light microscopy was used to measure the respective lesion depth relative to the dentinoenamel junction. Lesion contrast measured from NIR crosspolarized reflectance images positively correlated (p<0.05) with increasing lesion depth and a statistically significant difference between inner enamel and dentin lesions was observed. The lateral width of pit and fissures lesions measured in both NIR cross-polarized reflectance and NIR transillumination positively correlated with lesion depth.

Systematic review of noninvasive treatments to arrest dentin non-cavitated caries lesions

PubMed Central

de Assunção, Isauremi Vieira; da Costa, Giovanna de Fátima Alves; Borges, Boniek Castillo Dutra

2014-01-01

AIM: To systematically review the literature on the efficacy of noninvasive methods of arresting the progression of non-cavitated occlusal carious lesions in dentin. METHODS: The Medline/PubMed, LILACS, SciELO and Scopus databases were searched to identify relevant publications through to November 2013. Only clinical trials evaluating the ability of noninvasive methods to arrest the progression of occlusal non-cavitated carious lesions in dentin were included. Screening, data extraction and quality assessment were conducted independently and in duplicate. RESULTS: Of 167 citations identified, nine full text articles were screened and five were included in the analysis. All papers reported on occlusal fissure sealing using a self-curing glass ionomer (n = 1) or resin-based (n = 4) sealant. Only the use of resin-based sealant to obliterate occlusal fissures arrested the progression of non-cavitated occlusal carious lesions in dentin. CONCLUSION: Occlusal fissure sealing with a resin-based sealant may arrest the progression of non-cavitated occlusal dentinal caries. Further clinical trials with longer follow-up times should be performed to increase scientific evidence. PMID:24868513

One-year clinical evaluation of two resin composites, two polymerization methods, and a resin-modified glass ionomer in non-carious cervical lesions.

PubMed

Koubi, Stephen; Raskin, Anne; Bukiet, Frédéric; Pignoly, Christian; Toca, Edwige; Tassery, Hervé

2006-11-01

The aim of this study was to examine clinically relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data. Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study. A total of 56 restorations (14 with each material) were placed by three experienced, calibrated dental practitioners. Two other experienced and calibrated practitioners, under single-blind conditions, followed up on all restorations for a period of one year. Three materials were randomly placed: a micro-hybrid composite with two polymerization methods (G1 and G2), a flowable micro-hydrid composite (G3), and a resin-modified glass ionomer (G4). Statistical analysis was performed using the Kruskall-Wallis test (p<0.05) and a Mann-Whitney U modified test with a corrected significance level. At the one year evaluation time, there were no restorations with secondary caries and the retention rates in G1 (IntenS with a hard polymerization), G2 (IntenS with a soft polymerization), G3 (Filtek flow), and G4 (Fuji II LC) were 85.7% (two losses), 92.8% (one loss), 100%, and 100%, respectively. The total visual comparison of the results at baseline (15 days later) showed significant differences only with the clinical acceptance criterion: G1 was different from G2, with a soft polymerization device (p<0.05). In terms of surface quality at one year, G1, G2, and G3 exhibited a statistically significant difference from G4, p<0.05. The digital analysis at baseline showed significant differences only with the clinical acceptance criterion: G1=G2 was different from G3=G4, p<0.05. At one year, only the microporosity criterion showed any statistical differences: G1=G2=G3 was different from G4, p<0.05. The resin-modified glass ionomer was easier to use and had a high

OCT investigation of dental lesions

NASA Astrophysics Data System (ADS)

Osiac, Eugen; Popescu, Sanda Mihaela; Scrieciu, Monica; Mercuţ, Rǎzvan; Mercuţ, Veronica; Vǎtu, Mihaela

2018-03-01

There are several important non carious lesions affecting the tooth structure, lesions which may be classified into four clinical forms of dental wear: abfraction, erosion, attrition and abrasion, and different types of root resorption. Search for new, non-invasive and fast methods able to detect and describe such injuries is of utmost importance. Optical coherence tomography (OCT) proved itself as an appropriate investigation method for several medical fields including ophthalmology, dermatology, cardiology etc. Our study reveals OCT preliminary investigations as a promising tool for detecting and evaluating of the mentioned lesions.

Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists.

PubMed

Bomfim, Rafael Aiello; Crosato, Edgard; Mazzilli, Luiz Eugênio Nigro; Frias, Antonio Carlos

2015-01-01

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador - CEREST (Worker's Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

Cariotester, a new device for assessment of dentin lesion remineralization in vitro.

PubMed

Utaka, Sachiko; Nakashima, Syozi; Sadr, Alireza; Ikeda, Masaomi; Nikaido, Toru; Shimizu, Akihiko; Tagami, Junji

2013-01-01

This study aimed to evaluate the potential of a new device (Cariotester) for monitoring of incipient carious lesion remineralization in root dentin by topical fluoride in vitro. Demineralized bovine dentin specimens were treated by fluoride solutions (APF or neutral NaF) and remineralized for 4 weeks. Cariotester was used to measure penetration depth (CTR depth) of the indenter into the de- and remineralized specimen surface. The specimens were assessed by transverse microradiography (TMR) to determine lesion parameters (depth: LD, mineral loss: ΔZ). Pearson's correlation analysis showed an overall significant relationship between CTR depth and both TMR parameters. CTR depth appeared to distinguish the positive effect that topical fluoride application had on the remineralization of the outer zone of dentin lesions. Cariotester had the potential to serve as a quantitative tool for monitoring of incipient carious lesion remineralization in root dentin.

Critical evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following high-pressure gas and micro-particle abrasion.

PubMed

Dixon, P M; Savill, D; Horbyl, A; Reardon, R J M; Liuti, T

2014-06-01

Infundibular caries of the equine maxillary cheek teeth is an important disorder that can lead to dental fracture or apical infection. Treatment by removing food debris and carious dental tissue from affected infundibulae using high-pressure abrasion with aluminium hydroxide micro-particles, followed by filling the cleaned defect with endodontic restorative materials is a recommended treatment. However, although anecdotally considered a successful treatment option, there is currently no objective evidence to support this claim. Forty maxillary cheek teeth (CT) that contained 55 infundibulae with caries (mainly grade 2) were extracted post-mortem from 21 adult horses. Five of the CT were sectioned prior to treatment to facilitate visual examination of the carious infundibulae. The remaining carious infundibulae were cleaned using high-pressure abrasion with aluminium hydroxide particles and five CT were sectioned to assess the efficacy of this cleaning process. The remaining 30 CT containing 39 carious infundibulae were then filled with a composite restorative material. The efficacy of this restoration was assessed by computed tomography imaging followed by direct visual examination after sectioning the teeth. Only 46% (18/39) of restored infundibulae, all with shallow (mean 9.6 mm deep) defects, were fully cleaned of food debris and carious material, and filled with restorative material to their full depth. Of these 18, 11 had peripheral defects around the restoration, leaving just 18% (7/39) of restorations without any gross defects. The remaining 54% (21/39) of infundibulae (mean depth of infundibular caries defect, 18.3 mm) still contained food debris and/or carious material in more apical locations, with infundibulae with the deepest caries defects being the least effectively cleaned. The findings of this study indicate that high-pressure micro-particle abrasion is only effective in cleaning food debris from shallow, carious CT infundibulae and consequently

Assessment of cavitation in artificial approximal dental lesions with near-IR imaging

NASA Astrophysics Data System (ADS)

Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

2017-02-01

Bitewing radiography is still considered state-of-the-art diagnostic technology for assessing cavitation within approximal carious dental lesions, even though radiographs cannot resolve cavitated surfaces but instead are used to measure lesion depth in order to predict cavitation. Clinicians need new technologies capable of determining whether approximal carious lesions have become cavitated because not all lesions progress to cavitation. Assessing lesion cavitation from near-infrared (NIR) imaging methods holds great potential due to the high transparency of enamel in the NIR region from λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. The objective of this study was to measure the change in lesion appearance between non-cavitated and cavitated lesions in artificially generated lesions using NIR imaging modalities (two-dimensional) at λ=1300-nm and λ=1450-nm and cross-polarization optical coherence tomography (CP-OCT) (thee-dimensional) λ=1300-nm. Extracted human posterior teeth with sound proximal surfaces were chosen for this study and imaged before and after artificial lesions were made. A high speed dental hand piece was used to create artificial cavitated proximal lesions in sound samples and imaged. The cavitated artificial lesions were then filled with hydroxyapatite powder to simulate non-cavitated proximal lesions.

Assessment of cavitation in artificial approximal dental lesions with near-IR imaging.

PubMed

Simon, Jacob C; Darling, Cynthia L; Fried, Daniel

2017-01-28

Bitewing radiography is still considered state-of-the-art diagnostic technology for assessing cavitation within approximal carious dental lesions, even though radiographs cannot resolve cavitated surfaces but instead are used to measure lesion depth in order to predict cavitation. Clinicians need new technologies capable of determining whether approximal carious lesions have become cavitated because not all lesions progress to cavitation. Assessing lesion cavitation from near-infrared (NIR) imaging methods holds great potential due to the high transparency of enamel in the NIR region from λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. The objective of this study was to measure the change in lesion appearance between non-cavitated and cavitated lesions in artificially generated lesions using NIR imaging modalities (two-dimensional) at λ =1300-nm and λ=1450-nm and cross-polarization optical coherence tomography (CP-OCT) (thee-dimensional) λ =1300-nm. Extracted human posterior teeth with sound proximal surfaces were chosen for this study and imaged before and after artificial lesions were made. A high speed dental hand piece was used to create artificial cavitated proximal lesions in sound samples and imaged. The cavitated artificial lesions were then filled with hydroxyapatite powder to simulate non-cavitated proximal lesions.

The lateral infratrigeminal transpontine window to deep pontine lesions.

PubMed

Ferroli, Paolo; Schiariti, Marco; Cordella, Roberto; Boffano, Carlo; Nava, Simone; La Corte, Emanuele; Cavallo, Claudio; Bauer, Dario; Castiglione, Melina; Broggi, Morgan; Acerbi, Francesco; Broggi, Giovanni

2015-09-01

Surgery of brainstem lesions is increasingly performed despite the fact that surgical indications and techniques continue to be debated. The deep pons, in particular, continues to be a critical area in which the specific risks related to different surgical strategies continue to be examined. With the intention of bringing new knowledge into this important arena, the authors systematically examined the results of brainstem surgeries that have been performed through the lateral infratrigeminal transpontine window. Between 1990 and 2013, 29 consecutive patients underwent surgery through this window for either biopsy sampling or for removal of a deep pontine lesion. All of this work was performed at the Department of Neurosurgery of the Istituto Nazionale Neurologico "Carlo Besta", in Milan, Italy. A retrospective analysis of the findings was conducted with the intention of bringing further clarity to this important surgical strategy. The lateral infratrigeminal transpontine window was exposed through 4 different approaches: 1) classic retrosigmoid (15 cases), 2) minimally invasive keyhole retrosigmoid (10 cases), 3) translabyrinthine (1 case), and 4) combined petrosal (3 cases). No deaths occurred during the entire clinical study. The surgical complications that were observed included hydrocephalus (2 cases) and CSF leakage (1 case). In 6 (20.7%) of 29 patients the authors encountered new neurological deficits during the immediate postoperative period. All 6 of these patients had undergone lesion removal. In only 2 of these 6 patients were permanent sequelae observed at 3 months follow-up. These findings show that 93% of the patients studied did not report any permanent worsening of their neurological condition after this surgical intervention. This retrospective study supports the idea that the lateral infratrigeminal transpontine window is both a low-risk and safe corridor for either biopsy sampling or for removal of deep pontine lesions.

An ensemble deep learning based approach for red lesion detection in fundus images.

PubMed

Orlando, José Ignacio; Prokofyeva, Elena; Del Fresno, Mariana; Blaschko, Matthew B

2018-01-01

Diabetic retinopathy (DR) is one of the leading causes of preventable blindness in the world. Its earliest sign are red lesions, a general term that groups both microaneurysms (MAs) and hemorrhages (HEs). In daily clinical practice, these lesions are manually detected by physicians using fundus photographs. However, this task is tedious and time consuming, and requires an intensive effort due to the small size of the lesions and their lack of contrast. Computer-assisted diagnosis of DR based on red lesion detection is being actively explored due to its improvement effects both in clinicians consistency and accuracy. Moreover, it provides comprehensive feedback that is easy to assess by the physicians. Several methods for detecting red lesions have been proposed in the literature, most of them based on characterizing lesion candidates using hand crafted features, and classifying them into true or false positive detections. Deep learning based approaches, by contrast, are scarce in this domain due to the high expense of annotating the lesions manually. In this paper we propose a novel method for red lesion detection based on combining both deep learned and domain knowledge. Features learned by a convolutional neural network (CNN) are augmented by incorporating hand crafted features. Such ensemble vector of descriptors is used afterwards to identify true lesion candidates using a Random Forest classifier. We empirically observed that combining both sources of information significantly improve results with respect to using each approach separately. Furthermore, our method reported the highest performance on a per-lesion basis on DIARETDB1 and e-ophtha, and for screening and need for referral on MESSIDOR compared to a second human expert. Results highlight the fact that integrating manually engineered approaches with deep learned features is relevant to improve results when the networks are trained from lesion-level annotated data. An open source implementation of our

Quantitative microbiological study of human carious dentine by culture and real-time PCR: association of anaerobes with histopathological changes in chronic pulpitis.

PubMed

Martin, F Elizabeth; Nadkarni, Mangala A; Jacques, Nicholas A; Hunter, Neil

2002-05-01

The bacteria found in carious dentine were correlated with the tissue response of the dental pulps of 65 teeth extracted from patients with advanced caries and pulpitis. Standardized homogenates of carious dentine were plated onto selective and nonselective media under anaerobic and microaerophilic conditions. In addition, real-time PCR was used to quantify the recovery of anaerobic bacteria. Primers and fluorogenic probes were designed to detect the total anaerobic microbial load, the genera Prevotella and Fusobacterium, and the species Prevotella melaninogenica, Porphyromonas endodontalis, Porphyromonas gingivalis, and Micromonas (formerly Peptostreptococcus) micros. The pulpal pathology was categorized according to the cellular response and degenerative changes. Analysis of cultured bacteria showed a predominance of gram-positive microorganisms, particularly lactobacilli. Gram-negative bacteria were also present in significant numbers with Prevotella spp., the most numerous anaerobic group cultured. Real-time PCR analysis indicated a greater microbial load than that determined by colony counting. The total number of anaerobes detected was 41-fold greater by real-time PCR than by colony counting, while the numbers of Prevotella and Fusobacterium spp. detected were 82- and 2.4-fold greater by real-time PCR than by colony counting, respectively. Real-time PCR also identified M. micros, P. endodontalis, and P. gingivalis in 71, 60, and 52% of carious samples, respectively. Correlation matrices of the real-time PCR data revealed significant positive associations between M. micros and P. endodontalis detection and inflammatory degeneration of pulpal tissues. These anaerobes have been strongly implicated in endodontic infections that occur as sequelae to carious pulpitis. Accordingly, the data suggest that the presence of high levels of these bacteria in carious lesions may be indicative of irreversible pulpal pathology.

Image processing with the radial Hilbert transform of photo-thermal imaging for carious detection

NASA Astrophysics Data System (ADS)

El-Sharkawy, Yasser H.

2014-03-01

Knowledge of heat transfer in biological bodies has many diagnostic and therapeutic applications involving either raising or lowering of temperature, and often requires precise monitoring of the spatial distribution of thermal histories that are produced during a treatment protocol. The present paper therefore aims to design and implementation of laser therapeutic and imaging system used for carious tracking and drilling by develop a mathematical algorithm using Hilbert transform for edge detection of photo-thermal imaging. photothermal imaging has the ability to penetrate and yield information about an opaque medium well beyond the range of conventional optical imaging. Owing to this ability, Q- switching Nd:YAG laser at wavelength 1064 nm has been extensively used in human teeth to study the sub-surface deposition of laser radiation. The high absorption coefficient of the carious rather than normal region rise its temperature generating IR thermal radiation captured by high resolution thermal camera. Changing the pulse repetition frequency of the laser pulses affects the penetration depth of the laser, which can provide three-dimensional (3D) images in arbitrary planes and allow imaging deep within a solid tissue.

Laser-induced breakdown spectroscopy of dental lesions: diagnostic and therapeutic monitoring tool

NASA Astrophysics Data System (ADS)

Borisova, Ekaterina; Uzunov, Tzonko; Penev, Dimitar; Genova, Tsanislava; Avramov, Latchezar

2016-01-01

The carious decay develops a tiny area of demineralization on the enamel, which could be detected by element analytic techniques such as laser-induced breakdown spectroscopy (LIBS). That demineralization can quickly turn into a large lesion inside the tooth, it is often discovered too late to prevent the kind of decay that leads to cavities. The same optical LIBS detection approach could be used for monitoring of the caries removal using laser ablation or drilling techniques. For LIBS measurements we applied LIBS 2500Plus (Ocean Optics Inc., Dunedin, USA) system, which consists of seven spectrometric channels, covering spectral region from 200 to 980 nm, which optical resolution 0,05 nm, the spectrometers are connected with sample fiber bundle for 7-channels spectral system to the chamber for solid and liquid samples, Q-switched Nd:YAG laser, at 1 064 nm, with energy per pulse - 40 mJ, which is applied to induce plasma in the samples. LIBS spectra were obtained after single shot of the laser in the region of pathology. Samples investigated by LIBS are extracted teeth from patients, with periodontal problems on different stage of carious lesions, and their LIBS spectra are compared with the LIBS signals obtained from normal enamel and dentine tissues to receive complete picture of the carious lesion development. The major line of our investigations is related to the development of a methodology for real-time optical feedback control during selective ablation of tooth tissues using LIBS. Tooth structures, with and without pathological changes, are compared and their LIBS element analysis is used to differentiate major changes, which occur during tooth carious process and growth.

The effect of MTA application on the affected dentine remineralization after partial caries excavation (in vivo)

NASA Astrophysics Data System (ADS)

Pratiwi, A. R.; Meidyawati, R.; Djauharie, N.

2017-08-01

On deep carious lesions, only thin dentine remains, causing a high risk of pulp exposure during the removal of all infected dentine. A minimally invasive technique is required, such as a partial caries excavation method in the infected dentine tissue and the use of bioactive material that can promote (Mineral Trioxide Aggregate) MTA remineralization. To compare the remineralization of deep carious lesion-affected dentine with the removal of some and all the infected dentine after the application of MTA. Subjects were divided into two groups: group I had only some parts of the infected dentine removed before MTA application, while group II had all the infected dentine removed before MTA application. Each group was measured on the pixel grey value before the treatment and again four weeks after the MTA application, and then the results were compared. Furthermore, the enhancement of both groups’ grey values were compared. Remineralization occurred in both groups after the MTA application. There was no significant difference in the remineralization level of the affected dentine in both groups I and II four weeks after the MTA application. Remineralization occurred in the affected dentine in both groups, either by removing only some parts or all the infected dentine in the deep carious lesion.

Bilateral pallidal hemorrhage in toxoplasmosis update of acute symmetric lesions of deep nuclei.

PubMed

Finelli, Pasquale F; Wrubel, Gregory L

2015-08-01

As acute symmetric lesions of deep gray nuclei are often associated with an impaired level of consciousness and neuroimaging by itself cannot distinguish between etiologies, diagnosis may be problematic. Appreciation of the cause of the various neuroimaging patterns in conjunction with the history, examination and laboratory investigations allows for accurate diagnosis in the vast majority of cases. Given the metabolic vulnerability of deep gray nuclei, other than bi-thalamic infarction, it follows that toxic-metabolic and hypoxic-ischemic events account for the majority of cases. Nevertheless, the differential diagnosis is broad and diverse. We here describe two cases of bilateral pallidal hemorrhage in AIDS-associated toxoplasmosis, and review conditions recently described with acute symmetric deep gray nuclei lesions on neuroimaging. © The Author(s) 2015.

Efficacy of deep biopsy for subepithelial lesions in the upper gastrointestinal tract.

PubMed

Vaicekauskas, Rolandas; Stanaitis, Juozas; Valantinas, Jonas

2016-01-01

Accurate diagnosis of subepithelial lesions (SELs) in the gastrointestinal tract depends on a variety of methods: endoscopy, endoscopic ultrasound and different types of biopsy. Making an error-free diagnosis is vital for the subsequent application of an appropriate treatment. To evaluate the efficacy of deep biopsy via the endoscopic submucosal dissection (ESD) technique for SELs in the upper gastrointestinal tract. It was a case series study. Deep biopsy via the ESD technique was completed in 38 patients between November 2012 and October 2014. Thirty-eight SELs in the upper gastrointestinal tract of varying size (very small ≤ 1 cm, small 1-2 cm and large ≥ 2 cm) by means of the ESD technique after an incision with an electrosurgical knife of the overlying layers and revealing a small part of the lesion were biopsied under direct endoscopic view. Deep biopsy via the ESD technique was diagnostic in 28 of 38 patients (73.3%; 95% CI: 59.7-89.7%). The diagnostic yield for SELs with a clear endophytic shape increased to 91.3%. An evident endophytic appearance of a subepithelial lesion, the mean number of biopsied samples (6.65 ±1.36) and the total size in length of all samples per case (19.88 ±8.07 mm) were the main criteria influencing the positiveness of deep biopsy in the diagnostic group compared to the nondiagnostic one (p = 0.001; p = 0.025; p = 0.008). Deep biopsy via the ESD technique is an effective and safe method for the diagnosis of SELs especially with a clear endophytic appearance in a large number of biopsied samples.

Characterization of enamel caries lesions in rat molars using synchrotron X-ray microtomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Free, R. D.; DeRocher, K.; Stock, S. R.

Dental caries is a ubiquitous infectious disease with a nearly 100% lifetime prevalence. Rodent caries models are widely used to investigate the etiology, progression and potential prevention or treatment of the disease. To explore the suitability of these models for deeper investigations of intact surface zones during enamel caries, the structures of early-stage carious lesions in rats were characterized and compared with previous reports on white spot enamel lesions in humans. Synchrotron X-ray microcomputed tomography non-destructively mapped demineralization in carious rat molar specimens across a range of caries severity, identifying 52 lesions across the 30 teeth imaged. Of these lesions,more » 13 were shown to have intact surface zones. Depth profiles of fractional mineral density were qualitatively similar to lesions in human teeth. However, the thickness of the surface zone in the rat model ranges from 10 to 58 µm, and is therefore significantly thinner than in human enamel. These results indicate that a fraction of lesions in rat caries possess an intact surface zone and are qualitatively similar to human lesions at the micrometer scale. This suggests that rat caries models may be a suitable analog through which to investigate the structure of surface zone enamel and its role during dental caries.« less

Exploring DeepMedic for the purpose of segmenting white matter hyperintensity lesions

NASA Astrophysics Data System (ADS)

Lippert, Fiona; Cheng, Bastian; Golsari, Amir; Weiler, Florian; Gregori, Johannes; Thomalla, Götz; Klein, Jan

2018-02-01

DeepMedic, an open source software library based on a multi-channel multi-resolution 3D convolutional neural network, has recently been made publicly available for brain lesion segmentations. It has already been shown that segmentation tasks on MRI data of patients having traumatic brain injuries, brain tumors, and ischemic stroke lesions can be performed very well. In this paper we describe how it can efficiently be used for the purpose of detecting and segmenting white matter hyperintensity lesions. We examined if it can be applied to single-channel routine 2D FLAIR data. For evaluation, we annotated 197 datasets with different numbers and sizes of white matter hyperintensity lesions. Our experiments have shown that substantial results with respect to the segmentation quality can be achieved. Compared to the original parametrization of the DeepMedic neural network, the timings for training can be drastically reduced if adjusting corresponding training parameters, while at the same time the Dice coefficients remain nearly unchanged. This enables for performing a whole training process within a single day utilizing a NVIDIA GeForce GTX 580 graphics board which makes this library also very interesting for research purposes on low-end GPU hardware.

Classification of breast MRI lesions using small-size training sets: comparison of deep learning approaches

NASA Astrophysics Data System (ADS)

Amit, Guy; Ben-Ari, Rami; Hadad, Omer; Monovich, Einat; Granot, Noa; Hashoul, Sharbell

2017-03-01

Diagnostic interpretation of breast MRI studies requires meticulous work and a high level of expertise. Computerized algorithms can assist radiologists by automatically characterizing the detected lesions. Deep learning approaches have shown promising results in natural image classification, but their applicability to medical imaging is limited by the shortage of large annotated training sets. In this work, we address automatic classification of breast MRI lesions using two different deep learning approaches. We propose a novel image representation for dynamic contrast enhanced (DCE) breast MRI lesions, which combines the morphological and kinetics information in a single multi-channel image. We compare two classification approaches for discriminating between benign and malignant lesions: training a designated convolutional neural network and using a pre-trained deep network to extract features for a shallow classifier. The domain-specific trained network provided higher classification accuracy, compared to the pre-trained model, with an area under the ROC curve of 0.91 versus 0.81, and an accuracy of 0.83 versus 0.71. Similar accuracy was achieved in classifying benign lesions, malignant lesions, and normal tissue images. The trained network was able to improve accuracy by using the multi-channel image representation, and was more robust to reductions in the size of the training set. A small-size convolutional neural network can learn to accurately classify findings in medical images using only a few hundred images from a few dozen patients. With sufficient data augmentation, such a network can be trained to outperform a pre-trained out-of-domain classifier. Developing domain-specific deep-learning models for medical imaging can facilitate technological advancements in computer-aided diagnosis.

Association between the number of early carious lesions and diet in children with a high prevalence of caries.

PubMed

Llena, C; Leyda, A; Forner, L; Garcet, S

2015-03-01

An investigation was conducted in a population of paediatric patients with a high risk of caries in order to assess the association between caries history (CH) and the number of early carious lesions (ECLs) and the frequency and timing of cariogenic food and beverage intake, sugar-containing medication, the frequency and efficacy of tooth brushing, and the use of topical fluorides. Study design: descriptive study. One hundred children aged 6-15 years with≥ ECL of a permanent tooth and not enrolled in any dental health educational or preventive programme were selected. For diagnosis it was used an explorer according to the ICDAS II criteria. The participants completed a closed-list questionnaire on the frequency and timing of cariogenic food intake. There was a nonsignificant tendency to present more ECLs and a greater CH among patients who consumed cariogenic foods and beverages. A significant relationship (p<0.05) was observed between cariogenic beverages and the number of ECL or CH. Using the number of ECLs as dependent variable, regular fluoridated rinses (p=0.003), frequent sugar-containing medication (p=0.007), and cariogenic beverage consumption (p=0.024) were identified as explanatory parameters in the linear regression model. The Student t-test was used to compare ECL and CH with dietetic factors, fluoridated rinses, sugar- containing medicines, and the frequency and efficacy of tooth brushing. Linear regression analysis correlated the number of ECLs to the mentioned explanatory variables. The frequent consumption of sugary beverages and medications, and failure to regularly use fluoridated rinses, were positively correlated to an increased number of ECLs in patients with a high prevalence of caries.

Clinical Monitoring of Smooth Surface Enamel Lesions Using CP-OCT During Nonsurgical Intervention

PubMed Central

Chan, Kenneth H.; Tom, Henry; Lee, Robert C.; Kang, Hobin; Simon, Jacob C.; Staninec, Michal; Darling, Cynthia L.; Pelzner, Roger B.; Fried, Daniel

2017-01-01

Introduction Studies have shown that cross-polarization optical coherence tomography (CP-OCT) can be used to image the internal structure of carious lesions in vivo. The objective of this study was to show that CP-OCT can be used to monitor changes in the internal structure of early active carious lesions on smooth surfaces during non-surgical intervention with fluoride. Methods Lesions on the smooth surfaces of teeth were imaged using CP-OCT on 17 test subjects. Lesion structural changes were monitored during fluoride varnish application at 6-week intervals for 30 weeks. The lesion depth (Ld), integrated reflectivity (ΔR), and surface zone thickness (Sz) were monitored. Results A distinct transparent surface zone that may be indicative of lesion arrestment was visible in CP-OCT images on 62/63 lesions before application of fluoride varnish. The lesion depth and internal structure were resolved for all the lesions. The overall change in the mean values for Ld, ΔR, and Sz for all the lesions was minimal and was not significant during the study (P > 0.05). Only 5/63 lesions manifested a significant increase in Sz during intervention. Conclusion Even though it appears that most of the lesions manifested little change with fluoride varnish application in the 30 weeks of the study, CP-OCT was able to measure the depth and internal structure of all the lesions including the thickness of the important transparent surface zone located at the surface of the lesions, indicating that CP-OCT is ideally suited for monitoring lesion severity in vivo. PMID:26955902

Syringe Port: A Convenient, Safe, and Cost-Effective Tubular Retractor for Transportal Removal of Deep-Seated Lesions of the Brain.

PubMed

Singh, Harnarayan; Patir, Rana; Vaishya, Sandeep; Miglani, Rahul; Kaur, Amandeep

2018-06-01

Minimally invasive transportal resection of deep intracranial lesions has become a widely accepted surgical technique. Many disposable, mountable port systems are available in the market for this purpose, like the ViewSite Brain Access System. The objective of this study was to find a cost-effective substitute for these systems. Deep-seated brain lesions were treated with a port system made from disposable syringes. The syringe port could be inserted through minicraniotomies placed and planned with navigation. All deep-seated lesions like ventricular tumours, colloid cysts, deep-seated gliomas, and basal ganglia hemorrhages were treated with this syringe port system and evaluated for safety, operative site hematomas, and blood loss. 62 patients were operated on during the study period from January 2015 to July 2017, using this innovative syringe port system for deep-seated lesions of the brain. No operative site hematoma or contusions were seen along the port entry site and tract. Syringe port is a cost-effective and safe alternative to the costly disposable brain port systems, especially for neurosurgical setups in developing countries for minimally invasive transportal resection of deep brain lesions. Copyright © 2018 Elsevier Inc. All rights reserved.

Minimally invasive trans-portal resection of deep intracranial lesions.

PubMed

Raza, S M; Recinos, P F; Avendano, J; Adams, H; Jallo, G I; Quinones-Hinojosa, A

2011-02-01

The surgical management of deep intra-axial lesions still requires microsurgical approaches that utilize retraction of deep white matter to obtain adequate visualization. We report our experience with a new tubular retractor system, designed specifically for intracranial applications, linked with frameless neuronavigation for a cohort of intraventricular and deep intra-axial tumors. The ViewSite Brain Access System (Vycor, Inc) was used in a series of 9 adult and pediatric patients with a variety of pathologies. Histological diagnoses either resected or biopsied with the system included: colloid cyst, DNET, papillary pineal tumor, anaplastic astrocytoma, toxoplasmosis and lymphoma. The locations of the lesions approached include: lateral ventricle, basal ganglia, pulvinar/posterior thalamus and insular cortex. Post-operative imaging was assessed to determine extent of resection and extent of white matter damage along the surgical trajectory (based on T (2)/FLAIR and diffusion restriction/ADC signal). Satisfactory resection or biopsy was obtained in all patients. Radiographic analysis demonstrated evidence of white matter damage along the surgical trajectory in one patient. None of the patients experienced neurological deficits as a result of white matter retraction/manipulation. Based on a retrospective review of our experience, we feel that this access system, when used in conjunction with frameless neuronavigational systems, provides adequate visualization for tumor resection while permitting the use of standard microsurgical techniques through minimally invasive craniotomies. Our initial data indicate that this system may minimize white matter injury, but further studies are necessary. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical monitoring of smooth surface enamel lesions using CP-OCT during nonsurgical intervention.

PubMed

Chan, Kenneth H; Tom, Henry; Lee, Robert C; Kang, Hobin; Simon, Jacob C; Staninec, Michal; Darling, Cynthia L; Pelzner, Roger B; Fried, Daniel

2016-12-01

Studies have shown that cross-polarization optical coherence tomography (CP-OCT) can be used to image the internal structure of carious lesions in vivo. The objective of this study was to show that CP-OCT can be used to monitor changes in the internal structure of early active carious lesions on smooth surfaces during non-surgical intervention with fluoride. Lesions on the smooth surfaces of teeth were imaged using CP-OCT on 17 test subjects. Lesion structural changes were monitored during fluoride varnish application at 6-week intervals for 30 weeks. The lesion depth (L d ), integrated reflectivity (ΔR), and surface zone thickness (S z ) were monitored. A distinct transparent surface zone that may be indicative of lesion arrestment was visible in CP-OCT images on 62/63 lesions before application of fluoride varnish. The lesion depth and internal structure were resolved for all the lesions. The overall change in the mean values for L d , ΔR, and S z for all the lesions was minimal and was not significant during the study (P > 0.05). Only 5/63 lesions manifested a significant increase in S z during intervention. Even though it appears that most of the lesions manifested little change with fluoride varnish application in the 30 weeks of the study, CP-OCT was able to measure the depth and internal structure of all the lesions including the thickness of the important transparent surface zone located at the surface of the lesions, indicating that CP-OCT is ideally suited for monitoring lesion severity in vivo. Lasers Surg. Med. 48:915-923, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Non-carious cervical lesions (NCCLs) in a random sampling community population and the association of NCCLs with occlusive wear.

PubMed

Yang, J; Cai, D; Wang, F; He, D; Ma, L; Jin, Y; Que, K

2016-12-01

This study investigated the prevalence, risk factors and association of occlusive wear with non-carious cervical lesions (NCCLs) in the general Chinese population. A total of 1320 subjects were recruited, and multistage and random sampling methods of survey spots were performed. All age groups comprised similar numbers of participants and equal numbers of males and females. Each subject completed a structured interview, and all teeth of each subject were examined by a practitioner to determine NCCLs and occlusive wear. Binary logistic regression was conducted by analysing the association of risk factors with the occurrence of NCCLs. Bivariate correlation analysis was performed by determining the association of NCCLs dimension or depth with the range of occlusive wear facets. Clinical assessment showed that the overall prevalence of subjects diagnosed with NCCLs was 63%. The proportion of subjects or teeth with NCCLs significantly increased with age. Pre-molars were the most commonly affected teeth. Single variables and interactive effects of variables associated with the occurrence of NCCLs include the following: age group, intensity of toothbrushing, frequency of fresh fruit consumption and interactive effect between intensity of toothbrushing and frequency of fresh fruit consumption. A weak positive correlation of the grading index was found between NCCLs dimension, size or depth and range of occlusive wear facets. This study reported the higher prevalence of NCCLs in the general Chinese population. Implementation of a combined strategy to reduce risk factors of NCCLs could be more effective than individual techniques; meanwhile, the occurrence of NCCL could be related to the wear degree of occlusive defects in the population studied. © 2016 John Wiley & Sons Ltd.

A hybrid deep learning approach to predict malignancy of breast lesions using mammograms

NASA Astrophysics Data System (ADS)

Wang, Yunzhi; Heidari, Morteza; Mirniaharikandehei, Seyedehnafiseh; Gong, Jing; Qian, Wei; Qiu, Yuchen; Zheng, Bin

2018-03-01

Applying deep learning technology to medical imaging informatics field has been recently attracting extensive research interest. However, the limited medical image dataset size often reduces performance and robustness of the deep learning based computer-aided detection and/or diagnosis (CAD) schemes. In attempt to address this technical challenge, this study aims to develop and evaluate a new hybrid deep learning based CAD approach to predict likelihood of a breast lesion detected on mammogram being malignant. In this approach, a deep Convolutional Neural Network (CNN) was firstly pre-trained using the ImageNet dataset and serve as a feature extractor. A pseudo-color Region of Interest (ROI) method was used to generate ROIs with RGB channels from the mammographic images as the input to the pre-trained deep network. The transferred CNN features from different layers of the CNN were then obtained and a linear support vector machine (SVM) was trained for the prediction task. By applying to a dataset involving 301 suspicious breast lesions and using a leave-one-case-out validation method, the areas under the ROC curves (AUC) = 0.762 and 0.792 using the traditional CAD scheme and the proposed deep learning based CAD scheme, respectively. An ensemble classifier that combines the classification scores generated by the two schemes yielded an improved AUC value of 0.813. The study results demonstrated feasibility and potentially improved performance of applying a new hybrid deep learning approach to develop CAD scheme using a relatively small dataset of medical images.

Treatment of caries in relation to lesion severity: implications for minimum intervention dentistry.

PubMed

Brennan, D S; Balasubramanian, M; Spencer, A J

2015-01-01

To date there is little evidence of minimum intervention in relation to treatment patterns, particularly for initial carious lesions. The objective of this study was to investigate treatment provided to patients with a main diagnosis of coronal caries in relation to the severity of the caries lesion. A random sample of Australian dentists was surveyed by mailed questionnaires in 2009-2010 (response rate 67%). Data on services, patient characteristics and main diagnosis were collected from a service log. Models of service rates adjusted for age, sex, insurance status and reason for visit showed that compared to the reference category of gross caries lesions, there were higher rates [rate ratio, 95% CI] of restorative services for initial [1.63, 1.31-2.03] and cavitated [1.69, 1.39-2.05] lesions, higher rates of prophylaxis for initial [3.77, 2.09-6.79] and cavitated [3.88, 2.29-6.58] lesions, lower rates of endodontic services for initial [0.07, 0.02-0.30] and cavitated [0.11, 0.04-0.30] lesions, and lower rates of extraction for initial [0.15, 0.06-0.34] and cavitated [0.15, 0.07-0.31] lesions. Treatment of coronal caries was characterized by high rates of restorative services, but gross lesions had lower restorative rates and higher rates of endodontic and extraction services. There was little differentiation in treatment of coronal caries between initial and cavitated lesions, suggesting scope for increased management of initial carious lesions by the adoption of more minimum intervention approaches. Copyright © 2014 Elsevier Ltd. All rights reserved.

Automated Whole-Body Bone Lesion Detection for Multiple Myeloma on 68Ga-Pentixafor PET/CT Imaging Using Deep Learning Methods.

PubMed

Xu, Lina; Tetteh, Giles; Lipkova, Jana; Zhao, Yu; Li, Hongwei; Christ, Patrick; Piraud, Marie; Buck, Andreas; Shi, Kuangyu; Menze, Bjoern H

2018-01-01

The identification of bone lesions is crucial in the diagnostic assessment of multiple myeloma (MM). 68 Ga-Pentixafor PET/CT can capture the abnormal molecular expression of CXCR-4 in addition to anatomical changes. However, whole-body detection of dozens of lesions on hybrid imaging is tedious and error prone. It is even more difficult to identify lesions with a large heterogeneity. This study employed deep learning methods to automatically combine characteristics of PET and CT for whole-body MM bone lesion detection in a 3D manner. Two convolutional neural networks (CNNs), V-Net and W-Net, were adopted to segment and detect the lesions. The feasibility of deep learning for lesion detection on 68 Ga-Pentixafor PET/CT was first verified on digital phantoms generated using realistic PET simulation methods. Then the proposed methods were evaluated on real 68 Ga-Pentixafor PET/CT scans of MM patients. The preliminary results showed that deep learning method can leverage multimodal information for spatial feature representation, and W-Net obtained the best result for segmentation and lesion detection. It also outperformed traditional machine learning methods such as random forest classifier (RF), k -Nearest Neighbors ( k -NN), and support vector machine (SVM). The proof-of-concept study encourages further development of deep learning approach for MM lesion detection in population study.

Automated Whole-Body Bone Lesion Detection for Multiple Myeloma on 68Ga-Pentixafor PET/CT Imaging Using Deep Learning Methods

PubMed Central

Tetteh, Giles; Lipkova, Jana; Zhao, Yu; Li, Hongwei; Christ, Patrick; Buck, Andreas; Menze, Bjoern H.

2018-01-01

The identification of bone lesions is crucial in the diagnostic assessment of multiple myeloma (MM). 68Ga-Pentixafor PET/CT can capture the abnormal molecular expression of CXCR-4 in addition to anatomical changes. However, whole-body detection of dozens of lesions on hybrid imaging is tedious and error prone. It is even more difficult to identify lesions with a large heterogeneity. This study employed deep learning methods to automatically combine characteristics of PET and CT for whole-body MM bone lesion detection in a 3D manner. Two convolutional neural networks (CNNs), V-Net and W-Net, were adopted to segment and detect the lesions. The feasibility of deep learning for lesion detection on 68Ga-Pentixafor PET/CT was first verified on digital phantoms generated using realistic PET simulation methods. Then the proposed methods were evaluated on real 68Ga-Pentixafor PET/CT scans of MM patients. The preliminary results showed that deep learning method can leverage multimodal information for spatial feature representation, and W-Net obtained the best result for segmentation and lesion detection. It also outperformed traditional machine learning methods such as random forest classifier (RF), k-Nearest Neighbors (k-NN), and support vector machine (SVM). The proof-of-concept study encourages further development of deep learning approach for MM lesion detection in population study. PMID:29531504

Laser speckle imaging for lesion detection on tooth

NASA Astrophysics Data System (ADS)

Gavinho, Luciano G.; Silva, João. V. P.; Damazio, João. H.; Sfalcin, Ravana A.; Araujo, Sidnei A.; Pinto, Marcelo M.; Olivan, Silvia R. G.; Prates, Renato A.; Bussadori, Sandra K.; Deana, Alessandro M.

2018-02-01

Computer vision technologies for diagnostic imaging applied to oral lesions, specifically, carious lesions of the teeth, are in their early years of development. The relevance of this public problem, dental caries, worries countries around the world, as it affects almost the entire population, at least once in the life of each individual. The present work demonstrates current techniques for obtaining information about lesions on teeth by segmentation laser speckle imagens (LSI). Laser speckle image results from laser light reflection on a rough surface, and it was considered a noise but has important features that carry information about the illuminated surface. Even though these are basic images, only a few works have analyzed it by application of computer vision methods. In this article, we present the latest results of our group, in which Computer vision techniques were adapted to segment laser speckle images for diagnostic purposes. These methods are applied to the segmentation of images between healthy and lesioned regions of the tooth. These methods have proven to be effective in the diagnosis of early-stage lesions, often imperceptible in traditional diagnostic methods in the clinical practice. The first method uses first-order statistical models, segmenting the image by comparing the mean and standard deviation of the intensity of the pixels. The second method is based on the distance of the chi-square (χ2 ) between the histograms of the image, bringing a significant improvement in the precision of the diagnosis, while a third method introduces the use of fractal geometry, exposing, through of the fractal dimension, more precisely the difference between lesioned areas and healthy areas of a tooth compared to other methods of segmentation. So far, we can observe efficiency in the segmentation of the carious regions. A software was developed for the execution and demonstration of the applicability of the models

Absence of carious lesions at margins of glass-ionomer cement and amalgam restorations: An update of systematic review evidence

PubMed Central

2011-01-01

Background This article aims to update the existing systematic review evidence elicited by Mickenautsch et al. up to 18 January 2008 (published in the European Journal of Paediatric Dentistry in 2009) and addressing the review question of whether, in the same dentition and same cavity class, glass-ionomer cement (GIC) restored cavities show less recurrent carious lesions on cavity margins than cavities restored with amalgam. Methods The systematic literature search was extended beyond the original search date and a further hand-search and reference check was done. The quality of accepted trials was assessed, using updated quality criteria, and the risk of bias was investigated in more depth than previously reported. In addition, the focus of quantitative synthesis was shifted to single datasets extracted from the accepted trials. Results The database search (up to 10 August 2010) identified 1 new trial, in addition to the 9 included in the original systematic review, and 11 further trials were included after a hand-search and reference check. Of these 21 trials, 11 were excluded and 10 were accepted for data extraction and quality assessment. Thirteen dichotomous datasets of primary outcomes and 4 datasets with secondary outcomes were extracted. Meta-analysis and cumulative meta-analysis were used in combining clinically homogenous datasets. The overall results of the computed datasets suggest that GIC has a higher caries-preventive effect than amalgam for restorations in permanent teeth. No difference was found for restorations in the primary dentition. Conclusion This outcome is in agreement with the conclusions of the original systematic review. Although the findings of the trials identified in this update may be considered to be less affected by attrition- and publication bias, their risk of selection- and detection/performance bias is high. Thus, verification of the currently available results requires further high-quality randomised control trials. PMID

Mixed periapical lesion: differential diagnosis of a case.

PubMed

Krithika, C; Kota, S; Gopal, K S; Koteeswaran, D

2011-03-01

A radicular cyst associated with carious teeth is a very common odontogenic lesion in the oral cavity, but calcifications in residual radicular cysts are quite rare. We report one such case where a routine pre-implant radiographic assessment revealed a mixed periapical radiopaque radiolucent lesion in the right maxillary central incisor region. Histological and radiographic studies show that there is a slow increase in the mineralized deposits within the cyst lumen with time. This becomes prominent histochemically in cysts more than 8 years old and radiographically 6 years later, as seen in our case. In this paper we would like to highlight the importance of a residual radicular cyst with calcifications in the differential diagnosis of a mixed periapical radiopaque radiolucent lesion.

Mixed periapical lesion: differential diagnosis of a case

PubMed Central

Krithika, C; Kota, S; Gopal, KS; Koteeswaran, D

2011-01-01

A radicular cyst associated with carious teeth is a very common odontogenic lesion in the oral cavity, but calcifications in residual radicular cysts are quite rare. We report one such case where a routine pre-implant radiographic assessment revealed a mixed periapical radiopaque radiolucent lesion in the right maxillary central incisor region. Histological and radiographic studies show that there is a slow increase in the mineralized deposits within the cyst lumen with time. This becomes prominent histochemically in cysts more than 8 years old and radiographically 6 years later, as seen in our case. In this paper we would like to highlight the importance of a residual radicular cyst with calcifications in the differential diagnosis of a mixed periapical radiopaque radiolucent lesion. PMID:21346087

Functional Remineralization of Dentin Lesions Using Polymer-Induced Liquid-Precursor Process

PubMed Central

Burwell, Anora K.; Thula-Mata, Taili; Gower, Laurie B.; Habeliz, Stefan; Kurylo, Michael; Ho, Sunita P.; Chien, Yung-Ching; Cheng, Jing; Cheng, Nancy F.; Gansky, Stuart A.; Marshall, Sally J.; Marshall, Grayson W.

2012-01-01

It was hypothesized that applying the polymer-induced liquid-precursor (PILP) system to artificial lesions would result in time-dependent functional remineralization of carious dentin lesions that restores the mechanical properties of demineralized dentin matrix. 140 µm deep artificial caries lesions were remineralized via the PILP process for 7–28 days at 37°C to determine temporal remineralization characteristics. Poly-L-aspartic acid (27 KDa) was used as the polymeric process-directing agent and was added to the remineralization solution at a calcium-to-phosphate ratio of 2.14 (mol/mol). Nanomechanical properties of hydrated artificial lesions had a low reduced elastic modulus (ER = 0.2 GPa) region extending about 70 μm into the lesion, with a sloped region to about 140 μm where values reached normal dentin (18–20 GPa). After 7 days specimens recovered mechanical properties in the sloped region by 51% compared to the artificial lesion. Between 7–14 days, recovery of the outer portion of the lesion continued to a level of about 10 GPa with 74% improvement. 28 days of PILP mineralization resulted in 91% improvement of ER compared to the artificial lesion. These differences were statistically significant as determined from change-point diagrams. Mineral profiles determined by micro x-ray computed tomography were shallower than those determined by nanoindentation, and showed similar changes over time, but full mineral recovery occurred after 14 days in both the outer and sloped portions of the lesion. Scanning electron microscopy and energy dispersive x-ray analysis showed similar morphologies that were distinct from normal dentin with a clear line of demarcation between the outer and sloped portions of the lesion. Transmission electron microscopy and selected area electron diffraction showed that the starting lesions contained some residual mineral in the outer portions, which exhibited poor crystallinity. During remineralization, intrafibrillar

Molecular and Histological Association Between Candida albicans from Oral Soft Tissue and Carious Dentine of HIV-Positive Children.

PubMed

Blignaut, Elaine; van Heerden, Willie F P

2015-10-01

Candida albicans and caries are frequently investigated among healthy and immunosuppressed individuals. The objective of this study was to demonstrate the presence of C. albicans on both oral soft and hard tissue and to investigate, at molecular level, the genetic subtype of the organism from the two oral sites. Tongue swabs and dentine scrapings from 362 HIV-positive children, referred for the extraction of carious primary teeth, were cultured on CHROMagar and identified to species level with ID32C. Histological staining of extracted carious teeth was also done. In patients with positive C. albicans cultures from both the tongue and carious dentine, DNA fingerprinting of such paired isolates was performed, using Southern blot hybridisation with the Ca3 probe. Yeasts were cultured from the tongue of 151 (41.7 %) individuals and 57 (37.7 %) simultaneously yielded positive C. albicans cultures from carious dentine. Nine different yeast spp. were identified from the tongue using the ID32C commercial system, but C. albicans was the only species recovered from carious dentine and histological investigation demonstrated fungal elements penetrated into the dentine and not limited to superficial debris on the floor of the cavity. Twelve of 13 paired isolates of C. albicans revealed identical fingerprinting patterns. The findings from this study demonstrated that in a particular individual, the same genetic subtype of C. albicans was capable of colonising both oral soft tissue and carious dentine. This renders carious teeth a constant source, or reservoir, of potentially infectious agents and, particularly among immunosuppressed individuals, should therefore not be left unattended.

Clinical antibacterial effectiveness and biocompatibility of gaseous ozone after incomplete caries removal.

PubMed

Krunić, Jelena; Stojanović, Nikola; Đukić, Ljiljana; Roganović, Jelena; Popović, Branka; Simić, Ivana; Stojić, Dragica

2018-06-01

To evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD). Antibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and Lactobacillus spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively. Ozone application decreased number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. The VEGF (p < 0.001) and nNOS (p = 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) comparing to those in control pulp. Antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility. Ozone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.

Remineralization of early enamel caries lesions using different bioactive elements containing toothpastes: An in vitro study.

PubMed

Wang, Yu; Mei, Li; Gong, Lin; Li, Jialing; He, Shaowei; Ji, Yan; Sun, Weibin

2016-09-14

Demineralization can be arrested or reversed when remineralization agents are applied to incipient carious or non-cavitated carious lesions. A large number of therapeutic agents including non-fluoridated products have been developed to promote enamel remineralization. This study aims to evaluate the efficacy of different bioactive elements containing toothpastes in remineralization of artificial enamel lesions. Artificial carious lesions were created on 40 human enamel slabs, and were randomly divided into four groups: (1) control group (no treatment), (2) casein phosphopeptide-amorphous calcium phosphate group (CPP-ACP, GC Tooth Mousse), (3) 8% arginine and calcium carbonate group (ACC, Colgate Sensitive Pro-Relief), (4) calcium sodium phosphosilicate group (CSP, NovaMin®). All samples were subjected to 15 days of pH-cycling. Subsequently, a one-hour acid resistance test was carried out. Surface hardness of the samples was assessed using the Knoop hardness test, and surface morphology and roughness were assessed by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Data were analyzed using one-way ANOVA, Tukey's test and paired t test. The three tested toothpastes exhibited a significantly higher remineralization efficacy compared with the control group (P< 0.05 for all). After pH-cycling, the specimens treated with Colgate Sensitive Pro-Relief and NovaMin® showed a significant higher surface hardness (P< 0.001 and P= 0.03, respectively) and lower surface roughness (P< 0.05 for both) compared those treated with GC Tooth Mousse. While after the acid resistance test, all groups showed a significant loss of surface hardness (P< 0.001 for all) and significant increase of surface roughness (P< 0.05). The specimens treated with Colgate Sensitive Pro-Relief and NovaMin® still showed a significant higher surface hardness and lower surface roughness in comparison with those treated with GC Tooth Mousse (P< 0.05 for all). No significant difference was

Computed Tomography-Assisted Thoracoscopic Surgery: A Novel, Innovative Approach in Patients With Deep Intrapulmonary Lesions of Unknown Malignant Status.

PubMed

Kostrzewa, Michael; Kara, Kerim; Rathmann, Nils; Tsagogiorgas, Charalambos; Henzler, Thomas; Schoenberg, Stefan O; Hohenberger, Peter; Diehl, Steffen J; Roessner, Eric D

2017-06-01

Minimally invasive resection of small, deep intrapulmonary lesions can be challenging due to the difficulty of localizing them during video-assisted thoracoscopic surgery (VATS). We report our preliminary results evaluating the feasibility of an image-guided, minimally invasive, 1-stop-shop approach for the resection of small, deep intrapulmonary lesions in a hybrid operating room (OR). Fifteen patients (5 men, 10 women; mean age, 63 years) with a total of 16 solitary, deep intrapulmonary nodules of unknown malignant status were identified for intraoperative wire marking. Patients were placed on the operating table for resection by VATS. A marking wire was placed within the lesion under 3D laser and fluoroscopic guidance using a cone beam computed tomography system. Then, wedge resection by VATS was performed in the same setting without repositioning the patient. Complete resection with adequate safety margins was confirmed for all lesions. Marking wire placement facilitated resection in 15 of 16 lesions. Eleven lesions proved to be malignant, either primary or secondary; 5 were benign. Mean lesion size was 7.7 mm; mean distance to the pleural surface was 15.1 mm (mean lesion depth-diameter ratio, 2.2). Mean procedural time for marking wire placement was 35 minutes; mean VATS duration was 36 minutes. Computed tomography-assisted thoracoscopic surgery is a new, safe, and effective procedure for minimally invasive resection of small, deeply localized intrapulmonary lesions. The benefits of computed tomography-assisted thoracoscopic surgery are 1. One-stop-shop procedure, 2. Lower risk for the patient (no patient relocation, no marking wire loss), and 3. No need to coordinate scheduling between the CT room and OR.

Materials for Paediatric Dentistry. Part 1: Background to the Treatment of Carious Primary Teeth.

PubMed

Jenkins, Natalie

2015-12-01

Dental caries is a disease that affects many people, including children, and presents numerous challenges to healthcare providers. As clinicians it is important that we consider the advantages and disadvantages of treating carious primary teeth, and make an informed decision about when it is appropriate or not. This paper describes the background to the treatment of carious primary teeth, looking at the differences between primary and permanent teeth, and the relevance of this. It also suggests points to consider when looking at restoration survival studies, as the ability to appraise the literature critically is important for us all in this 'evidence-based' age. CPD/Clinical Relevance: Our early life experiences have the ability to shape our future attitudes and behaviour. Children with carious teeth require careful management so that pain and suffering is minimized, and positive attitudes towards dentistry are fostered.

Real-Time Ultrasound-Guided Catheter Navigation for Approaching Deep-Seated Brain Lesions: Role of Intraoperative Neurosonography with and without Fusion with Magnetic Resonance Imaging.

PubMed

Manjila, Sunil; Karhade, Aditya; Phi, Ji Hoon; Scott, R Michael; Smith, Edward R

2017-01-01

Brain shift during the exposure of cranial lesions may reduce the accuracy of frameless stereotaxy. We describe a rapid, safe, and effective method to approach deep-seated brain lesions using real-time intraoperative ultrasound placement of a catheter to mark the dissection trajectory to the lesion. With Institutional Review Board approval, we retrospectively reviewed the radiographic, pathologic, and intraoperative data of 11 pediatric patients who underwent excision of 12 lesions by means of this technique. Full data sets were available for 12 lesions in 11 patients. Ten lesions were tumors and 2 were cavernous malformations. Lesion locations included the thalamus (n = 4), trigone (n = 3), mesial temporal lobe (n = 3), and deep white matter (n = 2). Catheter placement was successful in all patients, and the median time required for the procedure was 3 min (range 2-5 min). There were no complications related to catheter placement. The median diameter of surgical corridors on postresection magnetic resonance imaging was 6.6 mm (range 3.0-12.1 mm). Use of real-time ultrasound guidance to place a catheter to aid in the dissection to reach a deep-seated brain lesion provides advantages complementary to existing techniques, such as frameless stereotaxy. The catheter insertion technique described here provides a quick, accurate, and safe method for reaching deep-seated lesions. © 2017 S. Karger AG, Basel.

A randomized controlled clinical trial of a HEMA-free all-in-one adhesive in non-carious cervical lesions at 1 year.

PubMed

Van Landuyt, K L; Peumans, M; Fieuws, S; De Munck, J; Cardoso, M V; Ermis, R B; Lambrechts, P; Van Meerbeek, B

2008-10-01

One-step self-etch adhesives are the most recent generation of adhesives introduced onto the market. The objective of this randomized controlled clinical trial was to test the hypothesis that a one-step self-etch adhesive performs equally well as a conventional three-step etch&rinse adhesive (gold standard). Fifty-two patients had 267 non-carious cervical lesions restored with Gradia Direct Anterior (GC). These composite restorations were bonded either with the 'all-in-one' adhesive G-Bond (GC) or with the three-step etch&rinse adhesive Optibond FL (Kerr). The restorations were evaluated after 6 and 12 months clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. A logistic regression analysis with generalized estimating equations was used to account for the clustered data (multiple restorations per patient). The recall rate at 1 year was 98%. The statistical analysis revealed a relatively low patient factor, indicating that supplementary information could be obtained from the additional restorations placed per patient. The retention rate for G-Bond was 98.5% compared to 99.3% for Optibond FL, due to the retention loss of two and one restorations, respectively. There were no significant differences between the two adhesives regarding the evaluated parameters except for the presence of small enamel marginal defects with G-Bond. After 12 months, the simplified one-step G-Bond and the three-step Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation of marginal adaptation, and G-Bond exhibited more small enamel marginal defects.

[Stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain].

PubMed

Qin, F; Huang, Z C; Cai, M Q; Xu, X F; Lu, T T; Dong, Q; Wu, A M; Lu, Z Z; Zhao, C; Guo, Y

2018-06-12

Objective: To investigate the value of stereotactic biopsy in the accurate diagnosis of lesions in the brain stem and deep brain. Methods: A total of 29 consecutive patients who underwent stereotactic biopsy of brainstem and deep brain lesions between May 2012 and January 2018 were retrospectively reviewed. The Cosman-Roberts-Wells (CRW) stereotactic frame was installed under local anesthesia. Thin-layer CT and MRI scanning were performed. Target coordinates were calculated by inputting CT-MRI data into the radionics surgical planning system. The individualized puncture path was designed according to the location of the lesions and the characteristics of the image. Target distributions were as follows: 12 cases of midbrain or pons, 2 cases of internal capsule, 3 cases of thalamus, 12 cases of basal ganglia. The biopsy samples were used for further pathological and/or genetic diagnosis. Results: Twenty-eight of the 29 cases (96.6%) were diagnosed accurately by histopathology and genomic examination following stereotactic biopsy. Pathological results were as follows: 8 cases of lymphoma, 7 cases of glioma, 4 cases of demyelination, 2 cases of germ cell tumor, 2 cases of metastatic tumor, 1 cases of cerebral sparganosis, 1 case of tuberculous granuloma, 1 case of hereditary prion disease, 1 case of glial hyperplasia, 1 case of leukemia. The accurate diagnosis of one case required a combination of histopathology and genomic examination. Undefined diagnosis was still made in 1 cases (3.45%) after biopsy. After biopsy, there were 2 cases (6.9%) with symptomatic slight hemorrhage, 1 case (3.45%) with symptomatic severe hemorrhage, and 1 cass (3.45%) with permanent neurological dysfunction. No one died because of surgery or surgical complications. Conclusions: Stereotactic biopsy is fast, safe and minimally invasive. It is an ideal strategy for accurate diagnosis of lesions in brain stem and deep brain.

Automatic Skin Lesion Segmentation Using Deep Fully Convolutional Networks With Jaccard Distance.

PubMed

Yuan, Yading; Chao, Ming; Lo, Yeh-Chi

2017-09-01

Automatic skin lesion segmentation in dermoscopic images is a challenging task due to the low contrast between lesion and the surrounding skin, the irregular and fuzzy lesion borders, the existence of various artifacts, and various imaging acquisition conditions. In this paper, we present a fully automatic method for skin lesion segmentation by leveraging 19-layer deep convolutional neural networks that is trained end-to-end and does not rely on prior knowledge of the data. We propose a set of strategies to ensure effective and efficient learning with limited training data. Furthermore, we design a novel loss function based on Jaccard distance to eliminate the need of sample re-weighting, a typical procedure when using cross entropy as the loss function for image segmentation due to the strong imbalance between the number of foreground and background pixels. We evaluated the effectiveness, efficiency, as well as the generalization capability of the proposed framework on two publicly available databases. One is from ISBI 2016 skin lesion analysis towards melanoma detection challenge, and the other is the PH2 database. Experimental results showed that the proposed method outperformed other state-of-the-art algorithms on these two databases. Our method is general enough and only needs minimum pre- and post-processing, which allows its adoption in a variety of medical image segmentation tasks.

Detection of white spot lesions by segmenting laser speckle images using computer vision methods.

PubMed

Gavinho, Luciano G; Araujo, Sidnei A; Bussadori, Sandra K; Silva, João V P; Deana, Alessandro M

2018-05-05

This paper aims to develop a method for laser speckle image segmentation of tooth surfaces for diagnosis of early stages caries. The method, applied directly to a raw image obtained by digital photography, is based on the difference between the speckle pattern of a carious lesion tooth surface area and that of a sound area. Each image is divided into blocks which are identified in a working matrix by their χ 2 distance between block histograms of the analyzed image and the reference histograms previously obtained by K-means from healthy (h_Sound) and lesioned (h_Decay) areas, separately. If the χ 2 distance between a block histogram and h_Sound is greater than the distance to h_Decay, this block is marked as decayed. The experiments showed that the method can provide effective segmentation for initial lesions. We used 64 images to test the algorithm and we achieved 100% accuracy in segmentation. Differences between the speckle pattern of a sound tooth surface region and a carious region, even in the early stage, can be evidenced by the χ 2 distance between histograms. This method proves to be more effective for segmenting the laser speckle image, which enhances the contrast between sound and lesioned tissues. The results were obtained with low computational cost. The method has the potential for early diagnosis in a clinical environment, through the development of low-cost portable equipment.

Dental cervical lesions associated with occlusal erosion and attrition.

PubMed

Khan, F; Young, W G; Shahabi, S; Daley, T J

1999-09-01

Acid demineralization of teeth causes occlusal erosion and attrition, and shallow and wedge-shaped cervical lesions putatively involving abfraction. From 250 patients with tooth wear, 122 with cervical lesions were identified. From epoxy resin replicas of their dentitions, associations of occlusal attrition or erosion or no wear with cervical lesions were recorded at 24 tooth sites (total 2928 sites). Criteria used to discriminate occlusal attrition from erosion, and shallow from grooved, wedge-shaped or restored cervical lesions were delineated by scanning electron microscopy. A 96 per cent association was found between occlusal and cervical pathology. Shallow cervical lesions were more commonly found in association with occlusal erosion. Wedge-shaped lesions were found equally commonly in association with occlusal erosion, as with attrition. Grooved and restored cervical lesions were uncommon. Differences were appreciated in the associations within incisor, canine, premolar and molar tooth sites which related more to the site-specificity of dental erosion than to attrition from occlusal forces. Non-carious lesions on teeth then have multifactorial aetiology and pathogenesis in which erosion and salivary protection play central roles. Dentists should primarily consider erosion in the diagnosis, prevention and treatment of tooth wear.

Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions.

PubMed

Dhar, Vineet; Marghalani, Abdullah A; Crystal, Yasmi O; Kumar, Ashok; Ritwik, Priyanshi; Tulunoglu, Ozlem; Graham, Laurel

2017-09-15

This manuscript presents evidence-based guidance on the use of vital pulp therapies for treatment of deep caries lesions in children. A guideline panel convened by the American Academy of Pediatric Dentistry formulated evidence-based recommendations on three vital pulp therapies: indirect pulp treatment (IPT; also known as indirect pulp cap), direct pulp cap (DPC), and pulpotomy. The basis of the guideline's recommendations was evidence from "Primary Tooth Vital Pulp Therapy: A Systematic Review and Meta-Analysis." (Pediatr Dent 2017;15;39[1]:16-23.) A systematic search was conducted in PubMed®/MEDLINE, Embase®, Cochrane Central Register of Controlled Trials, and trial databases to identify randomized controlled trials and systematic reviews addressing peripheral issues of vital pulp therapies such as patient preferences of treatment and impact of cost. Quality of the evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation approach; the evidence-to-decision framework was used to formulate a recommendation. The panel was unable to make a recommendation on superiority of any particular type of vital pulp therapy owing to lack of studies directly comparing these interventions. The panel recommends use of mineral trioxide aggregate (MTA) and formocresol in pulpotomy treatments; these are recommendations based on moderate-quality evidence at 24 months. The panel made weak recommendations regarding choice of medicament in both IPT (moderate-quality evidence [24 months], low quality evidence [48 months]) and DPC (very-low quality evidence [24 months]). Success of both treatments was independent of type of medicament used. The panel also recommends use of ferric sulfate (low-quality evidence), lasers (low-quality evidence), sodium hypochlorite (very low-quality evidence), and tricalcium silicate (very low-quality evidence) in pulpotomies; these are weak recommendations based on low-quality evidence. The panel recommended

3D-Image analysis of the impact of toothpaste abrasivity on the progression of simulated non-carious cervical lesions.

PubMed

Sabrah, Alaa H; Turssi, Cecilia P; Lippert, Frank; Eckert, George J; Kelly, Adam B; Hara, Anderson T

2018-06-01

To investigate the effect of toothpaste abrasive level on the progression of non-carious cervical lesions (NCCLs) using 3D-image subtraction. Upper first premolars were allocated into seven groups (n = 16) of toothpaste/abrasive slurries: A-Zeodent113/5%, B-Zeodent124/10%, C-Zeodent103/15%, D-Sensodyne Pronamel, E-Crest Cavity-Protection, F-Crest Pro-Health-Whitening, and G-Deionized water (DIW). Teeth were mounted on acrylic blocks, and their root surfaces covered with acrylic resin, except for 2-mm near the cemento-enamel junction that was exposed to toothbrushing. Specimens were brushed with the slurries for 5000-, 15,000-, 35,000- and 65,000-strokes. Impressions were taken at baseline and after each brushing time, and then scanned by a 3D optical profilometer. Dentine volume loss was calculated by image subtraction software and subjected to mixed-model ANOVA and multiple comparison tests (α = 0.05). No significant differences among slurries were observed at 5000 and 15,000. At 35,000, F showed higher loss than all other groups except C, which did not differ from the others. At 65,000, F (4.19 ± 3.29 mm 3 ) showed the highest loss, followed by C (2.33 ± 1.47 mm 3 ), which differed from all the other groups except B (1.85 ± 0.91 mm 3 ). Groups B, A (1.35 ± 0.65 mm 3 ), D (1.17 ± 0.48 mm 3 ), E (1.40 ± 0.68 mm 3 ) and G (1.12 ± 0.73 mm 3 ) did not differ from each other. Groups F and C showed significant increase of volume loss starting at 35,000, while B, A, D and E only at 65,000; no increase loss was observed for G. 3D-image subtraction was able to quantify and differentiate tooth loss, but only at advanced stages. The progression of NCCLs was more evident and faster for highly abrasive slurries. Upon root dentin exposure, brushing with lower abrasive dentifrices is advisable to reduce the risk for NCCLs development. Copyright © 2018 Elsevier Ltd. All rights reserved.

Fully automatic detection of deep white matter T1 hypointense lesions in multiple sclerosis

NASA Astrophysics Data System (ADS)

Spies, Lothar; Tewes, Anja; Suppa, Per; Opfer, Roland; Buchert, Ralph; Winkler, Gerhard; Raji, Alaleh

2013-12-01

A novel method is presented for fully automatic detection of candidate white matter (WM) T1 hypointense lesions in three-dimensional high-resolution T1-weighted magnetic resonance (MR) images. By definition, T1 hypointense lesions have similar intensity as gray matter (GM) and thus appear darker than surrounding normal WM in T1-weighted images. The novel method uses a standard classification algorithm to partition T1-weighted images into GM, WM and cerebrospinal fluid (CSF). As a consequence, T1 hypointense lesions are assigned an increased GM probability by the standard classification algorithm. The GM component image of a patient is then tested voxel-by-voxel against GM component images of a normative database of healthy individuals. Clusters (≥0.1 ml) of significantly increased GM density within a predefined mask of deep WM are defined as lesions. The performance of the algorithm was assessed on voxel level by a simulation study. A maximum dice similarity coefficient of 60% was found for a typical T1 lesion pattern with contrasts ranging from WM to cortical GM, indicating substantial agreement between ground truth and automatic detection. Retrospective application to 10 patients with multiple sclerosis demonstrated that 93 out of 96 T1 hypointense lesions were detected. On average 3.6 false positive T1 hypointense lesions per patient were found. The novel method is promising to support the detection of hypointense lesions in T1-weighted images which warrants further evaluation in larger patient samples.

Microbiological characterization and effect of resin composites in cervical lesions.

PubMed

Carlo, Bonfanti; Barabanti, Nicola; Piccinelli, Giorgio; Faus-Matoses, Vicente; Cerutti, Antonio

2017-01-01

Non carious cervical lesions associated to muscle hyperfunctions are increasing. Microhybrid resin composites are used to restore cervical abfractions. The purpose of this study was to investigate if resin composites modify tooth plaque, inducing an increment of cariogenic microflora and evaluate their effect, in vivo and in vitro , against S. mutans . Eight abfractions were restored with two microhybrid resin composites (Venus, Heraeus-Kulzer® and Esthet-X, Dentsply®), after gnatological therapy, in three patients with muscle hyperfunctions. For each abfraction three samples of plaque were taken from the cervical perimeter: before the restoration, one week and three months after restoration. The samples were evaluated both by traditional microbiological methods and by Polymerase Chain Reaction (PCR). In vitro , disk-shaped specimens of the two composites were prepared to estimate the effects against pre-cultured S. mutans , after incubation at 37°C for 24h and assessed by a turbidimetric technique. In vivo no differences were found in plaque growth, for all samples, before and after restoration with both composites; in vitro , instead, a significant reduction of S. mutans growth was found between specimens of two composites (Mann-Whitney U-test p >0,06). In this study a relevant consideration was elicited: composite materials, in vivo , do not modify plaque composition of non carious cervical lesions to a potential cariogenic plaque. Key words: Abfraction, restoration, S. mutans, composite, class V.

Frameless Stereotactic Insertion of Viewsite Brain Access System with Microscope-Mounted Tracking Device for Resection of Deep Brain Lesions: Technical Report

PubMed Central

Chakraborty, Shamik; Lall, Rohan; Fanous, Andrew A; Boockvar, John; Langer, David J

2017-01-01

The surgical management of deep brain tumors is often challenging due to the limitations of stereotactic needle biopsies and the morbidity associated with transcortical approaches. We present a novel microscopic navigational technique utilizing the Viewsite Brain Access System (VBAS) (Vycor Medical, Boca Raton, FL, USA) for resection of a deep parietal periventricular high-grade glioma as well as another glioma and a cavernoma with no related morbidity. The approach utilized a navigational tracker mounted on a microscope, which was set to the desired trajectory and depth. It allowed gentle continuous insertion of the VBAS directly to a deep lesion under continuous microscopic visualization, increasing safety by obviating the need to look up from the microscope and thus avoiding loss of trajectory. This technique has broad value for the resection of a variety of deep brain lesions. PMID:28331774

Frameless Stereotactic Insertion of Viewsite Brain Access System with Microscope-Mounted Tracking Device for Resection of Deep Brain Lesions: Technical Report.

PubMed

White, Tim; Chakraborty, Shamik; Lall, Rohan; Fanous, Andrew A; Boockvar, John; Langer, David J

2017-02-04

The surgical management of deep brain tumors is often challenging due to the limitations of stereotactic needle biopsies and the morbidity associated with transcortical approaches. We present a novel microscopic navigational technique utilizing the Viewsite Brain Access System (VBAS) (Vycor Medical, Boca Raton, FL, USA) for resection of a deep parietal periventricular high-grade glioma as well as another glioma and a cavernoma with no related morbidity. The approach utilized a navigational tracker mounted on a microscope, which was set to the desired trajectory and depth. It allowed gentle continuous insertion of the VBAS directly to a deep lesion under continuous microscopic visualization, increasing safety by obviating the need to look up from the microscope and thus avoiding loss of trajectory. This technique has broad value for the resection of a variety of deep brain lesions.

Fluorine determination in human healthy and carious teeth using the PIGE technique

NASA Astrophysics Data System (ADS)

Carvalho, M. L.; Karydas, A. G.; Casaca, C.; Zarkadas, Ch; Paradellis, Th; Kokkoris, M.; Nsouli, B.; Cunha, A. S.

2001-09-01

The purpose of this study is to determine and compare the fluorine concentration in human teeth from two different populations, living in the Portuguese quite isolated islands of Açores: S. Miguel and Terceira. Both populations have similar dietary habits, similar occupational activities, mostly rural, and the age of both populations is more or less the same, around 40 years. No chronic diseases were registered in any of the donors. The two groups are exposed to different levels of fluorine in drinking water. Terceira island has moderate fluorine concentration levels (1-2 μg g -1) while S. Miguel island is known for the high fluorine concentration levels in its water (>3 μg g -1), especially in one area known as Furnas. Thirty-three teeth, 17 healthy and 16 carious without restoration (14 incisors and canines, 7 premolars and 12 molars), were collected and analyzed for the determination of fluorine concentration in the dentine region, using the nuclear reaction 19F( p, αγ) 16O. The teeth were cross-sectioned along the vertical plane and polished, in order to obtain a smooth and plane surface of about 1 mm thickness. In this work an association between caries prevalence and fluorine content of drinking water is discussed and the variation of fluorine concentration among different types of teeth (canines and incisors, premolars, molars) and physical state (carious and non-carious) is examined.

A deep learning framework for supporting the classification of breast lesions in ultrasound images.

PubMed

Han, Seokmin; Kang, Ho-Kyung; Jeong, Ja-Yeon; Park, Moon-Ho; Kim, Wonsik; Bang, Won-Chul; Seong, Yeong-Kyeong

2017-09-15

In this research, we exploited the deep learning framework to differentiate the distinctive types of lesions and nodules in breast acquired with ultrasound imaging. A biopsy-proven benchmarking dataset was built from 5151 patients cases containing a total of 7408 ultrasound breast images, representative of semi-automatically segmented lesions associated with masses. The dataset comprised 4254 benign and 3154 malignant lesions. The developed method includes histogram equalization, image cropping and margin augmentation. The GoogLeNet convolutionary neural network was trained to the database to differentiate benign and malignant tumors. The networks were trained on the data with augmentation and the data without augmentation. Both of them showed an area under the curve of over 0.9. The networks showed an accuracy of about 0.9 (90%), a sensitivity of 0.86 and a specificity of 0.96. Although target regions of interest (ROIs) were selected by radiologists, meaning that radiologists still have to point out the location of the ROI, the classification of malignant lesions showed promising results. If this method is used by radiologists in clinical situations it can classify malignant lesions in a short time and support the diagnosis of radiologists in discriminating malignant lesions. Therefore, the proposed method can work in tandem with human radiologists to improve performance, which is a fundamental purpose of computer-aided diagnosis.

A deep learning framework for supporting the classification of breast lesions in ultrasound images

NASA Astrophysics Data System (ADS)

Han, Seokmin; Kang, Ho-Kyung; Jeong, Ja-Yeon; Park, Moon-Ho; Kim, Wonsik; Bang, Won-Chul; Seong, Yeong-Kyeong

2017-10-01

In this research, we exploited the deep learning framework to differentiate the distinctive types of lesions and nodules in breast acquired with ultrasound imaging. A biopsy-proven benchmarking dataset was built from 5151 patients cases containing a total of 7408 ultrasound breast images, representative of semi-automatically segmented lesions associated with masses. The dataset comprised 4254 benign and 3154 malignant lesions. The developed method includes histogram equalization, image cropping and margin augmentation. The GoogLeNet convolutionary neural network was trained to the database to differentiate benign and malignant tumors. The networks were trained on the data with augmentation and the data without augmentation. Both of them showed an area under the curve of over 0.9. The networks showed an accuracy of about 0.9 (90%), a sensitivity of 0.86 and a specificity of 0.96. Although target regions of interest (ROIs) were selected by radiologists, meaning that radiologists still have to point out the location of the ROI, the classification of malignant lesions showed promising results. If this method is used by radiologists in clinical situations it can classify malignant lesions in a short time and support the diagnosis of radiologists in discriminating malignant lesions. Therefore, the proposed method can work in tandem with human radiologists to improve performance, which is a fundamental purpose of computer-aided diagnosis.

A Study of the Potential to Detect Caries Lesions at the White-Spot Stage Using V(Z) Technique

NASA Astrophysics Data System (ADS)

Bakulin, E. Y.; Denisova, L. A.; Maev, R. Gr.

Current wide-spread methods of non-destructive methods of caries diagnostics, such as X-ray techniques, do not provide the possibility to efficiently detect enamel caries lesions at the beginning ("white-spot") stage, when the tooth tissue is only slightly altered and no loss of the tissue occurs. Therefore, it is of paramount importance to develop new, more sensitive methods of caries diagnostics. In this paper, certain aspects of the ultrasonic approach to the problem are discussed - in particular, detection of the enamel's surface caries at the white-spot stage with a focused ultrasonic sensor positioned in front of the caries lesion (without cross-sectioning the tooth). Theoretical model using V(z) approach for layered media was applied to perform computer simulations resulting in V(z) curves for the different parameters of carious tissue and the degree of degradation. The curves were analyzed and it was shown that, comparing to a short-pulse/echo technique, V(z) approach provides much better distinction between sound and carious enamel and even makes possible to evaluate the degree of demineralization.

Microbiological characterization and effect of resin composites in cervical lesions

PubMed Central

Carlo, Bonfanti; Piccinelli, Giorgio; Faus-Matoses, Vicente; Cerutti, Antonio

2017-01-01

Background Non carious cervical lesions associated to muscle hyperfunctions are increasing. Microhybrid resin composites are used to restore cervical abfractions. The purpose of this study was to investigate if resin composites modify tooth plaque, inducing an increment of cariogenic microflora and evaluate their effect, in vivo and in vitro, against S. mutans. Material and Methods Eight abfractions were restored with two microhybrid resin composites (Venus, Heraeus-Kulzer® and Esthet-X, Dentsply®), after gnatological therapy, in three patients with muscle hyperfunctions. For each abfraction three samples of plaque were taken from the cervical perimeter: before the restoration, one week and three months after restoration. The samples were evaluated both by traditional microbiological methods and by Polymerase Chain Reaction (PCR). In vitro, disk-shaped specimens of the two composites were prepared to estimate the effects against pre-cultured S. mutans, after incubation at 37°C for 24h and assessed by a turbidimetric technique. Results In vivo no differences were found in plaque growth, for all samples, before and after restoration with both composites; in vitro, instead, a significant reduction of S. mutans growth was found between specimens of two composites (Mann-Whitney U-test p>0,06). Conclusions In this study a relevant consideration was elicited: composite materials, in vivo, do not modify plaque composition of non carious cervical lesions to a potential cariogenic plaque. Key words:Abfraction, restoration, S. mutans, composite, class V. PMID:28149461

Glass ionomer-silver cermet Class II tunnel-restorations for primary molars.

PubMed

Croll, T P

1988-01-01

Tunnel preparations preserve the anatomical marginal ridge and minimize the loss of healthy tooth structure adjacent to the carious lesion. When the practitioner has developed proficiency in restoring class II carious lesions with tunnel restorations, less treatment time is required than with traditional class II preparations. The technique for restoring a primary first molar with a class II carious lesion, using a tunnel preparation and Ketac-Silver restorative material is described.

Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions☆

PubMed Central

Lawson, Nathaniel C.; Robles, Augusto; Fu, Chin-Chuan; Lin, Chee Paul; Sawlani, Kanchan; Burgess, John O.

2016-01-01

Objectives To compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs). Methods 37 adults were recruited with 3 or 6 NCCLs (>1.5 mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan–Meier method was used to compare the retention between adhesive materials. Results Clinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (p <0.0001). Both Scotchbond Universal self-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively. Conclusions Scotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively. Clinical significance 24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode. PMID:26231300

The use of JJ stent in the management of deep endometriosis lesion, affecting or potentially affecting the ureter: a review of our practice.

PubMed

Weingertner, A S; Rodriguez, B; Ziane, A; Gibon, E; Thoma, V; Osario, F; Haddad, C; Wattiez, A

2008-08-01

With the increasing number of operative laparoscopies performed for the treatment of deep pelvic endometriosis, technical difficulties and risk of complications inevitably increase. We report our experience using JJ stents, in women treated for deep pelvic endometriosis, with regard to prevention and management of ureteral lesions. Descriptive retrospective analysis between March 2004 and March 2007. Department of Obstetrics and Gynaecology, University Hospital, Strasbourg, France. Cases of women who underwent laparoscopic surgery for severe endometriosis and who needed a JJ stent in their management were recorded. Laparoscopic surgery was performed at the Department of Obstetrics and Gynaecology at CMCO-SIHCUS and Hautepierre Hospitals, Strasbourg, which are referral centres in the treatment of deep endometriosis. To evaluate the contribution of JJ stent in the prevention and management of ureteral lesions from endometriotic origin and/or iatrogenic origin in women treated for deep pelvic endometriosis. A total of 145 women had surgery for deep pelvic endometriosis. Seventeen (11.7%) women had a JJ ureteral stent inserted. In 82.4% of women, the stent was inserted pre- or peroperatively. We noted three ureteral complications, of which only one needed management by laparotomy. Except in extreme cases, management of ureteral endometriosis should be performed laparoscopically. Ureteral lesions whether iatrogenic, or secondary to endometriotic disease, can be treated by cystoscopy, JJ stent and laparoscopy. The combination of these three elements is the optimal management and is unlikely to cause subsequent complications. Laparotomy and its associated morbidity should be avoided.

Comparison of endoscope- versus microscope-assisted resection of deep-seated intracranial lesions using a minimally invasive port retractor system.

PubMed

Hong, Christopher S; Prevedello, Daniel M; Elder, J Bradley

2016-03-01

Tubular brain retractors may improve access to deep-seated brain lesions while potentially reducing the risks of collateral neurological injury associated with standard microsurgical approaches. Here, microscope-assisted resection of lesions using tubular retractors is assessed to determine if it is superior to endoscope-assisted surgery due to the technological advancements associated with modern tubular ports and surgical microscopes. Following institutional approval of the tubular port, data obtained from the initial 20 patients to undergo transportal resection of deep-seated brain lesions were analyzed in this study. The pathological entities of the resected tissues included metastatic tumors (8 patients), glioma (7), meningioma (1), neurocytoma (1), radiation necrosis (1), primitive neuroectodermal tumor (1), and hemangioblastoma (1). Surgery incorporated endoscopic (5 patients) or microscopic (15) assistance. The locations included the basal ganglia (11 patients), cerebellum (4), frontal lobe (2), temporal lobe (2), and parietal lobe (1). Cases were reviewed for neurological outcomes, extent of resection (EOR), and complications. Technical data for the port, surgical microscope, and endoscope were analyzed. EOR was considered total in 14 (70%), near total (> 95%) in 4 (20%), and subtotal (< 90%) in 2 (10%) of 20 patients. Incomplete resection was associated with the basal ganglia location (p < 0.05) and use of the endoscope (p < 0.002). Four of 5 (80%) endoscope-assisted cases were near-total (2) or subtotal (2) resection. Histopathological diagnosis, presenting neurological symptoms, and demographics were not associated with EOR. Complication rates were low and similar between groups. Initial experience with tubular retractors favors use of the microscope rather than the endoscope due to a wider and 3D field of view. Improved microscope optics and tubular retractor design allows for binocular vision with improved lighting for the resection of deep

Effectiveness of Photogem® activated by LED on the decontamination of artificial carious bovine dentin

NASA Astrophysics Data System (ADS)

Giusti, J. S. M.; Santos-Pinto, L.; Pizzolitto, A. C.; Kurachi, C.; Bagnato, V. S.

2006-05-01

The aim of this study was the evaluation of the effectiveness of photodynamic therapy on the decontamination of artificially induced carious bovine dentin, using Photogem® as the photosensitizer agent and an LED device as a light source. Dentin samples obtained from bovine incisors were immersed in sterile broth supplemented by Lactobacillus acidophillus 108 colony formation units (CFU) and Streptococcus mutans 108 CFU. Different concentrations of photosensitizer, PA = 1 mg/ml, PB = 2 mg/ml, and PC = 3 mg/ml, and two fluences, D = 24 J/cm2 and D = 48 J/cm2, were investigated. After CFU counting per milligram of carious dentin and statistical analysis, we observed that the photodynamic therapy (PDT) parameters used were effective for bacterial reduction in the in vitro model under study. The best result was achieved with the application of Photogem® at 2 mg/ml and photoactivated under 24 J/cm2 showing a survival factor of 0.14. At higher photosensitizer concentrations, a higher dark toxicity was observed. We propose a simple mathematical expression for the determination of PDT parameters of photosensitizer concentration and light fluence for different survival factor values. Since LED devices are simpler and cheaper compared to laser systems, it would be interesting to verify their efficacy as a light source in photodynamic therapy for the decontamination of carious dentin.

Characterization of acute and long-term pathologies of superficial and deep dermal sulfur mustard skin lesions in the hairless guinea pig model.

PubMed

Dachir, Shlomit; Cohen, Maayan; Kamus-Elimeleh, Dikla; Fishbine, Eliezer; Sahar, Rita; Gez, Rellie; Brandeis, Rachel; Horwitz, Vered; Kadar, Tamar

2012-01-01

Sulfur mustard induces severe acute and prolonged damage to the skin and only partially effective treatments are available. We have previously validated the use of hairless guinea pigs as an experimental model for skin lesions. The present study aimed to characterize a model of a deep dermal lesion and to compare it with the previously described superficial lesion. Clinical evaluation of the lesions was conducted using reflectance colorimetry, trans-epidermal water loss and wound area measurements. Prostaglandin E(2) content, matrix metalloproteinase-2 and 9 activity, and histopathology were conducted up to 4 weeks post-exposure. Sulfur mustard skin injury, including erythema and edema, impairment of skin barrier and wounds developed in a dose-dependent manner. Prostaglandin E(2) content and matrix metalloproteinase-2 and 9 activities were elevated during the wound development and the healing process. Histological evaluation revealed severe damage to the epidermis and deep dermis and vesications. At 4 weeks postexposure, healing was not completed: significantly impaired stratum corneum, absence of hair follicles, and epidermal hyperplasia were observed. These results confirm the use of the superficial and deep dermal skin injuries in the hairless guinea pigs as suitable models that can be utilized for the investigation of the pathological processes of acute as well as long-term injuries. These models will be further used to develop treatments to improve the healing process and prevent skin damage and long-term effects. © 2012 by the Wound Healing Society.

Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm.

PubMed

Lee, Chulsung; Lee, Dustin; Darling, Cynthia L; Fried, Daniel

2010-01-01

The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (p<0.05). The Ge-enhanced CMOS camera equipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm

PubMed Central

Lee, Chulsung; Lee, Dustin; Darling, Cynthia L.; Fried, Daniel

2010-01-01

The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (p<0.05). The Ge-enhanced CMOS camera equipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity. PMID:20799842

Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm

NASA Astrophysics Data System (ADS)

Lee, Chulsung; Lee, Dustin; Darling, Cynthia L.; Fried, Daniel

2010-07-01

The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (p<0.05). The Ge-enhanced CMOS camera equipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

Clinical evaluation of demineralization and remineralization of intact root surface lesions in the clinic by a quantitative light-induced fluorescence system.

PubMed

Durmusoglu, Oykü; Tağtekin, Dilek Arslantunali; Yanikoğlu, Funda

2012-03-01

Detection of demineralization of root surface caries is an important issue since preventive approaches prolong tooth life. Quantitative light-induced fluorescence (QLF) has been shown to be useful for the laboratory assessment of demineralization of root surfaces. The aim of this study was to determine the demineralization and remineralization of root surface intact and cavitated caries lesions using a QLF system as a nondestructive in vivo method. Noncavitated and demineralized root surface lesions were detected and scored using the QLF system. Oral hygiene education was given and periodontal cleaning was completed before the remineralization treatment. After obtaining baseline QLF data, the patients were informed about the remineralization treatment. Fluoride varnish was applied to the carious lesions at the baseline visit, and the patients were then reviewed after 1, 2, 3 and 4 weeks, with QLF assessment and fluoride varnish application repeated at each review. Repeated-measures ANOVA (α = 0.05) showed significant differences between ΔQ values at each visit (p < 0.001); ΔQ showed marked decreases at all the cut-off values (15, 20, 25, 30). The changes in ΔQ were not affected by the cut-off value. The ΔQ values of QLF showed differences at all visits. The QLF system was able to detect early root surface caries lesions in vivo. Bifluoride 12 varnish improved mineral levels as shown by the QLF system. The treatment response to chemicals of intact noncavitated root surface carious lesions could be followed nondestructively in the clinic using QLF to quantify remineralization at recall visits. Teeth with root surface caries can be kept by controlling their remineralization.

Newly developed hardness testing system, "Cariotester": measurement principles and development of a program for measuring Knoop hardness of carious dentin.

PubMed

Shimizu, Akihiko; Nakashima, Syozi; Nikaido, Toru; Sugawara, Toyotaro; Yamamoto, Takatsugu; Momoi, Yasuko

2013-01-01

We previously discovered that when a cone-shaped indenter coated with paint was pressed into an object, the paint disappeared in accordance with the depth of the indentation. Based on this fact, we developed the Cariotester, a portable system for measuring the Knoop hardness (KHN) of carious dentin. The Cariotester is composed of a handpiece with an indenter, a microscope, and a computer. In this system, the painted indenter is forced into the material with a 150-gf load, and the indentation depth (CT depth) is obtained from the paint disappearance. The CT depth by the Cariotester and the KHN by a microhardness tester were determined at 14 dentin regions. From the data, a program was created to convert the CT depth of the carious dentin into the KHN. As a result, if the CT depth is measured with this system, the KHN of carious dentin can be displayed in real time.

The Hall Technique for managing carious primary molars.

PubMed

Innes, Nicola; Evans, Dafydd; Hall, Norna

2009-10-01

The Hall Technique, a method of managing carious primary molars effectively with preformed metal crowns, without the use of local anaesthesia, caries removal or tooth preparation of any kind, is described.The technique is illustrated with a case report.The evidence underpinning the technique is discussed, along with indications and contra-indications for its use, and details of where clinicians can obtain further information on the technique if they are considering using it. Research evidence has indicated that the Hall Technique is effective in managing dental caries in primary molar teeth when used by General Dental Practitioners, and is preferred by them, their child patients and the children's parents to conventional restorative methods for these teeth.

Stereomicroscopic study of the human tooth caries: clinical and morphological correlations

NASA Astrophysics Data System (ADS)

Oancea, Roxana; Vasile, Liliana; Marchese, Cristian; Sava-Rosianu, Ruxandra

2012-06-01

Objectives: Stereomicroscopy allows a three-dimensional study of the images and of laterality at superior quality in comparison with other methods. Those advantages are given by the large examination fields and the wide work distances. The adding of the clinical and morphological data at the results gathered with stereomicroscopy and the stereo micrometry is useful in order to appreciate the deepness and the widening of the carious process, and the necessity to reconsider the therapeutically strategy. Materials and methods: During 2009-2011 the study material was represented by 10 surgically removed impacted third molars, and by 20 premolars extracted for orthodontic purposes, with closed and macroscopically apparently integer surfaces. 13 premolars with different degrees of carious affectation and periodontal lesions, which were surgically extracted without trauma, were also selected. The in situ measurements at the occlusal site were realized through the utilization of a fluorescent laser device - DIAGNOdent. The basic principles in stereomicroscopy stood at the base of the obliquely and circularly coaxial illumination techniques, one with optical alignment adjustment of the optical microscope and mechanical adjustment for the optimal illumination and micrometry. The Olympus Microscope SZ ×7 and an Olympus camera with 2,5 × digital zoom and a 3× optical zoom has been used to study the samples in stereomicroscopy and through polarized light it. Results: The DiagnoDent measured the following data: out of 43 apparently healthy teeth, 18 presented values between 2 and 13 (D1), 13 showed values between 14 and 24 (D2), 12 measured values over 24 (D3). After the histological examination in stereomicroscopy and in the polarized light: 25 teeth were healthy, 10 presented caries extended in dental enamel and 8 presented dentinal caries. Stereomicroscopy has allowed the morphological study, the color absorption, the appreciation of the lesions' deepness and substance

Optical Assessment of Caries Lesion Structure and Activity

NASA Astrophysics Data System (ADS)

Lee, Robert Chulsung

technology will be employed for the detection and monitoring of early carious lesions without the use of ionizing radiation, thereby enabling conservative non-surgical intervention and the preservation of healthy tissue structure.

Application of NIR Raman spectroscopy for detecting and characterizing early dental caries

NASA Astrophysics Data System (ADS)

Ko, A. C.; Choo-Smith, L.-P.; Zhu, R.; Hewko, M.; Dong, C.; Cleghorn, B.; Sowa, M. G.

2006-02-01

Early dental caries detection facilitates implementation of non-surgical methods for arresting caries progression and promoting tooth remineralization. We present a method based on Raman spectroscopy with near-IR laser excitation to provide biochemical contrast for detecting and characterizing incipient carious lesions found in extracted human teeth. Changes in Raman spectra are observed in PO 4 3- vibrations arising from hydroxyapatite of mineralized tooth tissue. Examination of various intensities of the PO 4 3- ν2, ν3, ν4 vibrations showed consistent increased intensities in spectra of carious lesions compared to sound enamel. The spectral changes are attributed to demineralization-induced alterations of enamel crystallite morphology and/or orientation. This hypothesis is supported by reduced Raman polarization anisotropy derived from polarized Raman spectra of carious lesions. Polarized Raman spectral imaging of carious lesions found on whole (i.e. un-sectioned) tooth samples will also be presented.

Odontoblastic differentiation of dental pulp stem cells from healthy and carious teeth on an original PCL-based 3D scaffold.

PubMed

Louvrier, A; Euvrard, E; Nicod, L; Rolin, G; Gindraux, F; Pazart, L; Houdayer, C; Risold, P Y; Meyer, F; Meyer, C

2018-05-01

To isolate and characterize dental pulp stem cells (DPSCs) obtained from carious and healthy mature teeth extracted when conservative treatment was not possible or for orthodontic reasons; to evaluate the ability of DPSCs to colonize, proliferate and differentiate into functional odontoblast-like cells when cultured onto a polycaprolactone cone made by jet-spraying and prototyped into a design similar to a gutta-percha cone. DPSCs were obtained from nine carious and 12 healthy mature teeth. Then cells were characterized by flow cytometry and submitted to multidifferentiation to confirm their multipotency. These DPSCs were then cultured on a polycaprolactone cone in an odontoblastic differentiation medium. Cell proliferation, colonization of the biomaterial and functional differentiation of cells were histologically assessed. For the characterization, a t-Student test was used to compare the two groups. In all cell cultures, characterization highlighted a mesenchymal stem cell phenotype (CD105+, CD90+, CD73+, CD11b-, CD34-, CD45-, HLA-DR-). No significant differences were found between cultures obtained from carious and healthy mature teeth. DPSCs from both origins were able to differentiate into osteocytes, adipocytes and chondrocytes. Cell colonization was observed both on the surface and in the thickness of polycaprolactone cones as well as a mineralized pericellular matrix deposit composed of type I collagen, alkaline phosphatase, osteocalcin and dentin sialophosphoprotein. DPSCs were isolated from both carious and healthy mature teeth. They were able to colonize and proliferate within a polycaprolactone cone and could be differentiated into functional odontoblast-like cells. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Molecular detection of bacteria associated to caries activity in dentinal lesions.

PubMed

Neves, Beatriz Gonçalves; Stipp, Rafael Nóbrega; da Silva Bezerra, Daniela; de Figueiredo Guedes, Sarah Florindo; Rodrigues, Lidiany Karla Azevedo

2017-07-01

This study aimed at identifying and quantifying Actinomyces naeslundii, Bifidobacterium spp., Streptococcus mitis group, Lactobacillus acidophilus, Lactobacillus casei group, Streptococcus gordonii, and Streptococcus mutans in active and inactive carious dentine lesions of children with early childhood caries by using quantitative polymerase chain reaction. Fifty-six dentin lesion samples, classified as active (n = 39) or inactive (n = 17), were collected from children aged from 2 to 5 years old. Dentinal-cavitated lesions were evaluated by Nyvad criteria for the assessment of caries lesion activity. Relative quantification revealed that Bifidobacterium spp. and the L. casei group were significantly more abundant in active dentin lesions (p < 0.05). Concentrations of A. naeslundii, S. mitis group, and S. gordonii were not significantly different when comparing dentin lesion activity. The relative proportion of S. mutans was significantly greater in inactive than in active lesions (p < 0.05). Bifidobacterium spp. and L. casei group demonstrated a positive correlation (p = 0.001) in active lesions. The positive detection of L. acidophilus (odds ratio = 15.1) and S. gordonii (odds ratio = 7.7) was significantly associated to the active lesions. The data indicate that higher detection levels of Bifidobacterium spp. and the L. casei group may be linked to dentin lesion activity. Additionally, the presence of L. acidophilus and S. gordonii was associated with lesion activity. Considering that information about the oral microbiota related to dentin caries activity status is relevant, this study provides insights to better understand the differences in the microbiotas between active and arrested dentin cavities.

Radiofrequency Lesions through Deep Brain Stimulation Electrodes in Movement Disorders: Case Report and Review of the Literature.

PubMed

Pérez-Suárez, Javier; Torres Díaz, Cristina V; López Manzanares, Lydia; Navas García, Marta; Pastor, Jesús; Barrio Fernández, Patricia; G de Sola, Rafael

2017-01-01

Although there are few reports of radiofrequency lesions performed through deep brain stimulation (DBS) electrodes in patients with movement disorders, experience with this method is scarce. We present 2 patients who had been previously treated with DBS of subthalamic nuclei (STN) and the ventral intermediate (VIM) nucleus of the thalamus for Parkinson's disease and essential tremor, respectively, and underwent a radiofrequency lesion through their DBS electrodes after developing a hardware infection. The authors conduct a review of the literature regarding this method. Both patients had a good clinical outcome after 20 and 8 months, respectively, as assessed by a reduction in Fahn-Tolosa-Marin Scale and Unified Parkinson's Disease Rating Scale scores. The second patient underwent a second DBS system implantation surgery after his radiofrequency treatment to optimize his management, achieving optimal clinical control with lower current and drug requirements than before the radiofrequency intervention. No adverse effects were observed. Radiofrequency lesions through DBS electrodes allow the creation of small and localized lesions. Its effectiveness and low-risk profile, in addition to its low cost, make this procedure suitable and a possible alternative in the therapeutic repertoire for the surgical treatment of movement disorders. © 2017 S. Karger AG, Basel.

Performance comparison of deep learning and segmentation-based radiomic methods in the task of distinguishing benign and malignant breast lesions on DCE-MRI

NASA Astrophysics Data System (ADS)

Antropova, Natasha; Huynh, Benjamin; Giger, Maryellen

2017-03-01

Intuitive segmentation-based CADx/radiomic features, calculated from the lesion segmentations of dynamic contrast-enhanced magnetic resonance images (DCE-MRIs) have been utilized in the task of distinguishing between malignant and benign lesions. Additionally, transfer learning with pre-trained deep convolutional neural networks (CNNs) allows for an alternative method of radiomics extraction, where the features are derived directly from the image data. However, the comparison of computer-extracted segmentation-based and CNN features in MRI breast lesion characterization has not yet been conducted. In our study, we used a DCE-MRI database of 640 breast cases - 191 benign and 449 malignant. Thirty-eight segmentation-based features were extracted automatically using our quantitative radiomics workstation. Also, 2D ROIs were selected around each lesion on the DCE-MRIs and directly input into a pre-trained CNN AlexNet, yielding CNN features. Each method was investigated separately and in combination in terms of performance in the task of distinguishing between benign and malignant lesions. Area under the ROC curve (AUC) served as the figure of merit. Both methods yielded promising classification performance with round-robin cross-validated AUC values of 0.88 (se =0.01) and 0.76 (se=0.02) for segmentationbased and deep learning methods, respectively. Combination of the two methods enhanced the performance in malignancy assessment resulting in an AUC value of 0.91 (se=0.01), a statistically significant improvement over the performance of the CNN method alone.

[High-Definition Exoscope System for Microneurosurgery:Use of an Exoscope in Combination with Tubular Retraction and Frameless Neuronavigation for Microsurgical Resection of Deep Brain Lesions].

PubMed

Nagatani, Kimihiro; Takeuchi, Satoru; Feng, Dongxia; Mori, Kentaro; Day, J Diaz

2015-07-01

The high-definition exoscope (VITOM®, Karl Storz GmbH & Co., Tuttlingen, Germany) is a new equipment that can be used as an alternative to the operating microscope in neurosurgery. Several neurosurgeons have recently reported that the exoscope allows for long working distances and great depth of field. Herein, we review reported cases of exoscope use in neurosurgery. We also describe the advantages of the exoscope compared to the operating microscope and endoscope. Furthermore, we introduce a novel technique for microsurgical resection of deep brain lesions, in which the exoscope is used along with tubular retraction and frameless neuronavigation. Before the operation, neuronavigation is registered and the surgical trajectory is planned to avoid damaging the functional cortex and eloquent white matter tracts. By using intraoperative neuronavigation, the tubular retractor (NICO BrainPath®, NICO Corporation, Indianapolis, US), which is designed to split the white matter when gently inserted, is inserted transcortically into the brain to reach the lesion, along the preplanned trajectory. After insertion, the tubular retractor is fixed in place using a self-retaining arm. This creates a narrow corridor that enables the use of the exoscope (for optimum visualization), bimanual dissection technique, and long bayoneted surgical instruments. The large focal distance of the exoscope allows it to be placed sufficiently further away from the surgical site, permitting the passage of long surgical instruments under the scope. Although obtaining surgical access to deep-seated brain lesions is challenging, we consider that this technique facilitates a safe surgical approach for lesions in deep locations.

Dental Calculus Arrest of Dental Caries.

PubMed

Keyes, Paul H; Rams, Thomas E

An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. These observations further document the potential protective effects of dental calculus mineralization against dental caries.

Dental Calculus Arrest of Dental Caries

PubMed Central

Keyes, Paul H.; Rams, Thomas E.

2016-01-01

Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993

Multiple Hereditary Osteochondromatosis: A Case Report

PubMed Central

Küçükesmen, Çiḡdem; Özen, Buḡra; Akçam, Mustafa

2007-01-01

Objectives Common carious lesions owing to vomiting are not widespread in children. In this case, we aimed to report an 11-years-old male patient with common carious lesions due to repeated vomitings, chewing and eating difficulty and retarded growth with Multiple Hereditary Osteochondromatosis (MHO). Case Report An 11-years-old boy was referred to Department of Pediatric Dentistry in Faculty of Dentistry because of eating difficulty owing to common carious lesions. It was seen that the patient growth was generally retarded in extra-oral examination. Some exostoses were also present on the extremities. It was learned that he was previously diagnosed as MHO in Faculty of Medicine. Nausea and vomiting have been commonly occurring after taking of Didronat. Chewing and eating difficulty and inadequate nutrition were present because of bad oral hygiene, carious lesions and remained roots. Growth was negatively affected by malnutrition and MHO. Results Diet recommendations were given and oral hygiene behaviors were rearranged. Preventive, surgical, restorative and prosthetical dental applications were applied for dental treatments. PMID:19212564

Molecular analysis of microbial diversity in advanced caries.

PubMed

Chhour, Kim-Ly; Nadkarni, Mangala A; Byun, Roy; Martin, F Elizabeth; Jacques, Nicholas A; Hunter, Neil

2005-02-01

Real-time PCR analysis of the total bacterial load in advanced carious lesions has shown that the total load exceeds the number of cultivable bacteria. This suggests that an unresolved complexity exists in bacteria associated with advanced caries. In this report, the profile of the microflora of carious dentine was explored by using DNA extracted from 10 lesions selected on the basis of comparable total microbial load and on the relative abundance of Prevotella spp. Using universal primers for the 16S rRNA gene, PCR amplicons were cloned, and approximately 100 transformants were processed for each lesion. Phylogenetic analysis of 942 edited sequences demonstrated the presence of 75 species or phylotypes in the 10 carious lesions. Up to 31 taxa were represented in each sample. A diverse array of lactobacilli were found to comprise 50% of the species, with prevotellae also abundant, comprising 15% of the species. Other taxa present in a number of lesions or occurring with high abundance included Selenomonas spp., Dialister spp., Fusobacterium nucleatum, Eubacterium spp., members of the Lachnospiraceae family, Olsenella spp., Bifidobacterium spp., Propionibacterium sp., and Pseudoramibacter alactolyticus. The mechanisms by which such diverse patterns of bacteria extend carious lesions, including the aspect of infection of the vital dental pulp, remain unclear.

Comparative evaluation of remineralization potential of casein phosphopeptide-amorphous calcium phosphate and casein phosphopeptide-amorphous calcium phosphate fluoride on artificial enamel white spot lesion: an in vitro light fluorescence study.

PubMed

Mehta, R; Nandlal, B; Prashanth, S

2013-01-01

World-wide, the contribution of dental caries to the burden of oral diseases is about 10 times higher than that of periodontal disease, the other common oral condition. Owing to its globally high prevalence, dental caries is a "pandemic" disease characterized by a high percentage of untreated carious cavities causing pain, discomfort and functional limitations. Untreated carious cavities; furthermore, have a significant impact on the general health of children and on the social and economic well-being of communities. A surgical approach to the elimination of carious lesion was developed a century ago; this approach was necessary at that time, because there was no valid alternative. The focus in caries has recently shifted to the development of methodologies for the detection of the early stages of caries lesions and the non-invasive treatment of these lesions. The non-invasive treatment of early lesions by remineralization has the potential to be a major advance in the clinical management of the disease. Remineralization of white-spot lesions may be possible with a variety of currently available agents containing fluoride, bioavailable calcium and phosphate and phosphate. This concept bridges the traditional gap between prevention and surgical procedures, which is just what dentistry needs today. The aim of this in vitro study was to evaluate and to compare the remineralization potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) on artificial white spot enamel lesions using the quantitative light fluorescence (QLF). A total of 45 caries-free extracted maxillary first premolars were embedded in acrylic resin. The samples were randomly divided into three groups namely control group, CPP-ACP group and CPP-ACFP group with 15 samples in each group. The samples of each group were subjected to demineralization process for a period of 96 h. The samples were then mounted in the

Deep 3D Convolutional Encoder Networks With Shortcuts for Multiscale Feature Integration Applied to Multiple Sclerosis Lesion Segmentation.

PubMed

Brosch, Tom; Tang, Lisa Y W; Youngjin Yoo; Li, David K B; Traboulsee, Anthony; Tam, Roger

2016-05-01

We propose a novel segmentation approach based on deep 3D convolutional encoder networks with shortcut connections and apply it to the segmentation of multiple sclerosis (MS) lesions in magnetic resonance images. Our model is a neural network that consists of two interconnected pathways, a convolutional pathway, which learns increasingly more abstract and higher-level image features, and a deconvolutional pathway, which predicts the final segmentation at the voxel level. The joint training of the feature extraction and prediction pathways allows for the automatic learning of features at different scales that are optimized for accuracy for any given combination of image types and segmentation task. In addition, shortcut connections between the two pathways allow high- and low-level features to be integrated, which enables the segmentation of lesions across a wide range of sizes. We have evaluated our method on two publicly available data sets (MICCAI 2008 and ISBI 2015 challenges) with the results showing that our method performs comparably to the top-ranked state-of-the-art methods, even when only relatively small data sets are available for training. In addition, we have compared our method with five freely available and widely used MS lesion segmentation methods (EMS, LST-LPA, LST-LGA, Lesion-TOADS, and SLS) on a large data set from an MS clinical trial. The results show that our method consistently outperforms these other methods across a wide range of lesion sizes.

Removing or Controlling? How Caries Management Impacts on the Lifetime of Teeth.

PubMed

Schwendicke, Falk; Lamont, Thomas; Innes, Nicola

2018-05-24

Historically, traditional carious lesion management focused on the importance of removal of all carious tissue, with little thought to the lesion origins. The surgical removal of any sign of a carious lesion was prioritised with little, or no, consideration to pulp vitality, loss of tooth structure, or caries disease management. This symptomatic approach concentrating on lesions rather than on the cause of the disease, focused on preventing secondary carious lesion development. Early detection and improved understanding of the caries process - that lesion progress can be arrested or slowed - has led to preventive measures and less destructive management as a focus. The choice of lesion management depends on: whether a primary or permanent tooth is involved; which tooth surface(s) is/are involved; whether the lesion is confined to enamel or extends into dentine; the lesion depth, and lesion cleansability. Use of preventive and minimally invasive operative strategies is complicated by the lack of predictable ways of recording lesions' status to allow early detection of failed strategies and early intervention. Because re-restoration usually makes the cavity larger and, consequently, the tooth weaker, the clinician should be certain about initiating the repeat restoration cycle, delaying the first restoration as much as possible. The 3 main principles that support preventing or slowing the repeat restoration cycle are: (1) avoid restoration placement until there is no other option; (2) place them for maximum longevity; (3) if re-restoration is necessary, repair or refurbishment is preferable to replacement of a defective restoration. © 2018 S. Karger AG, Basel.

Influence of education level and experience on detection of approximal caries in digital dental radiographs. An in vitro study.

PubMed

Hellén-Halme, Kristina; Petersson, Gunnel Hänsel

2010-01-01

This study evaluated whether variations in education level and experience among dental staff influence the diagnostic accuracy of carious lesions on digital radiographs. Three student groups and a fourth group of general practitioners (Dentists) with more than five years of clinical experience participated in this study.The student groups were (i) dental students in their final (tenth) semester (DS-10), (ii) dental students in the sixth semester (DS-6) who just finished dental radiology training, and (iii) dental hygiene students (DHS) in their final (fourth) semester. Seven observers from each group participated. Standard radiographs of 100 extracted teeth (premolars and molars) were taken. The 28 observers evaluated the images for approximal carious lesions on a standard monitor. All evaluations were made in ambient light below 50 lux. Receiver operating characteristic curves were plotted to assess results. The standard criterion for healthy or carious lesions was a histological examination of sliced teeth. Kappa statistics evaluated intra-observer agreement. For carious lesions that had extended into the dentine, significant differences were found between (i) Dentists and all other groups, (ii) Dentists and DS-10 (p < 0.01), and (iii) Dentists and DS-6 and DHS (p < 0.001). Differences between DS-10 and DHS (p < or = 0.05) were also significant. In this study, education level and experience clearly influenced the diagnostic accuracy of approximal carious lesions that had extended into the dentine on digital radiographs.

Relationship between caries experience and demarcated hypomineralised lesions (including MIH) in the permanent dentition of 15-year-olds.

PubMed

Kühnisch, Jan; Kabary, Lamiaa; Malyk, Yuri; Rothmaier, Katrin; Metz, Isabel; Hickel, Reinhard; Heinrich, Joachim; Manton, David; Standl, Marie

2018-06-01

This cross-sectional study compared the caries experience in 15-year-olds with and without demarcated hypomineralised lesions (DHL) in permanent teeth. One thousand three hundred and two 15-year-old adolescents from two ongoing birth cohorts (GINIplus15 and LISAplus15) were examined to determine non-cavitated carious lesions (NCCL) and the DMF index. Furthermore, DHL was scored on all permanent teeth/surfaces according to the molar-incisor hypomineralisation criteria of the European Academy of Paediatric Dentistry (MIH/EAPD). Adolescents with DHL were categorised into those with a minimum of one DHL in the permanent dentition (DHL ≥ 1), with DHL on at least one first permanent molar (MIH/EAPD) and with DHL on at least one first permanent molar and permanent incisor (MIH/Severe). The study was conducted in the metropolitan area of Munich. The proportion of children without caries amounted to 63.7% (DMF > 0) and 26.0% (D 1-4 MF > 0); the caries experience was mean = 4.0(SD = 5.2) NCCL/T and 0.9(1.7) DMF/T. Existence of DHL ≥ 1, MIH/EAPD and MIH/Severe was detected in 40.2, 17.2 and 9.8% of all adolescents, respectively. The corresponding DMF/T values were: no DHL 0.9(1.7); DHL ≥ 1 1.0(1.7); MIH/EAPD 1.1(1.6); MIH/Severe 1.1(1.7). The group of adolescents with MIH/EAPD and MIH/Severe were found to have statistically higher caries rates in comparison to those with no DHL. Caries and DHL are prevalent and influenced the dental health of 15-year-old adolescents. A significant positive association existed between the presence of caries and DHL. Children with MIH/EAPD or MIH/Severe had a higher probability to develop carious lesions in the permanent dentition.

Parental attitudes to the care of the carious primary dentition experience from a Nigerian tertiary hospital.

PubMed

Popoola, B O; Kolude, B; Denloye, O O

2013-03-01

To examine the factors associated with parents choices of dental care concerning carious primary teeth of their children. A structured, self administered questionnaire was issued to parents of children attending the paediatric dental clinic of the University College Hospital (UCH) Ibadan. Items in the questionnaire included a section on the past dental visit(s) of parents, reason(s) for the clinic attendance and treatment(s) received, the second section contained items on parental treatment preferences under two different clinical scenarios of child dental health; scenario 1, asymptomatic carious primary tooth and scenario 2, symptomatic carious primary tooth. The last section contained items on determinants of parents' choice of treatment. Majority of the accompanying parent were mothers (75.8%) with a mean age of 39.3 +/- 6.81, fathers were 20.8% with a mean age of 45.1 +/- 5.24 while others were 3.4% with a mean age of 51.2 +/- 1.09. Under the two clinical scenarios, majority of the parents preferred the dentist to determine the treatment of their children (scenario 1 = 53.7%; scenario 2 = 62.5%). The accompanying parents and their socioeconomic status had no significant effect on parental preferences under the two clinical scenarios while past parental dental treatment had the greatest influence on parental choice (scenario 1:x2 = 12.93; p = 0.03 for past fillings experience and scenario 2: X2 = 6.881. = X 0.001 for past extraction experience). The reliance of parents on dentist for decision on the choice of their children dental treatment and the dependence of parents choice on their past dental treatment experience suggested the need for dental health education to both parents and children on dental caries.

Deep Learning in Gastrointestinal Endoscopy.

PubMed

Patel, Vivek; Armstrong, David; Ganguli, Malika; Roopra, Sandeep; Kantipudi, Neha; Albashir, Siwar; Kamath, Markad V

2016-01-01

Gastrointestinal (GI) endoscopy is used to inspect the lumen or interior of the GI tract for several purposes, including, (1) making a clinical diagnosis, in real time, based on the visual appearances; (2) taking targeted tissue samples for subsequent histopathological examination; and (3) in some cases, performing therapeutic interventions targeted at specific lesions. GI endoscopy is therefore predicated on the assumption that the operator-the endoscopist-is able to identify and characterize abnormalities or lesions accurately and reproducibly. However, as in other areas of clinical medicine, such as histopathology and radiology, many studies have documented marked interobserver and intraobserver variability in lesion recognition. Thus, there is a clear need and opportunity for techniques or methodologies that will enhance the quality of lesion recognition and diagnosis and improve the outcomes of GI endoscopy. Deep learning models provide a basis to make better clinical decisions in medical image analysis. Biomedical image segmentation, classification, and registration can be improved with deep learning. Recent evidence suggests that the application of deep learning methods to medical image analysis can contribute significantly to computer-aided diagnosis. Deep learning models are usually considered to be more flexible and provide reliable solutions for image analysis problems compared to conventional computer vision models. The use of fast computers offers the possibility of real-time support that is important for endoscopic diagnosis, which has to be made in real time. Advanced graphics processing units and cloud computing have also favored the use of machine learning, and more particularly, deep learning for patient care. This paper reviews the rapidly evolving literature on the feasibility of applying deep learning algorithms to endoscopic imaging.

Disseminated paracoccidioidomycosis diagnosis based on oral lesions.

PubMed

Webber, Liana Preto; Martins, Manoela Domingues; de Oliveira, Márcia Gaiger; Munhoz, Etiene Andrade; Carrard, Vinicius Coelho

2014-04-01

Paracoccidioidomycosis (PCM) is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.

Oral diagnosis and treatment planning: part 4. Non-carious tooth surface loss and assessment of risk.

PubMed

Kaidonis, J A

2012-08-01

Non-carious tooth surface loss or tooth wear is becoming an increasingly significant factor affecting the long-term health of the dentition. The adverse effects of tooth wear are becoming increasingly apparent both in young persons and, as more people retain their teeth, into old age. This situation challenges the preventive and restorative skills of dental practitioners.

Deep versus periventricular white matter lesions and cognitive function in a community sample of middle-aged participants.

PubMed

Soriano-Raya, Juan José; Miralbell, Júlia; López-Cancio, Elena; Bargalló, Núria; Arenillas, Juan Francisco; Barrios, Maite; Cáceres, Cynthia; Toran, Pere; Alzamora, Maite; Dávalos, Antoni; Mataró, Maria

2012-09-01

The association of cerebral white matter lesions (WMLs) with cognitive status is not well understood in middle-aged individuals. Our aim was to determine the specific contribution of periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWMHs) to cognitive function in a community sample of asymptomatic participants aged 50 to 65 years. One hundred stroke- and dementia-free adults completed a comprehensive neuropsychological battery and brain MRI protocol. Participants were classified according to PVH and DWMH scores (Fazekas scale). We dichotomized our sample into low grade WMLs (participants without or with mild lesions) and high grade WMLs (participants with moderate or severe lesions). Analyses were performed separately in PVH and DWMH groups. High grade DWMHs were associated with significantly lower scores in executive functioning (-0.45 standard deviations [SD]), attention (-0.42 SD), verbal fluency (-0.68 SD), visual memory (-0.52 SD), visuospatial skills (-0.79 SD), and psychomotor speed (-0.46 SD). Further analyses revealed that high grade DWMHs were also associated with a three- to fourfold increased risk of impaired scores (i.e.,<1.5 SD) in executive functioning, verbal fluency, visuospatial skills, and psychomotor speed. Our findings suggest that only DWMHs, not PVHs, are related to diminished cognitive function in middle-aged individuals. (JINS, 2012, 18, 1-12).

Nondestructive monitoring of the repair of enamel artificial lesions by an acidic remineralization model using polarization – sensitive optical coherence tomography

PubMed Central

Kang, Hobin; Darling, Cynthia L.; Fried, Daniel

2011-01-01

Objectives It is difficult to completely remineralize carious lesions because diffusion into the interior of the lesion is inhibited as new mineral is deposited in the outermost layers. In previous remineralization studies employing polarization sensitive optical coherence tomography (PS-OCT), two models of remineralization were employed and in both models there was preferential deposition of mineral in the outer most layer. In this study we attempted to remineralize the entire lesion using an acidic remineralization model and demonstrate that this remineralization can be monitored using PS-OCT. Methods Artificial lesions approximately 100–150 µm in-depth were exposed to an acidic remineralization regimen and the integrated reflectivity from the lesions was measured before and after remineralization using PS-OCT. Results Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Although there was a high degree of remineralization, there was still incomplete remineralization of the body of the lesion. Conclusion This study demonstrated that PS-OCT can be used to non-destructively measure changes in lesion structure and severity upon exposure to an acidic remineralization model. This study also demonstrated that automated algorithms can be used to assess the lesion severity even with the presence of a weakly reflective surface zone. PMID:22204914

Disseminated paracoccidioidomycosis diagnosis based on oral lesions

PubMed Central

Webber, Liana Preto; Martins, Manoela Domingues; de Oliveira, Márcia Gaiger; Munhoz, Etiene Andrade; Carrard, Vinicius Coelho

2014-01-01

Paracoccidioidomycosis (PCM) is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed. PMID:24963249

Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans

NASA Astrophysics Data System (ADS)

Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

2016-04-01

This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features.

Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans.

PubMed

Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

2016-04-15

This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features.

Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans

PubMed Central

Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

2016-01-01

This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features. PMID:27079888

Female Sexual Function in Women with Suspected Deep Infiltrating Endometriosis.

PubMed

Lima, Ryane Vieira; Pereira, Ana Maria Gomes; Beraldo, Fernando Bray; Gazzo, Cláudia; Martins, João Alfredo; Lopes, Reginaldo Guedes Coelho

2018-03-01

 To evaluate the quality of the sexual function of women with suspected deep infiltrating endometriosis.  A cross-sectional, observational and prospective study was conducted between May 2015 and August 2016, in which 67 patients with deep infiltrating endometriosis, suspected or diagnosed, were assessed for epidemiological and clinical characteristics, such as pain level through a visual analog scale (VAS), features of deep infiltrating endometriosis lesions and score on the Female Sexual Function Index (FSFI) before the onset of treatment. The statistical analysis was performed using the software STATA version 12.0 (StataCorp LLC, College Station, TX, USA) to compare the variables through multiple regression analysis.  The average age of the patients was 39.2 years old; most patients were symptomatic (92.5%); and the predominant location of the deep infiltrating lesions was on the rectosigmoid colon (50%), closely followed by the retrocervical region (48.3%). The median overall score on the FSFI was 23.4; in 67.2% of the cases the score was ≤ 26.5 (cutoff point for sexual dysfunction). Deep dyspareunia ( p  = 0.000, confidence interval [CI]: 0.64-0.83) and rectosigmoid endometriosis lesions ( p  = 0.008, CI: 0.72-0.95) showed significant correlation with lower FSFI scores, adjusted by bladder lesion, patients' age and size of lesions. Deep dyspareunia ( p  = 0.003, CI: 0.49-0.86) also exhibited significant correlation with FSFI pain domain, adjusted by cyclic bowel pain, vaginal lesion and use of gonadotropin-releasing hormone (GnRH) analog. These results reflect the influence of deep dyspareunia on the sexual dysfunction of the analyzed population.  Most patients exhibited sexual dysfunction, and deep dyspareunia was the pelvic painful symptom that showed correlation with sexual dysfunction. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

Enhanced UGT1A1 Gene and Protein Expression in Endometriotic Lesions.

PubMed

Piccinato, Carla A; Neme, Rosa M; Torres, Natália; da Silva Victor, Elivane; Brudniewski, Heloísa F; Rosa E Silva, Júlio C; Ferriani, Rui A

2018-01-01

The cellular function in endometriosis lesions depends on a highly estrogenic milieu. Lately, it is becoming evident that, besides the circulating levels of estrogens, the balance of synthesis versus inactivation (metabolism) of estrogens by intralesion steroid-metabolizing enzymes also determines the local net estrogen availability. In order to extend the knowledge of the role of estrogen-metabolizing enzymes in endometriosis, we investigated the gene and protein expression of a key uridine diphospho-glucuronosyltransferase (UGT) for estrogen glucuronidation, UGT1A1, in eutopic endometrial samples obtained from nonaffected and endometriosis-affected women and also from endometriotic lesions. Although UGT1A1 messenger RNA (mRNA) expression was detected at similar frequencies in endometriotic lesions and in eutopic endometrial samples, the levels of mRNA expression were greater in deep-infiltrating endometriotic lesions and in non-deep-infiltrating lesions when compared with either control endometrium or eutopic endometrium from women with endometriosis. Overall, we observed that protein expression of UGT1A1 was significantly more frequent in samples from endometriotic lesions in comparison with endometria. In addition, expression of UGT1A1 protein was greater in deep-infiltrating than in non-deep-infiltrating endometriotic lesions. We suggest that the finding of increased expression of UGT1A1 in lesions versus endometria might be related to impairment of regulatory mechanisms, in response to a highly estrogenic milieu, and that this enzyme may be a new target for therapy.

Nondestructive monitoring of the repair of enamel artificial lesions by an acidic remineralization model using polarization-sensitive optical coherence tomography.

PubMed

Kang, Hobin; Darling, Cynthia L; Fried, Daniel

2012-05-01

It is difficult to completely remineralize carious lesions because diffusion into the interior of the lesion is inhibited as new mineral is deposited in the outermost layers. In previous remineralization studies employing polarization sensitive optical coherence tomography (PS-OCT), two models of remineralization were employed and in both models there was preferential deposition of mineral in the outer most layer. In this study we attempted to remineralize the entire lesion using an acidic remineralization model and demonstrate that this remineralization can be monitored using PS-OCT. Artificial lesions approximately 100-150 μm in-depth were exposed to an acidic remineralization regimen and the integrated reflectivity from the lesions was measured before and after remineralization using PS-OCT. Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Although there was a high degree of remineralization, there was still incomplete remineralization of the body of the lesion. This study demonstrated that PS-OCT can be used to non-destructively measure changes in lesion structure and severity upon exposure to an acidic remineralization model. This study also demonstrated that automated algorithms can be used to assess the lesion severity even with the presence of a weakly reflective surface zone. Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children

PubMed Central

Tandon, Shobha; Nayak, Rashmi; Ratnanag, P Venkat; Prajapati, Deepesh; Kamath, Namitha

2016-01-01

Aim To assess the effect of combined use of chlorhexidine and fluoride varnish on the remineralization of incipient carious lesions in young children. Materials and methods Twenty caries-active children (80 lesions) were randomly divided into four groups and subjected to initial examination. Caries status was assessed visually and with the aid of DIAGNOdent. Baseline enamel biopsies were obtained. Subjects of groups I and II received fluoride and chlorhexidine varnish respectively. Group III received both fluoride and chlorhexidine varnish alternatively, for a period of 4 weeks. Group IV served as the control. At 3-month follow-up, the incipient lesions were assessed again with DIAGNOdent and enamel biopsy. Results Increased calcium, phosphate, and fluoride levels were noticed in groups I, II, III compared to group IV, at the 3-month follow-up (p < 0.001). Conclusion The combined therapy with fluoride and chlorhex-idine varnish may be considered an alternative therapy for early reversal of incipient lesions. How to cite this article Naidu S, Tandon S, Nayak R, Ratnanag PV, Prajapati D, Kamath N. Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children. Int J Clin Pediatr Dent 2016;9(4):296-302. PMID:28127159

Discriminating solitary cysts from soft tissue lesions in mammography using a pretrained deep convolutional neural network.

PubMed

Kooi, Thijs; van Ginneken, Bram; Karssemeijer, Nico; den Heeten, Ard

2017-03-01

using a resolution of 100 versus 200 micron. The proposed tissue augmentations give a small improvement in performance, but this improvement was also not found to be significant. The final system obtained an AUC of 0.80 with 95% confidence interval [0.78, 0.83], calculated using bootstrapping. The system works best for lesions larger than 27 mm where it obtains an AUC value of 0.87. We have presented a computer-aided diagnosis (CADx) method to discriminate cysts from solid lesion in mammography using features from a deep CNN trained on a large set of mass candidates, obtaining an AUC of 0.80 on a set of diagnostic exams recalled from screening. We believe the system shows great potential and comes close to the performance of recently developed spectral mammography. We think the system can be further improved when more data and computational power becomes available. © 2017 American Association of Physicists in Medicine.

[Caries patterns and diet in early childhood caries].

PubMed

Faye, M; Ba, A A; Yam, A A; Ba, I

2006-01-01

Early childhood caries (EEC) are multiple carious lesions affecting the primary teeth of infants and preschool children. They are related to a prolonged and night bottle-feeding rich in fermentable carbohydrates. The carious lesions characterised by their patterns and the rapidity of their process can lead to a widespread tooth destruction. The aim of this study was to evaluate the patterns of the carious lesions and their relationship to the diet. This prospective study was carried out in Dakar in public heath structures that have a dental office. It has included 68 children of both sex aged from two to 6 years consisted of 35 boys (51% of the sample) and 33 girls (49%) with the predominance of the 5-year-old children. These children were examined using a plan mouth mirror and probes and their mothers were interviewed. The observed carious lesions were distributed on all tooth surfaces but the complete coronal destruction was the most common lesions observed and represented 25 of the lesions, followed by lesions in three faces of the tooth (17%). The most frequently affected tooth was the association maxillar incisors and molars and the mandibular molars (32.4%). The incisor alone represented 22.1% of the affected teeth. The children were breast-fed associated with either pap or with hard food (52.9%). The bottle was added to this association in 32.4% of the cases and 10% of the children were exclusively breast-fed. The carious lesions were more severe and more frequent in children fed with breast associated with pap and hard food and in those fed with breast associated with the bottle pap and food than to children exclusively breast-fed. These differences were not statistically significant (p = 0.73 > 0.05). Early childhood caries are related to a diet rich in carbon hydrate. They lead to severe tooth destruction. The treatments cost are very high thus prevention by information on the bad effects of sugar on diet and the baby bottle are of great interest.

Wavelength comparison for laser induced breakdown spectroscopy caries detection

NASA Astrophysics Data System (ADS)

Amaral, Marcello M.; Raele, Marcus P.; Ana, Patrícia A.; Núñez, Sílvia C.; Zamataro, Claudia B.; Zezell, Denise M.

2018-02-01

Laser Induced Breakdown Spectroscopy (LIBS) is a technique capable to perform elemental analyses of a variety of samples, independent of matter state. Other spectroscopy techniques may require a destructive and time-consuming sample preparation. On the other hand, LIBS is a less destructive technique with no (or considerably less) sample preparation, using a relatively simple experimental setup. LIBS also provides a multielement analysis into one single spectrum acquisition, applying a Nd:YAG short-pulsed laser to ensure the stoichiometry between the sample and the generated plasma. LIBS have been applied on the study of carious lesions using a Nd:YAG into its fundamental emission at 1064 nm. It was shown that ratio of P/Ca and Zn/Ca can be used to monitor the cariogenic process. Another minor elements, e.g. C and Cu, associated with bacteria biofilm were also measured with the Nd:YAG laser. The fundamental wavelength emission (1064 nm) of Nd:YAG is coincident with a hydroxyapatite transmission window and it may affect the result. In order to address this issue a study used the second harmonic of the Nd:YAG laser at 532 nm. It was show that it is also possible perform LIBS on carious lesion using the Nd:YAG at 532 nm. However, there is not a work direct comparing the LIBS at 532 nm and 1064 nm for carious lesion detection. So, the aim of this work was to investigate the influence of laser wavelength on the LIBS performance for carious lesion detection. In both cases the carious lesion was detected with the advantage of no interference with hydroxyapatite at 532 nm.

Characterization of a human tooth with carious lesions using conventional and synchrotron radiation-based micro computed tomography

NASA Astrophysics Data System (ADS)

Dziadowiec, Iwona; Beckmann, Felix; Schulz, Georg; Deyhle, Hans; Müller, Bert

2014-09-01

In a dental office, every day X rays of teeth within the oral cavity are obtained. Caries induces a mineral loss and, therefore, becomes visible by reduced X-ray absorption. The detailed spatial distribution of the mineral loss, however, is inaccessible in conventional dental radiology, since the dose for such studies is intolerable. As a consequence, such measurements can only be performed after tooth extraction. We have taken advantage of synchrotron radiation-based micro computed tomography to characterize a human tooth with a rather small, natural caries lesion and an artificially induced lesion provoked by acidic etching. Both halves of the tooth were separately visualized from 2400 radiographs recorded at the beam line P07 / PETRA III (HASYLAB at DESY, Hamburg, Germany) with an asymmetric rotation axis at photon energy of 45 keV. Because of the setup, one finds an energy shift in the horizontal plane, to be corrected. After the appropriate three-dimensional registration of the data with the ones of the same crown using the better accessible phoenix nanotom® m of General Electric, Wunstorf, Germany, one can determine the joint histogram, which enable to calibrate the system with the conventional X-ray source.

The role of glass ionomer cement on the remineralization of infected dentin: an in vivo study.

PubMed

Kuhn, Eunice; Chibinski, Ana Claudia Rodrigues; Reis, Alessandra; Wambier, Denise Stadler

2014-01-01

This study's purpose was to investigate the effect of a glass ionomer cement as a liner over infected unexcavated dentin after 60 days and at 10 to 15 months. Forty-five permanent molars with deep carious lesions were selected. Fragments of carious dentin were removed prior to lining the cavity (baseline sample) with glass ionomer cement (G1) or an inert wax material (G2). Cavities were restored with composite resin and reopened 60 days later, when other fragments were removed (60-day sample). The dentin morphology (scanning electron microscopy) and mineral content of calcium, phosphorus, and fluorine were assessed. During the follow-up periods (60 days and 10 to 15 months), restorations were evaluated and standardized radiographs were taken. A postprocessing routine was used to identify changes in the radiographic density between periods. After 60 days, the dentin exhibited a better organization, fewer bacteria, and signs of remineralization. The weight percents of calcium and phosphorus were higher 60 days after the cavity sealing, regardless of the group. Higher gray levels of carious and sound dentin were seen on the 10- to 15-month radiographs, irrespective of the group. The success rates of G1 and G2 were 89 percent and 88 percent, respectively. The lining material isn't fundamental for caries arrestment. Early (60-day) and late (10 to 15 months) dentin changes occurred, indicating the remineralization of dentin carious tissue.

Pathogenesis of deep endometriosis.

PubMed

Gordts, Stephan; Koninckx, Philippe; Brosens, Ivo

2017-12-01

The pathophysiology of (deep) endometriosis is still unclear. As originally suggested by Cullen, change the definition "deeper than 5 mm" to "adenomyosis externa." With the discovery of the old European literature on uterine bleeding in 5%-10% of the neonates and histologic evidence that the bleeding represents decidual shedding, it is postulated/hypothesized that endometrial stem/progenitor cells, implanted in the pelvic cavity after birth, may be at the origin of adolescent and even the occasionally premenarcheal pelvic endometriosis. Endometriosis in the adolescent is characterized by angiogenic and hemorrhagic peritoneal and ovarian lesions. The development of deep endometriosis at a later age suggests that deep infiltrating endometriosis is a delayed stage of endometriosis. Another hypothesis is that the endometriotic cell has undergone genetic or epigenetic changes and those specific changes determine the development into deep endometriosis. This is compatible with the hereditary aspects, and with the clonality of deep and cystic ovarian endometriosis. It explains the predisposition and an eventual causal effect by dioxin or radiation. Specific genetic/epigenetic changes could explain the various expressions and thus typical, cystic, and deep endometriosis become three different diseases. Subtle lesions are not a disease until epi(genetic) changes occur. A classification should reflect that deep endometriosis is a specific disease. In conclusion the pathophysiology of deep endometriosis remains debated and the mechanisms of disease progression, as well as the role of genetics and epigenetics in the process, still needs to be unraveled. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Caries-removal effectiveness of a papain-based chemo-mechanical agent: A quantitative micro-CT study.

PubMed

Neves, Aline A; Lourenço, Roseane A; Alves, Haimon D; Lopes, Ricardo T; Primo, Laura G

2015-01-01

The aim of this study was to access the effectiveness and specificity of a papain-based chemo-mechanical caries-removal agent in providing minimum residual caries after cavity preparation. In order to do it, extracted carious molars were selected and scanned in a micro-CT before and after caries-removal procedures with the papain-based gel. Similar parameters for acquisition and reconstruction of the image stacks were used between the scans. After classification of the dentin substrate based on mineral density intervals and establishment of a carious tissue threshold, volumetric parameters related to effectiveness (mineral density of removed dentin volume and residual dentin tissue) and specificity (relation between carious dentin in removed volume and initial caries) of this caries-removal agent were obtained. In general, removed dentin volume was similar or higher than the initial carious volume, indicating that the method was able to effectively remove dentin tissue. Samples with an almost perfect accuracy in carious dentin removal also showed an increased removal of caries-affected tissue. On the contrary, less or no affected dentin was removed in samples where some carious tissue was left in residual dentin. Mineral density values in residual dentin were always higher or similar to the threshold for mineral density values in carious dentin. In conclusion, the papain-based gel was effective in removing carious dentin up to a conservative in vitro threshold. Lesion characteristics, such as activity and morphology of enamel lesion, may also influence caries-removal properties of the method. © Wiley Periodicals, Inc.

Comparison of four lasers (λ = 650, 808, 980, and 1075 nm) for noninvasive creation of deep subsurface lesions in tissue

NASA Astrophysics Data System (ADS)

Chang, Chun-Hung; Wilson, Christopher R.; Fried, Nathaniel M.

2015-07-01

Lasers have been used in combination with applied cooling methods to preserve superficial skin layers (100's μm's) during cosmetic surgery. Preservation of a thicker tissue surface layer (millimeters) may also allow development of other noninvasive laser procedures. We are exploring noninvasive therapeutic laser applications in urology (e.g. laser vasectomy and laser treatment of female stress urinary incontinence), which require surface tissue preservation on the millimeter scale. In this preliminary study, four lasers were compared for noninvasive creation of deep subsurface thermal lesions. Laser energy from three diode lasers (650, 808, and 980 nm) and a Ytterbium fiber laser (1075 nm) was delivered through a custom built, side-firing, laser probe with integrated cooling. An alcohol-based solution at -5 °C was circulated through a flow cell, cooling a sapphire window, which in turn cooled the tissue surface. The probe was placed in contact with porcine liver tissue, ex vivo, kept hydrated in saline and maintained at ~ 35 °C. Incident laser power was 4.2 W, spot diameter was 5.3 mm, and treatment time was 60 s. The optimal laser wavelength tested for creation of deep subsurface thermal lesions during contact cooling of tissues was 1075 nm, which preserved a surface layer of ~ 2 mm. The Ytterbium fiber laser provides a compact, low maintenance, and high power alternative laser source to the Neodymium:YAG laser for noninvasive thermal therapy.

Multiple sclerosis deep grey matter: the relation between demyelination, neurodegeneration, inflammation and iron

PubMed Central

Haider, Lukas; Simeonidou, Constantina; Steinberger, Günther; Hametner, Simon; Grigoriadis, Nikolaos; Deretzi, Georgia; Kovacs, Gabor G; Kutzelnigg, Alexandra; Lassmann, Hans; Frischer, Josa M

2014-01-01

In multiple sclerosis (MS), diffuse degenerative processes in the deep grey matter have been associated with clinical disabilities. We performed a systematic study in MS deep grey matter with a focus on the incidence and topographical distribution of lesions in relation to white matter and cortex in a total sample of 75 MS autopsy patients and 12 controls. In addition, detailed analyses of inflammation, acute axonal injury, iron deposition and oxidative stress were performed. MS deep grey matter was affected by two different processes: the formation of focal demyelinating lesions and diffuse neurodegeneration. Deep grey matter demyelination was most prominent in the caudate nucleus and hypothalamus and could already be seen in early MS stages. Lesions developed on the background of inflammation. Deep grey matter inflammation was intermediate between low inflammatory cortical lesions and active white matter lesions. Demyelination and neurodegeneration were associated with oxidative injury. Iron was stored primarily within oligodendrocytes and myelin fibres and released upon demyelination. In addition to focal demyelinated plaques, the MS deep grey matter also showed diffuse and global neurodegeneration. This was reflected by a global reduction of neuronal density, the presence of acutely injured axons, and the accumulation of oxidised phospholipids and DNA in neurons, oligodendrocytes and axons. Neurodegeneration was associated with T cell infiltration, expression of inducible nitric oxide synthase in microglia and profound accumulation of iron. Thus, both focal lesions as well as diffuse neurodegeneration in the deep grey matter appeared to contribute to the neurological disabilities of MS patients. PMID:24899728

Effect of Galla chinensis on the remineralization of two bovine root lesions morphous in vitro.

PubMed

Guo, Bin; Que, Ke-Hua; Jing Yang; Wang, Bo; Liang, Qian-Qian; Xie, Hong-Hui

2012-09-01

The present study aims to evaluate the effect of Galla chinensis compounds on the remineralization of two artificial root lesions morphous in vitro. Sixty bovine dentine blocks were divided into two groups and individually treated with two levels of demineralization solutions to form erosive and subsurface artificial carious lesions in vitro. Each group was then divided into three subgroups, each of which were treated with a remineralization solution (positive control), deionized water (negative control), or 4 000 mg⋅L(-1) aqueous solutions of Galla chinensis extract. The dentine blocks were then subjected to a pH-cycling regime for 7 days. During the first 4 days, the daily cycle included 21-h deal and 3-h demineralization applications. The dentine blocks were dealt with the entire day during the remaining 3 days. Two specimens from each of the treatment groups were selected and observed under a polarized light microscope. Data collected using a laser scanning confocal microscope were computerized and analyzed. Galla chinensis extract clearly enhanced the remineralization of both erosive lesion and subsurface lesion patterns in the specimens (P<0.05). The level of remineralization of the erosive lesion by Galla chinensis extract was lower than that of the subsurface lesion (P<0.05). In addition, the remineralization of the subsurface lesion by Galla chinensis extract was higher than that of the remineralization solution (P<0.05). No significant difference between the remineralization of erosive lesions by Galla chinensis extract and the remineralization solution was observed (P>0.05). So Galla chinensis extract has the potential to improve the remineralization of artificial root lesions under dynamic pH-cyclic conditions, indicating its potential use as a natural remineralization medicine.

Multiple sclerosis deep grey matter: the relation between demyelination, neurodegeneration, inflammation and iron.

PubMed

Haider, Lukas; Simeonidou, Constantina; Steinberger, Günther; Hametner, Simon; Grigoriadis, Nikolaos; Deretzi, Georgia; Kovacs, Gabor G; Kutzelnigg, Alexandra; Lassmann, Hans; Frischer, Josa M

2014-12-01

In multiple sclerosis (MS), diffuse degenerative processes in the deep grey matter have been associated with clinical disabilities. We performed a systematic study in MS deep grey matter with a focus on the incidence and topographical distribution of lesions in relation to white matter and cortex in a total sample of 75 MS autopsy patients and 12 controls. In addition, detailed analyses of inflammation, acute axonal injury, iron deposition and oxidative stress were performed. MS deep grey matter was affected by two different processes: the formation of focal demyelinating lesions and diffuse neurodegeneration. Deep grey matter demyelination was most prominent in the caudate nucleus and hypothalamus and could already be seen in early MS stages. Lesions developed on the background of inflammation. Deep grey matter inflammation was intermediate between low inflammatory cortical lesions and active white matter lesions. Demyelination and neurodegeneration were associated with oxidative injury. Iron was stored primarily within oligodendrocytes and myelin fibres and released upon demyelination. In addition to focal demyelinated plaques, the MS deep grey matter also showed diffuse and global neurodegeneration. This was reflected by a global reduction of neuronal density, the presence of acutely injured axons, and the accumulation of oxidised phospholipids and DNA in neurons, oligodendrocytes and axons. Neurodegeneration was associated with T cell infiltration, expression of inducible nitric oxide synthase in microglia and profound accumulation of iron. Thus, both focal lesions as well as diffuse neurodegeneration in the deep grey matter appeared to contribute to the neurological disabilities of MS patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Protocol for the Hall Technique study: A trial to measure clinical effectiveness and cost-effectiveness of stainless steel crowns for dental caries restoration in primary molars in young children.

PubMed

Tonmukayakul, Utsana; Martin, Rachel; Clark, Richard; Brownbill, John; Manton, David; Hall, Martin; Armfield, Jason; Smith, Michael; Shankumar, Ramini; Sivasithamparam, Kavitha; Martin-Kerry, Jacqueline; Calache, Hanny

2015-09-01

The Hall Technique (HT) is a carious primary molar treatment that does not require local analgesia, carious tissue removal or tooth preparation. The carious lesions in carefully selected teeth are sealed with a stainless steel crown (preformed metal crown). The study aims are to determine the clinical effectiveness, acceptability and cost-effectiveness of the HT for management of carious lesions in young dental patients. Children, aged 3-7years, with a primary molar tooth with a carious lesion extending no further than the middle third of dentine, with no signs or symptoms of pulp inflammation or infection, and attending one of three community agencies are recruited. Target sample size is 220. A control tooth with an intra-coronal restoration is sourced from the same mouth. The primary outcome is the period of time free from further treatment. The assessments are scheduled at 6, 12 and 24months. In addition to the clinical assessment, acceptability of the HT will be assessed via questionnaires among patients and their primary carers at baseline, 6, 12 and 24months. Cost-outcome description and cost-effectiveness analysis from healthcare provider and societal perspective will be conducted. The clinical effectiveness, acceptability and cost-effectiveness of the HT in the community dental setting will be evaluated. The results of this study will determine the implementation of HT in the management of dental caries in young children. Copyright © 2015 Elsevier Inc. All rights reserved.

Deep learning based classification of morphological patterns in RCM to guide noninvasive diagnosis of melanocytic lesions (Conference Presentation)

NASA Astrophysics Data System (ADS)

Kose, Kivanc; Bozkurt, Alican; Ariafar, Setareh; Alessi-Fox, Christi A.; Gill, Melissa; Dy, Jennifer G.; Brooks, Dana H.; Rajadhyaksha, Milind

2017-02-01

In this study we present a deep learning based classification algorithm for discriminating morphological patterns that appear in RCM mosaics of melanocytic lesions collected at the dermal epidermal junction (DEJ). These patterns are classified into 6 distinct types in the literature: background, meshwork, ring, clod, mixed, and aspecific. Clinicians typically identify these morphological patterns by examination of their textural appearance at 10X magnification. To mimic this process we divided mosaics into smaller regions, which we call tiles, and classify each tile in a deep learning framework. We used previously acquired DEJ mosaics of lesions deemed clinically suspicious, from 20 different patients, which were then labelled according to those 6 types by 2 expert users. We tried three different approaches for classification, all starting with a publicly available convolutional neural network (CNN) trained on natural image, consisting of a series of convolutional layers followed by a series of fully connected layers: (1) We fine-tuned this network using training data from the dataset. (2) Instead, we added an additional fully connected layer before the output layer network and then re-trained only last two layers, (3) We used only the CNN convolutional layers as a feature extractor, encoded the features using a bag of words model, and trained a support vector machine (SVM) classifier. Sensitivity and specificity were generally comparable across the three methods, and in the same ranges as our previous work using SURF features with SVM . Approach (3) was less computationally intensive to train but more sensitive to unbalanced representation of the 6 classes in the training data. However we expect CNN performance to improve as we add more training data because both the features and the classifier are learned jointly from the data. *First two authors share first authorship.

The use of sodium trimetaphosphate as a biomimetic analog of matrix phosphoproteins for remineralization of artificial caries-like dentin

PubMed Central

Liu, Yan; Li, Nan; Qi, Yipin; Niu, Li-na; Elshafiy, Sally; Mao, Jing; Breschi, Lorenzo; Pashley, David H.; Tay, Franklin R.

2011-01-01

Objectives This study examined the use of sodium trimetaphosphate (STMP) as a biomimetic analog of matrix phosphoproteins for remineralization of artificial carious-affected dentin. Methods Artificial carious lesions with lesion depths of 300±30 µm were created by pH-cycling. 2.5% hydrolyzed STMP was applied to the artificial carious lesions to phosphorylate the partially-demineralized collagen matrix. Half of the STMP-treated specimens were bonded with One-Step. The adhesive and non-adhesive infiltrated specimens were remineralized in a Portland cement-simulated body fluid system containing polyacrylic acid (PAA) to stabilize amorphous calcium phosphate as nanoprecursors. Micro-computed tomography (micro-CT) and transmission electron microscopy (TEM) were used to evaluate the results of remineralization after a 4-month period. Results In absence of PAA and STMP as biomimetic analogs (control groups), there was no remineralization irrespective of whether the lesions were infiltrated with adhesive. For the STMP-treated experimental groups immersed in PAA-containing simulated body fluid, specimens without adhesive infiltration were more heavily remineralized than those infiltrated with adhesive. Statistical analysis of the 4-month micro-CT data revealed significant differences in the lesion depth, relative mineral content along the lesion surface and changes in ΔZ between the non-adhesive and adhesive experimental groups (p<0.05 for all the three parameters). TEM examination indicated that collagen degradation occurred in both the non-adhesive and adhesive control and experimental groups after 4 months of remineralization. Significance Biomimetic remineralization using STMP is a promising method to remineralize artificial carious lesions particularly in areas devoid of seed crystallites. Future studies should consider the incorporation of MMP-inhibitors within the partially-demineralized collagen matrix to prevent collagen degradation during remineralization. PMID

Adverse effects associated with the clinical use of 4% TiF₄ on teeth enamel: case report.

PubMed

Pedro, Rafael de Lima; Pomarico, Luciana; Villardi, Michele; Maia, Lucianne Cople

2011-05-01

Titanium tetrafluoride (TiF₄) has been studied in dentistry as a promissory alternative for prevention and treatment of carious lesions. However, there are few in vivo studies concerning the consequences of its use on tooth enamel. The goal of this study was to report the effects of a 4% TiF₄ application on the remineralization of an incipient carious lesion of a permanent tooth. This research found an unexpected clinical outcome. A patient with active white spots had two of these lesions treated with 4% TiF₄ associated with fluoridated dentifrice and another lesion treated with fluoridated dentifrice only, thus the remineralization of the two kinds of treatment administered could be observed and compared. An extrinsic pigment appeared in the regions that received the TiF₄ treatment, which was partially removed by professional prophylaxis. Also, regular recidivists of this pigmentation in the review consultations were noted. The authors concluded that although the use of 4% TiF₄ was effective in treating incipient carious lesions on enamel, it was also responsible for an undesired pigmented layer on the tooth to which it was applied. Beyond the varied fluoridated materials used in dentistry, titanium tetrafluoride (TiF₄) deserves attention. This compound has the common properties of fluorides, and researchers are exploring its role in carious lesion prevention, fissure sealing, and tooth erosion prevention in in vitro and in situ studies. Research is also exploring its use for microinfiltration prevention in tooth restoration and hypersensitivity treatment. However, when compared to other fluoridated products TiF₄ demonstrates additional, specific particularities, such as the formation of a titanium dioxide (TiO₂) layer, which is tough, hydrophobic, and resistant in acidic environments. Nevertheless, there are insufficient in vivo studies concerning the consequences of TiF₄-containing products affecting tooth enamel. Thus, the goals of this study

Imaging of noncarious cervical lesions by means of a fast swept source optical coherence tomography system

NASA Astrophysics Data System (ADS)

Stoica, Eniko T.; Marcauteanu, Corina; Bradu, Adrian; Sinescu, Cosmin; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil Florin; Podoleanu, Adrian Gh.

2014-01-01

Non-carious cervical lesions (NCCL) are defined as the loss of tooth substance at the cemento-enamel junction and are caused by abrasion, erosion and/or occlusal overload. In this paper we proved that our fast swept source OCT system is a valuable tool to track the evolution of NCCL lesions in time. On several extracted bicuspids, four levels of NCCL were artificially created. After every level of induced lesion, OCT scanning was performed. B scans were acquired and 3D reconstructions were generated. The swept source OCT instrument used in this study has a central wavelength of 1050 nm, a sweeping range of 106 nm (measured at 10 dB), an average output power of 16 mW and a sweeping rate of 100 kHz. A depth resolution determined by the swept source of 12 μm in air was experimentally obtained. NCCL were measured on the B-scans as 2D images and 3D reconstructions (volumes). For quantitative evaluations of volumes, the Image J software was used. By calculating the areas of the amount of lost tissue corresponding to each difference of Bscans, the final volumes of NCCL were obtained. This swept source OCT method allows the dynamic diagnosis of NCCL in time.

Selective treatment of carious dentin using a mid-infrared tunable pulsed laser at 6 μm wavelength range

NASA Astrophysics Data System (ADS)

Saiki, Masayuki; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

2011-03-01

Optical technologies have good potential for caries detection, prevention, excavation, and the realization of minimal intervention dentistry. This study aimed to develop a selective excavation technique of carious tissue using the specific absorption in 6 μm wavelength range. Bovine dentin demineralized with lactic acid solution was used as a carious dentin model. A mid-infrared tunable pulsed laser was obtained by difference-frequency generation technique. The wavelength was tuned to 6.02 and 6.42 μm which correspond to absorption bands called amide I and amide II, respectively. The laser delivers 5 ns pulse width at a repetition rate of 10 Hz. The morphological change after irradiation was observed with a scanning electron microscope, and the measurement of ablation depth was performed with a confocal laser microscope. At λ = 6.02 μm and the average power density of 15 W/cm2, demineralized dentin was removed selectively with less-invasive effect on sound dentin. The wavelength of 6.42 μm also showed the possibility of selective removal. High ablation efficiency and low thermal side effect were observed using the nanosecond pulsed laser with λ = 6.02 μm. In the near future, development of compact laser device will open the minimal invasive laser treatment to the dental clinic.

The influence of the lining material on the repair of the infected dentin in young permanent molars after restoration: A randomized clinical trial

PubMed Central

Kuhn, Eunice; Reis, Alessandra; Chibinski, Ana Claudia Rodrigues; Wambier, Denise Stadler

2016-01-01

Aim: This study evaluated the impact of liner material on the fluorescence, morphological and mineral characteristics of permanent carious dentin after cavity sealing. Methods: Thirty children (11.0 ± 2.7 years old) presenting at least one active deep carious lesion in permanent molars were selected. Fragments of carious dentin were removed from teeth before lining the cavity (baseline samples) with high-viscosity glass ionomer cement (G1) or an inert material (wax - G2). Cavities were restored with composite resin and reopened 60 days later, and other fragments were removed (60-day sample). The laser fluorescence (LF) readings and morphological and mineral changes of both groups were compared. Results: After 60 days, forty teeth were available for evaluation. Lower LF means were obtained (Wilcoxon signed-rank test; P < 0.05), and enhanced calcium and phosphorus levels were detected for both groups (t-test, P < 0.05). An uptake of fluorine was observed only in G1 (t-test; P < 0.05). Regardless of the group, baseline samples exhibited clear signs of bacterial invasion, and the collagen fibers were exposed; the 60-day samples showed a better-organized tissue with a more compact intertubular dentin. Conclusion: Caries arrestment with dentin reorganization occurs regardless of the lining material placed in contact with the infected dentin. PMID:27994311

Dense deconvolution net: Multi path fusion and dense deconvolution for high resolution skin lesion segmentation.

PubMed

He, Xinzi; Yu, Zhen; Wang, Tianfu; Lei, Baiying; Shi, Yiyan

2018-01-01

Dermoscopy imaging has been a routine examination approach for skin lesion diagnosis. Accurate segmentation is the first step for automatic dermoscopy image assessment. The main challenges for skin lesion segmentation are numerous variations in viewpoint and scale of skin lesion region. To handle these challenges, we propose a novel skin lesion segmentation network via a very deep dense deconvolution network based on dermoscopic images. Specifically, the deep dense layer and generic multi-path Deep RefineNet are combined to improve the segmentation performance. The deep representation of all available layers is aggregated to form the global feature maps using skip connection. Also, the dense deconvolution layer is leveraged to capture diverse appearance features via the contextual information. Finally, we apply the dense deconvolution layer to smooth segmentation maps and obtain final high-resolution output. Our proposed method shows the superiority over the state-of-the-art approaches based on the public available 2016 and 2017 skin lesion challenge dataset and achieves the accuracy of 96.0% and 93.9%, which obtained a 6.0% and 1.2% increase over the traditional method, respectively. By utilizing Dense Deconvolution Net, the average time for processing one testing images with our proposed framework was 0.253 s.

Noninvasive diagnosis of early caries with polarization-sensitive optical coherence tomography (PS-OCT)

NASA Astrophysics Data System (ADS)

Everett, Matthew J.; Colston, Bill W., Jr.; Sathyam, Ujwal S.; Da Silva, Luiz B.; Fried, Daniel; Featherstone, John D. B.

1999-05-01

There is no diagnostic technology presently available utilizing non-ionizing radiation that can image the state of demineralization of dental enamel in vivo for the detection, characterization and monitoring of early, incipient caries lesions. In this study, a Polarization Sensitive Optical Coherence Tomography (PS-OCT) system was evaluated for its potential for the non-invasive diagnosis of early carious lesions. We demonstrated clear discrimination in PS-OCT imags between regions of normal and demineralized enamel in bovine enamel blocks containing well-characterized artificial lesions. Moreover, high-resolution, cross- sectional images were acquired that clearly discriminate between the normal and carious regions of extracted human teeth. Regions that appeared to be demineralized in the PS- OCT imags were verified using histological thin sections examined under polarized light. The PS-OCT system discriminates between normal and carious regions by measuring the state of polarization of the back-scattered 1310 nm light, which is affected by the state of demineralization of the enamel. The demineralized regions of enamel have a large scattering coefficient, thus depolarizing the incident light. This initial study shows that PS-OCT has great potential for the detection, characterization, and monitoring of incipient caries lesions.

Effect of two X-ray tube voltages on detection of approximal caries in digital radiographs. An in vitro study.

PubMed

Hellén-Halme, Kristina

2011-04-01

This study evaluated the effect of two different tube voltages on clinicians' ability to diagnose approximal carious lesions in digital radiographs. One hundred extracted teeth were radiographed twice at two voltage settings, 60 and 70 kV, using a standardized procedure. Seven observers evaluated the radiographs on a standard color monitor pre-calibrated according to DICOM part 14. Evaluations were made at ambient light levels below 50 lx. All observations were analyzed with receiver operating characteristic curves. A histological examination of the teeth served as the criterion standard. A paired t test compared the effects of the two voltages. The significance level was set to p < 0.05. Weighted kappa statistics estimated intra-observer agreement. No significant difference in accuracy of approximal carious lesion diagnosis was found between the two voltage settings. But five observers rated dentin lesions on radiographs exposed at 70 kV better than on radiographs exposed at 60 kV. Intra-observer agreement differed from fair to moderate. There was no significant difference in accuracy of approximal carious lesion diagnosis between digital radiographs exposed with 60 or 70 kV.

Recurrent neural networks for breast lesion classification based on DCE-MRIs

NASA Astrophysics Data System (ADS)

Antropova, Natasha; Huynh, Benjamin; Giger, Maryellen

2018-02-01

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) plays a significant role in breast cancer screening, cancer staging, and monitoring response to therapy. Recently, deep learning methods are being rapidly incorporated in image-based breast cancer diagnosis and prognosis. However, most of the current deep learning methods make clinical decisions based on 2-dimentional (2D) or 3D images and are not well suited for temporal image data. In this study, we develop a deep learning methodology that enables integration of clinically valuable temporal components of DCE-MRIs into deep learning-based lesion classification. Our work is performed on a database of 703 DCE-MRI cases for the task of distinguishing benign and malignant lesions, and uses the area under the ROC curve (AUC) as the performance metric in conducting that task. We train a recurrent neural network, specifically a long short-term memory network (LSTM), on sequences of image features extracted from the dynamic MRI sequences. These features are extracted with VGGNet, a convolutional neural network pre-trained on a large dataset of natural images ImageNet. The features are obtained from various levels of the network, to capture low-, mid-, and high-level information about the lesion. Compared to a classification method that takes as input only images at a single time-point (yielding an AUC = 0.81 (se = 0.04)), our LSTM method improves lesion classification with an AUC of 0.85 (se = 0.03).

Effect of caries infiltration technique and fluoride therapy on the colour masking of white spot lesions.

PubMed

Rocha Gomes Torres, Carlos; Borges, Alessandra Buhler; Torres, Luciana Marcondes Sarmento; Gomes, Isabela Silva; de Oliveira, Rodrigo Simões

2011-03-01

A carious lesion is initiated through the subsurface demineralization of enamel, and presents clinically as a white spot, interfering with the aesthetics. This lesion should not receive restorative treatment because it is capable of remineralization. The aim of this study was to evaluate the performance of different treatments on masking white spot lesions by assessing the colour change. Artificial white spot lesions were produced in bovine enamel of 60 cylindrical-shaped samples. The samples were randomly divided into four groups: CON (control) - immersion in artificial saliva; DF - daily application of 0.05% fluoride solution; WF - weekly application of 2% fluoride gel; and IC - resin infiltration (Icon(®) - DMG). The assessment of colour was performed by a spectrophotometer in four distinct stages: baseline, after the production of artificial caries; after 4 weeks; after 8 weeks; and after a new acid challenge. The ΔL values were calculated at each stage in relation to the baseline colour. The application of RM ANOVA revealed significant differences between the factors' treatment and time (p=0.001). For the interaction between factors there were no significant differences (p=0.27). The Tukey's test (p<0.05) was then applied and showed that the specimens treated with Icon(®) exhibited the lowest means, followed by Group DF, Group CON, and Group WF, in that order. Resin infiltration was proven to be an effective treatment for masking white spot lesions. Also, after a new acid challenge, the group infiltrated with low viscosity resin presented the lowest means of colour change. Copyright © 2011. Published by Elsevier Ltd.

Laboratory investigations into the potential anticaries efficacy of fluoride varnishes.

PubMed

Lippert, Frank; Hara, Anderson Takeo; Martinez-Mier, Esperanza Angeles; Zero, Domenick T

2014-01-01

The purpose of this study was to investigate the potential anticaries efficacy of fluoride varnishes (FVs) by studying their ability to reharden and deliver fluoride to carious lesions and to release fluoride into saliva. Enamel carious lesions were created and allocated to 24 groups (11 FVs with two FV incubation times and two control groups) based on Knoop microhardness test values. FVs were applied to lesions, which were incubated in artificial saliva for two or six hours, with saliva being renewed hourly. FV was removed and lesions were remineralized in artificial saliva for 22 hours. Microhardness was measured and enamel fluoride uptake (EFU) was determined. Saliva samples (six-hour groups) were analyzed to determine fluoride release characteristics. Data were analyzed using analysis of variance. FVs differed considerably in their ability to reharden and deliver fluoride to carious lesions and in their fluoride release characteristics. Little consistency was found between investigated study variables for virtually all tested FVs. For example, a particular FV showed the highest EFU and fluoride release values but the lowest rehardening value. A longer FV contact time led to increased EFU for five of the 11 FVs. Some FVs delivered more fluoride to lesions in two hours than others did in six hours. Fluoride varnishes differ greatly in their in vitro anticaries efficacy.

Characterization of the Growth of Deep and Subcortical White Matter Hyperintensity on MR Imaging: A Retrospective Cohort Study.

PubMed

Adachi, Michito; Sato, Takamichi

2017-07-10

In elderly patients, deep and subcortical white matter hyperintense lesions are frequently observed on MRI; however, the growth process of these lesions is unclear. The aims of this retrospective cohort study were to elucidate the growth characteristics of deep and subcortical white matter hyperintense lesions, and to insight their etiology. We enrolled 103 patients (1610 lesions) whose deep and subcortical white matter hyperintense lesions were monitored for 3 or more years by MRI examination. The area of each hyperintense lesion was measured using a tracing method in the first and last MRI examinations. The annual rate of increase in the area of each lesion was calculated, and using the Pearson product-moment correlation coefficient the correlation between the annual rate of increase in area and the interval between the first and last MRI examinations was determined. The paired t-test showed a significant increase in the mean area of all the deep and subcortical white matter hyperintense lesions between the first and last MRI examinations (P < 0.001). However, hyperintense lesions had decreased in the area or disappeared in 227 (14.1%) lesions in the last MRI examination, particularly in patients with diabetes. The mean annual rate of increase in area of all hyperintense lesions was 0.013 ± 0.021 cm 2 per year. The annual rate of increase in area and the interval between the first and last MRI examinations showed a weak negative correlation (r = -0.121; P < 0.01). Decrease in the area and the disappearance of the subcortical white matter hyperintense lesions, and a decline in the annual rate of increase in the lesion area with time suggest that the interstitial fluid accumulation associated with dysfunctional drainage around the vessels may be involved in the possible etiologies of deep and subcortical white matter hyperintense lesions.

Surface variations affecting human dental enamel studied using nanomechanical and chemical analysis

NASA Astrophysics Data System (ADS)

Dickinson, Michelle Emma

The enamel surface is the interface between the tooth and its ever changing oral environment. Cavity (caries) formation and extrinsic tooth staining are due, respectively, to degradation of the enamel structure under low pH conditions and interactions between salivary pellicle and dietary elements. Both of these occur at the enamel surface and are caused by the local environment changing the chemistry of the surface. The results can be detrimental to the enamel's mechanical integrity and aesthetics. Incipient carious lesions are the precursor to caries and form due to demineralisation of enamel. These carious lesions are a reversible structure where ions (e.g. Ca2+, F -) can diffuse in (remineralisation) to preserve the tooth's structural integrity. This investigation used controlled in vitro demineralisation and remineralisation to study artificial carious lesion formation and repair. The carious lesions were cross-sectioned and characterised using nanoindentation, electron probe micro-analysis and time of flight secondary ion mass spectrometry. Mechanical and chemical maps showed the carious lesion had a significantly reduced hardness and elastic modulus, and the calcium and phosphate content was lower than in sound enamel. Fluoride based remineralisation treatments gave a new phase (possibly fluorohydroxyapatite) within the lesion with mechanical properties higher than sound enamel. The acquired salivary pellicle is a protein-rich film formed by the physisorption of organic molecules in saliva onto the enamel surface. Its functions include lubrication during mastication and chemical protection. However, pellicle proteins react with dietary elements such as polyphenols (tannins in tea) causing a brown stain. This study has used in vitro dynamic nanoindentation and atomic force microscopy to examine normal and stained pellicles formed in vivo. The effects of polyphenols on the pellicle's mechanical properties and morphology have been studied. It was found that the

Trial shows partial caries removal is an effective technique in primary molars.

PubMed

Santamaria, Ruth; Innes, Nicola

2014-09-01

Randomised controlled trial in a university setting. Children aged three to eight years, with at least one molar with an acute, deep carious lesion into the dentine were recruited. Treatment took place under rubber dam with decayed dentine being removed completely from the lateral walls of cavities in both groups using round burs operated at low speed. TCR or PCR was then performed in the pulpal wall of each tooth. After caries removal teeth were restored with calcium hydroxide cement and composite resin. Teeth with pulpal exposure were pulpotomised using ferric sulphate. The presence of a fistula, swelling, spontaneous pain and mobility not compatible with root resorption were considered to be clinical signs of failure. Radiolucency at the furcation or in the periapical region and internal or external pathological resorption were considered to be radiographic signs of failure. One hundred and twenty-four teeth in 51 patients were randomised. In the TCR group there were 57 teeth and 38 patients, with 41 patients and 67 teeth in the PCR group. Three patients (four teeth; one PCR and three TCR) dropped out leaving 120 teeth (PCR: n = 66; TCR: n = 54) for analysis. In the TCR group 27.5% (15) teeth in 13 children had pulp exposure compared with one tooth in one child in the PCR group (2%). The mean operative time was significantly higher for TCR (28.1 min; 95% CI: 23.6-32.6 min) than for PCR (17.9 min; 95% CI: 16.3-19.5 min). There was no statistical difference in success rates at 24 months between the groups. The success rate in the TCR group was 96%; (95% CI: 85-99%) compared with 92%; (95% CI: 81-96%) in the PCR group. The clinical and radiographic success rates of PCR and TCR in primary teeth with deep carious lesions were high and did not differ significantly, indicating that PCR is a reliable minimally invasive approach in primary teeth and that the retention of carious dentine does not interfere with pulp vitality. Moreover, PCR provided other clinically

Inverse correlation between the proportion of salivary bacteria inhibiting Streptococcus mutans and the percentage of untreated carious teeth.

PubMed

Goyette, N; Parrot, M; Sutzescu, D; Leduc, M; Dufour, L; Trahan, L; Lavoie, M C

1995-11-01

To evaluate the role of inhibitory substances produced by bacteria in the oral cavity, we estimated, by a deferred test on Todd-Hewitt agar enriched with hemin and vitamin K, the proportion of bacteria that inhibited or stimulated the growth of Streptococcus mutans and Porphyromonas gingivalis, from the saliva of 109 patients (54 males and 55 females) attending our dental clinics. The patients, aged from 8 to 75 years old (mean: 31 +/- 18 years), were randomly selected whatever the reason for their visit. The results, evaluated with the Spearman rank test, indicated that there was no statistically significant (P > 0.05) correlation between the proportion of salivary bacteria inhibiting or stimulating P. gingivalis with the Community Periodontal Index of Treatment Needs (CPITN), the number of carious, missing and filled teeth, or with the decayed, missing and filled teeth index (DMFT). Also, no statistically significant correlation was observed between the proportion of salivary bacteria stimulating the growth of S. mutans and the above mentioned health indexes. However, a statistically significant (P < 0.005) negative correlation was found between the percentage of cultivated bacteria that inhibit S. mutans and the percentage of untreated carious teeth as well as with the CPITN. The results thus indicate a possible role for inhibitory substances produced by bacteria in the maintenance of oral health.

Efficacy of Motivational Interviewing in Conjunction with Caries Risk Assessment (MICRA) Programmes in Improving the Dental Health Status of Preschool Children: A Randomised Controlled Trial.

PubMed

Saengtipbovorn, Saruta

To assess the efficacy of motivational interviewing in conjuction with a caries risk assessment (MICRA) programme to improve the dental health status of preschool children. A randomised controlled trial was conducted among 214 parents or caregivers and their children at Health Centre 54, Bangkok, Thailand, from September 2015 to February 2016. The participants were randomised to the intervention and the control groups (107 participants per group). At baseline, the intervention group received a caries risk assessment, individual counseling by using motivational interviewing, and oral hygiene instruction. The intervention group received reinforcement education and individual counseling by motivational interviewing every 3 months. The control group received a routine programme. Participants were assessed at baseline, 3 months, and 6 months for plaque index and caries. The data were analysed by using descriptive statistics, the chi-squared test, Fisher's exact test, t-test, repeated-measures ANOVA, and negative binomial distribution. After the 6-month follow-up, participants in the intervention group had a significantly lower plaque index, non-cavitated plus cavitated carious lesions, and cavitated carious lesions when compared to the control group. The intervention group had a lower caries incidence, non-cavitated plus cavitated carious lesions (1.81 times) and cavitated carious lesions (2.04 times) than the control group. The combination of motivational interviewing and caries risk assessment in one programme decreased early childhood caries in preschool children. It is not known whether the effects are due to the motivational interviewing, the caries risk assessment, or the combination of both.

Atraumatic restorative treatment and minimal intervention dentistry.

PubMed

Frencken, J E

2017-08-11

Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and fill' treatments and embrace the holistic oral healthcare approach that is minimal intervention dentistry (MID) and includes within it minimally invasive operative skills. Dental caries is, after all, a preventable disease. The atraumatic restorative treatment (ART) concept is an example of MID. ART consists of a preventive (ART sealant) and a restorative (ART restoration) component. ART sealants using high-viscosity glass-ionomer (HVGIC) have a very high dentine carious lesion preventive effect. The survival rate of these sealants is not significantly different from that of sealants produced with resin. The survival rate of ART/HVGIC restorations matches those of amalgam and resin composite in single- and multiple-surface cavities in primary teeth and in single-surface cavities in permanent teeth. The principles of carious tissue removal within a cavity recommended by the International Caries Consensus Collaboration are in line with those of treating a cavity using ART. Owing to its good performance and the low levels of discomfort/pain and dental anxiety associated with it, ART and/or other evidence-based atraumatic care procedures should be the first treatment for a primary dentine carious lesion. Only if the use of ART is not indicated should other more invasive and less-atraumatic care procedures be used in both primary and permanent dentitions.

Patient age and dentists’ decisions about occlusal caries treatment thresholds

PubMed Central

Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Yokoyama, Yoko; Gilbert, Gregg H; Gordan, Valeria V

2014-01-01

Objectives This study was performed to (1) quantify dentists’ treatment thresholds for occlusal primary caries; (2) determine if patient's age affects dentists’ decisions to surgically treat these carious lesions; (3) test the hypothesis that patients’, dentists’, and practices’ characteristics are significantly associated with surgical enamel intervention. Methods The study used a cross-sectional design consisting of a questionnaire survey in Japan. This study queried dentists working in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan (JDPBRN), which aims to allow dentists to investigate research questions and share experiences and expertise (n=282). Participants were asked whether they would surgically intervene in a series of cases depicting occlusal caries. Each case included a photograph of an occlusal surface displaying typical characteristics of caries penetration, and written descriptions of adult and pediatric patients at high caries risk. Results In a case of a carious lesion within inner enamel, the proportion of dentists who indicated surgical intervention was significantly higher in the adult patient (48%) when compared to the pediatric patient (34%) (p< 0.01). Logistic regression analysis showed that using a dental explorer for the diagnosis of primary occlusal caries, type of practice, practice busyness, and percentage of patients who self-pay were significantly associated with dentists’ decisions to intervene surgically into the inner enamel carious lesion. Conclusions These findings demonstrate that over one-third of participants chose to intervene surgically into inner enamel carious lesions, and patients’ age affects dentists’ decisions about when to intervene surgically (clinicaltrials.gov registration number NCT01680848). PMID:24809540

Relationship between brain lesion characteristics and communication in preschool children with cerebral palsy.

PubMed

Coleman, Andrea; Fiori, Simona; Weir, Kelly A; Ware, Robert S; Boyd, Roslyn N

2016-11-01

MRI shows promise as a prognostic tool for clinical findings such as gross motor function in children with cerebral palsy(CP), however the relationship with communication skills requires exploration. To examine the relationship between the type and severity of brain lesion on MRI and communication skills in children with CP. 131 children with CP (73 males(56%)), mean corrected age(SD) 28(5) months, Gross Motor Functional Classification System distribution: I=57(44%), II=14(11%), III=19(14%), IV=17(13%), V=24(18%). Children were assessed on the Communication and Symbolic Behavioral Scales Developmental Profile (CSBS-DP) Infant-Toddler Checklist. Structural MRI was analysed with reference to type and semi-quantitative assessment of the severity of brain lesion. Children were classified for motor type, distribution and GMFCS. The relationships between type/severity of brain lesion and communication ability were analysed using multivariable tobit regression. Children with periventricular white matter lesions had better speech than children with cortical/deep grey matter lesions (β=-2.6, 95%CI=-5.0, -0.2, p=0.04). Brain lesion severity on the semi-quantitative scale was related to overall communication skills (β=-0.9, 95%CI=-1.4, -0.5, p<0.001). Motor impairment better accounted for impairment in overall communication skills than brain lesion severity. Structural MRI has potential prognostic value for communication impairment in children with CP. WHAT THIS PAPER ADDS?: This is the first paper to explore important aspects of communication in relation to the type and severity of brain lesion on MRI in a representative cohort of preschool-aged children with CP. We found a relationship between the type of brain lesion and communication skills, children who had cortical and deep grey matter lesions had overall communication skills>1 SD below children with periventricular white matter lesions. Children with more severe brain lesions on MRI had poorer overall communication

Accurate GM atrophy quantification in MS using lesion-filling with co-registered 2D lesion masks☆

PubMed Central

Popescu, V.; Ran, N.C.G.; Barkhof, F.; Chard, D.T.; Wheeler-Kingshott, C.A.; Vrenken, H.

2014-01-01

Background In multiple sclerosis (MS), brain atrophy quantification is affected by white matter lesions. LEAP and FSL-lesion_filling, replace lesion voxels with white matter intensities; however, they require precise lesion identification on 3DT1-images. Aim To determine whether 2DT2 lesion masks co-registered to 3DT1 images, yield grey and white matter volumes comparable to precise lesion masks. Methods 2DT2 lesion masks were linearly co-registered to 20 3DT1-images of MS patients, with nearest-neighbor (NNI), and tri-linear interpolation. As gold-standard, lesion masks were manually outlined on 3DT1-images. LEAP and FSL-lesion_filling were applied with each lesion mask. Grey (GM) and white matter (WM) volumes were quantified with FSL-FAST, and deep gray matter (DGM) volumes using FSL-FIRST. Volumes were compared between lesion mask types using paired Wilcoxon tests. Results Lesion-filling with gold-standard lesion masks compared to native images reduced GM overestimation by 1.93 mL (p < .001) for LEAP, and 1.21 mL (p = .002) for FSL-lesion_filling. Similar effects were achieved with NNI lesion masks from 2DT2. Global WM underestimation was not significantly influenced. GM and WM volumes from NNI, did not differ significantly from gold-standard. GM segmentation differed between lesion masks in the lesion area, and also elsewhere. Using the gold-standard, FSL-FAST quantified as GM on average 0.4% of the lesion area with LEAP and 24.5% with FSL-lesion_filling. Lesion-filling did not influence DGM volumes from FSL-FIRST. Discussion These results demonstrate that for global GM volumetry, precise lesion masks on 3DT1 images can be replaced by co-registered 2DT2 lesion masks. This makes lesion-filling a feasible method for GM atrophy measurements in MS. PMID:24567908

Evaluation of the effect of photodynamic antimicrobial therapy in dentin caries: a pilot in vivo study

NASA Astrophysics Data System (ADS)

Borges, F. M. C.; de-Melo, M. A. S.; Lima, J. M. P.; Zanin, I. C. J.; Rodrigues, L. K. A.; Nobre-dos-Santos, M.

2010-02-01

In vitro and in situ studies have demonstrated that the photodynamic antimicrobial therapy (PACT) is effective in reducing Streptococcus mutans population in artificially carious dentin. This pilot in vivo study evaluated the antimicrobial effect of PACT using toluidine blue O (TBO) and a light-emitting diode (LED) in carious dentin lesions. Five healthy adult volunteers (19-36 yr), with at least 4 active carious cavities each, participated in this study. Teeth of each volunteer were randomly divided into four groups: (1) without TBO and without light (Control); (2) with TBO alone (TBO); (3) with LED at 94/J cm2 alone (LED); and (4) with TBO plus LED at 94 J/cm2 (PACT). Each cavity was divided into two halves. The baseline carious dentin sample was collected from half of each cavity. Following, the treatments were performed using a random distribution of tooth into treatments. Then, the second collection of carious dentin samples was performed. Before and after treatments, dentin samples were analyzed with regard to the counts of total viable microorganisms, total streptococci, mutans streptococci, and lactobacilli. The data were statistically analyzed by Kruskal-Wallis and Student-Newman-Keuls tests (α=5%). Log reductions ranged from -0.12 to 2.68 and significant reductions were observed for PACT (group 4) when compared to the other groups (1, 2, and 3) for total streptococci and mutans streptococci. Concluding, PACT was effective in killing oral microorganisms present in in vivo carious dentin lesions and may be a promising technique for eliminating bacteria from dentin before restoration.

Cerebral venous thrombosis with nonhemorrhagic lesions: clinical correlates and prognosis.

PubMed

Ferro, José M; Canhão, Patrícia; Bousser, Marie-Germaine; Stam, Jan; Barinagarrementeria, Fernando; Stolz, Erwin

2010-01-01

Brain imaging of patients with acute cerebral venous thrombosis often shows parenchymal hemorrhagic and nonhemorrhagic lesions. The clinical relevance of nonhemorrhagic lesions is poorly known. In the International Study on Cerebral Vein and Dural Sinus Thrombosis cohort, demographic, clinical, risk factor, prognosis and imaging findings were compared between patients with parenchymal nonhemorrhagic lesions and no hemorrhagic lesions (NHL) and (1) patients with parenchymal hemorrhagic lesions (HL) and (2) patients without brain lesions. Predictors of prognosis at the end of follow-up in the NHL group were analyzed by bivariate and Cox regression methods. We identified 147 patients (23.6%) with NHL. When compared to patients without brain lesions (n = 309), those with NHL more often presented mental status disturbances, aphasia, decreased alertness, motor deficits, seizures, occlusions of the straight sinus, deep venous system and cortical veins. Patients with NHL had a better prognosis in the acute phase and at the end of follow-up than those with HL, but a worse one than patients without brain lesions, as more NHL patients were dead or dependent (modified Rankin Scale score = 3-6) at discharge (19.7 vs. 6.5%, p < 0.001) and final follow-up (14.3 vs. 7.4%, p = 0.03). In Cox regression analysis, coma (HR = 13.7; 95% CI = 4.3-43.7) and thrombosis of the deep venous system (HR = 3.5; 95% CI = 1.4-8.7) were associated with death or dependency at the end of follow-up. Cerebral venous thrombosis patients with NHL are intermediate between patients without brain lesions and those with HL, both in initial clinical picture and prognosis. Copyright 2010 S. Karger AG, Basel.

Restorations in abrasion/erosion cervical lesions: 8-year results of a triple blind randomized controlled trial.

PubMed

Dall'Orologio, Giovanni Dondi; Lorenzi, Roberta

2014-10-01

An equivalence randomized controlled trial within the subject was organized to evaluate the clinical long-term success of a new 2-step etch & rinse adhesive and a new nano-filled ormocer. 50 subjects, 21 males and 29 females aged between 21 and 65, were randomized to receive 150 restorations, 100 with the new restorative material, 50 with the composite as control, placed in non-carious cervical lesions with the same bonding system. The main outcome measure was the cause of failure at 8 years. Randomization was number table-generated, with allocation concealment by opaque sequentially numbered sealed and stapled envelopes. Subjects, examiner, and analyst were blinded to group assignment. Two interim analyses were performed. Data were analyzed by ANOVA and Cox test (P < 0.05). After 8 years, 40 subjects and 120 teeth were included in the analysis of the primary outcome. There were eight failures in the experimental group and four failures in the control group. The cumulative loss rate was 7% for both restorative materials, with the annual failure lower than 1%, without any statistically significant difference. There were two key elements of failure: the presence of sclerotic dentin and the relationship between lesion and gingival margin.

In vitro remineralization of enamel subsurface lesions and assessment of dentine tubule occlusion from NaF dentifrices with and without calcium.

PubMed

Prabhakar, A R; Manojkumar, A Jaiswal; Basappa, N

2013-01-01

Currently, fluoride is the most effective preventive treatment for remineralization of incipient carious lesions and dentinal hypersensitivity due to wasting disorders. The products containing fluoride, calcium and phosphate are also claim to remineralize early, non-cavitated enamel demineralization. The aim of this study was to investigate and compare the efficacy of two such products, Tooth Mousse and Clinpro tooth crème on remineralization and tubule occluding ability with 5000ppm fluoride-containing toothpaste. Thirty third molar teeth were placed in demineralizing solution for 5 days such that only a window of 1mm x 5mm was exposed to the environment to produce artificial caries-like lesions and randomly assigned to three groups: Group I, 5000ppm sodium fluoride; Group II, GC MI paste plus and Group III, Clinpro tooth crème. Axial longitudinal sections of 140-160 μm of each tooth which included the artificial carious lesion taken and were photographed under polarized light microscope. The demineralized areas were then quantified with a computerized imaging system. The experimental materials were applied onto the tooth sections as a topical coating and subjected to pH-cycling for 28 days. To evaluate tubule occlusion ability, thirty dentin specimens of 2mm thickness were obtained from cervical third of sound third molars. Specimens were ultrasonicated and etched with 6% citric acid for 2 minutes to simulate the hypersensitive dentin. Specimens were randomly divided into above mentioned three groups (n=10). The test agents were brushed over the specimens with an electric toothbrush, prepared and observed under Scanning Electron Microscope for calculation of the percentage of occluded tubules. Group I showed a significantly greater percentage of remineralization than Group III and Group II. Comparison of the remineralization potential between group II and group III were not significant.In case of dentine hypersensitivity, Group I and group III showed greater

Detection of cavitated or non-cavitated approximal enamel caries lesions using CMOS and CCD digital X-ray sensors and conventional D and F-speed films at different exposure conditions.

PubMed

Bottenberg, Peter; Jacquet, Wolfgang; Stachniss, Vitus; Wellnitz, Johann; Schulte, Andreas G

2011-04-01

To determine the ability of digital sensors (CMOS and CCD sensors) and D and F-speed films to detect cavitated and non-cavitated enamel caries lesions at different exposure conditions compared to a gold standard. 100 extracted human molars and premolars were selected and mounted in a block between two neighboring teeth. Sensors or films were exposed with voltages of 60 or 70 kVp at varying times. Three observers assessed each approximal site independently. Lesion depth was rated according to an anatomical five-point scale (0 = no lesion to 4 = lesion reaching inner half of dentin). Serial sections of resin-embedded teeth were prepared. Gold-standard scores were established by consensus based on histological sectioning. A carious lesion was present at scores of 1 and higher. Statistical evaluation (sensitivity, specificity and receiver-operating curves) was based on caries-free surfaces and those presenting enamel caries (n=116). The ROC curves had "area under the curve" values (Az) from 0.50 (F-speed, 70 kVp, 0.20 seconds) to 0.58 (CCD 60 kVp, 0.08 seconds). The detection percentage of cavitated lesions was generally higher (0-52%, depending on technique and observer) than that of non-cavitated lesions (3-32%). The CMOS sensor showed Az values comparable to the CCD sensors but required higher exposure times. There was no significant difference between 60 and 70 kVp.

Effect of monitor display on detection of approximal caries lesions in digital radiographs.

PubMed

Isidor, S; Faaborg-Andersen, M; Hintze, H; Kirkevang, L-L; Frydenberg, M; Haiter-Neto, F; Wenzel, A

2009-12-01

The aim was to compare the accuracy of five flat panel monitors for detection of approximal caries lesions. Five flat panel monitors, Mermaid Ventura (15 inch, colour flat panel, 1024 x 768, 32 bit, analogue), Olórin VistaLine (19 inch, colour, 1280 x 1024, 32 bit, digital), Samsung SyncMaster 203B (20 inch, colour, 1024 x 768, 32 bit, analogue), Totoku ME251i (21 inch, greyscale, 1400 x 1024, 32 bit, digital) and Eizo FlexScan MX190 (19 inch, colour, 1280 x 1024, 32 bit, digital), were assessed. 160 approximal surfaces of human teeth were examined with a storage phosphor plate system (Digora FMX, Soredex) and assessed by seven observers for the presence of caries lesions. Microscopy of the teeth served as validation for the presence/absence of a lesion. The sensitivities varied between observers (range 7-25%) but the variation between the monitors was not large. The Samsung monitor obtained a significantly higher sensitivity than the Mermaid and Olórin monitors (P<0.02) and a lower specificity than the Eizo and Totoku monitors (P<0.05). There were no significant differences between any other monitors. The percentage of correct scores was highest for the Eizo monitor and significantly higher than for the Mermaid and Olórin monitors (P<0.03). There was no clear relationship between the diagnostic accuracy and the resolution or price of the monitor. The Eizo monitor was associated with the overall highest percentage of correct scores. The standard analogue flat panel monitor, Samsung, had higher sensitivity and lower specificity than some of the other monitors, but did not differ in overall accuracy for detection of carious lesions.

Delayed Presentation of a Chronic Morel-Lavallée Lesion.

PubMed

Christian, David; Leland, Hyuma A; Osias, Walter; Eberlin, Seth; Howell, Lori

2016-07-01

Morel-Lavellée lesions are soft tissue degloving injuries resulting from shearing trauma that induces separation of the superficial and deep fascias creating a potential space that becomes filled with hemolymph. Here we present a case of a 28-year-old male presenting with a persistent Type I Morel-Lavallée lesion 2.5 years after an automobile versus pedestrian accident. These lesions can be visualized via computed tomography, plain film and ultrasound, but magnetic resonance imaging is the modality of choice for their identification and characterization.

Toolkits and Libraries for Deep Learning.

PubMed

Erickson, Bradley J; Korfiatis, Panagiotis; Akkus, Zeynettin; Kline, Timothy; Philbrick, Kenneth

2017-08-01

Deep learning is an important new area of machine learning which encompasses a wide range of neural network architectures designed to complete various tasks. In the medical imaging domain, example tasks include organ segmentation, lesion detection, and tumor classification. The most popular network architecture for deep learning for images is the convolutional neural network (CNN). Whereas traditional machine learning requires determination and calculation of features from which the algorithm learns, deep learning approaches learn the important features as well as the proper weighting of those features to make predictions for new data. In this paper, we will describe some of the libraries and tools that are available to aid in the construction and efficient execution of deep learning as applied to medical images.

Miniature Pulpotomy of Symptomatic Mature Permanent Teeth: A Report of Two Cases.

PubMed

Asgary, Saeed; Nourzadeh, Mahdieh; Eghbal, Mohammad Jafar

2016-01-01

Human dental pulp inflammation can progress to periapical lesion formation and conventional root canal treatment (RCT) has been the traditional method for disease management. This observational study presents two cases of vital pulp therapy in mature molars diagnosed with irreversible pulpitis and associated with apical periodontitis. In these two clinical cases, the involved teeth had deep carious lesions with a history of spontaneous/lingering pain and radiographic examinations revealed the presence of apical radiolucencies. A conservative miniature pulpotomy (MP) using calcium-enriched mixture (CEM) was performed and the teeth were permanently restored with amalgam. Clinical evaluations indicated resolution of pain 24 hours after treatment; the teeth showed normal vitality, remained asymptomatic and maintained normal function after recall examinations. Furthermore, the 18-month radiographic evaluation showed healing of the apical lesions. Vital pulp therapy using the MP technique with CEM appeared successful in avoiding RCT intervention. These two reports of case outcome suggest that simple MP using a CEM bioregenerative technique may provide a favorable outcome for permanent teeth diagnosed with irreversible pulpitis and associated with apical periodontitis.

Quantitative comparison of cortical and deep grey matter in pathological subtypes of unilateral cerebral palsy.

PubMed

Scheck, Simon M; Pannek, Kerstin; Fiori, Simona; Boyd, Roslyn N; Rose, Stephen E

2014-10-01

The aim of this study was to quantify grey matter changes in children with unilateral cerebral palsy (UCP), differentiating between cortical or deep grey matter (CDGM) lesions, periventricular white matter (PWM) lesions, and unilateral and bilateral lesions. In a cross-sectional study we obtained high resolution structural magnetic resonance images from 72 children (41 males, 31 females, mean age 10y 9mo [SD 3y 1mo], range 5y 1mo-17y 1mo) with UCP (33 left, 39 right hemiplegia; Manual Ability Classification System level I n=29, II n=43; Gross Motor Function Classification System level I n=46, II n=26), and 19 children with typical development (CTD; eight males, 11 females, mean age 11y 2mo [SD 2y 7mo], range 7y 8mo-16y 4mo). Images were classified by lesion type and analyzed using voxel-based morphometry (VBM) and subcortical volumetric analysis. Deep grey matter volumes were not significantly different between children with CDGM and PWM lesions, with the thalamus, putamen, and globus pallidus being reduced unilaterally in both groups compared with CTD (p≤0.001). Children with CDGM lesions additionally showed widespread cortical changes involving all lobes using VBM (p<0.01). Children with bilateral lesions had reduced thalamus and putamen volumes bilaterally (p<0.001). The thalamic volume was reduced bilaterally in children with unilateral lesions (p=0.004). Lesions to the PWM cause secondary changes to the deep grey matter structures similar to primary changes seen in CDGM lesions. Despite having a unilateral phenotype, grey matter changes are observed bilaterally, even in children with unilateral lesions. © 2014 Mac Keith Press.

Morel-Lavallée lesion: A closed degloving injury that requires real attention.

PubMed

Nair, Anirudh V; Nazar, Pk; Sekhar, Resmi; Ramachandran, Pv; Moorthy, Srikanth

2014-07-01

Morel-Lavallée lesions are post-traumatic, closed degloving injuries occurring deep to subcutaneous plane due to disruption of capillaries resulting in an effusion containing hemolymph and necrotic fat. Magnetic resonance imaging (MRI) is the modality of choice in the evaluation of Morel-Lavallée lesion. Early diagnosis and management is essential as any delay in diagnosis or missed lesion will lead to the effusion becoming infected or leading to extensive skin necrosis.

Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries-active adults.

PubMed

Brown, John P; Amaechi, Bennett T; Bader, James D; Gilbert, Gregg H; Makhija, Sonia K; Lozano-Pineda, Juanita; Leo, Michael C; Chen, Chuhe; Vollmer, William M

2014-06-01

To better understand the effectiveness of xylitol in caries prevention in adults and to attempt improved clinical trial efficiency. As part of the Xylitol for Adult Caries Trial (X-ACT), non cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 g/day of xylitol, consumed by dissolving in the mouth five 1 g lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21-80, with complete data for four dental examinations, were selected from the 691 randomized into the 3-year trial, conducted at three sites. Acceptable inter- and intra-examiner reliability before and during the trial was quantified using the kappa statistic. The mean annualized noncavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically nonsignificant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non cavitated lesion assessment in this full-scale, placebo-controlled, multisite, randomized, double-blinded clinical trial in adults experiencing dental caries did not achieve added trial efficiency or demonstrate practical benefit of xylitol. ClinicalTrials.Gov NCT00393055. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Visual scoring of non-cavitated caries lesions and clinical trial efficiency, testing xylitol in caries active adults

PubMed Central

Brown, JP; Amaechi, BT; Bader, JD; Gilbert, GH; Makhija, SK; Lozano-Pineda, J; Leo, MC; Chuhe, C; Vollmer, WM

2013-01-01

Objectives To better understand the effectiveness of xylitol in caries prevention in adults, and to attempt improved clinical trial efficiency. Methods As part of the Xylitol for Adult Caries Trial (X-ACT), non-cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 grams/day of xylitol, consumed by dissolving in the mouth five 1 gram lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21–80, with complete data for four dental examinations were selected from the 691 randomized into the three year trial, conducted at three sites. Acceptable inter and intra examiner reliability before and during the trial was quantified using the kappa statistic. Results The mean annualized non-cavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically non-significant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. Conclusions There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non-cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non-cavitated lesion assessment in this full scale, placebo controlled, multi site, randomized, double blinded clinical trial in adults experiencing dental caries, did not achieve added trial efficiency or demonstrate practical benefit of xylitol. Trial Registration ClinicalTrials.Gov NCT00393055 PMID:24205951

Skin conditions: benign nodular skin lesions.

PubMed

Nguyen, Tam; Zuniga, Ramiro

2013-04-01

Benign subcutaneous lesions are a common reason that patients visit family physicians. Lipomas are the most common of these lesions; they most often occur on the trunk and proximal extremities. Recent data show that as many as half of the fat cells in lipomas are atypical. Ultrasound is used increasingly to confirm lipoma diagnosis, but deep lesions should be evaluated with magnetic resonance imaging study or computed tomography scan to exclude involvement of underlying structures and/or liposarcoma. Small lesions can sometimes be managed with serial injections of midpotency steroids. Larger lesions (larger than 5 cm), those compressing other structures, or those suspicious for malignancy should be excised using standard surgical excision or, when possible, the newer minimal-scar segmental extraction technique. Ganglion cysts are another common lesion, the presence of which often is confirmed with ultrasound if the diagnosis is not clinically apparent. Management includes splinting, aspiration, and/or injection of steroids, with or without hyaluronidase. Epidermal inclusion cysts, also called sebaceous cysts, typically are asymptomatic unless they become infected. Ultrasound can aid in diagnosis. The only definitive management is surgical excision with complete removal of the cyst wall or capsule, using minimal-scar segmental extraction or conventional surgical removal. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Effectiveness of computer-aided diagnosis of colorectal lesions using novel software for magnifying narrow-band imaging: a pilot study.

PubMed

Tamai, Naoto; Saito, Yutaka; Sakamoto, Taku; Nakajima, Takeshi; Matsuda, Takahisa; Sumiyama, Kazuki; Tajiri, Hisao; Koyama, Ryosuke; Kido, Shoji

2017-08-01

 Magnifying narrow-band imaging (M-NBI) enables detailed observation of microvascular architecture and can be used in endoscopic diagnosis of colorectal lesion. However, in clinical practice, differential diagnosis and estimation of invasion depth of colorectal lesions based on M-NBI findings require experience. Therefore, developing computer-aided diagnosis (CAD) for M-NBI would be beneficial for clinical practice. The aim of this study was to evaluate the effectiveness of software for CAD of colorectal lesions. In collaboration with Yamaguchi University, we developed novel software that enables CAD of colorectal lesions using M-NBI images. This software for CAD further specifically divides original Sano's colorectal M-NBI classification into 3 groups (group A, capillary pattern [CP] type I; group B, CP type II + CP type IIIA; group C, CP type IIIB), which describe hyperplastic polyps (HPs), adenoma/adenocarcinoma (intramucosal [IM] to submucosal [SM]-superficial) lesions, and SM-deep lesions, respectively. We retrospectively reviewed 121 lesions evaluated using M-NBI. The 121 reviewed lesions included 21 HP, 80 adenoma/adenocarcinoma (IM to SM-superficial), and 20 SM-deep lesions. The concordance rate between the CAD and the diagnosis of the experienced endoscopists was 90.9 %. The sensitivity, specificity, positive and negative predictive values, and accuracy of the CAD for neoplastic lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively. The values for SM-deep lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively.  Relatively high diagnostic values were obtained using CAD. This software for CAD could possibly lead to a wider use of M-NBI in the endoscopic diagnosis of colorectal lesions.

Noninvasive methods for determining lesion depth from vesicant exposure.

PubMed

Braue, Ernest H; Graham, John S; Doxzon, Bryce F; Hanssen, Kelly A; Lumpkin, Horace L; Stevenson, Robert S; Deckert, Robin R; Dalal, Stephen J; Mitcheltree, Larry W

2007-01-01

Before sulfur mustard (HD) injuries can be effectively treated, assessment of lesion depth must occur. Accurate depth assessment is important because it dictates how aggressive treatment needs to be to minimize or prevent cosmetic and functional deficits. Depth of injury typically is assessed by physical examination. Diagnosing very superficial and very deep lesions is relatively easy for the experienced burn surgeon. Lesions of intermediate depth, however, are often problematic in determining the need for grafting. This study was a preliminary evaluation of two noninvasive bioengineering methodologies, laser Doppler perfusion imaging (LDPI) and indocyanine green fluorescence imaging (ICGFI), to determine their ability to accurately diagnose depth of sulfur mustard lesions in a weanling swine model. Histological evaluation was used to assess the accuracy of the imaging techniques in determining burn depth. Six female weanling swine (8-12 kg) were exposed to 400 microl of neat sulfur mustard on six ventral sites for 2, 8, 30, or 60 minutes. This exposure regimen produced lesions of varying depths from superficial to deep dermal. Evaluations of lesion depth using the bioengineering techniques were conducted at 24, 48, and 72 hours after exposure. After euthanasia at 72 hours after exposure, skin biopsies were taken from each site and processed for routine hematoxylin and eosin histological evaluation to determine the true depth of the lesion. Results demonstrated that LDPI and ICGFI were useful tools to characterize skin perfusion and provided a good estimate of HD lesion depth. Traditional LDPI and the novel prototype ICGFI instrumentation used in this study produced images of blood flow through skin lesions, which provided a useful assessment of burn depth. LDPI and ICGFI accurately predicted the need for aggressive treatment (30- and 60-minute HD lesions) and nonaggressive treatment (2- and 8-minute HD lesions) for the lesions generated in this study. Histological

Evaluation of mast cell counts and microvessel density in reactive lesions of the oral cavity.

PubMed

Kouhsoltani, Maryam; Moradzadeh Khiavi, Monir; Tahamtan, Shabnam

2016-01-01

Background. Reliable immunohistochemical assays to assess the definitive role of mast cells (MCs) and angiogenesis in the pathogenesis of oral reactive lesions are generally not available. The aim of the present study was to evaluate mast cell counts (MCC) and microvessel density (MVD) in oral reactive lesions and determine the correlation between MCC and MVD. Methods. Seventy-five cases of reactive lesions of the oral cavity, including pyogenic granuloma, fibroma, peripheral giant cell granuloma, inflammatory fibrous hyperplasia, peripheral ossifying fibroma (15 for each category) were immunohisto-chemically stained with MC tryptase and CD31. Fifteen cases of normal gingival tissue were considered as the control group. The mean MCC and MVD in superficial and deep connective tissues were assessed and total MCC and MVD was computed for each lesion. Results . Statistically significant differences were observed in MCC and MVD between the study groups (P < 0.001). MC tryptase and CD31 expression increased in the superficial connective tissue of each lesion in comparison to the deep con-nective tissue. A significant negative correlation was not found between MCC and MVD in oral reactive lesions (P < 0.001, r = -0.458). Conclusion. Although MCs were present in the reactive lesions of the oral cavity, a direct correlation between MCC and MVD was not found in these lesions. Therefore, a significant interaction between MCs and endothelial cells and an active role for MCs in the growth of oral reactive lesions was not found in this study.

Remineralization Effect of Topical NovaMin Versus Sodium Fluoride (1.1%) on Caries-Like Lesions in Permanent Teeth

PubMed Central

Vahid Golpayegani, M.; Sohrabi, A.; Biria, M.; Ansari, G.

2012-01-01

Objective: NovaMin, a synthetic mineral composed of calcium, sodium, phosphorous and silica releases deposits of crystalline hydroxyl-carbonate apatite (HCA) structurally similar to tooth mineral composition. The aim of this investigation was to compare the potential remineralization effect of topical NovaMin and Sodium Fluoride gel on caries like lesions in permanent teeth. Materials and Methods: A total of 60 sound human freshly extracted teeth were subjected to a pH-cycling protocol. Specimens were randomly assigned to one of the two treatment groups with NovaMin contained dentifrice applied to group 1, while group 2 received a dentifrice containing 1.1% neutral Sodium Fluoride. Pastes were applied five times after the samples received a demineralization from an earlier cariogenic challenge. Specimens were then evaluated by a Surface Micro Hardness test (SMH, 25G, 5s). Post-treatment SMH measurements were conducted and Mann Whitney test was employed for statistical analysis. Results: Mean post lesion SMH values were 221.99±26.27 and 224.50±28.64 for the first and second groups, respectively. Post treatment SMH values were 232.52±24.34 for NovaMin and 232.03 ±24.46 for the fluoride group. Two way ANOVA test showed a highly significant difference between the two different treatment protocols (p<0.001). Conclusion: NovaMin dentifrice appears to have a greater effect on remineralization of carious-like lesions when compared to that of fluoride containing dentifrice in permanent teeth. PMID:22924104

Dermabrasion and staged excision of facial lesions in a neurofibromatosis case for improvement of facial appearance.

PubMed

Karabekmez, Furkan Erol; Duymaz, Ahmet; Karacor, Zeynep

2013-01-01

Neurofibromatosis may present with different skin lesions. Disfiguring lesions on the face might be challenging for the surgeon or clinician to correct and may have adverse effects on patients' social lives, especially in young women. To present the dermabrasion technique combined with serial excisions of a deeper accompanying lesion to treat superficial facial lesions in a young neurofibromatosis patient. Dermabrasion was applied to superficial lesions on the face, and staged excision was applied to the deeper lesion located on the forehead. We obtained high patient satisfaction with the result. The deep lesion was excised totally, and superficial lesions were decreased with dermabrasion. Dermabrasion may become a good alternative in cases of neurofibromatosis with superficial facial lesions.

Preventing Advanced Carious Lesions with Caries Atraumatic Restorative Technique.

PubMed

Byrd, Tammi O

2016-06-01

An alternative approach to controlling dental caries and preventing the associated pain, called atraumatic restorative technique (ART), is described for populations in need, where dental hygienists restore decayed teeth with glass ionomer restorations without prior removal of all decayed tooth structure. There are populations whose decay needs are not adequately being met within the current oral health care delivery system. These include those in poverty conditions, vulnerable children, and the elderly who are often in long-term care facilities without adequate resources or opportunities for traditional dentistry. ART provides a viable option for controlling caries and relieving the pain of untreated decay. The purpose of this article is to suggest that the evidence surrounding ART be viewed objectively and that dental hygienists, with additional education in this approach, can contribute to relieving the pain of untreated dental decay. Evidence suggests that teeth can be effectively restored with ART. Dental hygienists represent an appropriate workforce to provide ART with their current background and education combined plus a brief training program; it is suggested that dental hygiene educational programs include ART within the curriculum. Along with dental sealants and fluoride varnish application, ART can be an important component of a comprehensive preventive program to address the unmet needs of vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

Lesional perfusion abnormalities in Leigh disease demonstrated by arterial spin labeling correlate with disease activity.

PubMed

Whitehead, Matthew T; Lee, Bonmyong; Gropman, Andrea

2016-08-01

Leigh disease is a metabolic disorder of the mitochondrial respiratory chain culminating in symmetrical necrotizing lesions in the deep gray nuclei or brainstem. Apart from classic gliotic/necrotic lesions, small-vessel proliferation is also characteristic on histopathology. We have observed lesional hyperperfusion on arterial spin-labeling (ASL) sequence in children with Leigh disease. In this cross-sectional analysis, we evaluated lesional ASL perfusion characteristics in children with Leigh syndrome. We searched the imaging database from an academic children's hospital for "arterial spin labeling, perfusion, necrosis, lactate, and Leigh" to build a cohort of children for retrospective analysis. We reviewed each child's medical record to confirm a diagnosis of Leigh disease, excluding exams with artifact, technical limitations, and without ASL images. We evaluated the degree and extent of cerebral blood flow and relationship to brain lesions. Images were compared to normal exams from an aged-matche cohort. The database search yielded 45 exams; 30 were excluded. We evaluated 15 exams from 8 children with Leigh disease and 15 age-matched normal exams. In general, Leigh brain perfusion ranged from hyperintense (n=10) to hypointense (n=5). Necrotic lesions appeared hypointense/hypoperfused. Active lesions with associated restricted diffusion demonstrated hyperperfusion. ASL perfusion patterns differed significantly from those on age-matched normal studies (P=<.0001). Disease activity positively correlated with cerebral deep gray nuclei hyperperfusion (P=0.0037) and lesion grade (P=0.0256). Children with Leigh disease have abnormal perfusion of brain lesions. Hyperperfusion can be found in active brain lesions, possibly associated with small-vessel proliferation characteristic of the disease.

Deep erosions of the palmar aspect of the navicular bone diagnosed by standing magnetic resonance imaging.

PubMed

Sherlock, C; Mair, T; Blunden, T

2008-11-01

Erosion of the palmar (flexor) aspect of the navicular bone is difficult to diagnose with conventional imaging techniques. To review the clinical, magnetic resonance (MR) and pathological features of deep erosions of the palmar aspect of the navicular bone. Cases of deep erosions of the palmar aspect of the navicular bone, diagnosed by standing low field MR imaging, were selected. Clinical details, results of diagnostic procedures, MR features and pathological findings were reviewed. Deep erosions of the palmar aspect of the navicular bone were diagnosed in 16 mature horses, 6 of which were bilaterally lame. Sudden onset of lameness was recorded in 63%. Radiography prior to MR imaging showed equivocal changes in 7 horses. The MR features consisted of focal areas of intermediate or high signal intensity on T1-, T2*- and T2-weighted images and STIR images affecting the dorsal aspect of the deep digital flexor tendon, the fibrocartilage of the palmar aspect, subchondral compact bone and medulla of the navicular bone. On follow-up, 7/16 horses (44%) had been subjected to euthanasia and only one was being worked at its previous level. Erosions of the palmar aspect of the navicular bone were confirmed post mortem in 2 horses. Histologically, the lesions were characterised by localised degeneration of fibrocartilage with underlying focal osteonecrosis and fibroplasia. The adjacent deep digital flexor tendon showed fibril formation and fibrocartilaginous metaplasia. Deep erosions of the palmar aspect of the navicular bone are more easily diagnosed by standing low field MR imaging than by conventional radiography. The lesions involve degeneration of the palmar fibrocartilage with underlying osteonecrosis and fibroplasia affecting the subchondral compact bone and medulla, and carry a poor prognosis for return to performance. Diagnosis of shallow erosive lesions of the palmar fibrocartilage may allow therapeutic intervention earlier in the disease process, thereby preventing

Panographic Survey of U. S. Army Recruits: Analysis of Dental Health Status.

DTIC Science & Technology

1981-09-16

pathoses which may not be evident on a routine periapical survey.3-6 The advantages of panoramic radiography make it particularly attractive for mass...perlapical radiolucencles. Radiolucent lesions, other than periapical or anatomical, were recorded separately. Folli- cular enlargements (over 3 m) surrounding...retention cysts . RESULTS Table I summarizes the findings. Dental Caries. A 58 percent incidence of carious lesions was noted overall. Many of these lesions

Deep learning and three-compartment breast imaging in breast cancer diagnosis

NASA Astrophysics Data System (ADS)

Drukker, Karen; Huynh, Benjamin Q.; Giger, Maryellen L.; Malkov, Serghei; Avila, Jesus I.; Fan, Bo; Joe, Bonnie; Kerlikowske, Karla; Drukteinis, Jennifer S.; Kazemi, Leila; Pereira, Malesa M.; Shepherd, John

2017-03-01

We investigated whether deep learning has potential to aid in the diagnosis of breast cancer when applied to mammograms and biologic tissue composition images derived from three-compartment (3CB) imaging. The dataset contained diagnostic mammograms and 3CB images (water, lipid, and protein content) of biopsy-sampled BIRADS 4 and 5 lesions in 195 patients. In 58 patients, the lesion manifested as a mass (13 malignant vs. 45 benign), in 87 as microcalcifications (19 vs. 68), and in 56 as (focal) asymmetry or architectural distortion (11 vs. 45). Six patients had both a mass and calcifications. For each mammogram and corresponding 3CB images, a 128x128 region of interest containing the lesion was selected by an expert radiologist and used directly as input to a deep learning method pretrained on a very large independent set of non-medical images. We used a nested leave-one-out-by-case (patient) model selection and classification protocol. The area under the ROC curve (AUC) for the task of distinguishing between benign and malignant lesions was used as performance metric. For the cases with mammographic masses, the AUC increased from 0.83 (mammograms alone) to 0.89 (mammograms+3CB, p=.162). For the microcalcification and asymmetry/architectural distortion cases the AUC increased from 0.84 to 0.91 (p=.116) and from 0.61 to 0.87 (p=.006), respectively. Our results indicate great potential for the application of deep learning methods in the diagnosis of breast cancer and additional knowledge of the biologic tissue composition appeared to improve performance, especially for lesions mammographically manifesting as asymmetries or architectural distortions.

Depth profilometric case studies in caries diagnostics of human teeth using modulated laser radiometry and luminescence

NASA Astrophysics Data System (ADS)

Jeon, Raymond J.; Mandelis, Andreas; Abrams, Stephen H.

2003-01-01

Simultaneous measurements from human teeth of photothermal radiometric (PTR) and luminescence (LM) signals induced by an intensity modulated laser have been performed to assess the feasibility of detecting deep lesions and near-surface cracks, to examine the effects of varying enamel thicknesses, the presence of fillings, and stains on the surface of teeth. A commercial dc luminescence monitoring instrument (DIAGNOdent by KaVo) was also used to examine a set of teeth for comparison purposes with PTR and LM. PTR amplitude signals from carious regions and from thin enamel were higher than those from healthy regions and thicker enamel. A crack produces a peak in the PTR amplitude scan, as well as a sudden change in the luminescence amplitude at the corresponding point. At low frequencies (5 Hz), the PTR amplitude showed high sensitivity to a deep (about 2 mm) lesion, while at high frequencies (700 Hz) it was more sensitive to surface cracks. It was concluded that by selecting proper modulation frequencies of the laser, measurements of PTR and LM signals could be used as a dental diagnostic technique with a small, inexpensive, low-power (<30 mW) semiconductor laser as a light source emitting in the optical window range of hard tissue (650-1000 nm).

Anatomic feature of deltoid ligament attachment in posteromedial osteochondral lesion of talar dome.

PubMed

Nakasa, Tomoyuki; Sawa, Mikiya; Ikuta, Yasunari; Yoshikawa, Masahiro; Tsuyuguchi, Yusuke; Adachi, Nobuo

2018-03-01

Osteochondral lesions of the talus (OLT) are recognized as being commonly associated with trauma. However, the etiology of OLT remains unclear. In the case of a posteromedial lesion of OLT (medial OLT), the deep layer of the deltoid ligament is located close to the medial OLT, and this relationship between a medial lesion and deltoid ligament could be a risk factor for medial OLT. The purpose of this study is to investigate the unique anatomic feature of the deep deltoid attachment to the talus in patients with medial OLT compared with patients with non-medial OLT. Forty ankles with medial OLT and 40 ankles without medial OLT were retrospectively reviewed in this study. On the coronal images of MRI, the attachment of deltoid ligament was measured. The continuity of the osteochondral fragment and its bed was evaluated on MRI and arthroscopic findings. Coronal MRI images showed that the attachment of the deep deltoid ligament to the medial OLT was broader and located more proximally than in non-medial OLT. The continuity of fibers from the insertion site of deltoid ligament to the talus to the osteochondral fragment was observed (76.7%). In the arthroscopic findings, the osteochondral fragment was obviously connected to the talus at the medial site in 85.2% of feet. The location of the deep deltoid ligament attachment to the medial OLT was more proximal and there was the possibility of these anatomic feature might contribute to the pathogenesis of medial OLT. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Effects of pulsed CO2 laser in caries selective ablation

NASA Astrophysics Data System (ADS)

Colojoara, Carmen; David, Ion; Marinovici, Mariana

1995-03-01

We have evaluated the effect of pulsed carbon dioxide laser in the treatment for deep carious decay. The so called `caries profonda' is still a problem for conservative dentistry. A `Valvfivre' Master 20S carbon dioxide laser was pulsed to determine the effects on dentine and for testing the properties of softened dentine in selective ablation. Laser treatment parameters were from 1 to 2 W, 50 to 150 ms, 200 to 320 Hz. Fifteen human teeth samples were exposed to irradiation: extracted third molar were exposed to CO2 pulsed laser to determine in vitro the effects on pulp morphology. The tissue samples were analyzed histologically and by means of scanning electron microscopy for evidence of thermal damage. Next, we have evaluated the morphologic changes in vivo on 10 cases in patients with deep carious decay. Pulsed infrared lasers are capable of inducing physical and chemical changes in dentine structure. The results showed an artificially sclerosing and micro-hardness on the remaining dentine. CO2 laser can vaporized carious dentine.

Deep cerebral venous thrombosis mimicking influenza-associated acute necrotizing encephalopathy: a case report.

PubMed

Taniguchi, Daisuke; Nakajima, Sho; Hayashida, Arisa; Kuroki, Takuma; Eguchi, Hiroto; Machida, Yutaka; Hattori, Nobutaka; Miwa, Hideto

2017-09-26

Acute necrotizing encephalopathy is one of the most devastating neurological complications of influenza virus infection. Acute necrotizing encephalopathy preferentially affects the thalamus bilaterally, as does deep cerebral venous thrombosis, which can lead to misdiagnosis. A 52-year-old Japanese woman infected with seasonal influenza B virus presented to the emergency care unit in our hospital with progressive alteration of her level of consciousness. Bilateral thalamic lesions were demonstrated by magnetic resonance imaging, leading to a tentative diagnosis of acute necrotizing encephalopathy. However, she had deep cerebral venous thrombosis, and the presence of diminished signal and enlargement of deep cerebral veins on T2*-weighted imaging contributed to a revised diagnosis of deep cerebral venous thrombosis. Anticoagulant therapy was initiated, leading to her gradual recovery, with recanalization of the deep venous system and straight sinus. To the best of our knowledge, these results represent the first report of deep cerebral venous thrombosis associated with influenza infection. It is clinically important to recognize that deep cerebral venous thrombosis, although rare, might be one of the neurological complications of influenza infection. In the presence of bilateral thalamic lesions in patients with influenza infection, deep cerebral venous thrombosis should be considered in addition to acute necrotizing encephalopathy. Delays in diagnosis and commencement of anticoagulant therapy can lead to unfavorable outcomes.

Minimal Intervention Dentistry (MID) for managing dental caries – a review

PubMed Central

Frencken, Jo E.; Peters, Mathilde C.; Manton, David J.; Leal, Soraya C.; Gordan, Valeria V.; Eden, Ece

2012-01-01

This publication describes the history of Minimal Intervention Dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI’s policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836

Contralateral posterior interhemispheric approach to deep medial parietooccipital vascular malformations: surgical technique and results.

PubMed

Burkhardt, Jan-Karl; Winkler, Ethan A; Lawton, Michael T

2017-07-21

OBJECTIVE Deep medial parietooccipital arteriovenous malformations (AVMs) and cerebral cavernous malformations (CCMs) are traditionally resected through an ipsilateral posterior interhemispheric approach (IPIA), which creates a deep, perpendicular perspective with limited access to the lateral margins of the lesion. The contralateral posterior interhemispheric approach (CPIA) flips the positioning, with the midline positioned horizontally for retraction due to gravity, but with the AVM on the upper side and the approach from the contralateral, lower side. The aim of this paper was to analyze whether the perpendicular angle of attack that is used in IPIA would convert to a parallel angle of attack with the CPIA, with less retraction, improved working angles, and no significant increase in risk. METHODS A retrospective review of pre- and postoperative clinical and radiographic data was performed in 8 patients who underwent a CPIA. RESULTS Three AVMs and 5 CCMs were resected using the CPIA, with an average nidus size of 2.3 cm and CCM diameter of 1.7 cm. All lesions were resected completely, as confirmed on postoperative catheter angiography or MRI. All patients had good neurological outcomes, with either stable or improved modified Rankin Scale scores at last follow-up. CONCLUSIONS The CPIA is a safe alternative approach to the IPIA for deep medial parietooccipital vascular malformations that extend 2 cm or more off the midline. Contralaterality and retraction due to gravity optimize the interhemispheric corridor, the surgical trajectory to the lesion, and the visualization of the lateral margin, without resection or retraction of adjacent normal cortex. Although the falx is a physical barrier to accessing the lesion, it stabilizes the ipsilateral hemisphere while gravity delivers the dissected lesion through the transfalcine window. Patient positioning, CSF drainage, venous preservation, and meticulous dissection of the deep margins are critical to the safety of

Early diagnosis of incipient caries based on non-invasive lasers

NASA Astrophysics Data System (ADS)

Velescu, A.; Todea, C.; Vitez, B.

2016-03-01

AIM: The aim of this study is to detect incipient caries and enamel demineralization using laser fluorescence.This serves only as an auxilary aid to identify and to monitor the development of these lesions. MATERIALS AND METHODS: 6 patients were involved in this study, three females and three male. Each patient underwent a professional cleaning, visual examination of the oral cavity, and then direct inspection using DiagnoCam and DIAGNOdent. After data recording each patient was submitted to retro-alveolar X-ray on teeth that were detected with enamel lesions. All data was collected and analyzed statistically. RESULTS: Of 36 areas considered in clinically healthy, 24 carious surfaces were found using laser fluorescence, a totally non-invasive method for detecting incipient carious lesions compared with the radiographic examination. CONCLUSIONS: This method has good applicability for patients because it improves treatment plan by early detection of caries and involves less fear for anxious patients and children.

Deep image mining for diabetic retinopathy screening.

PubMed

Quellec, Gwenolé; Charrière, Katia; Boudi, Yassine; Cochener, Béatrice; Lamard, Mathieu

2017-07-01

Deep learning is quickly becoming the leading methodology for medical image analysis. Given a large medical archive, where each image is associated with a diagnosis, efficient pathology detectors or classifiers can be trained with virtually no expert knowledge about the target pathologies. However, deep learning algorithms, including the popular ConvNets, are black boxes: little is known about the local patterns analyzed by ConvNets to make a decision at the image level. A solution is proposed in this paper to create heatmaps showing which pixels in images play a role in the image-level predictions. In other words, a ConvNet trained for image-level classification can be used to detect lesions as well. A generalization of the backpropagation method is proposed in order to train ConvNets that produce high-quality heatmaps. The proposed solution is applied to diabetic retinopathy (DR) screening in a dataset of almost 90,000 fundus photographs from the 2015 Kaggle Diabetic Retinopathy competition and a private dataset of almost 110,000 photographs (e-ophtha). For the task of detecting referable DR, very good detection performance was achieved: A z =0.954 in Kaggle's dataset and A z =0.949 in e-ophtha. Performance was also evaluated at the image level and at the lesion level in the DiaretDB1 dataset, where four types of lesions are manually segmented: microaneurysms, hemorrhages, exudates and cotton-wool spots. For the task of detecting images containing these four lesion types, the proposed detector, which was trained to detect referable DR, outperforms recent algorithms trained to detect those lesions specifically, with pixel-level supervision. At the lesion level, the proposed detector outperforms heatmap generation algorithms for ConvNets. This detector is part of the Messidor® system for mobile eye pathology screening. Because it does not rely on expert knowledge or manual segmentation for detecting relevant patterns, the proposed solution is a promising image

Enamel remineralization on teeth adjacent to Class II glass ionomer restorations.

PubMed

Segura, A; Donly, K J; Stratmann, R G

1997-10-01

To examine the in vitro remineralization of incipient carious lesions on teeth adjacent interproximally to teeth with Class II glass ionomer cement restorations. Artificial carious lesions were created at the contact area of 30 teeth. Ten teeth had Class II glass ionomer cement/resin composite restorations placed, 10 teeth had Class II glass ionomer silver cermet restorations placed and 10 teeth had Class II amalgam restorations placed. Sections 100 microns thick were obtained longitudinally through the caries sites and polarized photomicrographs were taken in imbibition media of water and Thoulet's (R.I. 1.41 and 1.47) solutions, representing 5%, 10% and 25% pore volume respectively. Varnish was placed on the section, leaving only the external section site exposed, then sections were situated back into the original tooth. The restored teeth were abutted to the carious tooth so that the restorations came into contact with the adjacent restoration. The specimens were placed into closed environments of artificial saliva for 14 days, then were photographed again under polarized light and areas of the carious lesions were quantitated. An ANOVA indicated significant variance in adjacent tooth remineralization, when comparing the experimental groups, in imbibition media of water (P < 0.05), Thoulet's 1.41 solution (P < 0.008) and Thoulet's 1.47 solution (P < 0.006). Duncan's multiple range test demonstrated the glass ionomer cement/resin composite group to have significantly greater decrease in pore volume (P < 0.05) than the amalgam control group in water imbibition media and Thoulet's 1.47 media. There was no statistically significant difference between the glass ionomer cement/resin composite and glass ionomer silver cermet groups in these two imbibition media. The glass ionomer cement/resin composite group demonstrated significantly more (P < 0.05) decrease in pore volume than both the glass ionomer silver cermet group and amalgam control group in Thoulet's 1

Stress and strain distribution in demineralized enamel: A micro-CT based finite element study.

PubMed

Neves, Aline Almeida; Coutinho, Eduardo; Alves, Haimon Diniz Lopes; de Assis, Joaquim Teixeira

2015-10-01

Physiological oral mechanical forces may play a role on the progression of enamel carious lesions to cavitation. Thus, the aim of this study was to describe, by 3D finite element analysis, stress, and strain patterns in sound and carious enamel after a simulated occlusal load. Micro-CT based models were created and meshed with tetrahedral elements (based on an extracted third molar), namely: a sound (ST) and a carious tooth (CT). For the CT, enamel material properties were assigned according to the micro-CT gray values. Below the threshold corresponding to the enamel lesion (2.5 g/cm(3) ) lower and isotropic elastic modulus was assigned (E = 18 GPa against E1  = 80 GPa, E2  = E3  = 20 GPa for sound enamel). Both models were imported into a FE solver where boundary conditions were assigned and a pressure load (500 MPa) was applied at the occlusal surface. A linear static analysis was performed, considering anisotropy in sound enamel. ST showed a more efficient transfer of maximum principal stress from enamel to the dentin layer, while for the CT, enamel layer was subjected to higher and concentrated loads. Maximum principal strain distributions were seen at the carious enamel surface, especially at the central fossa, correlating to the enamel cavity seen at the original micro-CT model. It is possible to conclude that demineralized enamel compromises appropriate stress transfer from enamel to dentin, contributing to the odds of fracture and cavitation. Enamel fracture over a dentin lesion may happen as one of the normal pathways to caries progression and may act as a confounding factor during clinical diagnostic decisions. © 2015 Wiley Periodicals, Inc.

Deep learning with convolutional neural network in radiology.

PubMed

Yasaka, Koichiro; Akai, Hiroyuki; Kunimatsu, Akira; Kiryu, Shigeru; Abe, Osamu

2018-04-01

Deep learning with a convolutional neural network (CNN) is gaining attention recently for its high performance in image recognition. Images themselves can be utilized in a learning process with this technique, and feature extraction in advance of the learning process is not required. Important features can be automatically learned. Thanks to the development of hardware and software in addition to techniques regarding deep learning, application of this technique to radiological images for predicting clinically useful information, such as the detection and the evaluation of lesions, etc., are beginning to be investigated. This article illustrates basic technical knowledge regarding deep learning with CNNs along the actual course (collecting data, implementing CNNs, and training and testing phases). Pitfalls regarding this technique and how to manage them are also illustrated. We also described some advanced topics of deep learning, results of recent clinical studies, and the future directions of clinical application of deep learning techniques.

Melanoma Is Skin Deep: A 3D Reconstruction Technique for Computerized Dermoscopic Skin Lesion Classification

PubMed Central

Satheesha, T. Y.; Prasad, M. N. Giri; Dhruve, Kashyap D.

2017-01-01

Melanoma mortality rates are the highest amongst skin cancer patients. Melanoma is life threating when it grows beyond the dermis of the skin. Hence, depth is an important factor to diagnose melanoma. This paper introduces a non-invasive computerized dermoscopy system that considers the estimated depth of skin lesions for diagnosis. A 3-D skin lesion reconstruction technique using the estimated depth obtained from regular dermoscopic images is presented. On basis of the 3-D reconstruction, depth and 3-D shape features are extracted. In addition to 3-D features, regular color, texture, and 2-D shape features are also extracted. Feature extraction is critical to achieve accurate results. Apart from melanoma, in-situ melanoma the proposed system is designed to diagnose basal cell carcinoma, blue nevus, dermatofibroma, haemangioma, seborrhoeic keratosis, and normal mole lesions. For experimental evaluations, the PH2, ISIC: Melanoma Project, and ATLAS dermoscopy data sets is considered. Different feature set combinations is considered and performance is evaluated. Significant performance improvement is reported the post inclusion of estimated depth and 3-D features. The good classification scores of sensitivity = 96%, specificity = 97% on PH2 data set and sensitivity = 98%, specificity = 99% on the ATLAS data set is achieved. Experiments conducted to estimate tumor depth from 3-D lesion reconstruction is presented. Experimental results achieved prove that the proposed computerized dermoscopy system is efficient and can be used to diagnose varied skin lesion dermoscopy images. PMID:28512610

DENTINE CARIES: ACID-TOLERANT MICROORGANISMS AND ASPECTS ON COLLAGEN DEGRADATION.

PubMed

Lager, Anders Hedenbjörk

2014-01-01

Dental caries is a common disease all over the world, despite the fact that it can be both effectively prevented and treated. It is driven by acids produced by oral microorganisms as a consequence of their metabolism of dietary carbohydrates. Given enough acid challenge, eventually the tooth enamel barrier will be broken down, and the carious lesion will extend into underlying hard tissue, forming a macroscopic cavity in the dentine. In comparison to biofilm on enamel, a dentine carious lesion provides a vastly different environment for the residing microorganisms. The environment influences the types and numbers of microorganisms that can colonize the dentine caries lesion. The overall aims for this thesis are to enumerate and further study microorganisms found in established dentine caries lesions and also to illuminate how host-derived proteolytic enzymes might contribute to this degradation, not only to better understand the caries process in dentine but also to find incitements for new methods to influence the natural progression of caries lesions. In Paper I, the numbers of remaining viable microorganisms after completed excavation using two excavation methods were investigated. Samples of carious dentine tissue were collected before and after excavation and cultivated on different agar media in different atmospheres. Analysis was performed by counting the number of colony-forming units (CFUs). Key findings: The number of remaining microorganisms after excavation was low for both methods, but some microorganisms always remained in the cavity floors even when the cavities were judged as caries free using normal clinical criteria. In Paper II, the acid tolerant microbiota in established dentine caries lesions was investigated. Samples were taken as in Paper I, but on three levels (superficial, center of lesion, floor of lesion after completed excavation). The samples were cultivated in anaerobic conditions on solid pH-selective agar media of different acidity

Automated Melanoma Recognition in Dermoscopy Images via Very Deep Residual Networks.

PubMed

Yu, Lequan; Chen, Hao; Dou, Qi; Qin, Jing; Heng, Pheng-Ann

2017-04-01

Automated melanoma recognition in dermoscopy images is a very challenging task due to the low contrast of skin lesions, the huge intraclass variation of melanomas, the high degree of visual similarity between melanoma and non-melanoma lesions, and the existence of many artifacts in the image. In order to meet these challenges, we propose a novel method for melanoma recognition by leveraging very deep convolutional neural networks (CNNs). Compared with existing methods employing either low-level hand-crafted features or CNNs with shallower architectures, our substantially deeper networks (more than 50 layers) can acquire richer and more discriminative features for more accurate recognition. To take full advantage of very deep networks, we propose a set of schemes to ensure effective training and learning under limited training data. First, we apply the residual learning to cope with the degradation and overfitting problems when a network goes deeper. This technique can ensure that our networks benefit from the performance gains achieved by increasing network depth. Then, we construct a fully convolutional residual network (FCRN) for accurate skin lesion segmentation, and further enhance its capability by incorporating a multi-scale contextual information integration scheme. Finally, we seamlessly integrate the proposed FCRN (for segmentation) and other very deep residual networks (for classification) to form a two-stage framework. This framework enables the classification network to extract more representative and specific features based on segmented results instead of the whole dermoscopy images, further alleviating the insufficiency of training data. The proposed framework is extensively evaluated on ISBI 2016 Skin Lesion Analysis Towards Melanoma Detection Challenge dataset. Experimental results demonstrate the significant performance gains of the proposed framework, ranking the first in classification and the second in segmentation among 25 teams and 28 teams

Frequency of Fluoride Dentifrice Use and Caries Lesions Inhibition and Repair.

PubMed

Nóbrega, Diego Figueiredo; Fernández, Constanza Estefany; Del Bel Cury, Altair Antoninha; Tenuta, Livia Maria Andaló; Cury, Jaime Aparecido

2016-01-01

The clinical relevance of the frequency of fluoride dentifrice (FD) use on enamel caries is based on evidence. However, the relative effect of FD on reduction of demineralization or enhancement of remineralization is unknown and the effect of frequency on root dentine caries has not been explored. The aim of this double-blind, crossover, in situ study, which was conducted in 4 phases of 14 days each, was to evaluate the relationship between the frequency of FD use and enamel and root dentine de- and remineralization. Eighteen volunteers wore palatal appliances containing enamel and root dentine slabs, either sound or carious. Biofilm accumulation on the slab surface was allowed, and 20% sucrose solution was dripped 3 or 8 times per day on the carious and sound slabs, respectively. Volunteers used FD (1,100 μg F/g) in the frequencies 0 (fluoride-placebo dentifrice), 1, 2 and 3 times per day. The demineralization and remineralization that occurred in sound or carious slabs was estimated by the percentage of surface hardness loss (%SHL) or recovery (%SHR). Loosely (CaF2) and firmly (FAp) bound fluoride concentrations were also determined. The relationship between the variables was analyzed by linear regression. The %SHL, CaF2 and FAp concentrations were a function of the frequency of FD use for enamel and dentine, but the %SHR was a function of the frequency of FD use only for enamel (p < 0.05). The results suggest that demineralization in enamel and root dentine is reduced in proportion to the frequency of FD use, but for remineralization the effect of the frequency of FD use was relevant only to enamel. © 2016 S. Karger AG, Basel.

Comparison of antibacterial activity of glass-ionomer cement and amalgam in class two restorations by Streptococcus mutans count analysis at fixed intervals: an in vivo study.

PubMed

Tegginmani, Veeresh S; Goel, Beenarani; Uppin, Virendra; Horatti, Priya; Kumar, L S Vijay; Nainani, Abhinav

2013-05-01

The purpose of the present study was to determine the influence of glass ionomer cement and amalgam restoration on the level of Streptococcus mutans in the interproximal plaque at periodic intervals and also to compare these values. Seventeen adult patients having two proximal carious lesions on any quadrant of the jaw (either opposing or contralateral) were selected for this study. Carious lesions were diagnosed clinically and from bitewing radiographs. Of the two carious lesions, one was restored with glass ionomer cermet cement and another with amalgam. Plaque samples were collected from interproximal areas before and at 1 month and 3 months post-treatment in a test tube containing 5 ml of modified Stuart's liquid transport fluid. Identification of organisms in the colony was done after Gram staining. Comparison of values before restoration and after restoration at 1 month interval showed a statistically significant decrease (p<0.001). Similarly, comparison of values before and after restorations at 3 months also showed statistically significant decrease (p<0.02). But comparison of restorations of 1 and 3 months intervals showed no statistical significant difference (p>0.05). Glass ionomer restorations have definite advantage over the amalgam, as the tunnel preparation is more conservative and fluoride release from the glass ionomer inhibits the growth of S. mutans in the plaque. Glass ionomer cement should be preferred over amalgam in conservatively prepared restorations as it reduces the microbial activities due to fluoride release.

Quantitative Analysis of Diverse Lactobacillus Species Present in Advanced Dental Caries

PubMed Central

Byun, Roy; Nadkarni, Mangala A.; Chhour, Kim-Ly; Martin, F. Elizabeth; Jacques, Nicholas A.; Hunter, Neil

2004-01-01

Our previous analysis of 65 advanced dental caries lesions by traditional culture techniques indicated that lactobacilli were numerous in the advancing front of the progressive lesion. Production of organic acids by lactobacilli is considered to be important in causing decalcification of the dentinal matrix. The present study was undertaken to define more precisely the diversity of lactobacilli found in this environment and to quantify the major species and phylotypes relative to total load of lactobacilli by real-time PCR. Pooled DNA was amplified by PCR with Lactobacillus genus-specific primers for subsequent cloning, sequencing, and phylogenetic analysis. Based on 16S ribosomal DNA sequence comparisons, 18 different phylotypes of lactobacilli were detected, including strong representation of both novel and gastrointestinal phylotypes. Specific PCR primers were designed for nine prominent species, including Lactobacillus gasseri, L. ultunensis, L. salivarius, L. rhamnosus, L. casei, L. crispatus, L. delbrueckii, L. fermentum, and L. gallinarum. More than three different species were identified as being present in most of the dentine samples, confirming the widespread distribution and numerical importance of various Lactobacillus spp. in carious dentine. Quantification by real-time PCR revealed various proportions of the nine species colonizing carious dentine, with higher mean loads of L. gasseri and L. ultunensis than of the other prevalent species. The findings provide a basis for further characterization of the pathogenicity of Lactobacillus spp. in the context of extension of the carious lesion. PMID:15243071

Quantitative analysis of diverse Lactobacillus species present in advanced dental caries.

PubMed

Byun, Roy; Nadkarni, Mangala A; Chhour, Kim-Ly; Martin, F Elizabeth; Jacques, Nicholas A; Hunter, Neil

2004-07-01

Our previous analysis of 65 advanced dental caries lesions by traditional culture techniques indicated that lactobacilli were numerous in the advancing front of the progressive lesion. Production of organic acids by lactobacilli is considered to be important in causing decalcification of the dentinal matrix. The present study was undertaken to define more precisely the diversity of lactobacilli found in this environment and to quantify the major species and phylotypes relative to total load of lactobacilli by real-time PCR. Pooled DNA was amplified by PCR with Lactobacillus genus-specific primers for subsequent cloning, sequencing, and phylogenetic analysis. Based on 16S ribosomal DNA sequence comparisons, 18 different phylotypes of lactobacilli were detected, including strong representation of both novel and gastrointestinal phylotypes. Specific PCR primers were designed for nine prominent species, including Lactobacillus gasseri, L. ultunensis, L. salivarius, L. rhamnosus, L. casei, L. crispatus, L. delbrueckii, L. fermentum, and L. gallinarum. More than three different species were identified as being present in most of the dentine samples, confirming the widespread distribution and numerical importance of various Lactobacillus spp. in carious dentine. Quantification by real-time PCR revealed various proportions of the nine species colonizing carious dentine, with higher mean loads of L. gasseri and L. ultunensis than of the other prevalent species. The findings provide a basis for further characterization of the pathogenicity of Lactobacillus spp. in the context of extension of the carious lesion.

Polyphosphate-Accumulating Bacteria: Potential Contributors to Mineral Dissolution in the Oral Cavity

PubMed Central

Breiland, Ashley A.; Flood, Beverly E.; Nikrad, Julia; Bakarich, John; Husman, Matthew; Rhee, TaekHyun; Jones, Robert S.

2018-01-01

ABSTRACT Bacteria that accumulate polyphosphates have previously been shown to dynamically influence the solubility of phosphatic minerals in marine settings and wastewater. Here, we show that dental plaque, saliva, and carious lesions all contain abundant polyphosphate-accumulating bacteria. Saturation state modeling results, informed by phosphate uptake experiments using the model organism Lactobacillus rhamnosus, which is known to inhabit advanced carious lesions, suggest that polyphosphate accumulation can lead to undersaturated conditions with respect to hydroxyapatite under some oral cavity conditions. The cell densities of polyphosphate-accumulating bacteria we observed in some regions of oral biofilms are comparable to those that produce undersaturated conditions (i.e., those that thermodynamically favor mineral dissolution) in our phosphate uptake experiments with L. rhamnosus. These results suggest that the localized generation of undersaturated conditions by polyphosphate-accumulating bacteria constitutes a new potential mechanism of tooth dissolution that may augment the effects of metabolic acid production. IMPORTANCE Dental caries is a serious public health issue that can have negative impacts on overall quality of life and oral health. The role of oral bacteria in the dissolution of dental enamel and dentin that can result in carious lesions has long been solely ascribed to metabolic acid production. Here, we show that certain oral bacteria may act as a dynamic shunt for phosphate in dental biofilms via the accumulation of a polymer known as polyphosphate—potentially mediating phosphate-dependent conditions such as caries (dental decay). PMID:29352083

Oral health and school performance in a group of schoolchildren from the Federal District, Brazil.

PubMed

Almeida, Raquel Francis; Leal, Soraya Coelho; Medonca, Jordana Guedes Amorim; Hilgert, Leandro Augusto; Ribeiro, Ana Paula Dias

2018-05-12

To evaluate whether an association exists between school performance, quality of life, dental caries, and dental pain in children between 6 and 8 years of age. All 6- to 8-year-old children enrolled in the second year of the six public schools in Paranoá-FD were invited to participate in this cross-sectional study. In total, 374 consented. Dental caries was recorded according to the Caries Assessment Spectrum and Treatment (CAST) index by two trained examiners. Dental pain was assessed during clinical examination. The Child Perceptions Questionnaire (CPQ) was used to assess the oral health-related quality of life, and sociodemographic data were collected. The child's school performance was measured through Provinha Brasil according to the regulations of the Ministry of Education. Descriptive statistics, bivariate analysis, and a multivariate regression model were used for data analysis. 185 boys and 189 girls participants with a mean age of 7.2 (±0.5) years were included in the study. The prevalence of dentin carious lesions for this group was 40.6 and 49.2 percent, including enamel-only lesions. The prevalence of dental pain was 2.8 percent. A high performance in reading (63.6 percent) and in mathematics (79.4 percent) was observed and were not associated with the presence of cavitated dentin carious lesions or dental pain. A significant association was found between school performance and the final CPQ score. School performance as measured by the Provinha Brasil examination was not associated with carious lesions or dental pain. Students with lower school performance had higher CPQ scores. © 2018 American Association of Public Health Dentistry.

Development, characterization and comparison of two strontium doped nano hydroxyapatite molecules for enamel repair/regeneration.

PubMed

Krishnan, Vinod; Bhatia, Ankit; Varma, Harikrishna

2016-05-01

Enamel damage resulting or arising from/associated with orthodontic treatment such as white spot lesions and surface deterioration after debonding brackets along with incipient carious lesions are considered problems not amenable for routine restorations due to its invasive nature. The present study was aimed at synthesizing and characterizing nHAp and 25 and 50 mol% strontium nHAp as a surface application modality for dental enamel remineralization/repair. 25 and 50 mol% Sr nHAp was synthesized and characterized in comparison with custom made pure nHAp initially with the help of transmission and scanning electron microscopy as well as toxicological assessment. Further, comparative evaluation of these novel synthesized strontium substituted particles was assessed for its efficacy in repairing damaged enamel with the help of atomic force microscopy, scanning electron microscopy and micro indentation testing. There is increase in crystallinity and reduced particle size favoring dissolution and re-precipitation through small incipient carious lesions and soft white spot areas with 25% Sr-nHAp. Sr doped specimens showed more cell viability in comparison with pure nHAP make it less cytotoxic and hence a biologically friendly material which can be safely applied in patient's mouth. AFM images obtained from 25% and 50% Sr nHAp treated specimens clearly indicated increased roughness in surface topography and performed well with micro indentation test. The novel synthesized Sr doped nHAp forms an improved treatment modality to tackle the long standing quest for solving the problem of enamel loss with incipient carious lesions and WSL from orthodontic procedures. Copyright © 2016 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Adaptive Calcified Matrix Response of Dental Pulp to Bacterial Invasion Is Associated with Establishment of a Network of Glial Fibrillary Acidic Protein+/Glutamine Synthetase+ Cells

PubMed Central

Farahani, Ramin M.; Nguyen, Ky-Anh; Simonian, Mary; Hunter, Neil

2010-01-01

We report evidence for anatomical and functional changes of dental pulp in response to bacterial invasion through dentin that parallel responses to noxious stimuli reported in neural crest-derived sensory tissues. Sections of resin-embedded carious adult molar teeth were prepared for immunohistochemistry, in situ hybridization, ultrastructural analysis, and microdissection to extract mRNA for quantitative analyses. In odontoblasts adjacent to the leading edge of bacterial invasion in carious teeth, expression levels of the gene encoding dentin sialo-protein were 16-fold greater than in odontoblasts of healthy teeth, reducing progressively with distance from this site of the carious lesion. In contrast, gene expression for dentin matrix protein-1 by odontoblasts was completely suppressed in carious teeth relative to healthy teeth. These changes in gene expression were related to a gradient of deposited reactionary dentin that displayed a highly modified structure. In carious teeth, interodontoblastic dentin sialo-protein− cells expressing glutamine synthetase (GS) showed up-regulation of glial fibrillary acidic protein (GFAP). These cells extended processes that associated with odontoblasts. Furthermore, connexin 43 established a linkage between adjacent GFAP+/GS+ cells in carious teeth only. These findings indicate an adaptive pulpal response to encroaching caries that includes the deposition of modified, calcified, dentin matrix associated with networks of GFAP+/GS+ interodontoblastic cells. A regulatory role for the networks of GFAP+/GS+ cells is proposed, mediated by the secretion of glutamate to modulate odontoblastic response. PMID:20802180

Incomplete caries removal and indirect pulp capping in primary molars: a randomized controlled trial.

PubMed

Bressani, Ana Eliza Lemes; Mariath, Adriela Azevedo Souza; Haas, Alex Nogueira; Garcia-Godoy, Franklin; de Araujo, Fernando Borba

2013-08-01

To compare the effect of incomplete caries removal (ICR) and indirect pulp capping (IPC) with calcium hydroxide (CH) or an inert material (wax) on color, consistency and contamination of the remaining dentin of primary molars. This double-blind, parallel-design, randomized controlled trial included 30 children presenting one primary molar with deep caries lesion. Children were randomly assigned after ICR to receive IPC with CH or wax. All teeth were then restored with resin composite. Baseline dentin color and consistency were evaluated after ICR, and dentin samples were collected for contamination analyses using scanning electron microscopy. After 3 months, restorations were removed and the three parameters were re-evaluated. In both groups, dentin became significantly darker after 3 months. No cases of yellow dentin were observed after 3 months with CH compared to 33.3% of the wax cases (P < 0.05). A statistically significant difference over time was observed only for CH regarding consistency. CH stimulated a dentin hardening process in a statistically higher number of cases than wax (86.7% vs. 33.3%; P = 0.008). Contamination changed significantly over time in CH and wax without significant difference between groups. It was concluded that CH and wax arrested the carious process of the remaining carious dentin after indirect pulp capping, but CH showed superior dentin color and consistency after 3 months.

The deep plantar arch in humans: constitution and topography.

PubMed

Gabrielli, C; Olave, E; Mandiola, E; Rodrigues, C F; Prates, J C

2001-01-01

The integrity of the various structures within the feet depends on their blood supply. Lesions of the feet often require revascularization, which if successful avoids the need for amputation. To provide greater anatomical detail to aid vascular surgery and imaging, the anatomy and constitution of the deep plantar arch was studied in 50 adult cadaveric feet. The arteries of the foot were injected with red neoprene latex and dissected under magnification. The deep plantar arch, present in all feet, was the result of anastomosis between the deep plantar artery and the deep branch of the lateral plantar artery. The deep plantar artery was predominant in 72% of specimens (Type I arches) and the lateral plantar artery in 22% (Type II), with the contribution being equal in 6% (Type III). The medial plantar artery contributed to the medial segment of the deep plantar arch by its deep branch in 12% of specimens. The distance between the deep plantar arch and each interdigital commissure was generally constant, averaging 29% of total foot length. The deep plantar arch was located in the middle third of the foot in all specimens, being in the distal part of this third in 90%. The deep plantar arch is, therefore formed mainly by the deep plantar artery, a branch of the dorsal artery of foot; its location can be estimated if foot length is known.

Zero-Echo-Time and Dixon Deep Pseudo-CT (ZeDD CT): Direct Generation of Pseudo-CT Images for Pelvic PET/MRI Attenuation Correction Using Deep Convolutional Neural Networks with Multiparametric MRI.

PubMed

Leynes, Andrew P; Yang, Jaewon; Wiesinger, Florian; Kaushik, Sandeep S; Shanbhag, Dattesh D; Seo, Youngho; Hope, Thomas A; Larson, Peder E Z

2018-05-01

Accurate quantification of uptake on PET images depends on accurate attenuation correction in reconstruction. Current MR-based attenuation correction methods for body PET use a fat and water map derived from a 2-echo Dixon MRI sequence in which bone is neglected. Ultrashort-echo-time or zero-echo-time (ZTE) pulse sequences can capture bone information. We propose the use of patient-specific multiparametric MRI consisting of Dixon MRI and proton-density-weighted ZTE MRI to directly synthesize pseudo-CT images with a deep learning model: we call this method ZTE and Dixon deep pseudo-CT (ZeDD CT). Methods: Twenty-six patients were scanned using an integrated 3-T time-of-flight PET/MRI system. Helical CT images of the patients were acquired separately. A deep convolutional neural network was trained to transform ZTE and Dixon MR images into pseudo-CT images. Ten patients were used for model training, and 16 patients were used for evaluation. Bone and soft-tissue lesions were identified, and the SUV max was measured. The root-mean-squared error (RMSE) was used to compare the MR-based attenuation correction with the ground-truth CT attenuation correction. Results: In total, 30 bone lesions and 60 soft-tissue lesions were evaluated. The RMSE in PET quantification was reduced by a factor of 4 for bone lesions (10.24% for Dixon PET and 2.68% for ZeDD PET) and by a factor of 1.5 for soft-tissue lesions (6.24% for Dixon PET and 4.07% for ZeDD PET). Conclusion: ZeDD CT produces natural-looking and quantitatively accurate pseudo-CT images and reduces error in pelvic PET/MRI attenuation correction compared with standard methods. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

Endoscopic analysis of colorectal serrated lesions with cancer.

PubMed

Nagata, Shuichiro; Mitsuyama, Keiichi; Kawano, Hiroshi; Noda, Tetsuhiro; Maeyama, Yasuhiko; Mukasa, Michita; Takedatsu, Hidetoshi; Yoshioka, Shinichiro; Kuwaki, Kotaro; Akiba, Jun; Tsuruta, Osamu; Torimura, Takuji

2018-06-01

Serrated lesions, including hyperplastic polyps (HPs), traditional serrated adenomas (TSAs) and sessile serrated adenomas/polyps (SSA/Ps), are important contributors to colorectal carcinogenesis. The aim of the present study was to analyze the potential of conventional endoscopy and advanced endoscopic imaging techniques to delineate the characteristic features of serrated lesions with cancer. The present study was a retrospective analysis of the data of 168 patients who had undergone colonoscopy, and a total of 228 serrated lesions (77 HPs, 58 TSAs, 84 SSA/Ps, 9 SSA/P plus TSAs) have been identified in these patients. A cancer component was identified in 2.6% of HPs, 13.8% of TSAs and 10.7% of SSA/Ps, but none of SSA/P plus TSAs. Compared with the lesions without cancer, the lesions with cancer exhibited a larger size (HP, TSA and SSA/P), a reddish appearance (SSA/P), a two-tier raised appearance (HP and SSA/P), a central depression (HP, TSA and SSA/P), the type V pit pattern (HP, TSA and SSA/P), and/or the type III capillary pattern (TSA and SSA/P). Deep invasion was identified in 50.0% of HPs, 12.5% of TSAs and 55.6% of SSA/Ps with cancer. The Ki-67 proliferative zone was distributed diffusely within the area of the cancer, but partially within the non-cancer area of HPs, TSAs and SSA/Ps. The lesion types were also analyzed on the basis of mucin phenotype. The present study suggested that a detailed endoscopic analysis of serrated lesions with cancer is useful for delineating characteristic features, and the analysis aids treatment selection.

Feasibility of deep-inspiration breath-hold PET/CT with short-time acquisition: detectability for pulmonary lesions compared with respiratory-gated PET/CT.

PubMed

Yamashita, Shozo; Yokoyama, Kunihiko; Onoguchi, Masahisa; Yamamoto, Haruki; Hiko, Shigeaki; Horita, Akihiro; Nakajima, Kenichi

2014-01-01

Deep-inspiration breath-hold (DIBH) PET/CT with short-time acquisition and respiratory-gated (RG) PET/CT are performed for pulmonary lesions to reduce the respiratory motion artifacts, and to obtain more accurate standardized uptake value (SUV). DIBH PET/CT demonstrates significant advantages in terms of rapid examination, good quality of CT images and low radiation exposure. On the other hand, the image quality of DIBH PET is generally inferior to that of RG PET because of short-time acquisition resulting in poor signal-to-noise ratio. In this study, RG PET has been regarded as a gold standard, and its detectability between DIBH and RG PET studies was compared using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were determined. In the clinical study, 19 cases were examined using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were different. Reconstruction parameters of DIBH PET could be obtained by reducing the number of subsets for those of RG PET in the state of fixing the number of iterations. In the clinical study, high correlation in the maximum SUV was observed between DIBH and RG PET studies. The clinical result was consistent with that of the phantom study surrounded by air since most of the lesions were located in the low pulmonary radioactivity. DIBH PET/CT may be the most practical method which can be the first choice to reduce respiratory motion artifacts if the detectability of DIBH PET is equivalent with that of RG PET. Although DIBH PET may have limitations in suboptimal signal-to-noise ratio, most of the lesions surrounded by low background radioactivity could provide nearly equivalent image quality between DIBH and RG PET studies when each of the most optimal reconstruction parameters was used.

Designing Preclinical Instruction for Psychomotor Skills (II)--Instructional Engineering: Task Analysis.

ERIC Educational Resources Information Center

Knight, G. William; And Others

1994-01-01

The first step in engineering the instruction of dental psychomotor skills, task analysis, is explained. A chart details the procedural, cognitive, desired-criteria, and desired-performance analysis of a single task, occlusal preparation for amalgam restoration with carious lesion. (MSE)

Experimental investigation of demineralization and remineralization of human teeth using infrared photothermal radiometry and modulated luminescence

NASA Astrophysics Data System (ADS)

Jeon, Raymond J.; Hellen, Adam; Matvienko, Anna; Mandelis, Andreas; Abrams, Stephen H.; Amaechi, Bennett T.

2008-02-01

Photothermal radiometry (PTR) and modulated luminescence (LUM) were applied to detect and monitor the demineralization of root and enamel surfaces of human teeth to produce caries lesions and the subsequent remineralization of the produced lesions. The experimental set-up consisted of a semiconductor laser (659 nm, 120 mW), a mercury-cadmium-telluride IR detector for PTR, a photodiode for LUM, and two lock-in amplifiers. A lesion was created on a 1-mm × 4-mm rectangular window, spanning root to enamel surface, using an artificial caries lesion gel to demineralize the tooth surface and create small carious lesions. The samples were subsequently immersed in a remineralization solution. Each sample was examined with PTR/LUM on root and enamel before and after treatment at times from 1 to 10 days of demineralization and 2 to 10 days of remineralization. PTR/LUM signals showed gradual and consistent changes with treatment time. At the completion of the experiments, transverse micro-radiography (TMR) analysis was performed to correlate the PTR/LUM signals to depth of the carious lesions and mineral losses. In this study, TMR showed good correlation with PTR/LUM. It was also found that treatment duration did not correlate well to any technique, PTR/LUM, or TMR, which is indicative of significant variations in demineralization - remineralization rates among different teeth.

Actinomyces spp. gene expression in root caries lesions

PubMed Central

Dame-Teixeira, Naile; Parolo, Clarissa Cavalcanti Fatturi; Maltz, Marisa; Tugnait, Aradhna; Devine, Deirdre; Do, Thuy

2016-01-01

Background The studies of the distribution of Actinomyces spp. on carious and non-carious root surfaces have not been able to confirm the association of these bacteria with root caries, although they were extensively implicated as a prime suspect in root caries. Objective The aim of this study was to observe the gene expression of Actinomyces spp. in the microbiota of root surfaces with and without caries. Design The oral biofilms from exposed sound root surface (SRS; n=10) and active root caries (RC; n=30) samples were collected. The total bacterial RNA was extracted, and the mRNA was isolated. Samples with low RNA concentration were pooled, yielding a final sample size of SRS=10 and RC=9. Complementary DNA (cDNA) libraries were prepared and sequenced on an Illumina® HiSeq 2500 system. Sequence reads were mapped to eight Actinomyces genomes. Count data were normalized using DESeq2 to analyse differential gene expression applying the Benjamini-Hochberg correction (false discovery rate [FDR]<0.001). Results Actinomyces spp. had similar numbers of reads (Mann-Whitney U-test; p>0.05), except for Actinomyces OT178 (p=0.001) and Actinomyces gerencseriae (p=0.004), which had higher read counts in the SRS. Genes that code for stress proteins (clp, dnaK, and groEL), enzymes of glycolysis pathways (including enolase and phosphoenolpyruvate carboxykinase), adhesion (Type-2 fimbrial and collagen-binding protein), and cell growth (EF-Tu) were highly – but not differentially (p>0.001) – expressed in both groups. Genes with the most significant upregulation in RC were those coding for hypothetical proteins and uracil DNA glycosylase (p=2.61E-17). The gene with the most significant upregulation in SRS was a peptide ABC transporter substrate-binding protein (log2FC=−6.00, FDR=2.37E-05). Conclusion There were similar levels of Actinomyces gene expression in both sound and carious root biofilms. These bacteria can be commensal in root surface sites but may be cariogenic

Thalamic lesions in multiple sclerosis by 7T MRI: Clinical implications and relationship to cortical pathology.

PubMed

Harrison, Daniel M; Oh, Jiwon; Roy, Snehashis; Wood, Emily T; Whetstone, Anna; Seigo, Michaela A; Jones, Craig K; Pham, Dzung; van Zijl, Peter; Reich, Daniel S; Calabresi, Peter A

2015-08-01

Pathology in both cortex and deep gray matter contribute to disability in multiple sclerosis (MS). We used the increased signal-to-noise ratio of 7-tesla (7T) MRI to visualize small lesions within the thalamus and to relate this to clinical information and cortical lesions. We obtained 7T MRI scans on 34 MS cases and 15 healthy volunteers. Thalamic lesion number and volume were related to demographic data, clinical disability measures, and lesions in cortical gray matter. Thalamic lesions were found in 24/34 of MS cases. Two lesion subtypes were noted: discrete, ovoid lesions, and more diffuse lesional areas lining the periventricular surface. The number of thalamic lesions was greater in progressive MS compared to relapsing-remitting (mean ±SD, 10.7 ±0.7 vs. 3.0 ±0.7, respectively, p < 0.001). Thalamic lesion burden (count and volume) correlated with EDSS score and measures of cortical lesion burden, but not with white matter lesion burden or white matter volume. Using 7T MRI allows identification of thalamic lesions in MS, which are associated with disability, progressive disease, and cortical lesions. Thalamic lesion analysis may be a simpler, more rapid estimate of overall gray matter lesion burden in MS. © The Author(s), 2015.

Distinguishing and diagnosing contemporary and conventional features of dental erosion.

PubMed

Bassiouny, Mohamed A

2014-01-01

The vast number and variety of erosion lesions encountered today require reconsideration of the traditional definition. Dental erosion associated with modern dietary habits can exhibit unique features that symbolize a departure from the decades-old conventional image known as tooth surface loss. The extent and diversity of contemporary erosion lesions often cause conflicting diagnoses. Specific examples of these features are presented in this article. The etiologies, genesis, course of development, and characteristics of these erosion lesions are discussed. Contemporary and conventional erosion lesions are distinguished from similar defects, such as mechanically induced wear, carious lesions, and dental fluorosis, which affect the human dentition.

Magnetic Resonance Imaging-Guided Focused Laser Interstitial Thermal Therapy for Intracranial Lesions: Single-Institution Series

PubMed Central

Hawasli, Ammar H.; Bagade, Swapnil; Shimony, Joshua S.; Miller-Thomas, Michelle

2013-01-01

BACKGROUND: Surgical treatments for deep-seated intracranial lesions have been limited by morbidities associated with resection. Real-time magnetic resonance imaging–guided focused laser interstitial thermal therapy (LITT) offers a minimally invasive surgical treatment option for such lesions. OBJECTIVE: To review treatments and results of patients treated with LITT for intracranial lesions at Washington University School of Medicine. METHODS: In a review of 17 prospectively recruited LITT patients (34-78 years of age; mean, 59 years), we report demographics, treatment details, postoperative imaging characteristics, and peri- and postoperative clinical courses. RESULTS: Targets included 11 gliomas, 5 brain metastases, and 1 epilepsy focus. Lesions were lobar (n = 8), thalamic/basal ganglia (n = 5), insular (n = 3), and corpus callosum (n = 1). Mean target volume was 11.6 cm3, and LITT produced 93% target ablation. Patients with superficial lesions had shorter intensive care unit stays. Ten patients experienced no perioperative morbidities. Morbidities included transient aphasia, hemiparesis, hyponatremia, deep venous thrombosis, and fatal meningitis. Postoperative magnetic resonance imaging showed blood products within the lesion surrounded by new thin uniform rim of contrast enhancement and diffusion restriction. In conjunction with other therapies, LITT targets often showed stable or reduced local disease. Epilepsy focus LITT produced seizure freedom at 8 months. Preliminary overall median progression-free survival and survival from LITT in tumor patients were 7.6 and 10.9 months, respectively. However, this small cohort has not been followed for a sufficient length of time, necessitating future outcomes studies. CONCLUSION: Early peri- and postoperative clinical data demonstrate that LITT is a safe and viable ablative treatment option for intracranial lesions, and may be considered for select patients. ABBREVIATION: LITT, laser interstitial thermal therapy

Extraction of skin lesions from non-dermoscopic images for surgical excision of melanoma.

PubMed

Jafari, M Hossein; Nasr-Esfahani, Ebrahim; Karimi, Nader; Soroushmehr, S M Reza; Samavi, Shadrokh; Najarian, Kayvan

2017-06-01

Computerized prescreening of suspicious moles and lesions for malignancy is of great importance for assessing the need and the priority of the removal surgery. Detection can be done by images captured by standard cameras, which are more preferable due to low cost and availability. One important step in computerized evaluation is accurate detection of lesion's region, i.e., segmentation of an image into two regions as lesion and normal skin. In this paper, a new method based on deep neural networks is proposed for accurate extraction of a lesion region. The input image is preprocessed, and then, its patches are fed to a convolutional neural network. Local texture and global structure of the patches are processed in order to assign pixels to lesion or normal classes. A method for effective selection of training patches is proposed for more accurate detection of a lesion's border. Our results indicate that the proposed method could reach the accuracy of 98.7% and the sensitivity of 95.2% in segmentation of lesion regions over the dataset of clinical images. The experimental results of qualitative and quantitative evaluations demonstrate that our method can outperform other state-of-the-art algorithms exist in the literature.

Effect of Er,Cr:YSGG Laser at Different Output Powers on the Micromorphology and the Bond Property of Non-Carious Sclerotic Dentin to Resin Composites.

PubMed

Sun, Xiang; Ban, Jinghao; Sha, Xinjia; Wang, Weiguo; Jiao, Yang; Wang, Wanshan; Yang, Yanwei; Wei, Jingjing; Shen, Lijuan; Chen, Jihua

2015-01-01

The objective of this study was to investigate the influence of Er,Cr:YSGG laser irradiated at different powers on the micromorphology and the bonding property of non-carious sclerotic dentin to resin composites. Two hundred bovine incisors characterized by non-carious sclerotic dentin were selected, and the seventy-two teeth of which for surface morphological analysis were divided into nine groups according to various treatments (A: the control group, B: only treated with the adhesive Adper Easy One, C: diamond bur polishing followed by Adper Easy One, D-I: Er,Cr:YSGG laser irradiating at 1W, 2W, 3W, 4W, 5W, 6W output power, respectively, followed by Adper Easy One). The surface roughness values were measured by the non-contact three-dimensional morphology scanner, then the surface micromorphologies of surfaces in all groups were assessed by scanning electron microscopy (SEM); meanwhile, Image Pro-Plus 6.0 software was used to measure the relative percentage of open tubules on SEM images. The rest, one hundred twenty-eight teeth for bond strength test, were divided into eight groups according to the different treatments (A: only treated with the adhesive Adper Easy One, B: diamond bur polishing followed by the above adhesive, C-H: Er,Cr:YSGG laser irradiating at 1 W, 2 W, 3 W, 4 W, 5 W, 6 W output power, respectively, followed by the above adhesive), and each group was subsequently divided into two subgroups according to whether aging is performed (immediately tested and after thermocycling). Micro-shear bond strength test was used to evaluate the bond strength. The 4W laser group showed the highest roughness value (30.84±1.93μm), which was statistically higher than the control group and the diamond bur groups (p<0.05). The mean percentages ((27.8±1.8)%, (28.0±2.2)%, (30.0±1.9)%) of open tubules area in the 4W, 5W, 6W group were higher than other groups (p<0.05). The 4W laser group showed the highest micro-shear bond strength not only in immediately tested

Human ventromedial prefrontal lesions alter incentivisation by reward

PubMed Central

Manohar, Sanjay G.; Husain, Masud

2016-01-01

Although medial frontal brain regions are implicated in valuation of rewards, evidence from focal lesions to these areas is scant, with many conflicting results regarding motivation and affect, and no human studies specifically examining incentivisation by reward. Here, 19 patients with isolated, focal damage in ventral and medial prefrontal cortex were selected from a database of 453 individuals with subarachnoid haemorrhage. Using a speeded saccadic task based on the oculomotor capture paradigm, we manipulated the maximum reward available on each trial using an auditory incentive cue. Modulation of behaviour by motivation permitted quantification of reward sensitivity. At the group level, medial frontal damage was overall associated with significantly reduced effects of reward on invigorating saccadic velocity and autonomic (pupil) responses compared to age-matched, healthy controls. Crucially, however, some individuals instead showed abnormally strong incentivisation effects for vigour. Increased sensitivity to rewards within the lesion group correlated with damage in subgenual ventromedial prefrontal cortex (vmPFC) areas, which have recently become the target for deep brain stimulation (DBS) in depression. Lesion correlations with clinical apathy suggested that the apathy associated with prefrontal damage is in fact reduced by damage at those coordinates. Reduced reward sensitivity showed a trend to correlate with damage near nucleus accumbens. Lesions did not, on the other hand, influence reward sensitivity of cognitive control, as measured by distractibility. Thus, although medial frontal lesions may generally reduce reward sensitivity, damage to key subregions paradoxically protect from this effect. PMID:26874940

Noninvasive Assessment of Early Dental Lesion Using a Dual-Contrast Photoacoustic Tomography

PubMed Central

Cheng, Renxiang; Shao, Jiaojiao; Gao, Xiaoxiang; Tao, Chao; Ge, Jiuyu; Liu, Xiaojun

2016-01-01

Dental hard tissue lesions, including caries, cracked-tooth, etc., are the most prevalent diseases of people worldwide. Dental lesions and correlative diseases greatly decrease the life quality of patients throughout their lifetime. It is still hard to noninvasively detect these dental lesions in their early stages. Photoacoustic imaging is an emerging hybrid technology combining the high spatial resolution of ultrasound in deep tissue with the rich optical contrasts. In this study, a dual-contrast photoacoustic tomography is applied to detect the early dental lesions. One contrast, named B-mode, is related to the optical absorption. It is good at providing the sharp image about the morphological and macro-structural features of the teeth. Another contrast, named S-mode, is associated with the micro-structural and mechanical properties of the hard tissue. It is sensitive to the change of tissue properties induced by the early dental lesions. Experiments show that the comprehensive analysis of dual-contrast information can provide reliable information of the early dental lesions. Moreover, the imaging parameter of S-mode is device-independent and it could measure tissue properties quantitatively. We expect that the proposed scheme could be beneficial for improving safety, accuracy and sensitivity of the clinical diagnosis of the dental lesion. PMID:26902394

Noninvasive Assessment of Early Dental Lesion Using a Dual-Contrast Photoacoustic Tomography

NASA Astrophysics Data System (ADS)

Cheng, Renxiang; Shao, Jiaojiao; Gao, Xiaoxiang; Tao, Chao; Ge, Jiuyu; Liu, Xiaojun

2016-02-01

Dental hard tissue lesions, including caries, cracked-tooth, etc., are the most prevalent diseases of people worldwide. Dental lesions and correlative diseases greatly decrease the life quality of patients throughout their lifetime. It is still hard to noninvasively detect these dental lesions in their early stages. Photoacoustic imaging is an emerging hybrid technology combining the high spatial resolution of ultrasound in deep tissue with the rich optical contrasts. In this study, a dual-contrast photoacoustic tomography is applied to detect the early dental lesions. One contrast, named B-mode, is related to the optical absorption. It is good at providing the sharp image about the morphological and macro-structural features of the teeth. Another contrast, named S-mode, is associated with the micro-structural and mechanical properties of the hard tissue. It is sensitive to the change of tissue properties induced by the early dental lesions. Experiments show that the comprehensive analysis of dual-contrast information can provide reliable information of the early dental lesions. Moreover, the imaging parameter of S-mode is device-independent and it could measure tissue properties quantitatively. We expect that the proposed scheme could be beneficial for improving safety, accuracy and sensitivity of the clinical diagnosis of the dental lesion.

After Superficial Ablation for Superficial Reflux Associated with Primary Deep Axial Reflux, Can Variable Outcomes be Caused by Deep Venous Valve Anomalies?

PubMed

Maleti, O; Lugli, M; Perrin, M

2017-02-01

To identify which deep anatomical anomalies can explain variable hemodynamic outcomes in patients with superficial reflux associated with primary deep axial reflux who underwent isolated superficial vein ablation without improvement. This is a retrospective study of deep venous valve anomalies in patients who underwent superficial vein ablation for superficial and associated deep reflux. A group of 21 patients who were diagnosed with saphenous reflux associated with primary deep axial reflux, were submitted to great saphenous vein ablation. In 17 patients the deep reflux was not abolished. In this subgroup, surgical exploration of the deep valve was carried out using venotomy for possible valve repair. Among the 17 subgroup patients, four post-thrombotic lesions were discovered intra-operatively in four patients; they underwent different surgical procedures. In 13 of the subgroup patients, primary valve incompetence was confirmed intra-operatively. In 11 cases the leaflets were asymmetrical and in only two were they symmetrical. After valvuloplasty, deep reflux was abolished in all 13 patients. Clinical improvement was obtained in 12/13 patients (92%). It is noteworthy that abolition of deep reflux was associated with significant improvement in air plethysmography data as well as with improvement in clinical status measured on CEAP class, VCSS and the SF-36 questionnaire. Failure to correct deep axial reflux by superficial ablation in patients with superficial and associated primary deep axial reflux may be related to asymmetry in the leaflets of the incompetent deep venous valve. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Epidemiological survey of Streptococcus mutans among Japanese children. Identification and serological typing of the isolated strains.

PubMed

Hamada, S; Masuda, N; Ooshima, T; Sobue, S; Kotani, S

1976-02-01

An epidemiological investigation was carried out to identify and determine the serotypes of Streptococcus mutans from carious lesions of young Japanese children. For this purpose, a direct fluorescent antibody technique was mainly used. Fluorescein isothiocyanate-conjugated antibodies were prepared for the five known serotypes of S. mutans. Cross reactions and nonspecific reactions were eliminated by adsorption, counterstaining, or DEAE-cellulosecolumn chromatography. Agar-gel immunodiffusion was used to distinguish between serotypes a and d. The epidemiological survey suggested that serotype c strains were most prevalent in dental plaques of Japanese children. The d and e serotypes were rare and serotypes a and b were not detected. It was also noted that more than one serotype of S. mutans could be found in the same locus of a carious lesion and that there might be no relationship between the degree of caries and the causative serotype(s) of S. mutans.

Impact of cysts during radiofrequency lesioning in deep brain structures—a simulation and in vitro study

NASA Astrophysics Data System (ADS)

Johansson, Johannes D.; Loyd, Dan; Wårdell, Karin; Wren, Joakim

2007-06-01

Radiofrequency lesioning of nuclei in the thalamus or the basal ganglia can be used to reduce symptoms caused by e.g. movement disorders such as Parkinson's disease. Enlarged cavities containing cerebrospinal fluid (CSF) are commonly present in the basal ganglia and tend to increase in size and number with age. Since the cavities have different electrical and thermal properties compared with brain tissue, it is likely that they can affect the lesioning process and thereby the treatment outcome. Computer simulations using the finite element method and in vitro experiments have been used to investigate the impact of cysts on lesions' size and shape. Simulations of the electric current and temperature distributions as well as convective movements have been conducted for various sizes, shapes and locations of the cysts as well as different target temperatures. Circulation of the CSF caused by the heating was found to spread heat effectively and the higher electric conductivity of the CSF increased heating of the cyst. These two effects were together able to greatly alter the resulting lesion size and shape when the cyst was in contact with the electrode tip. Similar results were obtained for the experiments.

[Detrusor sphincter disorders associated with deep endometriosis: Systematic review of the literature].

PubMed

Grouin, A; Florian, A; Sans Mischel, A C; Toullalan, O

2018-01-01

Detrusor sphincter disorders impact quality of life in case of deep endometriosis. Surgery, which is one of the main treatments, is responsible of detrusor sphincter disorders. Since then, it is essential to look for those disorders and find the right medical care. To specify the detrusor sphincter disorders, its links with anatomical localisation of deep endometriosis and its prognosis after surgery. A literature review was carried out via PubMed ® with the followings keywords: "deep endometriosis", "urinary disorders", "voiding dysfunction" and "urinary dysfunction". Prospective and retrospective studies as well as previous reviews were analyzed. Concerning bladder deep endometriosis, detrusor sphincter disorders are observed in more than 50%. Resection of the lesions allows a clear improvement or even a disappearance of the disorders. Concerning the deep endometriosis of the posterior part of the pelvis, disorders are highlighted even if women do not complain of urinary trouble. Detrusor sphincter disorders are observed in 2 to 50% and women with colorectal localisation have the highest rate. Resection of the lesions improves the symptoms described preoperatively but also provides de novo disorders of up to 47.5%. In terms of prevention, the nerve sparing surgery respects the pelvic nerve plexus, and reduces post-operative morbidity to less than 1%. Detrusor sphincter disorders associated with deep endometriosis have a prognosis if their management is adapted. Well-conducted interviews and standardized questionnaires is necessary to diagnosis them. Urodynamic test may be discussed in case of bladder endometriosis, including for urinary asymptomatic patients. The management of the detrusor sphincter disorders requires a complete resection of the nodules of deep endometriosis. In the case of posterior endometriosis, a dissection must be performed respecting the retroperitoneal vegetative nerves. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

PLACEMENT OF PREFORMED METAL CROWNS ON CARIOUS PRIMARY MOLARS BY DENTAL HYGIENE/THERAPY VOCATIONAL TRAINEES IN SCOTLAND: A SERVICE EVALUATION ASSESSING PATIENT AND PARENT SATISFACTION.

PubMed

Jackson, Guy

2015-11-01

The utility and acceptability of preformed metal crowns (PMC) for management of carious primary molars has been established in the literature and published guidance. The role of dental hygienist and therapists (DHT) in the evolving team model in primary care has been recognised as requiring further investigation. The importance of patient and parental acceptance is acknowledged in recent healthcare research. This study focuses on patient and parent acceptance of preformed metal crowns placed by DHTs. Prescription format is investigated and the availability of bitewing radiographs considered. Reflective assignments at the end of training gave an indication of DHTs views on increased professional autonomy and the issue of direct access. Patient and parent satisfaction following placement of PMCs by DHT vocational trainees (DHTVT) were evaluated. Data was collected in two audit rounds from 2013 to 2014 using a 'faces' scale for children and a Likert scale for parents following placement of PMCs on carious primary molars. 133 PMCs were placed (110 children) by 10 DHTVTs over an eight-month period. Overall, radiographs were available for 10.5% of cases. The data showed high levels of patient and parent acceptance of the use of PMCs. Low availability of radiographs may represent a missed diagnostic opportunity. PMC placement by DHTVTs resulted in high patient and parent satisfaction, comparable to other studies. Although caries has been declining over the last decade in Scotland, evidence shows that inequalities and a social gradient in experience of caries in children remain. There is a need for tools and strategies for the prevention, recognition, risk assessment, diagnosis, and management of caries in the primary dentition. These must be accessible, acceptable to children and their parents/carers, cost effective, affordable and applicable in the primary care general dental practice environment where most families are likely to be registered. The emerging theme of

Important role of collective cell migration and nerve fiber density in the development of deep nodular endometriosis.

PubMed

Orellana, Renan; García-Solares, Javier; Donnez, Jacques; van Kerk, Olivier; Dolmans, Marie-Madeleine; Donnez, Olivier

2017-04-01

To evaluate deep nodular endometriotic lesions induced in baboons over 12 months and analyze collective cell migration and nerve fiber density. Morphologic and immunohistochemical analysis of endometriotic lesions induced in baboons over the course of 1 year. Academic research unit. Three female baboons (Papio anubis). Recovery of induced deep nodular endometriotic nodules from baboons. Evaluation of the morphology of glands by analysis of the center of lesions and the invasion front; immunohistochemical staining with Ki67, E-cadherin, and β-catenin for investigation of mitotic activity and cell-cell junctions, and with protein gene product 9.5 and nerve growth factor (NGF) for study of nerve fiber density (NFD). All (100%) of the lesions were invasive 1 year after induction, compared with 42.29% after 6 months. Glands from the invasion front showed significantly reduced thickness but significantly higher mitotic activity. E-Cadherin and β-catenin expression were similar between the center and front. NFD was significantly higher in lesions induced after 1 year than after 6 months, and NGF expression was significantly lower in 1-year lesions than in 6-month lesions. Nodular endometriotic lesions induced in the baboon model were found to be significantly more invasive and innervated after 12 months than after 6 months. The invasive phenotype was highly expressed in glands at the invasion front, and our study suggests that nerve fibers play a role in the development of lesions as observed in women. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

An in vitro Comparative Evaluation of Three Remineralizing Agents using Confocal Microscopy

PubMed Central

Chokshi, Achala; Konde, Sapna; Shetty, Sunil Raj; Chandra, Kumar Narayan; Jana, Sinjana; Mhambrey, Sanjana; Thakur, Sneha

2016-01-01

Introduction The caries process has been thought to be irreversible, resulting in the permanent loss of tooth substance and eventually the development of a cavity. Recent approaches focused on application of remineralizing agents to incipient carious lesions, aim at controlling demineralization and promoting remineralization. Remineralizing agents create a supersaturated environment around the lesion; thus, preventing mineral loss and forces calcium and phosphate ions in the vacant areas. Aim To compare and evaluate the remineralization potential of Fluoride Varnish, CPP-ACP Paste (Casein Phosphopeptide-Amorphous Calcium Phosphate) and fTCP Paste (functionalized Tricalcium Phosphate) using confocal microscope. Materials and Methods Two windows of 3X3mm were created on the labial cervical and incisal thirds in 60 permanent maxillary central incisors. The teeth were demineralized to create artificial caries and divided into three groups of 20 each. Group I specimens were coated with Fluoride Varnish once whereas those in CPP-ACP paste group and fTCP group were brushed for 2 minutes, twice daily for 20 and 40 days. The specimens were stored in artificial saliva during the study period and were later sectioned and observed under confocal microscope. Data obtained was statistically analyzed using Fischer’s exact test, ANOVA and post-hoc Bonferroni’s test. Results Fluoride Varnish, CPP-ACP Paste and fTCP Paste showed remineralization of artificial carious lesions at both the time intervals. Fluoride varnish showed the highest remineralization followed by CPP-ACP Paste and fTCP Paste. A statistically significant increase in remineralization potential of CPP-ACP Paste and fTCP Paste was observed at the end of 40 days as compared to 20 days. Conclusion Fluoride varnish showed the greatest remineralization potential of artificial carious lesions followed by CPP-ACP Paste and fTCP Paste respectively. PMID:27504408

Microbiomes of Site-Specific Dental Plaques from Children with Different Caries Status.

PubMed

Richards, Vincent P; Alvarez, Andres J; Luce, Amy R; Bedenbaugh, Molly; Mitchell, Mary Lyn; Burne, Robert A; Nascimento, Marcelle M

2017-08-01

The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMI NGS ) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMI NGS , and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different ( P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis , which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans , Scardovia wiggsiae , Parascardovia denticolens , and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression. Copyright © 2017 American Society for Microbiology.

Microbiomes of Site-Specific Dental Plaques from Children with Different Caries Status

PubMed Central

Alvarez, Andres J.; Luce, Amy R.; Bedenbaugh, Molly; Mitchell, Mary Lyn

2017-01-01

ABSTRACT The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMINGS) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMINGS, and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different (P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis, which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans, Scardovia wiggsiae, Parascardovia denticolens, and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression. PMID:28507066

Deep Learning for Brain MRI Segmentation: State of the Art and Future Directions.

PubMed

Akkus, Zeynettin; Galimzianova, Alfiia; Hoogi, Assaf; Rubin, Daniel L; Erickson, Bradley J

2017-08-01

Quantitative analysis of brain MRI is routine for many neurological diseases and conditions and relies on accurate segmentation of structures of interest. Deep learning-based segmentation approaches for brain MRI are gaining interest due to their self-learning and generalization ability over large amounts of data. As the deep learning architectures are becoming more mature, they gradually outperform previous state-of-the-art classical machine learning algorithms. This review aims to provide an overview of current deep learning-based segmentation approaches for quantitative brain MRI. First we review the current deep learning architectures used for segmentation of anatomical brain structures and brain lesions. Next, the performance, speed, and properties of deep learning approaches are summarized and discussed. Finally, we provide a critical assessment of the current state and identify likely future developments and trends.

The sound of dental tissue ablation as a possible parameter for conservative dentistry

NASA Astrophysics Data System (ADS)

Robles, Fábio Renato P.; Mendes, Fausto Medeiros; Matos, Adriana Bona

2007-02-01

Studies in cariology have been struggling for the development of caries prevention techniques, precocious diagnoses of lesions, re-mineralization of incipient carious lesions and early restorative intervention with minimally invasive procedures. When removing caries, healthy dental structure is often removed inadvertently during its final phase, for being quite difficult to precise the limits between viable and decayed dental tissues clinically. With laser technologies, a subjective clinical hint, often used to indicate when tissue ablation should be stopped is that different sounds are perceptive whether in carious (bass) or in healthy (treble) dental structure; when sound produced by ablation turned treble it would mean that healthy tissue was reached. This study aims to classify those audio differences and to turn them into objective parameters for a conservative operative dentistry with minimally invasive tissue removal when using erbium lasers. Twenty freshly extracted human teeth were used (10 decayed and 10 sound teeth). Dentine was erbium laser irradiated under same parameters, distance and refrigeration and a mono directional microphone was set 10 cm far from the operative area in order to capture and record the ablation produced sounds when working either on carious or healthy dentine. Ten pulses per file were then analysed in a computer software (200 analyses). It was permitted to draw similarities among the patterns in each group (decayed and healthy teeth) as well as differences between decayed and healthy produced sounds. Audio analysis came out to be a technical reliable objective parameter to determine whether laser ablated dentine substrates are decayed or sound; therefore it can be proposed as a conservative parameter, avoiding unnecessary removal of healthy dentine and restricting it to carious one.

Near-IR and CP-OCT Imaging of Suspected Occlusal Caries Lesions

PubMed Central

Simon, Jacob C.; Kang, Hobin; Staninec, Michal; Jang, Andrew T.; Chan, Kenneth H.; Darling, Cynthia L.; Lee, Robert C.; Fried, Daniel

2017-01-01

Introduction Radiographic methods have poor sensitivity for occlusal lesions and by the time the lesions are radiolucent they have typically progressed deep into the dentin. New more sensitive imaging methods are needed to detect occlusal lesions. In this study, cross-polarization optical coherence tomography (CP-OCT) and near-IR imaging were used to image questionable occlusal lesions (QOC's) that were not visible on radiographs but had been scheduled for restoration on 30 test subjects. Methods Near-IR reflectance and transillumination probes incorporating a high definition InGaAs camera and near-IR broadband light sources were used to acquire images of the lesions before restoration. The reflectance probe utilized cross-polarization and operated at wavelengths from 1500–1700-nm where there is an increase in water absorption for higher contrast. The transillumination probe was operated at 1300-nm where the transparency of enamel is highest. Tomographic images (6×6×7 mm3) of the lesions were acquired using a high-speed swept-source CP-OCT system operating at 1300-nm before and after removal of the suspected lesion. Results Near-IR reflectance imaging at 1500–1700-nm yielded significantly higher contrast (p<0.05) of the demineralization in the occlusal grooves compared with visible reflectance imaging. Stains in the occlusal grooves greatly reduced the lesion contrast in the visible range yielding negative values. Only half of the 26 lesions analyzed showed the characteristic surface demineralization and increased reflectivity below the dentinal-enamel junction (DEJ) in 3D OCT images indicative of penetration of the lesion into the dentin. Conclusion This study demonstrates that near-IR imaging methods have great potential for improving the early diagnosis of occlusal lesions. PMID:28339115

Human ventromedial prefrontal lesions alter incentivisation by reward.

PubMed

Manohar, Sanjay G; Husain, Masud

2016-03-01

Although medial frontal brain regions are implicated in valuation of rewards, evidence from focal lesions to these areas is scant, with many conflicting results regarding motivation and affect, and no human studies specifically examining incentivisation by reward. Here, 19 patients with isolated, focal damage in ventral and medial prefrontal cortex were selected from a database of 453 individuals with subarachnoid haemorrhage. Using a speeded saccadic task based on the oculomotor capture paradigm, we manipulated the maximum reward available on each trial using an auditory incentive cue. Modulation of behaviour by motivation permitted quantification of reward sensitivity. At the group level, medial frontal damage was overall associated with significantly reduced effects of reward on invigorating saccadic velocity and autonomic (pupil) responses compared to age-matched, healthy controls. Crucially, however, some individuals instead showed abnormally strong incentivisation effects for vigour. Increased sensitivity to rewards within the lesion group correlated with damage in subgenual ventromedial prefrontal cortex (vmPFC) areas, which have recently become the target for deep brain stimulation (DBS) in depression. Lesion correlations with clinical apathy suggested that the apathy associated with prefrontal damage is in fact reduced by damage at those coordinates. Reduced reward sensitivity showed a trend to correlate with damage near nucleus accumbens. Lesions did not, on the other hand, influence reward sensitivity of cognitive control, as measured by distractibility. Thus, although medial frontal lesions may generally reduce reward sensitivity, damage to key subregions paradoxically protect from this effect. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ph-activated nano-amorphous calcium phosphate-based cement to reduce dental enamel demineralization.

PubMed

Melo, Mary A S; Weir, Michael D; Passos, Vanara F; Powers, Michael; Xu, Hockin H K

2017-12-01

Enamel demineralization is destructive, esthetically compromised, and costly complications for orthodontic patients. Nano-sized amorphous calcium phosphate (NACP) has been explored to address this challenge. The 20% NACP-loaded ortho-cement notably exhibited favorable behavior on reducing demineralization of enamel around brackets in a caries model designed to simulate the carious attack. The 20% NACP-loaded ortho-cement markedly promotes higher calcium and phosphate release at a low pH, and the mineral loss was almost two fold lower and carious lesion depth decreased the by 1/3. This novel approach is promising co-adjuvant route for prevention of dental caries dissemination in millions of patients under orthodontic treatment.

Oral diagnosis and treatment planning: part 5. Preventive and treatment planning for dental caries.

PubMed

Yip, K; Smales, R

2012-09-01

The practice of operative dentistry continues to evolve, to reflect the many changes occurring in society and in dental diseases and conditions. However, the belief that all questionable and early carious lesions should be restored still persists. This belief is largely based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. Yet restorations are not permanent and do not cure caries, as the causes remain. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth.

Technology-enhanced caries detection and diagnosis.

PubMed

Strassler, Howard E; Sensi, Luis Guilherme

2008-10-01

The prevalence of dental caries in children and adults in the United States has been declining the past 40 years primarily because of increased use of fluoride, improved oral hygiene and better oral hygiene devices, a greater emphasis on disease prevention and control, and better access to dental care made available by the dental profession. Caries diagnosis and detection for pit-and-fissure lesions has changed dramatically in the past 25 years. Research has confirmed that the carious process is bacterially mediated and is accompanied by changes in salivary flow and pH and the intake of refined carbohydrates. In recent years a number of new technologies have become available as adjuncts to traditional methods of diagnosing carious lesions. While using these new technologies, the clinician still needs to understand the concepts of caries risk, diagnosis, detection, and assessment. Working from the evidence, dental practitioners can decide on a sound clinical diagnosis and treatment plan.

[Paradigm shift in conservative dentistry: from a mechanistic to a prevention-oriented perception].

PubMed

Hellwig, E; Altenburger, M

2011-09-01

The application of different preventive measures has resulted in a decline of clinically detectable carious lesions in children and adolescents. Not only have caries symptoms changed significantly, but the number of extracted teeth in adults has decreased. Due to these epidemiological facts, modern conservative dentistry is based on a careful risk analysis and caries diagnosis, which also takes into consideration biological and psychosocial components of caries etiology. Conservative dentistry will fail if the dentists are only interested in repairing defects. Simultaneous with the positive outcome of prevention, some unanswered problems have arisen, for which there are no adequate solutions. In young children, caries prevalence is still high and the restorative care of these primary teeth should be improved. For adolescents, early detection of carious lesions should be improved and polarization of caries prevalence should be eliminated. In older adults, evidence-based therapy options for treatment of erosions, abrasions, and root caries are lacking. For seniors needing general care, preventive and restorative concepts should be established.

Lesion progression in post-treatment persistent endodontic lesions.

PubMed

Yu, Victoria Soo Hoon; Messer, Harold Henry; Shen, Liang; Yee, Robert; Hsu, Chin-ying Stephen

2012-10-01

Radiographic lesions related to root-filled teeth may persist for long periods after treatment and are considered to indicate failure of initial treatment. Persistent lesions are found in a proportion of cases, but information on lesion progression is lacking. This study examined the incidence of lesion improvement, remaining unchanged, and deterioration among persistent lesions in a group of patients recruited from a university-based clinic and identified potential predictors for lesion progression. Patients of a university clinic with persistent endodontic lesions at least 4 years since treatment and with original treatment radiographs available were recruited with informed consent. Data were obtained by interview and from dental records and clinical and radiographic examinations. Univariate and multivariate statistical analyses were carried out by using SPSS (version 19). One hundred fifty-one persistent lesions were identified in 114 patients. A majority of the lesions (107, 70.9%) received treatment between 4 and 5 years prior. Eighty-six lesions (57.0%) improved, 18 (11.9%) remained unchanged, and 47 (31.1%) deteriorated since treatment. Potential predictors for lesions that did not improve included recall lesion size, pain on biting at recall examination, history of a postobturation flare-up, and a non-ideal root-filling length (P < .05). Lesions that had persisted for a longer period appeared less likely to be improving (relative risk, 1.038; 95% confidence interval, 1.000-1.077). A specific time interval alone should not be used to conclude that a lesion will not resolve without intervention. This study identified several clinical factors that are associated with deteriorating persistent lesions, which should aid in identifying lesions that require further intervention. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effect of Er,Cr:YSGG Laser at Different Output Powers on the Micromorphology and the Bond Property of Non-Carious Sclerotic Dentin to Resin Composites

PubMed Central

Wang, Weiguo; Jiao, Yang; Wang, Wanshan; Yang, Yanwei; Wei, Jingjing; Shen, Lijuan; Chen, Jihua

2015-01-01

Background The objective of this study was to investigate the influence of Er,Cr:YSGG laser irradiated at different powers on the micromorphology and the bonding property of non-carious sclerotic dentin to resin composites. Methods Two hundred bovine incisors characterized by non-carious sclerotic dentin were selected, and the seventy-two teeth of which for surface morphological analysis were divided into nine groups according to various treatments (A: the control group, B: only treated with the adhesive Adper Easy One, C: diamond bur polishing followed by Adper Easy One, D-I: Er,Cr:YSGG laser irradiating at 1W, 2W, 3W, 4W, 5W, 6W output power, respectively, followed by Adper Easy One). The surface roughness values were measured by the non-contact three-dimensional morphology scanner, then the surface micromorphologies of surfaces in all groups were assessed by scanning electron microscopy (SEM); meanwhile, Image Pro-Plus 6.0 software was used to measure the relative percentage of open tubules on SEM images. The rest, one hundred twenty-eight teeth for bond strength test, were divided into eight groups according to the different treatments (A: only treated with the adhesive Adper Easy One, B: diamond bur polishing followed by the above adhesive, C-H: Er,Cr:YSGG laser irradiating at 1 W, 2 W, 3 W, 4 W, 5 W, 6 W output power, respectively, followed by the above adhesive), and each group was subsequently divided into two subgroups according to whether aging is performed (immediately tested and after thermocycling). Micro-shear bond strength test was used to evaluate the bond strength. Results The 4W laser group showed the highest roughness value (30.84±1.93μm), which was statistically higher than the control group and the diamond bur groups (p<0.05). The mean percentages ((27.8±1.8)%, (28.0±2.2)%, (30.0±1.9)%) of open tubules area in the 4W, 5W, 6W group were higher than other groups (p<0.05). The 4W laser group showed the highest micro-shear bond strength not

Quantitative Analysis of Remineralization of Artificial Carious Lesions with Commercially Available Newer Remineralizing Agents Using SEM-EDX- In Vitro Study”

PubMed Central

Rambabu, Tanikonda; Sajjan, Girija; Varma, Madhu; Satish, Kalyan; Raju, Vijayalakshmi Bhupathi; Ganguru, Sirisha; Ventrapati, Nagalkashmi

2017-01-01

Introduction The basic principle of remineralization is by advocating a biological or non-invasive approach rather than the surgical approach for early enamel lesions. There are relatively newer products available for remineralization, latest being the resin-infiltration technique, commercially available as Icon. Aim The aim of the study was to evaluate the remineralizing potential of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP), Vantej and Icon by the quantitative evaluation of mineral gain. Materials and Methods Seventy eight maxillary premolars were decoronated at Cemento-Enamel Junction (CEJ) and then sectioned mesio-distally using diamond disc into two halves. Mineral content of the sound specimens were recorded using Energy Dispersive X-ray (EDAX) micro-analyser. The samples were then subjected to demineralization by using demineralizing solution. The samples were grouped (n=26) based on the remineralizing agent used, Group 1: Vantej, Group 2: CPP-ACP, Group 3: Icon. After the application of remineralizing agent, the mineral content was measured using EDAX. Results After remineralization, there was a significant difference between the groups when calcium and phosphorous ratios (Ca:P) were compared, showing greater potential of remineralization for CPP-ACP followed by Vantej and Icon group. Conclusion CPP-ACP performed better than Vantej and Icon in remineralizing the demineralized enamel. PMID:28571254

[Surgery for deep infiltrating endometriosis before in vitro fertilization: no benefit for fertility?].

PubMed

Capelle, A; Lepage, J; Langlois, C; Lefebvre, C; Dewailly, D; Collinet, P; Rubod, C

2015-02-01

Does surgery for deep infiltrating endometriosis (DIE) before in vitro fertilization (IVF) improve pregnancy and birth rate? Cohort study of 177 consecutive patients with DIE related infertility and receiving IVF. Patients were divided into 3 groups according to surgical management decided during multidisciplinary team meeting. Group no surgery (NS) (n=65), group complete surgery (CS) with complete resection of all lesions (n=49) and group incomplete surgery (IS) with gestures improving ovaries accessibility for IVF and/or facilitating embryonic implantation (n=63). Pre-surgery clinical, MRI lesion locations, and history of IVF characteristics were analyzed with logistic regression. There was no significant difference in general and IVF characteristics and in the severity of endometriosis among the three groups (P=0.43). Overall pregnancy and birth rates after IVF were 45.8% and 33.3%, respectively and were not different among the 3 groups (P=0.59 and P=0.49). Four major complications during oocytes retrievals were observed in NS group, one in IS group and none in CS group. Presence of an inter-utero-rectal lesion at MRI decreased the rate of pregnancy (OR=0.49 [0.25, 0.97]). Surgery for deep infiltrating endometriosis does not improve pregnancy and birth rates before IVF. This inter-utero-rectal extensive lesion might explain IVF failures by ovarian difficult access and difficulties in embryonic transfers. Further studies should explore the impact of surgical excision of inter-utero-rectal lesion on oocyte retrieval and embryonic transfer. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Pulsed Nd:YAG laser selective ablation of surface enamel caries: II. Histology and clinical trials

NASA Astrophysics Data System (ADS)

Harris, David M.; Goodis, Harold E.; White, Joel M.; Arcoria, Charles J.; Simon, James; Burkart, John; Yessik, Michael J.; Myers, Terry D.

2000-03-01

High intensity infrared light from the pulsed Nd:YAG dental laser is absorbed by pigmented carious enamel and not absorbed by normal enamel. Therefore, this system is capable of selective removal of surface enamel caries. Safety and efficacy of the clinical procedure was evaluated in two sets of clinical trials at three dental schools. Carious lesions were randomized to drill or laser treatment. Pulp vitality, surface condition, preparations and restorations were evaluated by blinded evaluators. In Study 1 surface caries were removed from 104 third molars scheduled for extraction. One week post-treatment teeth were extracted and the pulp was examined histologically. In Study 2 90 patients with 422 lesions on 376 teeth were randomized to laser or drill and followed for six months. There were no adverse events and both clinical and histological evaluations of pulp vitality showed no abnormalities. Caries were removed in all conditions. A significantly greater number of preparations in the drill groups vs. laser groups entered dentin (drill equals 11, laser equals 1, p less than 0.001). This indicates that the more conservative laser treatment removed the caries but not the sound enamel below the lesion.

Deep Learning in Radiology.

PubMed

McBee, Morgan P; Awan, Omer A; Colucci, Andrew T; Ghobadi, Comeron W; Kadom, Nadja; Kansagra, Akash P; Tridandapani, Srini; Auffermann, William F

2018-03-29

As radiology is inherently a data-driven specialty, it is especially conducive to utilizing data processing techniques. One such technique, deep learning (DL), has become a remarkably powerful tool for image processing in recent years. In this work, the Association of University Radiologists Radiology Research Alliance Task Force on Deep Learning provides an overview of DL for the radiologist. This article aims to present an overview of DL in a manner that is understandable to radiologists; to examine past, present, and future applications; as well as to evaluate how radiologists may benefit from this remarkable new tool. We describe several areas within radiology in which DL techniques are having the most significant impact: lesion or disease detection, classification, quantification, and segmentation. The legal and ethical hurdles to implementation are also discussed. By taking advantage of this powerful tool, radiologists can become increasingly more accurate in their interpretations with fewer errors and spend more time to focus on patient care. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Taking the Pain out of Waiting: The Oral Health Counselling Experiences of Parents of Children with Extensive Dental Caries

ERIC Educational Resources Information Center

Cashmore, Aaron W.; Noller, Jennifer; Johnson, Bronwyn; Ritchie, Jan; Blinkhorn, Anthony S.

2011-01-01

Objective: The Tooth Smart Programme is a hospital-based parent-counselling programme established to stabilize existing carious lesions and prevent new caries in children. The purpose of this qualitative study was to: explore participating parents' experiences of and views about parent counselling; identify and describe factors that influence the…

Effect of 5,000 ppm Fluoride Dentifrice or 1,100 ppm Fluoride Dentifrice Combined with Acidulated Phosphate Fluoride on Caries Lesion Inhibition and Repair.

PubMed

Fernández, Constanza E; Tenuta, Livia Maria Andaló; Del Bel Cury, Altair Antoninha; Nóbrega, Diego Figueiredo; Cury, Jaime Aparecido

2017-01-01

High fluoride dentifrice (FD; 5,000 ppm F) has been recommended to arrest root dentine lesions and to control enamel caries in high-risk patients. Also, standard FD (1,100 ppm F) in combination with professional fluoride application has been recommended to control dentine caries, but the effect of this combination on enamel has been considered modest. Considering the lack of evaluation comparing the use of 5,000 ppm FD (5,000-FD) versus acidulated phosphate fluoride (APF) application combined with 1,100 ppm FD (1,100-FD) on the inhibition and repair of caries lesions in both enamel and dentine, we conducted this in situ, double-blind, crossover study of 3 phases of 14 days. In each phase, 18 volunteers wore palatal appliances containing enamel and root dentine specimens, either sound or carious, to evaluate the effect of the treatments on the inhibition or repair of caries lesions, respectively. The treatments were non-FD (negative control), 5,000-FD, or 1 APF gel application on dental specimens combined with 1,100-FD used twice per day (APF + 1,100-FD). The reduction of demineralization and enhancement of remineralization were assessed by surface and cross-sectional hardness. Fluoride concentration was determined on dental specimens and on the formed biofilm. For enamel, APF + 1,100-FD and 5,000-FD did not differ regarding the inhibition of demineralization and repair of caries lesions. However, for dentine the difference between these treatments was inconclusive because while APF + 1,100-FD was more effective than 5,000-FD in caries lesion reduction and repair, 5,000-FD was more effective than APF + 1,100-FD in the reduction of surface demineralization. Therefore, the findings show that the combination of APF + 1,100-FD is as effective as 5,000-FD in enamel inhibition of demineralization and enhancement of remineralization. © 2017 S. Karger AG, Basel.

aMMP-8 in correlation to caries and periodontal condition in adolescents-results of the epidemiologic LIFE child study.

PubMed

Schmidt, Jana; Guder, Ulrike; Kreuz, Markus; Löffler, Markus; Kiess, Wieland; Hirsch, Christian; Ziebolz, Dirk; Haak, Rainer

2018-01-01

The suitability of a chairside aMMP-8 test in determination of periodontal inflammation and caries in adolescents was assessed. Secondly, the influence of orthodontic treatment on aMMP-8 test result was analyzed. Within the LIFE Child study, 434 adolescents (10 to 18 years) were included. Clinical dental examinations comprised caries experience (DMF/T-Index), signs of periodontal inflammation (probing pocket depth, PPD; community periodontal index of treatment needs; CPITN) at six index teeth and oral hygiene (OH). Information about orthodontic appliances (OA) and socioeconomic status (SES) were obtained by validated questionnaires. Test's sensitivity and specificity to detect periodontal inflammation and carious lesions were evaluated. The influence of OA on the test result was analyzed (multivariate model). No associations between age, gender, SES or OH, and test outcome were found (p > 0.05). Positive test results correlated to periodontal findings (CPITN, mean PPD; p < 0.001). However, for the detection of ≥ 1 site(s) with PPD ≥ 4 mm, the test's sensitivity and specificity were found to be 61 and 69%, respectively. Multivariate analysis revealed a higher probability for a positive test result in cases of fixed OA (odds ratio 5.02, 95% confidence interval 1.90-13.19). The test had no diagnostic value considering carious lesions. The chairside aMMP-8 test does not reliably identify adolescents with periodontal inflammation. Positive test results were more frequent in case of OA. The chairside aMMP-8 test is no appropriate tool to screen children and adolescents neither for periodontal inflammation nor for carious lesions.

Introduction: From pathogenesis to therapy, deep endometriosis remains a source of controversy.

PubMed

Donnez, Jacques

2017-12-01

Deep endometriosis remains a source of controversy. A number of theories may explain its pathogenesis and many arguments support the hypothesis that genetic or epigenetic changes are a prerequisite for development of lesions into deep endometriosis. Deep endometriosis is frequently responsible for pelvic pain, dysmenorrhea, and/or deep dyspareunia, but can also cause obstetrical complications. Diagnosis may be improved by high-quality imaging. Therapeutic approaches are a source of contention as well. In this issue's Views and Reviews, medical and surgical strategies are discussed, and it is emphasized that treatment should be designed according to a patient's symptoms and individual needs. It is also vital that referral centers have the knowledge and experience to treat deep endometriosis medically and/or surgically. The debate must continue because emerging trends in therapy need to be followed and investigated for optimal management. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Remineralization of enamel subsurface lesions with casein phosphopeptide-amorphous calcium phosphate: A quantitative energy dispersive X-ray analysis using scanning electron microscopy: An in vitro study

PubMed Central

Hegde, Mithra N; Moany, Anu

2012-01-01

Aim: The objective of this study was to quantitatively evaluate the remineralization potential of casein phosphopeptide-amor-phous calcium phosphate paste on enamel subsurface lesions using scanning electron microscopy with energy dispersive X-ray analysis (SEM-EDX). Materials and Methods: Ninety enamel specimens were prepared from extracted human molars. All specimens were evaluated for mineral content (% weight) using SEM-EDX. The specimens were placed in demineralizing solution for four days to produce artificial carious lesions. The mineral content (calcium/phosphorus ratios, Ca/P ratios) was remeasured using SEM-EDX. The specimens were then randomly assigned to five study groups and one control group of 15 specimens per group. Except for the control group, all group specimens were incubated in remineralizing paste (CPP-ACP paste) for 7, 14, 21, 28, and 35 days twice daily for three minutes. The control group received no treatment with remineralizing paste. All the 90 specimens were stored in artificial saliva at 37°C. After remineralization, the mineral content (% weight) of the samples was measured using SEM-EDX. Results: All the study groups showed very highly significant differences between Ca/P ratios of the demineralized and remineralized samples. There was no significant difference seen in the control group. Conclusion: CPP-ACP paste could significantly remineralize the artificial enamel subsurface lesions in vitro: the remineralizing rates increasing with the time for which the samples were kept in the remineralizing paste. Energy dispersive X-ray analysis is an efficient way to quantitatively assess the changes in mineral content during demineralization and in vitro remineralization processes. PMID:22368338

Linear lesions in heart tissue using diffused laser radiation

NASA Astrophysics Data System (ADS)

Fried, Nathaniel M.; Lardo, Albert C.; Berger, Ronald D.; Calkins, Hugh; Halperin, Henry R.

2000-05-01

Transmural, continuous, and linear lesions may be necessary for successful catheter ablation of cardiac arrythmias such as atrial fibrillation. Laser ablation was studied as an alternative to radiofrequency ablation, which is noted to produce superficial and discontinuous lesions as well as tissue charring and vaporization. Samples of canine myocardium were placed in a saline bath and irradiated with an 1.06- micrometer Nd:YAG laser operated in either pulsed or continuous mode. For pulsed mode, the laser pulse duration was 10 s with 10 s cooling between pulses. Laser radiation was delivered radially through diffusing optical fiber tips oriented parallel to the endocardial surface. In CW mode, transmural (6-mm-deep), linear (16-mm-long), and continuous lesions were produced using a laser power of 30 W and an irradiation time of 180 s. Peak tissue temperatures measured 51 plus or minus 1 degree Celsius at the endocardial surface, 61 plus or minus 6 degrees Celsius in the mid-myocardium, and 55 plus or minus 6 degree Celsius at the epicardial surface. There was no evidence of tissue charring or vaporization. Pulsed laser irradiation produced comparable lesion depths to CW irradiation with more uniform heating of the subsurface myocardium, but at the expense of longer operation times. Further in vivo study of laser ablation is warranted for possible clinical applications.

Treatment of endo-periodontal lesion using leukocyte-platelet-rich fibrin. A case report

PubMed Central

Elgueta, Ricardo; Fuentes, Ramon

2017-01-01

Abstract Case Description: The main objective of this paper was to report the clinical effectiveness of leukocyte- platelet- rich fibrin (L-PRF) in the treatment of a combined endo-periodontal lesion of an upper first premolar. Clinical Findings: The tooth had a profound abfraction on the vestibular aspect and presented no mobility but revealed a deep pocket measuring of 11 mm on the mesial vestibular aspect and 14 mm on the mesial palatine aspect. The three dimensional image analysis showed total bone loss in the mesial aspect and an extensively bone loss of the vestibular aspect of the vestibular root. Treatment and Outcome: Endodontic treatment was performed and periodontal access surgery (surgical periodontal therapy) was done with the application of autologous L-PRF. Three month and 6 months after surgery, the cone beam computed tomography (CBCT) exams showed no bone regeneration in any aspect of the tooth. However, periodontal examination showed a significative improvement in the deepness of surcus. The mesial vestibular aspect had a deep pocket of 3 mm and 5 mm on the mesial palatine aspect showing a reduction in deepness of 8 mm and 9 mm, respectively. Clinical Relevance: The actual treatment for teeth with bad prognosis is the extraction and replacement with implants. Even though implants are capable of restore function and aesthetic, the abuse of this approach have led to the loss of teeth that could be successfully treated with a less invasive technique. The prognosis of teeth with endoperiodontal lesion is poor but could be enhanced with regenerative therapies. Until now there are no clinical trials and just four case report about the treatment of these teeth with platelet rich fibrin. PMID:29662262

The association of cognitive impairment with gray matter atrophy and cortical lesion load in clinically isolated syndrome.

PubMed

Diker, Sevda; Has, Arzu Ceylan; Kurne, Aslı; Göçmen, Rahşan; Oğuz, Kader Karlı; Karabudak, Rana

2016-11-01

Multiple sclerosis can impair cognition from the early stages and has been shown to be associated with gray matter damage in addition to white matter pathology. To investigate the profile of cognitive impairment in clinically isolated syndrome (CIS), and the contribution of cortical inflammation, cortical and deep gray matter atrophy, and white matter lesions to cognitive decline. Thirty patients with clinically isolated syndrome and twenty demographically- matched healthy controls underwent neuropsychologic assessment through the Rao Brief Repeatable Battery, and brain magnetic resonance imaging with double inversion recovery using a 3T scanner. Patients with clinically isolated syndrome performed significantly worse than healthy controls on tests that evaluated verbal memory, visuospatial learning and memory, and verbal fluency. Significant deep gray matter atrophy was found in the patients but cortical volume was not lower than the controls. Visual memory tests correlated with the volume of the hippocampus, cerebral white matter and deep gray matter structures and with cerebellar cortical atrophy. Cortical or white matter lesion load did not affect cognitive test results. In our patients with CIS, it was shown that cognitive impairment was mainly related to cerebral white matter, cerebellar cortical and deep gray matter atrophy, but not with cortical inflammation, at least in the early stage of disease. Copyright © 2016 Elsevier B.V. All rights reserved.

Computed tomography of deep fat masses in multiple symmetrical lipomatosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Enzi, G.; Biondetti, P.R.; Fiore, D.

1982-07-01

Deep fat masses were evaluated by computed tomography (CT) in 15 patients with multiple symmetrical lipomatosis. In 4 patients, peritracheal accumulations of fat were observed. In 3 of them, tracheal compression by lipomatous tissue was demonstrated: 2 were asymptomatic and the third severe respiratory insufficiency secondary to blockage of the air was by the vocal cords as the result of recurrent nerve palsy. In 6 patients, lipomatous tissue occupied the potential space between the spina scapulae and the trapezius, supraspinatus, and infraspinatus muscles. In 2, calcification of lipomatous masses was observed. There was no relationship between extension of subcutaneous fatmore » and accumulation at deep sites. CT facilitates early detection of peritracheal lipomatous tissue and is helpful in follow-up when deep fat accumulation is responsible for space-occupying lesions requiring surgery.« less

Evaluating a Team-Based Learning Method for Detecting Dental Caries in Dental Students

ERIC Educational Resources Information Center

Park, Sang E.; Kim, Junhyck; Anderson, Nina

2014-01-01

The purpose of the study was to investigate whether the team-based learning environment facilitated the competency of third year dental students in caries detection and activity assessment. Corresponding data were achieved using digital radiographs to determine the carious lesions in three clinical cases. The distribution of the caries evaluations…

Selective removal of carious human dentin using a nanosecond pulsed laser operating at a wavelength of 5.85 μ m

NASA Astrophysics Data System (ADS)

Ishii, Katsunori; Kita, Tetsuya; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

2015-05-01

Less invasive methods for treating dental caries are strongly desired. However, conventional dental lasers do not always selectively remove caries or ensure good bonding to the composite resin. According to our previous study, demineralized dentin might be removed by a nanosecond pulsed laser operating at wavelengths of around 5.8 μm. The present study investigated the irradiation effect of the light on carious human dentin classified into "remove," "not remove," and "unclear" categories. Under 5.85-μm laser pulses, at average power densities of 30 W/cm2 and irradiation time of 2 s, the ablation depth of "remove" and "not remove," and also the ablation depth of "unclear" and "not remove," were significantly different (p<0.01). The ablation depth was correlated with both Vickers hardness and Ca content. Thus, a nanosecond pulsed laser operating at 5.85 μm proved an effective less-invasive caries treatment.

Rapid and accurate intraoperative pathological diagnosis by artificial intelligence with deep learning technology.

PubMed

Zhang, Jing; Song, Yanlin; Xia, Fan; Zhu, Chenjing; Zhang, Yingying; Song, Wenpeng; Xu, Jianguo; Ma, Xuelei

2017-09-01

Frozen section is widely used for intraoperative pathological diagnosis (IOPD), which is essential for intraoperative decision making. However, frozen section suffers from some drawbacks, such as time consuming and high misdiagnosis rate. Recently, artificial intelligence (AI) with deep learning technology has shown bright future in medicine. We hypothesize that AI with deep learning technology could help IOPD, with a computer trained by a dataset of intraoperative lesion images. Evidences supporting our hypothesis included the successful use of AI with deep learning technology in diagnosing skin cancer, and the developed method of deep-learning algorithm. Large size of the training dataset is critical to increase the diagnostic accuracy. The performance of the trained machine could be tested by new images before clinical use. Real-time diagnosis, easy to use and potential high accuracy were the advantages of AI for IOPD. In sum, AI with deep learning technology is a promising method to help rapid and accurate IOPD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Application of Deep Learning in Automated Analysis of Molecular Images in Cancer: A Survey

PubMed Central

Xue, Yong; Chen, Shihui; Liu, Yong

2017-01-01

Molecular imaging enables the visualization and quantitative analysis of the alterations of biological procedures at molecular and/or cellular level, which is of great significance for early detection of cancer. In recent years, deep leaning has been widely used in medical imaging analysis, as it overcomes the limitations of visual assessment and traditional machine learning techniques by extracting hierarchical features with powerful representation capability. Research on cancer molecular images using deep learning techniques is also increasing dynamically. Hence, in this paper, we review the applications of deep learning in molecular imaging in terms of tumor lesion segmentation, tumor classification, and survival prediction. We also outline some future directions in which researchers may develop more powerful deep learning models for better performance in the applications in cancer molecular imaging. PMID:29114182

Caries assessment by clinical examination with or without radiographs of young Chinese adults.

PubMed

Chu, C H; Chung, B T O; Lo, E C M

2008-10-01

To compare caries status assessment of posterior teeth of young Chinese adults by using clinical examination alone and with the supplemental use of bitewing radiographs. Two calibrated dentists examined the posterior teeth of 200 Chinese university students (aged 18-24 years) using dental mirrors and probes under optimal lighting. Caries was diagnosed by visual detection of carious cavities. Duplicate examinations were performed to monitor intra- and inter-examiner variations. Bitewing radiographs were taken and examined by an independent dentist. Caries was recorded when a lesion extended into dentine. Among the 3,162 posterior teeth examined, 113 were detected with caries. More than one third (35.4%) of the caries found in the posterior teeth was not detected from reading the radiographs but was detected by clinical examination. About half (51.4%) of the caries was found on the bitewing radiographs only, leaving 13.2% being detected by using either method. With the supplement of bitewing radiographs, there was a 105% increase in the number of carious lesions detected. This leads to a correction factor of 1.13 for adjustment of the mean DMFT score obtained from conducting clinical examinations alone. Due to the significant number of clinically undetected carious cavities in these young Chinese adults who live in a community with water fluoridation, it may be advisable to use a correction factor to adjust the caries experience obtained from epidemiological surveys when bitewing radiographs are not available.

Fibroblastic connective tissue nevus: a rare cutaneous lesion analyzed in a series of 25 cases.

PubMed

de Feraudy, Sébastien; Fletcher, Christopher D M

2012-10-01

Fibroblastic connective tissue nevus (FCTN) represents a rare and distinct benign cutaneous mesenchymal lesion of fibroblastic/myofibroblastic lineage, which broadens the spectrum of lesions presently recognized as connective tissue nevus. A series of 25 cases of FCTN has been analyzed to further characterize the clinicopathologic spectrum and immunohistochemical features of this entity. Sixteen patients were female (64%) and 9 were male (36%), with age at presentation ranging from 1.5 months to 58 years (median, 10 y). Most patients presented with a solitary, slowly growing, painless plaque-like or nodular skin lesion. Eleven cases (44%) arose on the trunk, 9 (36%) on the head and neck, and 5 (20%) on the limbs. The lesion was present for a median duration of 11.5 months (mean, 13.2 mo). Grossly, the lesions were tan-brown to tan-white, smooth, and firm. Their size ranged from 0.3 to 2.0 cm in greatest dimension (mean size, 0.67 cm; median, 0.6 cm). All tumors showed poor circumscription and were situated primarily in the reticular deep dermis, extending into the superficial subcutis in 13 cases (52%). The lesion was associated with papillomatous epidermis in 17 cases (70%) and the presence of adipose tissue in the reticular dermis in 14 cases (60.9%). All tumors were composed of a proliferation of bland intradermal fibroblastic/myofibroblastic cells with indistinct palely eosinophilic cytoplasm and tapering nuclei, with no significant cytologic atypia or pleomorphism, arranged in short-intersecting fascicles and entrapping appendages. No mitoses were identified. Immunostains showed positivity for CD34 in 20 of 23 cases (87%) and weak focal positivity for smooth muscle actin in 9 of 19 cases (47%). No case stained positively for desmin or S100 protein. Clinical follow-up was obtained for 14 patients (median duration, 4 y). No tumor recurred locally, even when surgical excision was incomplete. No lesion metastasized. FCTN occurs most commonly as a plaque on the

Learning better deep features for the prediction of occult invasive disease in ductal carcinoma in situ through transfer learning

NASA Astrophysics Data System (ADS)

Shi, Bibo; Hou, Rui; Mazurowski, Maciej A.; Grimm, Lars J.; Ren, Yinhao; Marks, Jeffrey R.; King, Lorraine M.; Maley, Carlo C.; Hwang, E. Shelley; Lo, Joseph Y.

2018-02-01

Purpose: To determine whether domain transfer learning can improve the performance of deep features extracted from digital mammograms using a pre-trained deep convolutional neural network (CNN) in the prediction of occult invasive disease for patients with ductal carcinoma in situ (DCIS) on core needle biopsy. Method: In this study, we collected digital mammography magnification views for 140 patients with DCIS at biopsy, 35 of which were subsequently upstaged to invasive cancer. We utilized a deep CNN model that was pre-trained on two natural image data sets (ImageNet and DTD) and one mammographic data set (INbreast) as the feature extractor, hypothesizing that these data sets are increasingly more similar to our target task and will lead to better representations of deep features to describe DCIS lesions. Through a statistical pooling strategy, three sets of deep features were extracted using the CNNs at different levels of convolutional layers from the lesion areas. A logistic regression classifier was then trained to predict which tumors contain occult invasive disease. The generalization performance was assessed and compared using repeated random sub-sampling validation and receiver operating characteristic (ROC) curve analysis. Result: The best performance of deep features was from CNN model pre-trained on INbreast, and the proposed classifier using this set of deep features was able to achieve a median classification performance of ROC-AUC equal to 0.75, which is significantly better (p<=0.05) than the performance of deep features extracted using ImageNet data set (ROCAUC = 0.68). Conclusion: Transfer learning is helpful for learning a better representation of deep features, and improves the prediction of occult invasive disease in DCIS.

[Multiple cephalic deep granuloma annulare of children].

PubMed

Bulinckx, A; Cambier, N; Wayllace Gaspar, L; Théate, I; Roquet-Gravy, P P; Bessis, D

2017-10-01

Deep granuloma annulare is a fairly rare variety of granuloma annulare. It is seen predominantly in children and mainly affects the anterior aspect of the legs and the top of the feet; cephalic presentation is rare. Below, we report three cases of deep granuloma annulare in children presenting solely at the cephalic extremity. Case 1: a six-year-old boy presented 7 cutaneous nodules measuring 1 to 2cm that were flesh-coloured, insensitive to palpation, of hard consistency and deeply attached. The lesions were grouped together on the anterior half of the left temporal fossa. While spontaneous regression of the three nodules was noted in the month following cutaneous biopsy, these nodules recurred a few months later. Case 2: a four-year-old girl with five deep cephalic nodules measuring around one centimetre and the colour of normal skin were seen on her right temporal fossa. The child was lost to follow-up after biopsy. Case 3: a four-month-old infant was presenting some 15 deep cutaneous nodules arranged in linear fashion on the forehead next to the left temporal fossa. These nodules regressed spontaneously one month after biopsy. In all three cases, histological examination confirmed the diagnosis of deep granuloma annulare. There have been few published cases of multiple, cephalic, deep granuloma annulare at a single site in children. The condition has an extensive differential diagnosis that includes malignant tumours; in addition, histological confirmation is normally essential. Treatment is not qualified and therapeutic extension with clinical monitoring alone may frequently be recommended. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A deep semantic mobile application for thyroid cytopathology

NASA Astrophysics Data System (ADS)

Kim, Edward; Corte-Real, Miguel; Baloch, Zubair

2016-03-01

Cytopathology is the study of disease at the cellular level and often used as a screening tool for cancer. Thyroid cytopathology is a branch of pathology that studies the diagnosis of thyroid lesions and diseases. A pathologist views cell images that may have high visual variance due to different anatomical structures and pathological characteristics. To assist the physician with identifying and searching through images, we propose a deep semantic mobile application. Our work augments recent advances in the digitization of pathology and machine learning techniques, where there are transformative opportunities for computers to assist pathologists. Our system uses a custom thyroid ontology that can be augmented with multimedia metadata extracted from images using deep machine learning techniques. We describe the utilization of a particular methodology, deep convolutional neural networks, to the application of cytopathology classification. Our method is able to leverage networks that have been trained on millions of generic images, to medical scenarios where only hundreds or thousands of images exist. We demonstrate the benefits of our framework through both quantitative and qualitative results.

Serrated lesions of the appendix: a morphologic and immunohistochemical appraisal.

PubMed

Bellizzi, Andrew M; Rock, Jonathan; Marsh, William L; Frankel, Wendy L

2010-04-01

We performed a histologic and immunohistochemical assessment of 53 noninvasive appendiceal epithelial proliferations, appropriating terminology and using markers shown useful in differentiating serrated colorectal polyps. These were classified as hyperplastic polyp (HP), sessile serrated adenoma (SSA), mixed serrated and adenomatous lesion (MSAL), mucinous cystadenoma (MCA), or conventional adenoma (CAD). Immunohistochemical analysis for cytokeratin (CK) 20, Ki-67, MUC6, and beta-catenin was performed. Diagnoses were as follows: HP, 6; SSA, 12; HP vs SSA, 3; MSAL, 16; MCA, 14; and CAD, 2. All HPs showed expanded (beyond surface) CK20 and expanded or normal (base) Ki-67; 1 was MUC6+. Most SSAs and MSALs were CK20-expanded or expanded with random expression in deep crypts (Ex/I) and Ki-67-expanded, Ex/I (expanded with asymmetry), or normal. All SSAs and 8 of 16 MSALs were MUC6+. CADs were CK20-Ex/I, Ki-67-Ex, and MUC6-; 1 showed nuclear beta-catenin expression. Serrated appendiceal lesions can be categorized using colorectal terminology. MUC6 is associated with SSA morphologic features. Similar immunohistochemical patterns in SSA and MSAL suggest a link between these lesions.

Comparative Evaluation of Oral Candida albicans Carriage in Children with and without Dental Caries: A Microbiological in vivo Study.

PubMed

Srivastava, Binita; Bhatia, Hind Pal; Chaudhary, Visuja; Aggarwal, Archana; Kumar Singh, Ashish; Gupta, Nidhi

2012-05-01

The aim of this study was to examine the presence of Candida albicans in extensive carious lesions before and after treatment of the carious lesions and to evaluate the carriage of Candida albicans in children with and without caries. The study was conducted on 60 childrens who were divided into two groups: Experimental group (group 1) and controlled group (group 2). Each group was further divided into 3 subgroups according to the dentition as: Group A (Deciduous), group B (Mixed) and group C (Permanent). Swab samples for mycological studies were collected from the dorsum of the tongue, vestibular sulcus and peak of the palatal vault. All samples were cultured directly on SDA plate (Sabouraud's dextrose agar). Number of Candida colonies was determined by counting colony forming unit on SDA plates. Further identification of Candida albicans was done by germ-tube test and corn-meal agar. Overall prevalence of Candida albicans carriage was significantly higher and mean value of Candida albicans CFU (colony forming unit) was remarkably higher in group 1 (experimental group) as compare to group 2 (control group). Significant reduction in the frequency and mean value of Candida albicans CFU/plate was seen in children after treatment of carious lesions. This study supports the active role of Candida species in dental caries. Hence, Candida albicans may play an important role as a risk factor for dental caries. It was also seen that the oral environment stabilization procedures were able to reduce Candida albicans counts. Thus, these procedures can be considered efficient in the reduction of caries risk. How to cite this article: Srivastava B, Bhatia HP, Chaudhary V, Aggarwal A, Singh AK, Gupta N. Comparative Evaluation of Oral Candida albicans Carriage in Children with and without Dental Caries: A Microbiological in vivo Study. Int J Clin Pediatr Dent 2012;5(2):108-112.

The influence of parotid gland sparing on radiation damages of dental hard tissues.

PubMed

Hey, Jeremias; Seidel, Johannes; Schweyen, Ramona; Paelecke-Habermann, Yvonne; Vordermark, Dirk; Gernhardt, Christian; Kuhnt, Thomas

2013-07-01

The aim of the present study was to evaluate whether radiation damage on dental hard tissue depends on the mean irradiation dose the spared parotid gland is subjected to or on stimulated whole salivary flow rate. Between June 2002 and October 2008, 70 patients with neck and cancer curatively irradiated were included in this study. All patients underwent dental treatment referring to the guidelines and recommendations of the German Society of Dental, Oral and Craniomandibular Sciences prior, during, and after radiotherapy (RT). During the follow-up period of 24 months, damages on dental hard tissues were classified according to the RTOG/EORTC guidelines. The mean doses (D(mean)) during spared parotid gland RT were determined. Stimulated whole saliva secretion flow rates (SFR) were measured before RT and 1, 6, 12, 24 months after RT. Thirty patients showed no carious lesions (group A), 18 patients developed sporadic carious lesions (group B), and 22 patients developed general carious lesions (group C). Group A patients received a D mean of 21.2 ± 11.04 Gy. Group B patients received a D(mean) of 26.5 ± 11.59 Gy and group C patients received a D(mean) of 33.9 ± 9.93 Gy, respectively. The D(mean) of group A was significantly lower than the D(mean) of group C (p < 0.001). Additionally, the mean SFR 6 months after RT of group A was significantly higher than the mean SFR of group C (p < 0.01). Irradiation damage on dental hard tissue correlates with increased mean irradiation doses as well as decreased salivary flow rates. Parotid gland sparing resulting in a dose below 20 Gy reduces radiation damage on dental hard tissues, and therefore, the dose may act as a predictor for the damage to be expected.

Caries Experience in Children with and without Molar-Incisor Hypomineralisation: A Case-Control Study.

PubMed

Grossi, Juliana de Aguiar; Cabral, Renata Nunes; Leal, Soraya Coelho

2017-01-01

The aim of this study was to compare the caries experience of children with and without molar-incisor hypomineralisation (MIH). A case-control study was designed in which 130 children aged between 7 and 13 years with MIH (cases) were matched with 130 children without the condition (controls) according to age, sex, and school. Dental caries and MIH were assessed using the Caries Assessment Spectrum and Treatment (CAST) and European Academy of Paediatric Dentistry (EAPD) criteria, respectively, by three examiners. CAST was converted into DMFT/dmft; the Kruskal-Wallis test was performed to analyse whether dmft/DMFT was influenced by the severity of MIH. Associations between MIH and dental caries were analysed at child and tooth levels: between and within subjects, respectively. To correlate MIH severity and the occurrence of dental caries, the Cochran-Armitage test was used. The mean age of the children was 9.63 ± 1.29 years. The mean dmft for cases was 1.23 ± 1.99 and for controls 1.71 ± 2.22 (p > 0.05). For the DMFT, the mean scores for cases and controls were 0.45 ± 0.90 and 0.07 ± 0.25, respectively (p < 0.001). The between-subject analysis showed no difference in relation to enamel carious lesions; however, the prevalence of dentine carious lesions was significantly higher in children with MIH than in those without the condition. The same pattern was seen for the within-subject analysis. It was observed that the increase in MIH severity resulted in more teeth being affected by dentine carious lesions (p = 0.0003). Children with MIH presented a higher experience of caries in the permanent dentition than those without the condition. MIH was considered a risk factor for caries development. © 2017 S. Karger AG, Basel.

Evaluation of the Efficacy of Caries Removal Using Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie - An Invitro Comparative Study.

PubMed

Divya, Gaddam; Prasad, Madhu Ghanashyam; Vasa, Aron Arun Kumar; Vasanthi, Done; Ramanarayana, Boyapati; Mynampati, Praffulla

2015-07-01

Dental caries continues to affect a significant portion of the world population and treatment of the decay is associated with pain by many patients. Intervention and application of rotary instruments for treatment of carious lesions has often resulted in considerable removal of tooth structure. Chemo-mechanical method, a minimal invasive technique for caries removal was developed to overcome these shortcomings. This innovative method seems to be efficient in removing infected dentine without altering the healthy dental tissue or harming the adjacent oral mucosa. To evaluate the efficacy and efficiency of Caries removal Using Polymer Bur, Stainless Steel Bur, Carisolv and Papacarie. A total of 120 sectioned specimens were obtained from 60 extracted teeth. Each tooth was sectioned mesiodistally in the center of the carious lesion so that two halves (buccal and lingual or palatal) having equal sized carious lesions are compared. The sectioned specimens were subdivided into four groups (Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie) allotting 30 specimens to each for caries excavation. One-way ANOVA, Chi-square test analysis was done for comparison between groups which showed significant results with Stainless Steel Bur excavation taking less mean time when compared to other agents and Polymer Bur showed more amount of bacterial remnants after excavation whereas Carisolv and Papacarie were efficient with less dentinal tubule destruction and bacterial remnants after excavation. Further inter comparison between groups was done using Paired t-test and Fischer's Exact-test. The Mean time taken by Stainless Steel Bur excavation was found to be less and caused more amount of dentinal tubule destruction when compared to Polymer Bur, Carisolv and Papacarie. Chemo-mechanical methods found to be more efficient with lesser amount of bacterial remnants and dentinal tubule destruction after caries excavation when compared to conventional methods.

Evaluation of the Efficacy of Caries Removal Using Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie – An Invitro Comparative Study

PubMed Central

Prasad, Madhu Ghanashyam; Vasa, Aron Arun Kumar; Vasanthi, Done; Ramanarayana, Boyapati; Mynampati, Praffulla

2015-01-01

Context Dental caries continues to affect a significant portion of the world population and treatment of the decay is associated with pain by many patients. Intervention and application of rotary instruments for treatment of carious lesions has often resulted in considerable removal of tooth structure. Chemo-mechanical method, a minimal invasive technique for caries removal was developed to overcome these shortcomings. This innovative method seems to be efficient in removing infected dentine without altering the healthy dental tissue or harming the adjacent oral mucosa. Aim To evaluate the efficacy and efficiency of Caries removal Using Polymer Bur, Stainless Steel Bur, Carisolv and Papacarie. Materials and Methods A total of 120 sectioned specimens were obtained from 60 extracted teeth. Each tooth was sectioned mesiodistally in the center of the carious lesion so that two halves (buccal and lingual or palatal) having equal sized carious lesions are compared. The sectioned specimens were subdivided into four groups (Polymer Bur, Stainless Steel Bur, Carisolv, Papacarie) allotting 30 specimens to each for caries excavation. Results One-way ANOVA, Chi-square test analysis was done for comparison between groups which showed significant results with Stainless Steel Bur excavation taking less mean time when compared to other agents and Polymer Bur showed more amount of bacterial remnants after excavation whereas Carisolv and Papacarie were efficient with less dentinal tubule destruction and bacterial remnants after excavation. Further inter comparison between groups was done using Paired t-test and Fischer’s Exact-test. Conclusion The Mean time taken by Stainless Steel Bur excavation was found to be less and caused more amount of dentinal tubule destruction when compared to Polymer Bur, Carisolv and Papacarie. Chemo-mechanical methods found to be more efficient with lesser amount of bacterial remnants and dentinal tubule destruction after caries excavation when

Cost-effectiveness model for prevention of early childhood caries.

PubMed

Ramos-Gomez, F J; Shepard, D S

1999-07-01

This study presents and illustrates a model that determines the cost-effectiveness of three successively more complete levels of preventive intervention (minimal, intermediate, and comprehensive) in treating dental caries in disadvantaged children up to 6 years of age. Using existing data on the costs of early childhood caries (ECC), the authors estimated the probable cost-effectiveness of each of the three preventive intervention levels by comparing treatment costs to prevention costs as applied to a typical low-income California child for five years. They found that, in general, prevention becomes cost-saving if at least 59 percent of carious lesions receive restorative treatment. Assuming an average restoration cost of $112 per surface, the model predicts cost savings of $66 to $73 in preventing a one-surface, carious lesion. Thus, all three levels of preventive intervention should be relatively cost-effective. Comprehensive intervention would provide the greatest oral health benefit; however, because more children would receive reparative care, overall program costs would rise even as per-child treatment costs decline.

DIAGNOcam--a Near Infrared Digital Imaging Transillumination (NIDIT) technology.

PubMed

Abdelaziz, Marwa; Krejci, Ivo

2015-01-01

In developed countries, clinical manifestation of carious lesions is changing: instead of dentists being confronted with wide-open cavities, more and more hidden caries are seen. For a long time, the focus of the research community was on finding a method for the detection of carious lesions without the need for radiographs. The research on Digital Imaging Fiber-Optic Transillumination (DIFOTI) has been an active domain. The scope of the present article is to describe a novel technology for caries diagnostics based on Near Infrared Digital Imaging Transillumination (NIDIT), and to give first examples of its clinical indications. In addition, the coupling of NIDIT with a head-mounted retinal image display (RID) to improve clinical workflow is presented. The novel NIDIT technology was shown to be useful as a diagnostic tool in several indications, including mainly the detection of proximal caries and, less importantly, for occlusal caries, fissures, and secondary decay around amalgam and composite restorations. The coupling of this technology with a head-mounted retinal image system allows for its very efficient implementation into daily practice.

Positive immunostaining for feline infectious peritonitis (FIP) in a Sphinx cat with cutaneous lesions and bilateral panuveitis.

PubMed

Bauer, Bianca S; Kerr, Moira E; Sandmeyer, Lynne S; Grahn, Bruce H

2013-07-01

Feline infectious peritonitis (FIP) is a common, fatal, systemic disease of cats. This case report describes the antemortem diagnosis of FIP in a 2-year-old spayed female Sphinx cat that presented with a bilateral panuveitis and multiple papular cutaneous lesions. Histopathologically, the skin lesions were characterized by perivascular infiltrates of macrophages, neutrophils, with fewer plasma cells, mast cells, and small lymphocytes in the mid- to deep dermis. Immunohistochemistry for intracellular feline coronavirus (FeCoV) antigen demonstrated positive staining in dermal macrophages providing an antemortem diagnosis of a moderate, nodular to diffuse, pyogranulomatous perivascular dermatitis due to FIP infection. Obtaining an antemortem diagnosis of FIP can be a challenge and cutaneous lesions are rare in the disease. Recognition and biopsy of any cutaneous lesions in cats with panuveitis and suspected FIP can help establish an antemortem diagnosis of the disease. © 2013 American College of Veterinary Ophthalmologists.

Advanced zinc-doped adhesives for high performance at the resin-carious dentin interface.

PubMed

Toledano, Manuel; Osorio, Raquel; Osorio, Estrella; García-Godoy, Franklin; Toledano-Osorio, Manuel; Aguilera, Fátima S

2016-09-01

The purpose of this study was to evaluate the remineralization ability of an etch-and-rinse Zn-doped resin applied on caries-affected dentin (CAD). CAD surfaces were subjected to: (i) 37% phosphoric acid (PA) or (ii) 0.5M ethylenediaminetetraacetic acid (EDTA). 10wt% ZnO nanoparticles or 2wt% ZnCl2 were added into the adhesive Single Bond (SB), to create the following groups: PA+SB, PA+SB-ZnO, PA+SB-ZnCl2, EDTA+SB, EDTA+SB-ZnO, EDTA+SB-ZnCl2. Bonded interfaces were submitted to mechanical loading or stored during 24h. Remineralization of the bonded interfaces was studied by AFM nano-indentation (hardness and Young׳s modulus), Raman spectroscopy [mapping with principal component analysis (PCA), and hierarchical cluster analysis (HCA)] and Masson׳s trichrome staining technique. Dentin samples treated with PA+SB-ZnO attained the highest values of nano-mechanical properties. Load cycling increased both mineralization and crystallographic maturity at the interface; this effect was specially noticed when using ZnCl2-doped resin in EDTA-treated carious dentin. Crosslinking attained higher frequencies indicating better conformation and organization of collagen in specimens treated with PA+SB-ZnO, after load cycling. Trichrome staining technique depicted a deeper demineralized dentin fringe that became reduced after loading, and it was not observable in EDTA+SB groups. Multivariate analysis confirmed de homogenizing effect of load cycling in the percentage of variances, traces of centroids and distribution of clusters, especially in specimens treated with EDTA+SB-ZnCl2. Copyright © 2016 Elsevier Ltd. All rights reserved.

Voxel-based lesion mapping of meningioma: a comprehensive lesion location mapping of 260 lesions.

PubMed

Hirayama, Ryuichi; Kinoshita, Manabu; Arita, Hideyuki; Kagawa, Naoki; Kishima, Haruhiko; Hashimoto, Naoya; Fujimoto, Yasunori; Yoshimine, Toshiki

2018-06-01

OBJECTIVE In the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques. METHODS Magnetic resonance images obtained in 248 treatment-naïve meningioma patients with 260 lesions were retrospectively and consecutively collected. All images were registered to a 1-mm isotropic, high-resolution, T1-weighted brain atlas provided by the Montreal Neurological Institute (the MNI152), and a lesion frequency map was created, followed by 3D volume rendering to visualize the preferred locations of meningiomas in 3D. RESULTS The 3D lesion frequency map clearly showed that skull base structures such as parasellar, sphenoid wing, and petroclival regions were commonly affected by the tumor. The middle one-third of the superior sagittal sinus was most commonly affected in parasagittal tumors. Substantial lesion accumulation was observed around the leptomeninges covering the central sulcus and the sylvian fissure, with very few lesions observed at the frontal, parietal, and occipital convexities. CONCLUSIONS Using an objective visualization method, meningiomas were shown to be located around the middle third of the superior sagittal sinus, the perisylvian convexity, and the skull base. These observations, which are in line with previous descriptive analyses, justify further use of voxel-based lesion mapping techniques to help understand the biological nature of this disease.

Caries experience of Egyptian adolescents: does the atraumatic restorative treatment approach offer a solution?

PubMed

Mobarak, E H; Shabayek, M M; Mulder, J; Reda, A H; Frencken, J E

2011-01-01

To assess the prevalence and severity of dental caries amongst Egyptian adolescents and the prevalence of carious lesions treatable through the atraumatic restorative treatment (ART) approach. Using a convenient sample procedure, two secondary schools with a dental clinic were selected (967 students, average age: 13.7 ± 0.8 years, range: 12-15). Dental caries was diagnosed using the ART caries criteria, and plaque and calculus were assessed using the Green and Vermillion criteria amongst students grades 1-3 in the dental clinic by 3 calibrated examiners. The effect of the independent variables gender, age, tooth surface, jaw side (left or right) and type of jaw (mandible/maxilla) on dependent caries experience variables and D(2) and D(3) variables were tested using ANOVA. The prevalence of dental caries including enamel lesion (D(2)MFT) amongst the 967 students was 51.4% and that of dental caries excluding enamel lesions (D(3)MFT) was 38.1%. The mean D(2)MFT and D(3)MFT scores were 1.5 and 0.8, respectively. The percentage of teeth filled and extracted was low. Female students had statistically significantly higher mean D(3)MFT/S and D(2)MFT/S scores than males (p < 0.0001). The prevalence of cavitated carious lesions (D(3)) treatable through ART was 48% for score 2 and 28% for score 3. Most of the cavitated lesions were found untreated despite the presence of a dental clinic and a dentist on the school premises. The majority of cavitated lesions without pulp involvement could be treated using the preventive and restorative components of the ART approach. Copyright © 2011 S. Karger AG, Basel.

Transfer learning with convolutional neural networks for lesion classification on clinical breast tomosynthesis

NASA Astrophysics Data System (ADS)

Mendel, Kayla R.; Li, Hui; Sheth, Deepa; Giger, Maryellen L.

2018-02-01

With growing adoption of digital breast tomosynthesis (DBT) in breast cancer screening protocols, it is important to compare the performance of computer-aided diagnosis (CAD) in the diagnosis of breast lesions on DBT images compared to conventional full-field digital mammography (FFDM). In this study, we retrospectively collected FFDM and DBT images of 78 lesions from 76 patients, each containing lesions that were biopsy-proven as either malignant or benign. A square region of interest (ROI) was placed to fully cover the lesion on each FFDM, DBT synthesized 2D images, and DBT key slice images in the cranial-caudal (CC) and mediolateral-oblique (MLO) views. Features were extracted on each ROI using a pre-trained convolutional neural network (CNN). These features were then input to a support vector machine (SVM) classifier, and area under the ROC curve (AUC) was used as the figure of merit. We found that in both the CC view and MLO view, the synthesized 2D image performed best (AUC = 0.814, AUC = 0.881 respectively) in the task of lesion characterization. Small database size was a key limitation in this study, and could lead to overfitting in the application of the SVM classifier. In future work, we plan to expand this dataset and to explore more robust deep learning methodology such as fine-tuning.

Computer-aided classification of mammographic masses using the deep learning technology: a preliminary study

NASA Astrophysics Data System (ADS)

Qiu, Yuchen; Yan, Shiju; Tan, Maxine; Cheng, Samuel; Liu, Hong; Zheng, Bin

2016-03-01

Although mammography is the only clinically acceptable imaging modality used in the population-based breast cancer screening, its efficacy is quite controversy. One of the major challenges is how to help radiologists more accurately classify between benign and malignant lesions. The purpose of this study is to investigate a new mammographic mass classification scheme based on a deep learning method. In this study, we used an image dataset involving 560 regions of interest (ROIs) extracted from digital mammograms, which includes 280 malignant and 280 benign mass ROIs, respectively. An eight layer deep learning network was applied, which employs three pairs of convolution-max-pooling layers for automatic feature extraction and a multiple layer perception (MLP) classifier for feature categorization. In order to improve robustness of selected features, each convolution layer is connected with a max-pooling layer. A number of 20, 10, and 5 feature maps were utilized for the 1st, 2nd and 3rd convolution layer, respectively. The convolution networks are followed by a MLP classifier, which generates a classification score to predict likelihood of a ROI depicting a malignant mass. Among 560 ROIs, 420 ROIs were used as a training dataset and the remaining 140 ROIs were used as a validation dataset. The result shows that the new deep learning based classifier yielded an area under the receiver operation characteristic curve (AUC) of 0.810+/-0.036. This study demonstrated the potential superiority of using a deep learning based classifier to distinguish malignant and benign breast masses without segmenting the lesions and extracting the pre-defined image features.

A finite element model of remote palpation of breast lesions using radiation force: factors affecting tissue displacement.

PubMed

Nightingale, K R; Nightingale, R W; Palmeri, M L; Trahey, G E

2000-01-01

The early detection of breast cancer reduces patient mortality. The most common method of breast cancer detection is palpation. However, lesions that lie deep within the breast are difficult to palpate when they are small. Thus, a method of remote palpation, which may allow the detection of small lesions lying deep within the breast, is currently under investigation. In this method, acoustic radiation force is used to apply localized forces within tissue (to tissue volumes on the order of 2 mm3) and the resulting tissue displacements are mapped using ultrasonic correlation based methods. A volume of tissue that is stiffer than the surrounding medium (i.e., a lesion) distributes the force throughout the tissue beneath it, resulting in larger regions of displacement, and smaller maximum displacements. The resulting displacement maps may be used to image tissue stiffness. A finite-element-model (FEM) of acoustic remote palpation is presented in this paper. Using this model, a parametric analysis of the affect of varying tissue and acoustic beam characteristics on radiation force induced tissue displacements is performed. The results are used to evaluate the potential of acoustic remote palpation to provide useful diagnostic information in a clinical setting. The potential for using a single diagnostic transducer to both generate radiation force and track the resulting displacements is investigated.

Apply lightweight deep learning on internet of things for low-cost and easy-to-access skin cancer detection

NASA Astrophysics Data System (ADS)

Sahu, Pranjal; Yu, Dantong; Qin, Hong

2018-03-01

Melanoma is the most dangerous form of skin cancer that often resembles moles. Dermatologists often recommend regular skin examination to identify and eliminate Melanoma in its early stages. To facilitate this process, we propose a hand-held computer (smart-phone, Raspberry Pi) based assistant that classifies with the dermatologist-level accuracy skin lesion images into malignant and benign and works in a standalone mobile device without requiring network connectivity. In this paper, we propose and implement a hybrid approach based on advanced deep learning model and domain-specific knowledge and features that dermatologists use for the inspection purpose to improve the accuracy of classification between benign and malignant skin lesions. Here, domain-specific features include the texture of the lesion boundary, the symmetry of the mole, and the boundary characteristics of the region of interest. We also obtain standard deep features from a pre-trained network optimized for mobile devices called Google's MobileNet. The experiments conducted on ISIC 2017 skin cancer classification challenge demonstrate the effectiveness and complementary nature of these hybrid features over the standard deep features. We performed experiments with the training, testing and validation data splits provided in the competition. Our method achieved area of 0.805 under the receiver operating characteristic curve. Our ultimate goal is to extend the trained model in a commercial hand-held mobile and sensor device such as Raspberry Pi and democratize the access to preventive health care.

Use of Tubular Retractor for Resection of Deep-Seated Cerebral Tumors and Colloid Cysts: Single Surgeon Experience and Review of the Literature.

PubMed

Eichberg, Daniel G; Buttrick, Simon; Brusko, G Damian; Ivan, Michael; Starke, Robert M; Komotar, Ricardo J

2018-04-01

Brain retraction is often required to develop a surgical corridor during the resection of deep-seated intracranial lesions. Traditional blade retractors distribute pressure asymmetrically and may case local tissue damage. Tubular retractors minimize this pitfall by distributing pressure evenly, which has been shown to translate to significant safety and efficacy data. Further qualified reports regarding the use of tubular retractors are of interest. We performed a retrospective analysis of 1 surgeon's experience with 20 cases of minimally invasive resection with the ViewSite Brain Access System (n = 7) and BrainPath (n = 13) systems. In addition, a comprehensive review of all published cases of tubular retractor systems used for resection of subcortical neoplastic, cystic, infectious, vascular, and hemorrhagic lesions was conducted. Of the 20 cases analyzed, gross total resection was achieved in 18, with an associated 10% immediate postoperative complication rate and 5% long-term complication rate. A comprehensive review of the literature showed 30 articles describing 536 cases of resection of deep neoplastic or colloid cysts with an overall complication rate of 9.1%. Tubular retractor systems have a favorable safety profile and are an important tool in the armamentarium of a neurosurgeon for the resection of deep intracranial lesions. Copyright © 2017 Elsevier Inc. All rights reserved.

Diffusion tensor imaging of early changes in corpus callosum after acute cerebral hemisphere lesions in newborns.

PubMed

Righini, Andrea; Doneda, Chiara; Parazzini, Cecilia; Arrigoni, Filippo; Matta, Ursula; Triulzi, Fabio

2010-11-01

The main purpose was to investigate any early diffusion tensor imaging (DTI) changes in corpus callosum (CC) associated with acute cerebral hemisphere lesions in term newborns. We retrospectively analysed 19 cases of term newborns acutely affected by focal or multi-focal lesions: hypoxic-ischemic encephalopathy, hypoglycaemic encephalopathy, focal ischemic stroke and deep medullary vein associated lesions. DTI was acquired at 1.5 Tesla with dedicated neonatal coil. DTI metrics (apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial λ(∐) and radial λ(⟂) diffusivity) were measured in the hemisphere lesions and in the CC. The control group included seven normal newborns. The following significant differences were found between patients and normal controls in the CC: mean ADC was lower in patients (0.88 SD 0.23 versus 1.18 SD 0.07 μm(2)/s) and so was mean FA (0.50 SD 0.1 versus 0.67 SD 0.05) and mean λ(∐) value (1.61 SD 0.52 versus 2.36 SD 0.14 μm(2)/s). In CC the percentage of ADC always diminished independently of lesion age (with one exception), whereas in hemisphere lesions, it was negative in earlier lesions, but exceeded normal values in the older lesions. CC may undergo early DTI changes in newborns with acute focal or multi-focal hemisphere lesions of different aetiology. Although a direct insult to CC cannot be totally ruled out, DTI changes in CC (in particular λ(∐)) may also be compatible with very early Wallerian degeneration or pre-Wallerian degeneration.

RETINAL DEEP CAPILLARY ISCHEMIA ASSOCIATED WITH AN OCCLUDED CONGENITAL RETINAL MACROVESSEL.

PubMed

Hasegawa, Taiji; Ogata, Nahoko

2017-01-01

To report the case of a patient with an occluded congenital retinal macrovessel accompanied by retinal deep capillary ischemia. A 38-year-old woman presented with a 2-day history of a paracentral scotoma of her right eye. Fundus photograph showed a dilated congenital retinal macrovessel with arteriovenous anastomosis, an intravascular white region indicating the thrombus at arteriovenous anastomotic region, and an area of retinal whitening temporal to the fovea. The spectral domain optical coherence tomography images through the area of retinal whitening showed a thickening and highly reflectivity at the level of the inner nuclear layer, which is likely due to the deep capillary ischemia. After 6 weeks, spectral domain optical coherence tomography images through the same area demonstrated a thinning and atrophy of only the inner nuclear layer, and the patient's paracentral scotoma persisted. Acute capillary hemodynamic changes caused deep capillary ischemia. The spectral domain optical coherence tomography showed a highly reflective lesion at the level of the inner nuclear layer in the acute phase.

Application of radiosurgical techniques to produce a primate model of brain lesions

PubMed Central

Kunimatsu, Jun; Miyamoto, Naoki; Ishikawa, Masayori; Shirato, Hiroki; Tanaka, Masaki

2015-01-01

Behavioral analysis of subjects with discrete brain lesions provides important information about the mechanisms of various brain functions. However, it is generally difficult to experimentally produce discrete lesions in deep brain structures. Here we show that a radiosurgical technique, which is used as an alternative treatment for brain tumors and vascular malformations, is applicable to create non-invasive lesions in experimental animals for the research in systems neuroscience. We delivered highly focused radiation (130–150 Gy at ISO center) to the frontal eye field (FEF) of macaque monkeys using a clinical linear accelerator (LINAC). The effects of irradiation were assessed by analyzing oculomotor performance along with magnetic resonance (MR) images before and up to 8 months following irradiation. In parallel with tissue edema indicated by MR images, deficits in saccadic and smooth pursuit eye movements were observed during several days following irradiation. Although initial signs of oculomotor deficits disappeared within a month, damage to the tissue and impaired eye movements gradually developed during the course of the subsequent 6 months. Postmortem histological examinations showed necrosis and hemorrhages within a large area of the white matter and, to a lesser extent, in the adjacent gray matter, which was centered at the irradiated target. These results indicated that the LINAC system was useful for making brain lesions in experimental animals, while the suitable radiation parameters to generate more focused lesions need to be further explored. We propose the use of a radiosurgical technique for establishing animal models of brain lesions, and discuss the possible uses of this technique for functional neurosurgical treatments in humans. PMID:25964746

Patients with advanced Parkinson's disease with and without freezing of gait: a comparative analysis of vascular lesions using brain MRI.

PubMed

Gallardo, M J; Cabello, J P; Pastor, C; Muñoz-Torrero, J J; Carrasco, S; Ibañez, R; Vaamonde, J

2014-05-01

Freezing of gait (FOG) is one of the most disabling and enigmatic symptoms in Parkinson's disease. Vascular lesions, observed in magnetic resonance imaging (MRI) scans, may produce or exacerbate this symptom. The study includes 22 patients with Parkinson's disease subjects, 12 with freezing of gait and 10 without. All patients underwent an MRI scan and any vascular lesions were analysed using the modified Fazekas scale. Patients with FOG scored higher on the modified Fazekas scale than the rest of the group. Although the two groups contained the same percentage of patients with vascular lesions (50% in both groups), lesion load was higher in the group of patients with FOG. Vascular lesions in the periventricular area and deep white matter seem to be the most involved in the development of FOG. Vascular lesions may contribute to the onset or worsening of FOG in patients with PD. This study suggests that cerebral vascular disease should be considered in patients with FOG. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Unilateral Postoperative Deep Cerebral Venous Thrombosis with Complete Recovery: A Report of 2 Cases.

PubMed

Benifla, Mony; Laughlin, Suzzanne; Tovar-Spinoza, Zulma S; Rutka, James T; Dirks, Peter B

2017-01-01

Postsurgical deep brain venous thrombosis has not been well described in children before. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the internal cerebral veins (ICVs) and the vein of Galen. However, even when they are well preserved during surgery, postoperative hemodynamic changes, mainly in the first 24 h, or surgical manipulation can cause thrombosis of these veins. We report 2 children with unilateral postoperative ICV thrombosis; in 1 of the patients the vein of Galen was also thrombosed. Although both patients had altered sensorium initially, no anticoagulation therapy was given, and they both recovered well. When approaching thalamic or intraventricular lesions, extra care should be taken to prevent injury to the ICV and the vein of Galen. The surgeon should respect the deep brain venous system when approaching midline structures. Both the neurosurgeon and the neuroradiologist should be aware of this possible complication in order to make a prompt diagnosis and to offer proper treatment if needed. © 2017 S. Karger AG, Basel.

Acute hind limb paralysis secondary to an extradural spinal cord Cryptococcus gattii lesion in a dog

PubMed Central

Kurach, Lindsey; Wojnarowicz, Chris; Wilkinson, Tom; Sereda, Colin

2013-01-01

A 2-year-old, spayed female, German short-haired pointer was presented with a 1-day history of non-ambulatory paraplegia with absent deep pain perception. A computed tomography scan revealed an irregular eighth thoracic vertebral body and an extradural compressive lesion. Decompression was performed and abnormal tissues were submitted for analysis. Findings were consistent with a Cryptococcus gattii infection. PMID:24155428

Evolutionary pruning of transfer learned deep convolutional neural network for breast cancer diagnosis in digital breast tomosynthesis.

PubMed

Samala, Ravi K; Chan, Heang-Ping; Hadjiiski, Lubomir M; Helvie, Mark A; Richter, Caleb; Cha, Kenny

2018-05-01

Deep learning models are highly parameterized, resulting in difficulty in inference and transfer learning for image recognition tasks. In this work, we propose a layered pathway evolution method to compress a deep convolutional neural network (DCNN) for classification of masses in digital breast tomosynthesis (DBT). The objective is to prune the number of tunable parameters while preserving the classification accuracy. In the first stage transfer learning, 19 632 augmented regions-of-interest (ROIs) from 2454 mass lesions on mammograms were used to train a pre-trained DCNN on ImageNet. In the second stage transfer learning, the DCNN was used as a feature extractor followed by feature selection and random forest classification. The pathway evolution was performed using genetic algorithm in an iterative approach with tournament selection driven by count-preserving crossover and mutation. The second stage was trained with 9120 DBT ROIs from 228 mass lesions using leave-one-case-out cross-validation. The DCNN was reduced by 87% in the number of neurons, 34% in the number of parameters, and 95% in the number of multiply-and-add operations required in the convolutional layers. The test AUC on 89 mass lesions from 94 independent DBT cases before and after pruning were 0.88 and 0.90, respectively, and the difference was not statistically significant (p  >  0.05). The proposed DCNN compression approach can reduce the number of required operations by 95% while maintaining the classification performance. The approach can be extended to other deep neural networks and imaging tasks where transfer learning is appropriate.

Evolutionary pruning of transfer learned deep convolutional neural network for breast cancer diagnosis in digital breast tomosynthesis

NASA Astrophysics Data System (ADS)

Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.; Richter, Caleb; Cha, Kenny

2018-05-01

Deep learning models are highly parameterized, resulting in difficulty in inference and transfer learning for image recognition tasks. In this work, we propose a layered pathway evolution method to compress a deep convolutional neural network (DCNN) for classification of masses in digital breast tomosynthesis (DBT). The objective is to prune the number of tunable parameters while preserving the classification accuracy. In the first stage transfer learning, 19 632 augmented regions-of-interest (ROIs) from 2454 mass lesions on mammograms were used to train a pre-trained DCNN on ImageNet. In the second stage transfer learning, the DCNN was used as a feature extractor followed by feature selection and random forest classification. The pathway evolution was performed using genetic algorithm in an iterative approach with tournament selection driven by count-preserving crossover and mutation. The second stage was trained with 9120 DBT ROIs from 228 mass lesions using leave-one-case-out cross-validation. The DCNN was reduced by 87% in the number of neurons, 34% in the number of parameters, and 95% in the number of multiply-and-add operations required in the convolutional layers. The test AUC on 89 mass lesions from 94 independent DBT cases before and after pruning were 0.88 and 0.90, respectively, and the difference was not statistically significant (p  >  0.05). The proposed DCNN compression approach can reduce the number of required operations by 95% while maintaining the classification performance. The approach can be extended to other deep neural networks and imaging tasks where transfer learning is appropriate.

Current evidence supporting mucosal healing and deep remission as important treatment goals for inflammatory bowel disease.

PubMed

Pineton de Chambrun, Guillaume; Blanc, Pierre; Peyrin-Biroulet, Laurent

2016-08-01

Mucosal healing (MH) is now considered as a major treatment goal in clinical trials and clinical practice for patients with inflammatory bowel disease (IBD). MH is associated with sustained clinical remission, steroid-free remission, and reduced rates of hospitalization and surgery. There is a well-known disconnect between clinical symptoms and mucosal lesions that is more pronounced in CD. More stringent therapeutic goals have been discussed recently such as deep remission defined as clinical remission associated with MH. Recent international guidelines from the IOIBD recommended deep remission as a treatment goal in clinical practice. However there is no validated definition of deep remission in IBD. Also, the efficacy of available drugs to induce and maintain deep remission in IBD is poorly known. Finally, whether deep remission is the best way to modify the course of IBD and whether it should be achieved before considering drug de-escalation have to be formally evaluated in upcoming disease-modification trials.

Example based lesion segmentation

NASA Astrophysics Data System (ADS)

Roy, Snehashis; He, Qing; Carass, Aaron; Jog, Amod; Cuzzocreo, Jennifer L.; Reich, Daniel S.; Prince, Jerry; Pham, Dzung

2014-03-01

Automatic and accurate detection of white matter lesions is a significant step toward understanding the progression of many diseases, like Alzheimer's disease or multiple sclerosis. Multi-modal MR images are often used to segment T2 white matter lesions that can represent regions of demyelination or ischemia. Some automated lesion segmentation methods describe the lesion intensities using generative models, and then classify the lesions with some combination of heuristics and cost minimization. In contrast, we propose a patch-based method, in which lesions are found using examples from an atlas containing multi-modal MR images and corresponding manual delineations of lesions. Patches from subject MR images are matched to patches from the atlas and lesion memberships are found based on patch similarity weights. We experiment on 43 subjects with MS, whose scans show various levels of lesion-load. We demonstrate significant improvement in Dice coefficient and total lesion volume compared to a state of the art model-based lesion segmentation method, indicating more accurate delineation of lesions.

Photoacoustic imaging of hidden dental caries by using a bundle of hollow optical fibers

NASA Astrophysics Data System (ADS)

Koyama, Takuya; Kakino, Satoko; Matsuura, Yuji

2018-02-01

Photoacoustic imaging system using a bundle of hollow-optical fibers to detect hidden dental caries is proposed. Firstly, we fabricated a hidden caries model with a brown pigment simulating a common color of caries lesion. It was found that high frequency ultrasonic waves are generated from hidden carious part when radiating Nd:YAG laser light with a 532 nm wavelength to occlusal surface of model tooth. We calculated by Fourier transform and found that the waveform from the carious part provides frequency components of approximately from 0.5 to 1.2 MHz. Then a photoacoustic imaging system using a bundle of hollow optical fiber was fabricated for clinical applications. From intensity map of frequency components in 0.5-1.2 MHz, photoacoustic images of hidden caries in the simulated samples were successfully obtained.

Evaluation of the effect of a CO2 laser and fluoride on the reduction of carious lesions progression in primary teeth: an in vitro study

NASA Astrophysics Data System (ADS)

Zancopé, Bruna R.; Cesar, Marina M. C.; Rodrigues, Lidiany K. A.; Nobre-dos-Santos, Marinês

2014-02-01

This study aimed at investigating if CO2 laser irradiation (λ =10.6μm - 11.3 J/cm2) combined with fluoridated products, enhances the CaF2 formation on enamel surface and inhibits lesion progression of demineralized primary enamel. Thus, 135 demineralized primary enamel specimens (DES) were allocated to 9 groups (n=15) as follows: 1- DES only, 2- DES + pH cycling (control), 3- 1.23% acidulated phosphate fluoride gel (APF), 4- 1.23% fluoride foam (FF), 5- 5% fluoride varnish (FV), 6- CO2 Laser (L), 7 - Laser during APF application, 8-Laser during FF application and 9-Laser during FV application. Except for the demineralized enamel group, all specimens were submitted to a 7 day pH cycling regime. The knoop hardness number (KHN) was determined by cross-sectional microhardness analysis. After treatments application, three specimens of each group had their surface examined for CaF2 formation by scanning electron microscopy (SEM). The data was analyzed by ANOVA and Student's t-test (α= 0.05). Enamel mineral loss (ΔS) for groups 1 to 9 were respectively,(8,676.28+/-1,077.46b),(12,419.54+/-1,050.21a),(8,156.80+/-1,279.90b),(8,081.32+/-1,019.69b),(8,820.86+/-1,805. 99b),(8,723.45+/-1,167.14b),(9,003.17+/-796.90b),(8.229,03+/-961.25b),(9,023.32+/-1,1069b). The results showed statistically significant difference between control and all treatments groups (p<0.05). However there was no difference among them (p>0.05). SEM observations showed evidences of melting, fusion and calcium fluoride formation on enamel surface. In conclusion, laser irradiation alone or combined with fluoridated products inhibited lesion progression of demineralized primary enamel surface. However, no synergistic effect was observed when CO2 laser irradiation and fluoridated products application were combined.

Discrimination of Breast Cancer with Microcalcifications on Mammography by Deep Learning.

PubMed

Wang, Jinhua; Yang, Xi; Cai, Hongmin; Tan, Wanchang; Jin, Cangzheng; Li, Li

2016-06-07

Microcalcification is an effective indicator of early breast cancer. To improve the diagnostic accuracy of microcalcifications, this study evaluates the performance of deep learning-based models on large datasets for its discrimination. A semi-automated segmentation method was used to characterize all microcalcifications. A discrimination classifier model was constructed to assess the accuracies of microcalcifications and breast masses, either in isolation or combination, for classifying breast lesions. Performances were compared to benchmark models. Our deep learning model achieved a discriminative accuracy of 87.3% if microcalcifications were characterized alone, compared to 85.8% with a support vector machine. The accuracies were 61.3% for both methods with masses alone and improved to 89.7% and 85.8% after the combined analysis with microcalcifications. Image segmentation with our deep learning model yielded 15, 26 and 41 features for the three scenarios, respectively. Overall, deep learning based on large datasets was superior to standard methods for the discrimination of microcalcifications. Accuracy was increased by adopting a combinatorial approach to detect microcalcifications and masses simultaneously. This may have clinical value for early detection and treatment of breast cancer.

Discrimination of Breast Cancer with Microcalcifications on Mammography by Deep Learning

PubMed Central

Wang, Jinhua; Yang, Xi; Cai, Hongmin; Tan, Wanchang; Jin, Cangzheng; Li, Li

2016-01-01

Microcalcification is an effective indicator of early breast cancer. To improve the diagnostic accuracy of microcalcifications, this study evaluates the performance of deep learning-based models on large datasets for its discrimination. A semi-automated segmentation method was used to characterize all microcalcifications. A discrimination classifier model was constructed to assess the accuracies of microcalcifications and breast masses, either in isolation or combination, for classifying breast lesions. Performances were compared to benchmark models. Our deep learning model achieved a discriminative accuracy of 87.3% if microcalcifications were characterized alone, compared to 85.8% with a support vector machine. The accuracies were 61.3% for both methods with masses alone and improved to 89.7% and 85.8% after the combined analysis with microcalcifications. Image segmentation with our deep learning model yielded 15, 26 and 41 features for the three scenarios, respectively. Overall, deep learning based on large datasets was superior to standard methods for the discrimination of microcalcifications. Accuracy was increased by adopting a combinatorial approach to detect microcalcifications and masses simultaneously. This may have clinical value for early detection and treatment of breast cancer. PMID:27273294

Treating vascular lesions.

PubMed

Astner, Susanne; Anderson, R Rox

2005-01-01

The treatment of acquired vascular lesions is one of the most commonly requested and performed cutaneous laser procedures. Furthermore, every year, 40,000 children are born in the United States each with congenital vascular lesions and malformations. Laser treatment of vascular lesion is based on the principle of selective photothermolysis, conceived in the 1980s. A variety of different lasers and light sources have since been used in the treatment of vascular lesions: lasers with wavelengths between green and yellow, near infrared lasers, and broadband light sources. Despite limitations, this remains the treatment of choice today. This publication addresses acquired and congenital vascular lesions as different entities and proposes a separation of vascular lesions into those that can easily be treated from those where clearance is difficult. Different treatment modalities and the various endpoints of individual vascular lesions will be discussed.

Novel 3-D laparoscopic magnetic ultrasound image guidance for lesion targeting

PubMed Central

Sindram, David; McKillop, Iain H; Martinie, John B; Iannitti, David A

2010-01-01

Objectives: Accurate laparoscopic liver lesion targeting for biopsy or ablation depends on the ability to merge laparoscopic and ultrasound images with proprioceptive instrument positioning, a skill that can be acquired only through extensive experience. The aim of this study was to determine whether using magnetic positional tracking to provide three-dimensional, real-time guidance improves accuracy during laparoscopic needle placement. Methods: Magnetic sensors were embedded into a needle and laparoscopic ultrasound transducer. These sensors interrupted the magnetic fields produced by an electromagnetic field generator, allowing for real-time, 3-D guidance on a stereoscopic monitor. Targets measuring 5 mm were embedded 3–5 cm deep in agar and placed inside a laparoscopic trainer box. Two novices (a college student and an intern) and two experts (hepatopancreatobiliary surgeons) targeted the lesions out of the ultrasound plane using either traditional or 3-D guidance. Results: Each subject targeted 22 lesions, 11 with traditional and 11 with the novel guidance (n = 88). Hit rates of 32% (14/44) and 100% (44/44) were observed with the traditional approach and the 3-D magnetic guidance approach, respectively. The novices were essentially unable to hit the targets using the traditional approach, but did not miss using the novel system. The hit rate of experts improved from 59% (13/22) to 100% (22/22) (P < 0.0001). Conclusions: The novel magnetic 3-D laparoscopic ultrasound guidance results in perfect targeting of 5-mm lesions, even by surgical novices. PMID:21083797

Deep Convolutional Neural Networks for breast cancer screening.

PubMed

Chougrad, Hiba; Zouaki, Hamid; Alheyane, Omar

2018-04-01

Radiologists often have a hard time classifying mammography mass lesions which leads to unnecessary breast biopsies to remove suspicions and this ends up adding exorbitant expenses to an already burdened patient and health care system. In this paper we developed a Computer-aided Diagnosis (CAD) system based on deep Convolutional Neural Networks (CNN) that aims to help the radiologist classify mammography mass lesions. Deep learning usually requires large datasets to train networks of a certain depth from scratch. Transfer learning is an effective method to deal with relatively small datasets as in the case of medical images, although it can be tricky as we can easily start overfitting. In this work, we explore the importance of transfer learning and we experimentally determine the best fine-tuning strategy to adopt when training a CNN model. We were able to successfully fine-tune some of the recent, most powerful CNNs and achieved better results compared to other state-of-the-art methods which classified the same public datasets. For instance we achieved 97.35% accuracy and 0.98 AUC on the DDSM database, 95.50% accuracy and 0.97 AUC on the INbreast database and 96.67% accuracy and 0.96 AUC on the BCDR database. Furthermore, after pre-processing and normalizing all the extracted Regions of Interest (ROIs) from the full mammograms, we merged all the datasets to build one large set of images and used it to fine-tune our CNNs. The CNN model which achieved the best results, a 98.94% accuracy, was used as a baseline to build the Breast Cancer Screening Framework. To evaluate the proposed CAD system and its efficiency to classify new images, we tested it on an independent database (MIAS) and got 98.23% accuracy and 0.99 AUC. The results obtained demonstrate that the proposed framework is performant and can indeed be used to predict if the mass lesions are benign or malignant. Copyright © 2018 Elsevier B.V. All rights reserved.

[Surgical management of deep endometriosis with colorectal involvement: CNGOF-HAS Endometriosis Guidelines].

PubMed

Ballester, M; Roman, H

2018-03-01

Deep endometriosis with colorectal involvement is considered one of the most severe forms of the disease due to its impact on patients' quality of life and fertility but also by the difficulties encountered by the clinicians when proposing a therapeutic strategy. Although the literature is very rich, evidence based medicine remains poor explaining the great heterogeneity concerning the management of such patients. Surgery therefore remains a therapeutic option. It improves the intensity of gynecological, digestive and general symptoms and the quality of life. Concerning the surgical approach, it appears that laparoscopy should be the first option; the laparoscopic robot-assisted route can also be proposed. The techniques of rectal shaving, discoid resection and segmental resection are the three techniques used for surgical excision of colorectal endometriosis. The parameters taken into account for the use of either technique are: the surgeon's experience, the depth of infiltration of the lesion within the rectosigmoid wall, the lesion size and circumference, multifocality and the distance of the lesion from the anal margin. In the case of deep endometriosis with colorectal involvement, performing an incomplete surgery increases the rate of pain recurrence and decreases postoperative fertility. In case of surgery for colorectal endometriosis, pregnancy rates are similar to those obtained after ART in non-operated patients. Existing data are insufficient to formally recommend first line surgery or ART in infertile patients with colorectal endometriosis. The surgery for colorectal endometriosis exposes to a risk of postoperative complications and recurrence of which the patients should be informed preoperatively. Copyright © 2018. Published by Elsevier Masson SAS.

Handlebar palsy--a compression syndrome of the deep terminal (motor) branch of the ulnar nerve in biking.

PubMed

Capitani, Daniel; Beer, Serafin

2002-10-01

We describe 3 patients who developed a severe palsy of the intrinsic ulnar supplied hand muscles after bicycle riding. Clinically and electrophysiologically all showed an isolated lesion of the deep terminal motor branch of the ulnar nerve leaving the hypothenar muscle and the distal sensory branch intact. This type of lesion at the canal of Guyon is quite unusual, caused in the majority of cases by chronic external pressure over the ulnar palm. In earlier reports describing this lesion in bicycle riders, most patients experienced this lesion after a long distance ride. Due to the change of riding position and shape of handlebars (horn handle) in recent years, however, even a single bicycle ride may be sufficient to cause a lesion of this ulnar branch. Especially in downhill riding, a large part of the body weight is supported by the hand on the corner of the handlebar leading to a high load at Guyon's canal. As no sensory fibres are affected, the patients are not aware of the ongoing nerve compression until a severe lesion develops. Individual adaptation of the handlebar and riding position seems to be crucial for prevention of this type of nerve lesion.

Longitudinal survey of the distribution of various serotypes of Streptococcus mutans in infants.

PubMed

Masuda, N; Tsutsumi, N; Sobue, S; Hamada, S

1979-10-01

The establishment of various serotypes of Streptococcus mutans was studied serologically in plaque samples collected from label surfaces of upper primary incisors of 22 infants (starting age, 5 to 13 months) over a period fo 30 months. Clinical examinations were also performed. No clear-cut association between the initiation of dental caries and previous detection of S. mutans was noted. However, all 12 of the infants with caries had S. mutans isolated at some time during the course of this study. The most common serotype isolated at the initial establishment of S. mutans on the tooth surfaces was serotype c, whereas types d, e, and g became established in a few cases. During the test period, changes in the distribution of serotypes of S. mutans were observed in some cases. The initiation of carious lesions could be found in a few cases even when S. mutans comprised about 1% or less of the total streptococcal count of the specimen from the tooth surfaces. Serotype d/g strains tended to develop carious lesions on smooth surfaces, although serotype c was isolated from almost all individuals who developed caries.

A clinical study comparing digital radiography and near-infrared transillumination in caries detection.

PubMed

Berg, Stephen C; Stahl, Jonathan Miles; Lien, Wen; Slack, Casey M; Vandewalle, Kraig S

2018-01-01

The purpose of this study was to compare the effectiveness of detecting proximal carious lesions utilizing a new near-infrared transillumination (NIRTI) system (CariVu, Dexis) to traditional digital bitewing radiography (BWXR). Thirty patients received four posterior BWXRs and all premolars and molars were individually imaged with the NIRTI device. Sixty-seven proximal carious lesions were classified based on their depth into enamel or dentin for both BWXR and NIRTI images. The caries depth classification between the two systems were strongly correlated (r s  = 0.66; Spearman range: 0.60-0.79 = strong) and significant (P < .001) with a median score of 3 for NIRTI and 2 for BWXR. The new NIRTI system (CariVu) may serve as an adjunct to BWXR in the diagnosis of proximal caries. The NIRTI system could serve as an adjunct diagnostic system that could be used in high-caries risk programs where patients are closely monitored with regimented follow-up appointments. NIRTI could also be beneficial with pregnant or pediatric patients, and in situations where radiography may not be available such as remote humanitarian missions. © 2017 Wiley Periodicals, Inc.

The Influence of Insulin Dependent Diabetes Mellitus on Dental Caries and Salivary Flow

PubMed Central

Gupta, V. K.; Malhotra, Seema; Sharma, Vasuda; Hiremath, S. S.

2014-01-01

Objective. To assess whether or not there was any change in the dental caries and rate of salivary flow of patients with Insulin Dependent Diabetes Mellitus (IDDM) and the contribution of salivary flow to caries risk in IDDM. Setting. Department of Endocrinology, MS Ramaiah Hospital, Bangalore, India. Design. A comparative cross-sectional descriptive type. Materials and Methods. The sample consisted of two groups: 140 diabetic group (mean age 14.8 yr) and 140 nondiabetic group (mean age 13.7 yr). Dental caries by dmf(t) and dmf(s) indices for primary dentition and DMF(T) and DMF(S) indices was used in permanent dentition to assess the dental caries experience. Both stimulated and unstimulated salivary flow rate were assessed after collection of saliva. Results. In diabetic group 76% had carious lesion and in nondiabetic group 85.3% had carious lesion. Diabetics have lower mean DMFT, DMFS, dmft, and dmfs compared to the nondiabetic group. Diminished unstimulated and stimulated salivary flow rate in diabetic than nondiabetic group. Conclusions. The findings obtained conclude that even though there was reduced salivary flow rate in diabetic group the caries prevalence was low. PMID:26464864

The Influence of Insulin Dependent Diabetes Mellitus on Dental Caries and Salivary Flow.

PubMed

Gupta, V K; Malhotra, Seema; Sharma, Vasuda; Hiremath, S S

2014-01-01

Objective. To assess whether or not there was any change in the dental caries and rate of salivary flow of patients with Insulin Dependent Diabetes Mellitus (IDDM) and the contribution of salivary flow to caries risk in IDDM. Setting. Department of Endocrinology, MS Ramaiah Hospital, Bangalore, India. Design. A comparative cross-sectional descriptive type. Materials and Methods. The sample consisted of two groups: 140 diabetic group (mean age 14.8 yr) and 140 nondiabetic group (mean age 13.7 yr). Dental caries by dmf(t) and dmf(s) indices for primary dentition and DMF(T) and DMF(S) indices was used in permanent dentition to assess the dental caries experience. Both stimulated and unstimulated salivary flow rate were assessed after collection of saliva. Results. In diabetic group 76% had carious lesion and in nondiabetic group 85.3% had carious lesion. Diabetics have lower mean DMFT, DMFS, dmft, and dmfs compared to the nondiabetic group. Diminished unstimulated and stimulated salivary flow rate in diabetic than nondiabetic group. Conclusions. The findings obtained conclude that even though there was reduced salivary flow rate in diabetic group the caries prevalence was low.

Accuracy of open magnetic resonance imaging for guiding injection of the equine deep digital flexor tendon within the hoof.

PubMed

Groom, Lauren M; White, Nathaniel A; Adams, M Norris; Barrett, Jennifer G

2017-11-01

Lesions of the distal deep digital flexor tendon (DDFT) are frequently diagnosed using MRI in horses with foot pain. Intralesional injection of biologic therapeutics shows promise in tendon healing; however, accurate injection of distal deep digital flexor tendon lesions within the hoof is difficult. The aim of this experimental study was to evaluate accuracy of a technique for injection of the deep digital flexor tendon within the hoof using MRI-guidance, which could be performed in standing patients. We hypothesized that injection of the distal deep digital flexor tendon within the hoof could be accurately guided using open low-field MRI to target either the lateral or medial lobe at a specific location. Ten cadaver limbs were positioned in an open, low-field MRI unit. Each distal deep digital flexor tendon lobe was assigned to have a proximal (adjacent to the proximal aspect of the navicular bursa) or distal (adjacent to the navicular bone) injection. A titanium needle was inserted into each tendon lobe, guided by T1-weighted transverse images acquired simultaneously during injection. Colored dye was injected as a marker and postinjection MRI and gross sections were assessed. The success of injection as evaluated on gross section was 85% (70% proximal, 100% distal). The success of injection as evaluated by MRI was 65% (60% proximal, 70% distal). There was no significant difference between the success of injecting the medial versus lateral lobe. The major limitation of this study was the use of cadaver limbs with normal tendons. The authors conclude that injection of the distal deep digital flexor tendon within the hoof is possible using MRI guidance. © 2017 American College of Veterinary Radiology.

Multispectral near-IR reflectance imaging of simulated early occlusal lesions: Variation of lesion contrast with lesion depth and severity

PubMed Central

Simon, Jacob C.; Chan, Kenneth H.; Darling, Cynthia L.; Fried, Daniel

2014-01-01

Background and Objectives Early demineralization appears with high contrast at near-IR wavelengths due to a ten to twenty fold difference in the magnitude of light scattering between sound and demineralized enamel. Water absorption in the near-IR has a significant effect on the lesion contrast and the highest contrast has been measured in spectral regions with higher water absorption. The purpose of this study was to determine how the lesion contrast changes with lesion severity and depth for different spectral regions in the near-IR and compare that range of contrast with visible reflectance and fluorescence. Materials and Methods Forty-four human molars were used in this in vitro study. Teeth were painted with an acid-resistant varnish, leaving a 4×4 mm window on the occlusal surface of each tooth exposed for demineralization. Artificial lesions were produced in the unprotected windows after 12–48 hr exposure to a demineralizing solution at pH-4.5. Near-IR reflectance images were acquired over several near-IR spectral distributions, visible light reflectance, and fluorescence with 405-nm excitation and detection at wavelengths greater than 500-nm. Crossed polarizers were used for reflectance measurements to reduce interference from specular reflectance. Cross polarization optical coherence tomography (CP-OCT) was used to non-destructively assess the depth and severity of demineralization in each sample window. Matching two dimensional CP-OCT images of the lesion depth and integrated reflectivity were compared with the reflectance and fluorescence images to determine how accurately the variation in the lesion contrast represents the variation in the lesion severity. Results Artificial lesions appear more uniform on tooth surfaces exposed to an acid challenge at visible wavelengths than they do in the near-IR. Measurements of the lesion depth and severity using CP-OCT show that the lesion severity varies markedly across the sample windows and that the lesion

Peranal endoscopic myectomy (PAEM) for rectal lesions with severe fibrosis and exhibiting the muscle-retracting sign.

PubMed

Toyonaga, Takashi; Ohara, Yoshiko; Baba, Shinichi; Takihara, Hiroshi; Nakamoto, Manabu; Orita, Hitoshi; Okuda, Junji

2018-06-08

 Although endoscopic submucosal dissection has enabled complete tumor resection and accurate pathological assessment in a manner that is less invasive than surgery, the complete resection of lesions with severe fibrosis in the submucosal layer and exhibiting the muscle-retracting sign is often difficult. We have devised a new method, peranal endoscopic myectomy (PAEM), for rectal lesions with severe fibrosis, in which dissection is performed between the inner circular and outer longitudinal muscles, and have examined the usefulness and safety of this new technique.  All of the patients who underwent PAEM in our hospital and affiliated hospitals between July 2015 and June 2017 were retrospectively reviewed.  10 rectal lesions were treated with PAEM. En bloc resection with a negative vertical margin was achieved in eight patients (80 %), whose lesions were mucosal (n = 2), shallow submucosal (n = 1), deep submucosal (n = 4), and muscle invasive (n = 1). The clinical course of all patients after PAEM was favorable. In patients who underwent additional surgery, anus preservation was achieved on the basis of the pathological results from PAEM.  PAEM for lesions with severe fibrosis exhibiting the muscle-retracting sign appears to be both safe and useful. © Georg Thieme Verlag KG Stuttgart · New York.

Initial evaluation of an ultrasound measure for assessing the activity of skin lesions in juvenile localized scleroderma.

PubMed

Li, S C; Liebling, M S; Haines, K A; Weiss, J E; Prann, A

2011-05-01

To evaluate the construct validity of 2 proposed measures (the Ultrasound Disease Activity [U-DA] and the Tissue Thickness Score [TTS]) for evaluating sonographic differences in juvenile localized scleroderma skin lesions. We conducted a retrospective review of juvenile localized scleroderma patients who had ultrasound scans of their skin lesions between October 2005 and February 2009. Imaged lesions were classified as active or inactive based upon clinical assessment. Lesions had to have been imaged within 1 month of a clinic visit or have the same clinical assessment during both the visit before and the visit after the scan. Two physicians scored the scans using the U-DA, which scores for differences in lesion echogenicity and vascularity compared with normal tissue. Tissue thickness differences were evaluated by percent differences and by using the TTS. Wilcoxon's rank sum test was performed to assess differences. We studied 52 scans from 21 patients, 32 scans of active skin lesions and 20 scans of inactive skin lesions. Features reported by clinicians as indicative of active disease included erythema, warmth, violaceous color, new lesion, expansion of lesion, and induration. The U-DA was significantly different between active and inactive skin lesions (P = 0.0010) with significant differences found for the parameters of total echogenicity, hypodermis echogenicity, and deep tissue layer vascularity (P = 0.0014, P = 0.0023, and P = 0.0374, respectively). No significant differences were found for tissue layer thickness or TTS. The U-DA may be a useful tool in the identification of localized scleroderma activity. Further study is needed to prospectively evaluate the validity, reliability, and sensitivity of this potential monitoring tool. Copyright © 2011 by the American College of Rheumatology.

Vibration amplitude sonoelastography lesion imaging using low-frequency audible vibration

NASA Astrophysics Data System (ADS)

Taylor, Lawrence; Parker, Kevin

2003-04-01

Sonoelastography or vibration amplitude imaging is an ultrasound imaging technique in which low-amplitude, low-frequency shear waves, less than 0.1-mm displacement and 1-kHz frequency, are propagated deep into tissue, while real time Doppler techniques are used to image the resulting vibration pattern. Finite-element studies and experiments on tissue-mimicking phantoms verify that a discrete hard inhomogeneity present within a larger region of soft tissue will cause a decrease in the vibration field at its location. This forms the basis for tumor detection using sonoelastography. Real time relative imaging of the vibration field is possible because a vibrating particle will phase modulate an ultrasound signal. The particle's amplitude is directly proportional to the spectral spread of the reflected Doppler echo. Real time estimation of the variance of the Doppler power spectrum at each pixel allows the vibration field to be imaged. Results are shown for phantom lesions, thermal lesions, and 3-D in vitro and 2-D in vivo prostate cancer. MRI and whole mount histology is used to validate the system accuracy.

Potential Role of Semaphorin 3A and Its Receptors in Regulating Aberrant Sympathetic Innervation in Peritoneal and Deep Infiltrating Endometriosis

PubMed Central

Liang, Yanchun; Wang, Wei; Huang, Jiaming; Tan, Hao; Liu, Tianyu; Shang, Chunliang; Liu, Duo; Guo, Luyan; Yao, Shuzhong

2015-01-01

Previous studies have demonstrated the involvement of nerve repellent factors in regulation of the imbalanced innervation of endometriosis. This prospective study aims to explore the role of Sema 3A in regulating aberrant sympathetic innervation in peritoneal and deep infiltrating endometriosis. Ectopic endometriotic lesion were collected from patients with peritoneal endometriosis (n = 24) and deep infiltrating endometriosis of uterosacral ligament (n = 20) undergoing surgery for endometriosis. Eutopic endometrial samples were collected from patients with endometriosis (n = 22) or without endometriosis (n = 26). Healthy peritoneum (n = 13) from the lateral pelvic wall and healthy uterosacral ligament (n = 13) were obtained from patients who had no surgical and histological proof of endometriosis during hysterectomy for uterine fibroids. Firstly, we studied the immunostaining of Sema 3A, Plexin A1 and NRP-1 in all the tissues described above. Then we studied the nerve fiber density (NFD) of endometriosis-associated (sympathetic) nerve and para-endometriotic (sympathetic) nerve by double immunofluorescence staining. Finally we analyzed the relationship between expression of Sema 3A in stromal cells of endometriotic lesion and the aberrant innervation of endometriosis. Semi-quantitative immunostaining demonstrated that (1) Higher immunostaining of Sema 3A were found in the eutopic endometrial glandular epithelial cells from patients with endometriosis (p = 0.041) than those without endometriosis; (2) Sema 3A immunostaining was higher in glandular epithelial cells of peritoneal endometriosis (P<0.001) and deep infiltrating endometriotic lesions of uterosacral ligament (P = 0.028)compared with glandular epithelial cells of the endometrium from women with endometriosis, while its expression in ectopic stormal cells in both groups were significantly lower than that from eutopic endometrium of women without endometirosis (P<0.001, P<0.001, respectively). NFDs of Anti

Phase Transformations in a Human Tooth Tissue at the Initial Stage of Caries

PubMed Central

Prutskij, Tatiana; Ippolitov, Yury

2015-01-01

The aim of the paper is to study phase transformations in solid tissues of the human teeth during the development of fissure caries by Raman and fluorescence microspectroscopy. The study of the areas with fissure caries confirmed the assumption of the formation of a weak interaction between phosphate apatite enamel and organic acids (products of microorganisms). The experimental results obtained with by Raman microspectroscopy showed the formation of dicalcium phosphate dihydrate - CaHPO4-2H2O in the area of mural demineralization of carious fissure. A comparative analysis of structural and spectroscopic data for the intact and carious enamel shows that emergence of a more soluble phase - carbonate-substituted hydroxyapatite - is typical for the initial stage of caries. It is shown that microareas of dental hard tissues in the carious fissure due to an emerging misorientation of apatite crystals have a higher fluorescence yield than the area of the intact enamel. These areas can be easily detected even prior to a deep demineralization (white spot stage) for the case of irreversibly changed organomineral complex and intensive removal of the mineral component. PMID:25901743

Image-guided removal of occlusal caries lesions with a λ= 9.3-µm CO2 laser using near-IR transillumination

PubMed Central

Chung, Leon C.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Fried, Daniel; Darling, Cynthia L.

2015-01-01

Previous studies have shown that near-IR transillumination is well suited for imaging deep occlusal lesions. The purpose of this study was to determine if near-IR images can be used to guide a CO2 laser for the selective removal of natural occlusal lesions on extracted teeth. Near-IR occlusal transillumination images of extracted human teeth with natural occlusal caries lesions were acquired using an InGaAs camera and near-IR light at wavelengths from 1290 to 1470-nm from a filtered tungsten halogen source. A CO2 laser operating at 9.3-µm with a pulse duration of 10–15-µs and a pulse repetition rate of 100–300-Hz was used for caries removal. Optical Coherence tomography was used to confirm lesion presence and serial scans were used to assess selective removal. Teeth were also sectioned for histological examination using polarized light microscopy. This study suggests that near-infrared transillumination is a promising method for the image guided laser ablation of occlusal caries lesions but the use of serial near-IR transillumination imaging for monitoring lesion removal was limited. PMID:25914498

Use of new minimum intervention dentistry technologies in caries management.

PubMed

Tassery, H; Levallois, B; Terrer, E; Manton, D J; Otsuki, M; Koubi, S; Gugnani, N; Panayotov, I; Jacquot, B; Cuisinier, F; Rechmann, P

2013-06-01

Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the

Cervical dentin hypersensitivity: a cross-sectional investigation in Athens, Greece.

PubMed

Rahiotis, C; Polychronopoulou, A; Tsiklakis, K; Kakaboura, A

2013-12-01

The purpose of this study was to identify the prevalence of cervical dentin hypersensitivity in a cross-sectional investigation of Greek adults. Seven hundred and sixty-seven subjects were examined. Participants were patients processed for first examination in the Clinic of Oral Diagnosis and Radiology at the Faculty of Dentistry, University of Athens. The evaluation of hypersensitivity was performed using two methods: for each tooth, the response to a) tactile stimulus and b) air-blast stimulus was measured. Additional factors such as smoking habits, oral health behaviour, consumption of acidic foods, type of toothbrush, daily use of fluoride solution and of desensitising toothpaste, gingival recession and non-carious cervical lesions were recorded and evaluated as causative factors. Descriptive statistics on the demographics of the study sample, of oral health behaviour characteristics and of oral examination findings were performed. Comparisons of these characteristics in the presence or absence of hypersensitivity were conducted with the chi-square test. Data were further analysed using multiple logistic regression modelling. Among study participants, 21·3% had at least one cervical dentin hypersensitivity reaction to the tactile stimulus, and 38·6%, to the air-blast stimulus. Multivariate analysis detected association of the hypersensitivity in tactile or air-blast stimulus with the non-carious lesions and with the gingival recessions. Additionally, a relation between hypersensitivity and air-blast stimulus with gender (female) was found. There was no association between the hypersensitivity in both of the stimuli and the level of education, smoking, consumption of acidic foods, type of toothbrush and daily use of fluoride solution or desensitising toothpaste. The overall prevalence of cervical dentin hypersensitivity in the adult population in Athens ranged from 21·3% to 38·6% depending on the type of stimuli. Cervical non-carious lesions and gingival

Association of Deep Gray Matter Damage With Cortical and Spinal Cord Degeneration in Primary Progressive Multiple Sclerosis.

PubMed

Ruggieri, Serena; Petracca, Maria; Miller, Aaron; Krieger, Stephen; Ghassemi, Rezwan; Bencosme, Yadira; Riley, Claire; Howard, Jonathan; Lublin, Fred; Inglese, Matilde

2015-12-01

The investigation of cortical gray matter (GM), deep GM nuclei, and spinal cord damage in patients with primary progressive multiple sclerosis (PP-MS) provides insights into the neurodegenerative process responsible for clinical progression of MS. To investigate the association of magnetic resonance imaging measures of cortical, deep GM, and spinal cord damage and their effect on clinical disability. Cross-sectional analysis of 26 patients with PP-MS (mean age, 50.9 years; range, 31-65 years; including 14 women) and 20 healthy control participants (mean age, 51.1 years; range, 34-63 years; including 11 women) enrolled at a single US institution. Clinical disability was measured with the Expanded Disability Status Scale, 9-Hole Peg Test, and 25-Foot Walking Test. We collected data from January 1, 2012, through December 31, 2013. Data analysis was performed from January 21 to April 10, 2015. Cortical lesion burden, brain and deep GM volumes, spinal cord area and volume, and scores on the Expanded Disability Status Scale (score range, 0 to 10; higher scores indicate greater disability), 9-Hole Peg Test (measured in seconds; longer performance time indicates greater disability), and 25-Foot Walking Test (test covers 7.5 m; measured in seconds; longer performance time indicates greater disability). The 26 patients with PP-MS showed significantly smaller mean (SD) brain and spinal cord volumes than the 20 control group patients (normalized brain volume, 1377.81 [65.48] vs 1434.06 [53.67] cm3 [P = .003]; normalized white matter volume, 650.61 [46.38] vs 676.75 [37.02] cm3 [P = .045]; normalized gray matter volume, 727.20 [40.74] vs 757.31 [38.95] cm3 [P = .02]; normalized neocortical volume, 567.88 [85.55] vs 645.00 [42.84] cm3 [P = .001]; normalized spinal cord volume for C2-C5, 72.71 [7.89] vs 82.70 [7.83] mm3 [P < .001]; and normalized spinal cord volume for C2-C3, 64.86 [7.78] vs 72.26 [7.79] mm3 [P =.002]). The amount of damage in deep GM structures, especially

Clinical applications of the Er:YAG laser in cariology and oral surgery

NASA Astrophysics Data System (ADS)

Keller, Ulrich; Hibst, Raimund

1995-04-01

For the treatment of carious decays of enamel and dentin the Er:YAG laser is preferred in comparison to other laser systems, because of the thermomechanical process. Cavity preparation as well as removal of secondary carious lesions without thermal damage to the tooth hard substances and the pulp is possible. Clinical studies have shown that the pain perception is less than by drilling with the mechanical burr. From experimental studies it can be concluded, that the Er:YAG laser can possibly substitute the acid etching technique in conditioning the tooth surface. Further indications can be given in oral surgery for incision or excision of benign mucosal diseases and for cutting bone. As an advantage, opposite to other thermal laser systems, the wound healing process is very similar to the wound healing after mechanical cutting by the scalpel or by the burr.

Management of an endo-perio lesion in an immature tooth using autologous platelet-rich fibrin: a case report.

PubMed

Nagaveni, N B; Kumari, K Nandini; Poornima, P; Reddy, V V Subba

2015-01-01

Treatment of an endo-perio lesion involving a non-vital young permanent tooth is a highly challenging task to Pediatric Dentists. There is a quest for the newer biological approach to management of these lesions as traditional methods have various disadvantages. Recently, platelet-rich fibrin (PRF), a second-generation platelet concentrate, is rich in growth factors have been used in the periodontal regeneration procedure. The purpose of this paper is to describe the efficacy of PRF in the treatment of a deep intra bony defect associated with an endo-perio lesion in an immature right mandibular first premolar of 12-year-old female patient. A freshly prepared autologous PRF membrane was placed in the bony defect following debridement. Clinical and radiographic follow-up were performed at regular intervals that revealed absence of pain, gain in clinical attachment level, reduction in probing depth, and excellent bone regeneration indicating successful outcome.

Image-guided removal of occlusal caries lesions with a λ= 9.3-μm CO2 laser using near-IR transillumination

NASA Astrophysics Data System (ADS)

Chung, Leon C.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Fried, Daniel; Darling, Cynthia L.

2015-02-01

Previous studies have shown that near-IR transillumination is well suited for imaging deep occlusal lesions. The purpose of this study was to determine if near-IR images can be used to guide a CO2 laser for the selective removal of natural occlusal lesions on extracted teeth. Near-IR occlusal transillumination images of extracted human teeth with natural occlusal caries lesions were acquired using an InGaAs camera and near-IR light at wavelengths from 1290 to 1470-nm from a filtered tungsten halogen source. A CO2 laser operating at 9.3-μm with a pulse duration of 10-15-μs and a pulse repetition rate of 100-300-Hz was used for caries removal. Optical Coherence tomography was used to confirm lesion presence and serial scans were used to assess selective removal. Teeth were also sectioned for histological examination using polarized light microscopy. This study suggests that near-infrared transillumination is a promising method for the image guided laser ablation of occlusal caries lesions but the use of serial near-IR transillumination imaging for monitoring lesion removal was limited.

The mortality and morbidity of deep sea fishermen sailing from Grimsby in one year1

PubMed Central

Moore, S. R. W.

1969-01-01

Moore, S. R. W. (1969).Brit. J. industr. Med.,26, 25-46. The mortality and morbidity of deep sea fishermen sailing from Grimsby in one year. The injuries, illnesses, and deaths of Grimsby deep sea fishermen in the year 1963 have been studied using the trawler log-book as the basic source of information. Additional information has been obtained from other sources. The numbers of man-days sailed by Grimsby deep sea fishermen, by age and rating in 1963, have been ascertained. From these, incapacity rates for the measurement of morbidity due to injury and illness, and the mortality rate, have been calculated. There were 14 deaths, six due to accidental causes and eight to natural causes, giving a mortality rate of 5·7 per 1,000 for Grimsby deep sea fishermen in 1963. In a year when there was no foundering or loss of Grimsby trawlers, the fatal accident rate of Grimsby trawlermen was more than twice that of fishermen of the United Kingdom, four times the rate for miners, and 40 times that for the manufacturing industries. The most common injuries were, in order of incidence, contusions of varying degrees of severity, infected lesions, sprains and strains, lacerations, and fractures. More than half (56·3%) of the trawlermen were incapacitated by their injuries. The highest rates of incapacity were caused by fractures, contusions, and infected lesions. The upper limb, especially the hands and fingers, was most often affected, resulting most commonly in infected lesions. Third hands, mates, deck hands, deck trimmers, and deck learners had the highest incapacity rates due to injury. Third hands are especially at risk to injury. Most injuries and two deaths caused by casualties to boats occurred in fires aboard trawlers. The most common illnesses suffered by trawlermen were gastrointestinal, respiratory, and skin diseases. Illness caused incapacity in 68·8% of the trawlermen affected. The greatest incapacity was due to gastrointestinal, cardiac, psychiatric, and

A Fourier Transform Infrared Spectroscopy Analysis of Carious Dentin from Transparent Zone to Normal Zone

PubMed Central

Liu, Y.; Yao, X.; Liu, Y.W.; Wang, Y.

2015-01-01

It is well known that caries invasion leads to the differentiation of dentin into zones with altered composition, collagen integrity and mineral identity. However, understanding of these changes from the fundamental perspective of molecular structure has been lacking so far. In light of this, the present work aims to utilize Fourier transform infrared spectroscopy (FTIR) to directly extract molecular information regarding collagen's and hydroxyapatite's structural changes as dentin transitions from the transparent zone (TZ) into the normal zone (NZ). Unembedded ultrathin dentin films were sectioned from carious teeth, and an FTIR imaging system was used to obtain spatially resolved FTIR spectra. According to the mineral-to-matrix ratio image generated from large-area low-spectral-resolution scan, the TZ, the NZ and the intermediate subtransparent zone (STZ) were identified. High-spectral-resolution spectra were taken from each zone and subsequently examined with regard to mineral content, carbonate distribution, collagen denaturation and carbonate substitution patterns. The integrity of collagen's triple helical structure was also evaluated based on spectra collected from demineralized dentin films of selected teeth. The results support the argument that STZ is the real sclerotic layer, and they corroborate the established knowledge that collagen in TZ is hardly altered and therefore should be reserved for reparative purposes. Moreover, the close resemblance between the STZ and the NZ in terms of carbonate content, and that between the STZ and the TZ in terms of being A-type carbonate-rich, suggest that the mineral that initially occludes dentin tubules is hydroxyapatite newly generated from odontoblastic activities, which is then transformed into whitlockite in the demineralization/remineralization process as caries progresses. PMID:24556607

A Fourier transform infrared spectroscopy analysis of carious dentin from transparent zone to normal zone.

PubMed

Liu, Y; Yao, X; Liu, Y W; Wang, Y

2014-01-01

It is well known that caries invasion leads to the differentiation of dentin into zones with altered composition, collagen integrity and mineral identity. However, understanding of these changes from the fundamental perspective of molecular structure has been lacking so far. In light of this, the present work aims to utilize Fourier transform infrared spectroscopy (FTIR) to directly extract molecular information regarding collagen's and hydroxyapatite's structural changes as dentin transitions from the transparent zone (TZ) into the normal zone (NZ). Unembedded ultrathin dentin films were sectioned from carious teeth, and an FTIR imaging system was used to obtain spatially resolved FTIR spectra. According to the mineral-to-matrix ratio image generated from large-area low-spectral-resolution scan, the TZ, the NZ and the intermediate subtransparent zone (STZ) were identified. High-spectral-resolution spectra were taken from each zone and subsequently examined with regard to mineral content, carbonate distribution, collagen denaturation and carbonate substitution patterns. The integrity of collagen's triple helical structure was also evaluated based on spectra collected from demineralized dentin films of selected teeth. The results support the argument that STZ is the real sclerotic layer, and they corroborate the established knowledge that collagen in TZ is hardly altered and therefore should be reserved for reparative purposes. Moreover, the close resemblance between the STZ and the NZ in terms of carbonate content, and that between the STZ and the TZ in terms of being A-type carbonate-rich, suggest that the mineral that initially occludes dentin tubules is hydroxyapatite newly generated from odontoblastic activities, which is then transformed into whitlockite in the demineralization/remineralization process as caries progresses. © 2014 S. Karger AG, Basel.

Use of a compact fiber optic spectrometer for spectral feedback during the laser ablation of dental hard tissues and restorative materials

NASA Astrophysics Data System (ADS)

Cheng, Joyce Y.; Fan, Kenneth; Fried, Daniel

2006-02-01

One perceived disadvantage of caries removal using lasers is the loss of the tactile feedback associated with the handpiece. However, alternative methods of acoustic and optical feedback become available with the laser that can be exploited to provide information about the chemical composition of the material ablated, the ablation efficiency and rate, the depth of the incision, and the surface and plume temperature during ablation. Such information can be used to increase the selectivity of ablation, avoid peripheral thermal damage and excessive heat deposition in the tooth, and provide a mechanism of robotic automation. The objective of this study was to test the hypothesis that a compact fiberoptic spectrometer could be used to differentiate between the ablation of sound and carious enamel and dentin and between dental hard tissues and composite. Sound and carious tooth surfaces along with composite restorative materials were scanned with λ=0.355, 2.79 and 9.3 μm laser pulses at irradiation intensities ranging from 0.5-100 J/cm2 and spectra were acquired from λ=250-900-nm using a compact fiber-optic spectrometer. Emission spectra varied markedly with the laser wavelength and pulse duration. Optical feedback was not successful in differentiating between sound and carious enamel and dentin even with the addition of various chromophores to carious lesion areas. However, the spectral feedback was successfully used to differentiate between composites and sound enamel and dentin enabling the selective removal of composite from tooth surfaces using a computer controlled λ=9.3-μm pulsed CO II laser and scanning system.

Complete genome sequence of Streptococcus mutans GS-5, a serotype c strain.

PubMed

Biswas, Saswati; Biswas, Indranil

2012-09-01

Streptococcus mutans, a principal causative agent of dental caries, is considered to be the most cariogenic among all oral streptococci. Of the four S. mutans serotypes (c, e, f, and k), serotype c strains predominate in the oral cavity. Here, we present the complete genome sequence of S. mutans GS-5, a serotype c strain originally isolated from human carious lesions, which is extensively used as a laboratory strain worldwide.

Dental findings and treatment in consanguinity associated congenital chronic familial neutropenia.

PubMed

Buduneli, Nurcan; Cogulu, Dilsah; Kardesler, Levent; Kütükçüler, Necil

2006-01-01

The purpose of this report is to describe dental findings and treatment of an 11-year old male patient and a 5-year old female patient, children of first cousins, suffering from severe benign congenital chronic familial neutropenia. This case report emphazises the importance of differential diagnosis of immunodeficiencies including congenital chronic familial neutropenia in the background of severe periodontal diseases and/or diffuse carious lesions in children.

INVESTIGATING THE MANAGEMENT OF CARIOUS PRIMARY TEETH IN GENERAL DENTAL PRACTICE: AN OVERVIEW OF THE DEVELOPMENT AND CONDUCT OF THE FICTION TRIAL.

PubMed

Stewart, Matthew; Keightley, Alexander; Maguire, Anne; Chadwick, Barbara; Vale, Luke; Homer, Tara; Douglas, Gail; Deery, Chris; Marshman, Zoe; Ryan, Vicky; Innes, Nicola

2015-11-01

The management of carious primary teeth is a challenge for patients, parents and clinicians. Most evidence supporting different management strategies originates from a specialist setting and therefore its relevance to the primary care setting is questionable. The UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) has commissioned the FiCTION (Filling Children's Teeth: Indicated Or Not?) trial; a multi-centre primary dental care randomised controlled trial (RCT) to determine the most clinically and cost- effective approach to managing caries in the primary dentition in the UK. This large trial began in 2012, is due to be completed in late 2017 and involves 72 practices and 1,124 children initially aged three to seven years with dentine caries, following randomisation to one of three caries management strategies. Clinical, radiographic, quality of life, treatment acceptability and health economics data are collected during the three-year follow up period. This article provides an overview of the development and conduct of FiCTION and discusses some approaches adopted to manage challenges and achieve the patient recruitment target.

Morel-Lavallee Lesion: Case Report with Review of Literature.

PubMed

Padmanabhan, Elamparidhi; Rudrappa, Ramesh Kumar; Bhavishya, Talluri; Rajakumar, Sibhithran; Selvakkalanjiyam, Sivaranjinie

2017-07-01

Morel-Lavallee lesions are closed degloving soft tissue injuries which occur because of trauma and in which the skin and subcutaneous tissue are separated from superficial fascia. This shear trauma results in creation of a potential space filled with serosanguinous fluid, blood and necrotic fat. We discuss a case of 52-year-old female with history of trauma one week back, who presented with a boggy swelling over the postero-lateral aspect of proximal forearm and distal arm. Local examination showed fluctuating fluid collection. MRI showed variable intensity fluid collection in a potential space between the subcutaneous tissue and deep fascia in arm and forearm. Percutaneous decompression and evacuation of the collection with systemic antibiotic therapy resulted in rapid improvement.

Lesion site patterns in severe, nonverbal aphasia to predict outcome with a computer-assisted treatment program.

PubMed

Naeser, M A; Baker, E H; Palumbo, C L; Nicholas, M; Alexander, M P; Samaraweera, R; Prete, M N; Hodge, S M; Weissman, T

1998-11-01

To test whether lesion site patterns in patients with chronic, severe aphasia who have no meaningful spontaneous speech are predictive of outcome following treatment with a nonverbal, icon-based computer-assisted visual communication (C-ViC) program. Retrospective study in which computed tomographic scans performed 3 months after onset of stroke and aphasia test scores obtained before C-ViC therapy were reviewed for patients after receiving C-ViC treatment. A neurology department and speech pathology service of a Department of Veterans Affairs medical center and a university aphasia research center. Seventeen patients with stroke and severe aphasia who began treatment with C-ViC from 3 months to 10 years after onset of stroke. Level of ability to use C-ViC on a personal computer to communicate. All patients with bilateral lesions failed to learn C-ViC. For patients with unilateral left hemisphere lesion sites, statistical analyses accurately discriminated between those who could initiate communication with C-ViC from those who were only able to answer directed questions. The critical lesion areas involved temporal lobe structures (Wernicke cortical area and the subcortical temporal isthmus), supraventricular frontal lobe structures (supplementary motor area or cingulate gyrus 24), and the subcortical medial subcallosal fasciculus, deep to the Broca area. Specific lesion sites were also identified for appropriate candidacy for C-ViC. Lesion site patterns on computed tomographic scans are helpful to define candidacy for C-ViC training, and to predict outcome level. A practical method is presented for clinical application of these lesion site results in combination with aphasia test scores.

Earliest evidence of dental caries manipulation in the Late Upper Palaeolithic

PubMed Central

Oxilia, Gregorio; Peresani, Marco; Romandini, Matteo; Matteucci, Chiara; Spiteri, Cynthianne Debono; Henry, Amanda G.; Schulz, Dieter; Archer, Will; Crezzini, Jacopo; Boschin, Francesco; Boscato, Paolo; Jaouen, Klervia; Dogandzic, Tamara; Broglio, Alberto; Moggi-Cecchi, Jacopo; Fiorenza, Luca; Hublin, Jean-Jacques; Kullmer, Ottmar; Benazzi, Stefano

2015-01-01

Prehistoric dental treatments were extremely rare, and the few documented cases are known from the Neolithic, when the adoption of early farming culture caused an increase of carious lesions. Here we report the earliest evidence of dental caries intervention on a Late Upper Palaeolithic modern human specimen (Villabruna) from a burial in Northern Italy. Using Scanning Electron Microscopy we show the presence of striations deriving from the manipulation of a large occlusal carious cavity of the lower right third molar. The striations have a “V”-shaped transverse section and several parallel micro-scratches at their base, as typically displayed by cutmarks on teeth. Based on in vitro experimental replication and a complete functional reconstruction of the Villabruna dental arches, we confirm that the identified striations and the associated extensive enamel chipping on the mesial wall of the cavity were produced ante-mortem by pointed flint tools during scratching and levering activities. The Villabruna specimen is therefore the oldest known evidence of dental caries intervention, suggesting at least some knowledge of disease treatment well before the Neolithic. This study suggests that primitive forms of carious treatment in human evolution entail an adaptation of the well-known toothpicking for levering and scratching rather than drilling practices. PMID:26179739

Emerging technologies for diagnosis of dental caries: The road so far

NASA Astrophysics Data System (ADS)

Amaechi, Bennett T.

2009-05-01

It is now universally recognized that the development of new technologies for early detection and quantitative monitoring of dental decay at an early stage of formation could provide health and economic benefits ranging from timely preventive interventions to reduction in the time required for clinical trials of anticaries agents. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time. The need and the importance of these technologies were also discussed. The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, and in vitro and in vivo studies. References have been traced manually by MEDLINE® or through manufacturer's websites. While some of the devices are fully developed and commercially available, others are still under development. The devices vary in their modes of action as well as their capability as caries diagnostic aids. It is clear that the differences in caries presentations and behavior in different anatomical sites make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection of carious lesions for all sites; a combination of diagnostic tools will help us diagnose lesions earlier and detect failing restorations sooner, all to avoid more costly, destructive dental procedures and truly take dentistry into the preventive rather than the reactive mode.

Shades of Decay: The Meanings of Tooth Discoloration and Deterioration to Mexican Immigrant Caregivers of Young Children

PubMed Central

Masterson, Erin E.; Barker, Judith C.; Hoeft, Kristin S.; Hyde, Susan

2014-01-01

The objective of this article is to investigate parental understanding of tooth discoloration and decay and their related care seeking for young, Mexican-American children. The research design entailed semi-structured, face-to-face interviews conducted in Spanish with a convenience sample of 37 Mexican immigrant mothers of young children in a low-income urban neighborhood. Five major color terms – white, off-white, yellow, brown, and black – were used to describe tooth discoloration, the causes of which were mainly unrecognized or attributed to poor oral hygiene and exposure to sweet substances. Mothers also described three major levels of deterioration of the structural integrity of teeth due to caries, from stains to decayed portions to entirely rotten. A trend was observed between use of darker discoloration terms and extensive carious lesions. Teeth described as both dark in color and structurally damaged resulted in seeking of professional care. The paper concludes with the finding that Spanish terms used to describe tooth discoloration and carious lesions are broad and complex. Mexican immigrant mothers’ interpretations of tooth discoloration and decay may differ from dental professionals’ and result in late care seeking. Increased understanding between dental practitioners and caregivers is needed to create educational messages about the early signs of tooth decay. PMID:26279585

[Tooth decay: epidemiological and therapeutic aspects in dental service of University Teaching Hospital Yalgado Ouedraogo and Municipal Centre of Oral Health].

PubMed

Ouedraogo, Y; Kabore, W A D; Konsem, T; Fall, M; Millogo, M; Ouattara, S; Ouedraogo, D

2015-12-01

In order to improve the prevention and treatment of dental caries in Burkina Faso, we conducted a study on the epidemiological and therapeutic aspects of dental caries in the dental services of University Teaching Hospital Yalgado Ouedraogo and in the Municipal Centre of Oral Health of Ouagadougou. A prospective and descriptive study from October, 15th 2012 to January, 15th 2013 was conducted on a sample of 191 patients. The variables recorded were: patient's identity, age, sex, area of residence, food mode, socioeconomic level, reason for consultation, oral hygiene, DMFT index, degree of tissue damage, the topography of the carious lesions and the applied therapy. Caries prevalence was 93.19% more female consultations, with sex ratio at 0.77. The average age was 31 years for a sample often engaged in trade and the informal sector. Carious lesions were usually limited to less than 4 teeth. The main motivation for the consultation was pain at 82.20%. The use of preventive care is quite low in our population. Extractions still occupy an important part of treatment. We need to improve oral hygiene and show to patients the necessity of routine visits to the dentist every year for early treatment.

Effects of tung oil on salivary viscosity and extent and incidence of dental caries in rats.

PubMed

Biesbrock, A R; Dirksen, T; Schuster, G

1992-01-01

Increased salivary viscosity may be associated with an increase in dental caries. In order to examine this relationship, the caries level in rats was monitored following gastric intubation with tung oil which has been shown to significantly increase salivary viscosity. Tung oil intubation over an 8-week period significantly increased the salivary viscosity in rats as compared with deoinized water and corn oil intubation. The total number of carious lesions was significantly increased (p less than 0.05) in the tung oil intubated rats as compared with the two other groups. This increase in carious lesions was primarily associated with the smooth surfaces of the teeth. There was also a significant increase (p less than 0.05) in the extent of enamel and dentin involvement of the tung oil intubated rats as compared with the other two groups. Histologic examination of the submandibular glands revealed an increase in the amount of glycoprotein material in the convoluted granular tubules of the tung oil intubated rats as compared with the deionized water and corn oil intubated animals. Collectively, these results suggest that tung oil intubation is correlated with both increased salivary viscosity and increased smooth-surface dental caries, suggesting that the viscosity may be related to dental caries progression.

Uterine Vascular Lesions

PubMed Central

Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

2013-01-01

Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

Deep magnetic capture of magnetically loaded cells for spatially targeted therapeutics.

PubMed

Huang, Zheyong; Pei, Ning; Wang, Yanyan; Xie, Xinxing; Sun, Aijun; Shen, Li; Zhang, Shuning; Liu, Xuebo; Zou, Yunzeng; Qian, Juying; Ge, Junbo

2010-03-01

Magnetic targeting has recently demonstrated potential in promoting magnetically loaded cell delivery to target lesion, but its application is limited by magnetic attenuation. For deep magnetic capture of cells for spatial targeting therapeutics, we designed a magnetic pole, in which the magnetic field density can be focused at a distance from the pole. As flowing through a tube served as a model of blood vessels, the magnetically loaded mesenchymal stem cells (MagMSCs) were highly enriched at the site distance from the magnetic pole. The cell capture efficiency was positively influenced by the magnetic flux density, and inversely influenced by the flow velocity, and well-fitted with the deductive value by theoretical considerations. It appeared to us that the spatially-focused property of the magnetic apparatus promises a new deep targeting strategy to promote homing and engraftment for cellular therapy. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Cavitation of deep lacunar infarcts in patients with first-ever lacunar stroke: a 2-year follow-up study with MR.

PubMed

Loos, Caroline M J; Staals, Julie; Wardlaw, Joanna M; van Oostenbrugge, Robert J

2012-08-01

Studies in patients with lacunar stroke often assess the number of lacunes. However, data on how many symptomatic lacunar infarcts cavitate into a lacune are limited. We assessed the evolution of symptomatic lacunar infarcts over 2-year follow-up. In 82 patients with first-ever lacunar stroke with a lacunar infarct in the deep brain regions (excluding the centrum semiovale), we performed a brain MR at presentation and 2 years later. We classified cavitation of lacunar infarcts at baseline and on follow-up MR as absent, incomplete, or complete. We recorded time to imaging, infarct size, and vascular risk factors. On baseline MR, 38 (46%) index infarcts showed complete or incomplete cavitation. Median time to imaging was 8 (0-73) days in noncavitated and 63 (1-184) days in cavitated lesions (P<0.05). On follow-up imaging, 94% of the lacunar infarcts were completely or incompletely cavitated, most had reduced in diameter, and 5 (6%) had disappeared. Vascular risk factors were not associated with cavitation. Cavitation and lesion shrinkage were seen in almost all symptomatic lacunar infarcts in the deep brain regions over 2-year follow-up. Counting lacunes in these specific regions at a random moment might slightly, however not substantially, underestimate the burden of deep lacunar infarction.

Computer-aided classification of lung nodules on computed tomography images via deep learning technique

PubMed Central

Hua, Kai-Lung; Hsu, Che-Hao; Hidayati, Shintami Chusnul; Cheng, Wen-Huang; Chen, Yu-Jen

2015-01-01

Lung cancer has a poor prognosis when not diagnosed early and unresectable lesions are present. The management of small lung nodules noted on computed tomography scan is controversial due to uncertain tumor characteristics. A conventional computer-aided diagnosis (CAD) scheme requires several image processing and pattern recognition steps to accomplish a quantitative tumor differentiation result. In such an ad hoc image analysis pipeline, every step depends heavily on the performance of the previous step. Accordingly, tuning of classification performance in a conventional CAD scheme is very complicated and arduous. Deep learning techniques, on the other hand, have the intrinsic advantage of an automatic exploitation feature and tuning of performance in a seamless fashion. In this study, we attempted to simplify the image analysis pipeline of conventional CAD with deep learning techniques. Specifically, we introduced models of a deep belief network and a convolutional neural network in the context of nodule classification in computed tomography images. Two baseline methods with feature computing steps were implemented for comparison. The experimental results suggest that deep learning methods could achieve better discriminative results and hold promise in the CAD application domain. PMID:26346558

Computer-aided classification of lung nodules on computed tomography images via deep learning technique.

PubMed

Hua, Kai-Lung; Hsu, Che-Hao; Hidayati, Shintami Chusnul; Cheng, Wen-Huang; Chen, Yu-Jen

2015-01-01

Lung cancer has a poor prognosis when not diagnosed early and unresectable lesions are present. The management of small lung nodules noted on computed tomography scan is controversial due to uncertain tumor characteristics. A conventional computer-aided diagnosis (CAD) scheme requires several image processing and pattern recognition steps to accomplish a quantitative tumor differentiation result. In such an ad hoc image analysis pipeline, every step depends heavily on the performance of the previous step. Accordingly, tuning of classification performance in a conventional CAD scheme is very complicated and arduous. Deep learning techniques, on the other hand, have the intrinsic advantage of an automatic exploitation feature and tuning of performance in a seamless fashion. In this study, we attempted to simplify the image analysis pipeline of conventional CAD with deep learning techniques. Specifically, we introduced models of a deep belief network and a convolutional neural network in the context of nodule classification in computed tomography images. Two baseline methods with feature computing steps were implemented for comparison. The experimental results suggest that deep learning methods could achieve better discriminative results and hold promise in the CAD application domain.

A prospective clinical study to evaluate the safety and performance of wireless localization of nonpalpable breast lesions using radiofrequency identification technology.

PubMed

Dauphine, Christine; Reicher, Joshua J; Reicher, Murray A; Gondusky, Christina; Khalkhali, Iraj; Kim, Michelle

2015-06-01

The purpose of this study was to evaluate the safety and performance of localizing nonpalpable breast lesions using radiofrequency identification technology. Twenty consecutive women requiring preoperative localization of a breast lesion were recruited. Subjects underwent placement of both a hook wire and a radiofrequency identification tag immediately before surgery. The radiofrequency identification tag was the primary method used by the operating surgeon to localize each lesion during excision, with the hook wire serving as backup in case of tag migration or failed localization. Successful localization with removal of the intended lesion was the primary outcome measured. Tag migration and postoperative infection were also noted to assess safety. Twenty patients underwent placement of a radiofrequency identification tag, 12 under ultrasound guidance and eight with stereotactic guidance. In all cases, the radiofrequency identification tag was successfully localized by the reader at the level of the skin before incision, and the intended lesion was removed along with the radiofrequency identification tag. There were no localization failures and no postoperative infections. Tag migration did not occur before incision, but in three cases, occurred as the lesion was being retracted with fingers to make the final cut along the deep surface of the specimen. In this initial clinical study, radiofrequency tags were safe and able to successfully localize nonpalpable breast lesions. Radiofrequency identification technology may represent an alternative method to hook wire localization.

Retrospective Study on Laser Treatment of Oral Vascular Lesions Using the "Leopard Technique": The Multiple Spot Irradiation Technique with a Single-Pulsed Wave.

PubMed

Miyazaki, Hidetaka; Ohshiro, Takafumi; Romeo, Umberto; Noguchi, Tadahide; Maruoka, Yutaka; Gaimari, Gianfranco; Tomov, Georgi; Wada, Yoshitaka; Tanaka, Kae; Ohshiro, Toshio; Asamura, Shinichi

2018-06-01

This study aimed to retrospectively evaluate the efficacy and safety of laser treatment of oral vascular lesions using the multiple spot irradiation technique with a single-pulsed wave. In laser therapy for vascular lesions, heat accumulation induced by excessive irradiation can cause adverse events postoperatively, including ulcer formation, resultant scarring, and severe pain. To prevent heat accumulation and side effects, we have applied a multiple pulsed spot irradiation technique, the so-called "leopard technique" (LT) to oral vascular lesions. This approach was originally proposed for laser treatment of nevi. It can avoid thermal concentration at the same spot and spare the epithelium, which promotes smooth healing. The goal of the study was to evaluate this procedure and treatment outcomes. The subjects were 46 patients with 47 oral vascular lesions treated with the LT using a Nd:YAG laser (1064 nm), including 24 thick lesions treated using a combination of the LT and intralesional photocoagulation. All treatment outcomes were satisfactory without serious complications such as deep ulcer formation, scarring, bleeding, or severe swelling. Laser therapy with the LT is a promising less-invasive treatment for oral vascular lesions.

Sodium fluoride mouthrinse used twice daily increased incipient caries lesion remineralization in an in situ model.

PubMed

Songsiripradubboon, Siriporn; Hamba, Hidenori; Trairatvorakul, Chutima; Tagami, Junji

2014-03-01

To investigate the remineralizing effects of fluoride mouthrinses used at different times and frequency in addition to fluoride toothpaste. A randomized crossover single blinded study comprised 4 experimental phases of 21 days each. Twelve orthodontic volunteers were fixed with an orthodontic bracket containing an artificial carious enamel slab, which was from the same tooth in all 4 phases, and were randomly assigned to the following groups: (1) brushing with F toothpaste 2× per day (F- brush), (2) F- brush+rinsing with 0.05% NaF (F- rinse) after lunch, (3) F- brush+F-rinse before bedtime, and (4) F- brush+F- rinse 2× per day. Mean mineral gain after each phase was determined from mineral density profiles obtained using Micro-CT. The mean mineral gain in all treatments with F- brush and F-rinse were significantly greater than those in F- brush (p<0.05). Moreover F- rinse 2× per day increased lesion remineralization more than F- rinse once a day. The twice-daily use of 0.05% NaF mouthrinse combined with twice-daily regular use of fluoride toothpaste resulted in the greatest remineralization of incipient caries. These data indicate that rinsing frequency is a factor affecting the effectiveness of fluoride mouthrinse. The rinsing frequency of NaF mouthrinse, when used with fluoride toothpaste, also affects the remineralization. This finding, if confirmed by a clinical study, would lead to a new recommendation for fluoride mouthrinse used in high caries risk patients who could benefit from using it twice a day. Copyright © 2014 Elsevier Ltd. All rights reserved.

Precision Diagnosis Of Melanoma And Other Skin Lesions From Digital Images.

PubMed

Bhattacharya, Abhishek; Young, Albert; Wong, Andrew; Stalling, Simone; Wei, Maria; Hadley, Dexter

2017-01-01

Melanoma will affect an estimated 73,000 new cases this year and result in 9,000 deaths, yet precise diagnosis remains a serious problem. Without early detection and preventative care, melanoma can quickly spread to become fatal (Stage IV 5-year survival rate is 20-10%) from a once localized skin lesion (Stage IA 5- year survival rate is 97%). There is no biomarker for melanoma in clinical use, and the current diagnostic criteria for skin lesions remains subjective and imprecise. Accurate diagnosis of melanoma relies on a histopathologic gold standard; thus, aggressive excision of melanocytic skin lesions has been the mainstay of treatment. It is estimated that 36 biopsies are performed for every melanoma confirmed by pathology among excised lesions. There is significant morbidity in misdiagnosing melanoma such as progression of the disease for a false negative prediction vs the risks of unnecessary surgery for a false positive prediction. Every year, poor diagnostic precision adds an estimated $673 million in overall cost to manage the disease. Currently, manual dermatoscopic imaging is the standard of care in selecting atypical skin lesions for biopsy, and at best it achieves 90% sensitivity but only 59% specificity when performed by an expert dermatologist. Many computer vision (CV) algorithms perform better than dermatologists in classifying skin lesions although not significantly so in clinical practice. Meanwhile, open source deep learning (DL) techniques in CV have been gaining dominance since 2012 for image classification, and today DL can outperform humans in classifying millions of digital images with less than 5% error rates. Moreover, DL algorithms are readily run on commoditized hardware and have a strong online community of developers supporting their rapid adoption. In this work, we performed a successful pilot study to show proof of concept to DL skin pathology from images. However, DL algorithms must be trained on very large labelled datasets of

Spectrum of intra-thoracic lesion detected by computed tomography guided fine needle aspiration biopsy.

PubMed

Naqvi, Hanna; Edhi, Muhammad Muzzammil; Aslam, Hafiz Muhammad; Faridi, Naveen

2013-02-12

Fine needle aspiration biopsy (FNAB) is a rapid, sensitive and inexpensive procedure for diagnosing benign and malignant palpable lesions. For lesions that are not palpable or deep seated, FNAB can be performed under the guidance of radiological imaging. Our basic objective was to evaluate the spectrum of intrathoracic lesions by using Computed Tomography guided fine needle aspiration biopsy and evaluate its diagnostic yield. It was a retrospective study carried out in the Department of Histopathology, Liaquat National Hospital and Medical College, during the months of August 2011 and August 2012. All patients with pulmonary, mediastinal or paravertebral mass who underwent CT guided intrathoracic biopsy were included in this study. Fine needle aspiration biopsies were performed in the Radiology Department and specimen retrieved was sent in 10% buffered Formalin to the Histopathology Department. All the data was entered and analyzed through SPSS 19.0. A total of 130 cases were evaluated, out of which 108 (83.1%) were pulmonary, 16 (12.3%) were mediastinal and 6 (4.6%) were paravertebral. Conclusive biopsies were possible in 113 cases, while 17 biopsies were inconclusive. In those that showed a conclusive diagnosis, 83.1% were neoplastic and 16.9% were non neoplastic. Of the neoplastic cases, 27 (20.8%) were adenocarcinomas, followed by squamous cell carcinomas (15.4%) and large cell carcinoma, not otherwise specified, (12.3%). CT guided fine needle aspiration biopsy is a reliable tool for examination of intrathoracic lesions, with a high rate of conclusive diagnosis.

Multinodular and Vacuolating Neuronal Tumor of the Cerebrum: A New "Leave Me Alone" Lesion with a Characteristic Imaging Pattern.

PubMed

Nunes, R H; Hsu, C C; da Rocha, A J; do Amaral, L L F; Godoy, L F S; Watkins, T W; Marussi, V H; Warmuth-Metz, M; Alves, H C; Goncalves, F G; Kleinschmidt-DeMasters, B K; Osborn, A G

2017-10-01

Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion that is included in the 2016 updated World Health Organization classification of brain neoplasms as a unique cytoarchitectural pattern of gangliocytoma. We report 33 cases of presumed multinodular and vacuolating neuronal tumor of the cerebrum that exhibit a remarkably similar pattern of imaging findings consisting of a subcortical cluster of nodular lesions located on the inner surface of an otherwise normal-appearing cortex, principally within the deep cortical ribbon and superficial subcortical white matter, which is hyperintense on FLAIR. Only 4 of our cases are biopsy-proven because most were asymptomatic and incidentally discovered. The remaining were followed for a minimum of 24 months (mean, 3 years) without interval change. We demonstrate that these are benign, nonaggressive lesions that do not require biopsy in asymptomatic patients and behave more like a malformative process than a true neoplasm. © 2017 by American Journal of Neuroradiology.

Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: A report of the American Dental Association and the American Academy of Pediatric Dentistry.

PubMed

Wright, John T; Crall, James J; Fontana, Margherita; Gillette, E Jane; Nový, Brian B; Dhar, Vineet; Donly, Kevin; Hewlett, Edmond R; Quinonez, Rocio B; Chaffin, Jeffrey; Crespin, Matt; Iafolla, Timothy; Siegal, Mark D; Tampi, Malavika P; Graham, Laurel; Estrich, Cameron; Carrasco-Labra, Alonso

2016-08-01

This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits and fissures of occlusal surfaces. This is an update of the ADA 2008 recommendations on the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars. The authors conducted a systematic search in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and other sources to identify randomized controlled trials reporting on the effect of sealants (available on the US market) when applied to the occlusal surfaces of primary and permanent molars. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the quality of the evidence and to move from the evidence to the decisions. The guideline panel formulated 3 main recommendations. They concluded that sealants are effective in preventing and arresting pit-and-fissure occlusal carious lesions of primary and permanent molars in children and adolescents compared with the nonuse of sealants or use of fluoride varnishes. They also concluded that sealants could minimize the progression of noncavitated occlusal carious lesions (also referred to as initial lesions) that receive a sealant. Finally, based on the available limited evidence, the panel was unable to provide specific recommendations on the relative merits of 1 type of sealant material over the others. These

Complement is activated in progressive multiple sclerosis cortical grey matter lesions.

PubMed

Watkins, Lewis M; Neal, James W; Loveless, Sam; Michailidou, Iliana; Ramaglia, Valeria; Rees, Mark I; Reynolds, Richard; Robertson, Neil P; Morgan, B Paul; Howell, Owain W

2016-06-22

The symptoms of multiple sclerosis (MS) are caused by damage to myelin and nerve cells in the brain and spinal cord. Inflammation is tightly linked with neurodegeneration, and it is the accumulation of neurodegeneration that underlies increasing neurological disability in progressive MS. Determining pathological mechanisms at play in MS grey matter is therefore a key to our understanding of disease progression. We analysed complement expression and activation by immunocytochemistry and in situ hybridisation in frozen or formalin-fixed paraffin-embedded post-mortem tissue blocks from 22 progressive MS cases and made comparisons to inflammatory central nervous system disease and non-neurological disease controls. Expression of the transcript for C1qA was noted in neurons and the activation fragment and opsonin C3b-labelled neurons and glia in the MS cortical and deep grey matter. The density of immunostained cells positive for the classical complement pathway protein C1q and the alternative complement pathway activation fragment Bb was significantly increased in cortical grey matter lesions in comparison to control grey matter. The number of cells immunostained for the membrane attack complex was elevated in cortical lesions, indicating complement activation to completion. The numbers of classical (C1-inhibitor) and alternative (factor H) pathway regulator-positive cells were unchanged between MS and controls, whilst complement anaphylatoxin receptor-bearing microglia in the MS cortex were found closely apposed to cortical neurons. Complement immunopositive neurons displayed an altered nuclear morphology, indicative of cell stress/damage, supporting our finding of significant neurodegeneration in cortical grey matter lesions. Complement is activated in the MS cortical grey matter lesions in areas of elevated numbers of complement receptor-positive microglia and suggests that complement over-activation may contribute to the worsening pathology that underlies the

Local upregulation of transient receptor potential ankyrin 1 and transient receptor potential vanilloid 1 ion channels in rectosigmoid deep infiltrating endometriosis

PubMed Central

Bohonyi, Noémi; Pohóczky, Krisztina; Szalontai, Bálint; Perkecz, Anikó; Kovács, Krisztina; Kajtár, Béla; Orbán, Lajos; Varga, Tamás; Szegedi, Sarolta; Bódis, József; Koppán, Miklós

2017-01-01

Transient Receptor Potential Vanilloid 1 (TRPV1) and Transient Receptor Potential Ankyrin 1 (TRPA1) expressed mainly by primary sensory neurons function as major nociceptive integrators. They are also present on the rat endometrium in an oestrogen-regulated manner. TRPV1 is upregulated in peritoneal and ovarian endometriosis patients, but there is no information about TRPA1 and their pathophysiological significances. In this study, patients undergoing laparoscopic surgery were investigated: severe dysmenorrhoea due to rectosigmoid deep infiltrating endometriosis (n = 15), uterine fibroid-induced moderate dysmenorrhoea (n = 7) and tubal infertility with no pain (n = 6). TRPA1 and TRPV1 mRNA and protein expressions were determined by quantitative polymerase chain reaction and semi-quantitative immunohistochemistry from the endometrium samples taken by curettage. Results were correlated with the clinical characteristics including pain intensity. TRPA1 and TRPV1 receptors were expressed in the healthy human endometrium at mRNA and protein levels. Sparse, scattered cytoplasmic TRPA1 and TRPV1 immunopositivities were found in the stroma and epithelial layers. We detected upregulated mRNA levels in deep infiltrating endometriosis lesions, and TRPV1 gene expression was also elevated in autocontrol endometrium of deep infiltrating endometriosis patients. Histological scoring revealed significant TRPA1 and TRPV1 difference between deep infiltrating endometriosis stroma and epithelium, and in deep infiltrating endometriosis epithelium compared to control samples. Besides, we measured elevated stromal TRPV1 immunopositivity in deep infiltrating endometriosis. Stromal TRPA1 and TRPV1 immunoreactivities strongly correlated with dysmenorrhoea severity, as well TRPV1 expression on ectopic epithelial cells and macrophages with dyspareunia. Epithelial TRPA1 and stromal TRPV1 immunopositivity also positively correlated with dyschezia severity. We provide the first

Local upregulation of transient receptor potential ankyrin 1 and transient receptor potential vanilloid 1 ion channels in rectosigmoid deep infiltrating endometriosis.

PubMed

Bohonyi, Noémi; Pohóczky, Krisztina; Szalontai, Bálint; Perkecz, Anikó; Kovács, Krisztina; Kajtár, Béla; Orbán, Lajos; Varga, Tamás; Szegedi, Sarolta; Bódis, József; Helyes, Zsuzsanna; Koppán, Miklós

2017-01-01

Transient Receptor Potential Vanilloid 1 (TRPV1) and Transient Receptor Potential Ankyrin 1 (TRPA1) expressed mainly by primary sensory neurons function as major nociceptive integrators. They are also present on the rat endometrium in an oestrogen-regulated manner. TRPV1 is upregulated in peritoneal and ovarian endometriosis patients, but there is no information about TRPA1 and their pathophysiological significances. In this study, patients undergoing laparoscopic surgery were investigated: severe dysmenorrhoea due to rectosigmoid deep infiltrating endometriosis ( n = 15), uterine fibroid-induced moderate dysmenorrhoea ( n = 7) and tubal infertility with no pain ( n = 6). TRPA1 and TRPV1 mRNA and protein expressions were determined by quantitative polymerase chain reaction and semi-quantitative immunohistochemistry from the endometrium samples taken by curettage. Results were correlated with the clinical characteristics including pain intensity. TRPA1 and TRPV1 receptors were expressed in the healthy human endometrium at mRNA and protein levels. Sparse, scattered cytoplasmic TRPA1 and TRPV1 immunopositivities were found in the stroma and epithelial layers. We detected upregulated mRNA levels in deep infiltrating endometriosis lesions, and TRPV1 gene expression was also elevated in autocontrol endometrium of deep infiltrating endometriosis patients. Histological scoring revealed significant TRPA1 and TRPV1 difference between deep infiltrating endometriosis stroma and epithelium, and in deep infiltrating endometriosis epithelium compared to control samples. Besides, we measured elevated stromal TRPV1 immunopositivity in deep infiltrating endometriosis. Stromal TRPA1 and TRPV1 immunoreactivities strongly correlated with dysmenorrhoea severity, as well TRPV1 expression on ectopic epithelial cells and macrophages with dyspareunia. Epithelial TRPA1 and stromal TRPV1 immunopositivity also positively correlated with dyschezia severity. We provide the first

Thalamic diffusion differences related to cognitive function in white matter lesions.

PubMed

Fernández-Andújar, Marina; Soriano-Raya, Juan José; Miralbell, Júlia; López-Cancio, Elena; Cáceres, Cynthia; Bargalló, Núria; Barrios, Maite; Arenillas, Juan Francisco; Toran, Pere; Alzamora, Maite; Clemente, Imma; Dávalos, Antoni; Mataró, Maria

2014-05-01

Cerebral white matter lesions (WMLs) are related to cognitive deficits, probably due to a disruption of frontal-subcortical circuits. We explored thalamic diffusion differences related to white matter lesions (WMLs) and their association with cognitive function in middle-aged individuals. Ninety-six participants from the Barcelona-AsIA Neuropsychology Study were included. Participants were classified into groups based on low grade and high grade of periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWMHs). Tract-Based Spatial Statistics was used to study thalamic diffusion differences between groups. Mean fractional anisotropy (FA) values in significant areas were calculated for each subject and correlated with cognitive performance. Participants with high-grade PVHs and DWMHs showed lower FA thalamic values compared to those with low-grade PVHs and DWMHs, respectively. Decreased FA thalamic values in high-grade DWMHs, but not high-grade PVH, were related to lower levels of performance in psychomotor speed, verbal fluency, and visuospatial skills. Thalamic diffusion differences are related to lower cognitive function only in participants with high-grade DWMHs. These results support the hypothesis that fronto-subcortical disruption is associated with cognitive function only in DWMHs. Copyright © 2014 Elsevier Inc. All rights reserved.

Imaging review of lipomatous musculoskeletal lesions

PubMed Central

Burt, Ashley M.; Huang, Brady K.

2017-01-01

Lipomatous lesions are common musculoskeletal lesions that can arise within the soft tissues, bone, neurovascular structures, and synovium. The majority of these lesions are benign, and many of the benign lesions can be diagnosed by radiologic evaluation. However, radiologic differences between benign and malignant lipomatous lesions may be subtle and pathologic correlation is often needed. The use of sonography, computed tomography (CT), and magnetic resonance imaging (MRI) is useful not only in portraying fat within the lesion, but also for evaluating the presence and extent of soft tissue components. Lipomas make up most soft tissue lipomatous lesions, but careful evaluation must be performed to distinguish these lesions from a low-grade liposarcoma. In addition to the imaging appearance, the location of the lesion and the patient demographics can be utilized to help diagnose other soft tissue lipomatous lesions, such as elastofibroma dorsi, angiolipoma, lipoblastoma, and hibernoma. Osseous lipomatous lesions such as a parosteal lipoma and intraosseous lipoma occur less commonly as their soft tissue counterpart, but are also benign. Neurovascular and synovial lipomatous lesions are much rarer lesions but demonstrate more classic radiologic findings, particularly on MRI. A review of the clinical, radiologic, and pathologic characteristics of these lesions is presented. PMID:28474576

Non tuberculous mycobacterial lesion of the parotid gland and facial skin in a 4year old girl: A proposed treatment strategy.

PubMed

Berkovic, Juraj; Vanchiere, John A; Gungor, Anil

2016-01-01

We report a case of a parotid-facial caseating granulomatous infection caused by atypical mycobacteria (Mycobacterium avium) in an immuno-competent child. The size and depth of the lesion and its proximity to the facial nerve present a challenge for a purely surgical treatment strategy. An alternative treatment strategy is developed to avoid severe disfigurement. Atypical mycobacterial infection of the parotid region in a 5 year old girl: timeline and definition of a planned combined treatment strategy with antibiotics and surgical excision. Cervicofacial infections caused by non-tuberculous mycobacteria (NTM) may present surgical challenges due to the size and depth of the lesion and its proximity to the facial nerve and major vascular structures. Even minor scars are highly visible and poorly tolerated. Close clinical monitoring combined with judicious treatment strategies is necessary for successful treatment and good cosmesis. Recent literature provides insufficient guidance in formulating the best treatment strategy for the individual patient. Comparisons of antibiotic therapy with variations of surgical excision are abundant but poorly formulated. Our case presented with a lesion involving skin, superficial and deep lobe of the parotid gland. Lesion was in immediate proximity to the distribution of the facial nerve through the parotid gland. The risk of surgical damage to the facial nerve in the acute phase of the inflammation and the required extent of skin excision were significant. We decided to start treatment with combination antimycobacterial antibiotics in close cooperation with the pediatric infectious disease specialists. We observed and documented the regress and executed a delayed surgical excision when the lesion was reduced to skin only. In our opinion this was the best treatment strategy that helped us avoid extensive dissection in the vicinity of the facial nerve as well as a parotidectomy. Excision of the involved skin with the deep portion

Real-time caries diagnostics by optical PNC method

NASA Astrophysics Data System (ADS)

Masychev, Victor I.; Alexandrov, Michail T.

2000-11-01

The results of hard tooth tissues research by the optical PNC- method in experimental and clinical conditions are presented. In the experiment under 90 test-sample of tooth slices with thickness about 1mm (enamel, dentine and cement) were researched. The results of the experiment were processed by the method of correlation analyze. Clinical researches were executed on teeth of 210 patients. The regions of tooth tissue diseases with initial, moderate and deep caries were investigated. Spectral characteristics of intact and pathologically changed tooth tissues are presented and their peculiar features are discussed. The results the optical PNC-method application while processing tooth carious cavities are presented in order to estimate efficiency of the mechanical and antiseptic processing of teeth. It is revealed that the PNC-method can be sued as for differential diagnostics of a degree dental carious stage, as for estimating of carefulness of tooth cavity processing before filling.

Express diagnostics of intact and pathological dental hard tissues by optical PNC method

NASA Astrophysics Data System (ADS)

Masychev, Victor I.; Alexandrov, Michail T.

2000-03-01

The results of hard tooth tissues research by the optical PNC- method in experimental and clinical conditions are presented. In the experiment under 90 test-sample of tooth slices with thickness about 1 mm (enamel, dentine and cement) were researched. The results of the experiment were processed by the method of correlation analyze. Clinical researches were executed on teeth of 210 patients. The regions of tooth tissue diseases with initial, moderate and deep caries were investigated. Spectral characteristics of intact and pathologically changed tooth tissues are presented and their peculiar features are discussed. The results the optical PNC- method application while processing tooth carious cavities are presented in order to estimate efficiency of the mechanical and antiseptic processing of teeth. It is revealed that the PNC-method can be used as for differential diagnostics of a degree dental carious stage, as for estimating of carefulness of tooth cavity processing before filling.

Hock lesions and free-stall design.

PubMed

Weary, D M; Taszkun, I

2000-04-01

We compared the prevalence and severity of skin lesions on the hocks of lactating dairy cows in southern British Columbia, comparing 20 farms using three common bedding surfaces: sawdust, sand, and geotextile mattresses. Skin lesions were scored at five positions on the hock. For each position we noted if the lesion showed inflammatory attributes, and then assigned a severity score. Of the 1752 lactating cows scored, 1267 cows (73%) had at least one hock lesion. Of those cows with lesions, 87% had lesions on both legs, 76% had lesions on more than one location on the hock, and 78% had a lesion of at least moderate severity (i.e., evidence of skin breakage or an area of hair loss >10 cm2). Lesions were most prevalent on farms that used geotextile mattresses (91% of cows) and least common on farms that used sand (24% of cows). Moreover, lesions on cows from farms using mattresses were more numerous and more severe than those on cows from sand-bedded farms. The prevalence and severity of lesions on farms using sawdust was intermediate. Lesions also varied in relation to location on the hock. For farms using geotextile mattresses, lesions were more common and more severe on the lateral surfaces of both the tuber calcis and the tarsal joint. On farms using sawdust, lesions were common on the dorsal surface of the tuber calcis and the lateral surfaces of both the tuber calcis and the tarsal joint. Lesions were rare on all five positions for cows from sand-bedded farms. Among the 10 farms sampled using sawdust, we found a significant negative relationship between the length of the stall and severity of lesions. For cows with lesions, the number and severity of lesions increased with age.

Repair-Resistant DNA Lesions

PubMed Central

2017-01-01

The eukaryotic global genomic nucleotide excision repair (GG-NER) pathway is the major mechanism that removes most bulky and some nonbulky lesions from cellular DNA. There is growing evidence that certain DNA lesions are repaired slowly or are entirely resistant to repair in cells, tissues, and in cell extract model assay systems. It is well established that the eukaryotic DNA lesion-sensing proteins do not detect the damaged nucleotide, but recognize the distortions/destabilizations in the native DNA structure caused by the damaged nucleotides. In this article, the nature of the structural features of certain bulky DNA lesions that render them resistant to NER, or cause them to be repaired slowly, is compared to that of those that are good-to-excellent NER substrates. Understanding the structural features that distinguish NER-resistant DNA lesions from good NER substrates may be useful for interpreting the biological significance of biomarkers of exposure of human populations to genotoxic environmental chemicals. NER-resistant lesions can survive to replication and cause mutations that can initiate cancer and other diseases. Furthermore, NER diminishes the efficacy of certain chemotherapeutic drugs, and the design of more potent pharmaceuticals that resist repair can be advanced through a better understanding of the structural properties of DNA lesions that engender repair-resistance. PMID:28750166

Deep cerebral microbleeds are negatively associated with HDL-C in elderly first-time ischemic stroke patients.

PubMed

Igase, Michiya; Kohara, Katsuhiko; Igase, Keiji; Yamashita, Shiro; Fujisawa, Mutsuo; Katagi, Ryosuke; Miki, Tetsuro

2013-02-15

Cerebral microbleeds (CMBs) detected on T2*-weighted MRI gradient-echo have been associated with increased risk of cerebral infarction. We evaluated risk factors for these lesions in a cohort of first-time ischemic stroke patients. Presence of CMBs in consecutive first-time ischemic stroke patients was evaluated. The location of CMBs was classified by cerebral region as strictly lobar (lobar CMBs) and deep or infratentorial (deep CMBs). Logistic regression analysis was performed to determine the contribution of lipid profile to the presence of CMBs. One hundred and sixteen patients with a mean age of 70±10years were recruited. CMBs were present in 74 patients. The deep CMBs group had significantly lower HDL-C levels than those without CMBs. In univariable analysis, advanced periventricular hyperintensity grade (PVH>2) and decreased HDL-C were significantly associated with the deep but not the lobar CMB group. On logistic regression analysis, HDL-C (beta=-0.06, p=0.002) and PVH grade >2 (beta=3.40, p=0.005) were independent determinants of deep CMBs. Low HDL-C may be a risk factor of deep CMBs, including advanced PVH status, in elderly patients with acute ischemic stroke. Management of HDL-C levels might be a therapeutic target for the prevention of recurrence of stroke. Copyright © 2012 Elsevier B.V. All rights reserved.

[Managing focal incidental renal lesions].

PubMed

Nicolau, C; Paño, B; Sebastià, C

2016-01-01

Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Incidence of dental caries in primary dentition and risk factors: a longitudinal study.

PubMed

Corrêa-Faria, Patrícia; Paixão-Gonçalves, Suzane; Paiva, Saul Martins; Pordeus, Isabela Almeida

2016-05-20

The objectives of this prospective, longitudinal, population-based study were to estimate the incidence of dental caries in the primary dentition, identify risk factors and determine the proportion of children receiving dental treatment, through a two-year follow up. The first dental exam was conducted with 381 children aged one to five years, at health centers during immunization campaigns; 184 of them had dental caries and 197 had no caries experience. The second exam was carried out two years later at a nursery or at home with the same individuals who participated in the first exam. The diagnosis of dental caries was performed using the dmft criteria. Parents were interviewed regarding socioeconomic indicators. Descriptive, bivariate and adjusted Poisson regression analyses were performed. Among the 381 children, 234 were reexamined after two years (non-exposed: 139; exposed: 95). The overall incidence of dental caries was 46.6%. The greatest incidence of dental caries was found in the group of children with previous caries experience (61.1%). Among the children without dental caries in the first exam, 36.7% exhibited caries in the second exam. The majority of children (72.6%) received no treatment for carious lesions in the two-year interval between examinations. Children with previous dental caries (RR: 1.52, 95%CI: 1.12-2.05) had a greater risk of developing new lesions, compared with the children without previous dental caries. The incidence of dental caries was high and most of children's caries were untreated. Previous caries experience is a risk factor for developing new carious lesions in children.

Lesion network localization of criminal behavior

PubMed Central

Darby, R. Ryan; Horn, Andreas; Fox, Michael D.

2018-01-01

Following brain lesions, previously normal patients sometimes exhibit criminal behavior. Although rare, these cases can lend unique insight into the neurobiological substrate of criminality. Here we present a systematic mapping of lesions with known temporal association to criminal behavior, identifying 17 lesion cases. The lesion sites were spatially heterogeneous, including the medial prefrontal cortex, orbitofrontal cortex, and different locations within the bilateral temporal lobes. No single brain region was damaged in all cases. Because lesion-induced symptoms can come from sites connected to the lesion location and not just the lesion location itself, we also identified brain regions functionally connected to each lesion location. This technique, termed lesion network mapping, has recently identified regions involved in symptom generation across a variety of lesion-induced disorders. All lesions were functionally connected to the same network of brain regions. This criminality-associated connectivity pattern was unique compared with lesions causing four other neuropsychiatric syndromes. This network includes regions involved in morality, value-based decision making, and theory of mind, but not regions involved in cognitive control or empathy. Finally, we replicated our results in a separate cohort of 23 cases in which a temporal relationship between brain lesions and criminal behavior was implied but not definitive. Our results suggest that lesions in criminals occur in different brain locations but localize to a unique resting state network, providing insight into the neurobiology of criminal behavior. PMID:29255017

Inter-algorithm lesion volumetry comparison of real and 3D simulated lung lesions in CT

NASA Astrophysics Data System (ADS)

Robins, Marthony; Solomon, Justin; Hoye, Jocelyn; Smith, Taylor; Ebner, Lukas; Samei, Ehsan

2017-03-01

The purpose of this study was to establish volumetric exchangeability between real and computational lung lesions in CT. We compared the overall relative volume estimation performance of segmentation tools when used to measure real lesions in actual patient CT images and computational lesions virtually inserted into the same patient images (i.e., hybrid datasets). Pathologically confirmed malignancies from 30 thoracic patient cases from Reference Image Database to Evaluate Therapy Response (RIDER) were modeled and used as the basis for the comparison. Lesions included isolated nodules as well as those attached to the pleura or other lung structures. Patient images were acquired using a 16 detector row or 64 detector row CT scanner (Lightspeed 16 or VCT; GE Healthcare). Scans were acquired using standard chest protocols during a single breath-hold. Virtual 3D lesion models based on real lesions were developed in Duke Lesion Tool (Duke University), and inserted using a validated image-domain insertion program. Nodule volumes were estimated using multiple commercial segmentation tools (iNtuition, TeraRecon, Inc., Syngo.via, Siemens Healthcare, and IntelliSpace, Philips Healthcare). Consensus based volume comparison showed consistent trends in volume measurement between real and virtual lesions across all software. The average percent bias (+/- standard error) shows -9.2+/-3.2% for real lesions versus -6.7+/-1.2% for virtual lesions with tool A, 3.9+/-2.5% and 5.0+/-0.9% for tool B, and 5.3+/-2.3% and 1.8+/-0.8% for tool C, respectively. Virtual lesion volumes were statistically similar to those of real lesions (< 4% difference) with p >.05 in most cases. Results suggest that hybrid datasets had similar inter-algorithm variability compared to real datasets.

Imaging of cerebellopontine angle lesions: an update. Part 2: intra-axial lesions, skull base lesions that may invade the CPA region, and non-enhancing extra-axial lesions.

PubMed

Bonneville, Fabrice; Savatovsky, Julien; Chiras, Jacques

2007-11-01

Computed tomography (CT) and magnetic resonance (MR) imaging reliably demonstrate typical features of vestibular schwannomas or meningiomas in the vast majority of mass lesions responsible for cerebellopontine angle (CPA) syndrome. However, a large variety of unusual lesions can also be encountered in the CPA. Covering the entire spectrum of lesions potentially found in the CPA, these articles explain the pertinent neuroimaging features that radiologists need to know to make clinically relevant diagnoses in these cases, including data from diffusion- and perfusion-weighted imaging or MR spectroscopy, when available. A diagnostic algorithm based on the lesion's site of origin, shape and margins, density, signal intensity and contrast material uptake is also proposed. Non-enhancing extra-axial CPA masses are cystic (epidermoid cyst, arachnoid cyst, neurenteric cyst) or contain fat (dermoid cyst, lipoma). Tumours can also extend into the CPA by extension from the skull base (paraganglioma, chondromatous tumours, chordoma, cholesterol granuloma, endolymphatic sac tumour). Finally, brain stem or ventricular tumours can present with a significant exophytic component in the CPA that may be difficult to differentiate from an extra-axial lesion (lymphoma, hemangioblastoma, choroid plexus papilloma, ependymoma, glioma, medulloblastoma, dysembryoplastic neuroepithelial tumour).

In vitro near-infrared imaging of occlusal dental caries using a germanium-enhanced CMOS camera

NASA Astrophysics Data System (ADS)

Lee, Chulsung; Darling, Cynthia L.; Fried, Daniel

2010-02-01

The high transparency of dental enamel in the near-infrared (NIR) at 1310-nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study was to determine whether the lesion contrast derived from NIR transillumination can be used to estimate lesion severity. Another aim was to compare the performance of a new Ge enhanced complementary metal-oxide-semiconductor (CMOS) based NIR imaging camera with the InGaAs focal plane array (FPA). Extracted human teeth (n=52) with natural occlusal caries were imaged with both cameras at 1310-nm and the image contrast between sound and carious regions was calculated. After NIR imaging, teeth were sectioned and examined using more established methods, namely polarized light microscopy (PLM) and transverse microradiography (TMR) to calculate lesion severity. Lesions were then classified into 4 categories according to the lesion severity. Lesion contrast increased significantly with lesion severity for both cameras (p<0.05). The Ge enhanced CMOS camera equipped with the larger array and smaller pixels yielded higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

In vitro near-infrared imaging of occlusal dental caries using germanium enhanced CMOS camera.

PubMed

Lee, Chulsung; Darling, Cynthia L; Fried, Daniel

2010-03-01

The high transparency of dental enamel in the near-infrared (NIR) at 1310-nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study was to determine whether the lesion contrast derived from NIR transillumination can be used to estimate lesion severity. Another aim was to compare the performance of a new Ge enhanced complementary metal-oxide-semiconductor (CMOS) based NIR imaging camera with the InGaAs focal plane array (FPA). Extracted human teeth (n=52) with natural occlusal caries were imaged with both cameras at 1310-nm and the image contrast between sound and carious regions was calculated. After NIR imaging, teeth were sectioned and examined using more established methods, namely polarized light microscopy (PLM) and transverse microradiography (TMR) to calculate lesion severity. Lesions were then classified into 4 categories according to the lesion severity. Lesion contrast increased significantly with lesion severity for both cameras (p<0.05). The Ge enhanced CMOS camera equipped with the larger array and smaller pixels yielded higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

Ozone therapy effectiveness in patients with ulcerous lesions due to diabetes mellitus.

PubMed

Rosul, Myroslav V; Patskan, Bohdan M

2016-01-01

Development of purulo-necrotic foot lesions is one of the most dangerous surgical complications of diabetes mellitus, it causes high lethality, early disability, considerable economical expenses on treatment and rehabilitation. Mentioned above determine substantial actuality of diabetic foot problem and condition the necessity of further search of new ways and effective methods of lower extremities lesions complex treatment. of our research was to study the effectiveness of ozone use in complex therapy among patients with diabetic foot. Under our observation were 47 patients with I and II stages of diabetic foot that correspond to superficial and deep ulcers without involving of subcutaneous tissue, ligaments, tendons and muscles into the process, without bone lesion, phlegmons and abscess forming according to Meggit-Wagner (1978) classification. Depending on treatment every group of patients was divided into subgroups. B group composed patients that received traditional therapy.A group composed patients that along with traditional therapy course received course of systemic and regional ozone therapy for 12-14 days, one session per day. Cytological examination of discharge from wounds was carried, lipid peroxidation state and antioxidant protection state was assessed. Ozone use has more evident clinical effect, significantly affects the phase course of wound process, promotes the improvement of lipid peroxidation and antioxidant protection indexes, reduces the length of hospital stay and term of treatment of patients with diabetic foot. СONCLUSIONS: Studies conducted showed that including of ozone therapy into complex surgical treatment has positive effect on wound process.

OCT of early dental caries: a comparative study with histology and Raman spectroscopy

NASA Astrophysics Data System (ADS)

Hewko, Mark D.; Choo-Smith, Lin-P'ing; Ko, Alex C.; Leonardi, Lorenzo; Dong, Cecilia C.; Cleghorn, Blaine; Sowa, Michael G.

2005-03-01

Early dental caries result from destruction of the tooth's outer mineral matrix by acid-forming bacteria found in dental plaques. Early caries begin as surface disruptions where minerals are leached from the teeth resulting in regions of decreased mineral matrix integrity. Visually, these early carious regions appear as white spots due to the higher backscattering of incident light. With age these areas may become stained by organic compounds. Optical coherence tomography (OCT) examination of human teeth demonstrates a difference in penetration depth of the OCT signal into the carious region in comparison with sound enamel. However, while OCT demonstrates a structural difference in the enamel in the region of the caries, this technique provides little insight into the source of this difference. Raman spectroscopy provides biochemical measures derived from hydroxyapatite within the enamel as well as information on the crystallinity of the enamel matrix. The differences in the biochemical and morphological features of early caries and intact sound enamel are compared. Histological thin sections confirm the observations by OCT morphological imaging while Raman spectroscopy allows for biochemical identification of carious regions by a non-destructive method. Visual examination and conventional radiographic imaging of the intact tooth are used in clinical assessment prior to optical measurements. The combination of OCT, Raman spectroscopy and thin section histology aid in determining the changes that give rise to the visual white spot lesions.

Characterization of early dental caries by polarized Raman spectroscopy

NASA Astrophysics Data System (ADS)

Choo-Smith, Lin-P'ing; Ko, Alex C.-T.; Hewko, Mark D.; Dong, Cecilia C.; Cleghorn, Blaine M.; Sowa, Michael G.

2006-02-01

The early approximal caries lesion in enamel is observed clinically as a white spot and is difficult to detect and/or monitor with current methods available to dentists. New methods with high sensitivity and specificity are required to enable improved early dental caries diagnosis. Using unpolarized Raman spectroscopy to examine unsectioned teeth, peak intensity changes in the phosphate (PO 4 3-) vibrations (ν II, ν 3 and ν 4) were observed between spectra of sound and carious enamel. However, there is little change in the ν I vibration with this approach. In contrast, when tooth sections were examined by unpolarized Raman spectroscopy, marked changes in the ν I peak at 959 cm -1 were noted between healthy and carious enamel. These differences suggest that sampling orientation play a role in understanding the spectral changes. Using polarized Raman spectroscopy to examine unsectioned samples, cross polarized measurements from sound enamel exhibited significant reduction of the ν I peak compared with parallel polarized measurements. A similar reduction was observed with carious enamel, however, the reduction was not as prominent. By calculating the depolarization ratio of the area under the ν I peak, sound enamel can be clearly distinguished from demineralized regions. The spectral changes observed are attributed to changes in the structure and/or orientation of the apatite crystals as a result of the acid demineralization process.

Effect of fluorides from various restorative materials on remineralization of adjacent tooth: an in vitro study.

PubMed

Baliga, M S; Bhat, S S

2010-01-01

The aim of the study was to evaluate the extent of surface zone remineralization and the effect of fluoride at the inter-proximal adjacent tooth surface, using restorative materials FusionAlloy, Ketac-Fil and Heliomolar. Ninety extracted molar teeth were used of which 45 were placed in artificial caries for 10 weeks. The remaining 45 teeth were filled with the respective restorative materials, mounted with the artificial carious teeth in proximal contact with plaster and placed in artificial saliva for a period of 28 days. Finally, sectioning of artificially carious teeth was done mesio-distally and observed under the optical microscope and scanning electron microscope. Comparison among the groups was done by one-way analysis of variance [ANOVA] and Fischer's F test. Intercomparison between the groups was done by using Dunnett's t-test. Results obtained from transmitted electron microscopic and scanning electron microscopic observations were almost similar with the Ketac-Fil and Heliomolar showing better results in surface zone remineralization compared to FusionAlloy. Also, Ketac-Fil is a good material in releasing fluoride to remineralize enamel when compared to Heliomolar and FusionAlloy. Thus, it can be used mainly in class II cavity restorations of primary and permanent dentitions due to the potential ability of fluoride containing glass ionomer cements and composite resins to remineralize incipient carious lesions on adjacent teeth.

Supracerebellar Infratentorial Endoscopic and Endoscopic-Assisted Approaches to Pineal Lesions: Technical Report and Review of the Literature.

PubMed

Snyder, Rita; Felbaum, Daniel R; Jean, Walter C; Anaizi, Amjad

2017-06-09

The pineal gland has a deep central location, making it a surgeon's no man's land. Surgical pathology within this territory presents a unique challenge and an opportunity for employment of various surgical techniques. In modern times, the microsurgical technique has been competing with the endoscope for achieving superior surgical results. We describe two cases utilizing a purely endoscopic and an endoscopic-assisted supracerebellar infratentorial approach in accessing lesions of the pineal gland. We also discuss our early learning experience with these approaches.

Spectrum of intra-thoracic lesion detected by computed tomography guided fine needle aspiration biopsy

PubMed Central

2013-01-01

Background Fine needle aspiration biopsy (FNAB) is a rapid, sensitive and inexpensive procedure for diagnosing benign and malignant palpable lesions. For lesions that are not palpable or deep seated, FNAB can be performed under the guidance of radiological imaging. Our basic objective was to evaluate the spectrum of intrathoracic lesions by using Computed Tomography guided fine needle aspiration biopsy and evaluate its diagnostic yield. Methodology It was a retrospective study carried out in the Department of Histopathology, Liaquat National Hospital and Medical College, during the months of August 2011 and August 2012. All patients with pulmonary, mediastinal or paravertebral mass who underwent CT guided intrathoracic biopsy were included in this study. Fine needle aspiration biopsies were performed in the Radiology Department and specimen retrieved was sent in 10% buffered Formalin to the Histopathology Department. All the data was entered and analyzed through SPSS 19.0. Results A total of 130 cases were evaluated, out of which 108 (83.1%) were pulmonary, 16 (12.3%) were mediastinal and 6 (4.6%) were paravertebral. Conclusive biopsies were possible in 113 cases, while 17 biopsies were inconclusive. In those that showed a conclusive diagnosis, 83.1% were neoplastic and 16.9% were non neoplastic. Of the neoplastic cases, 27 (20.8%) were adenocarcinomas, followed by squamous cell carcinomas (15.4%) and large cell carcinoma, not otherwise specified, (12.3%). Conclusion CT guided fine needle aspiration biopsy is a reliable tool for examination of intrathoracic lesions, with a high rate of conclusive diagnosis. PMID:23402220

Skull base lesions: extracranial origins.

PubMed

Mosier, Kristine M

2013-10-01

A number of extracranial anatomical sites, including the nasopharynx, paranasal sinuses, and masticator space, may give rise to lesions involving the skull base. Implicit in the nature of an invasive lesion, the majority of these lesions are malignant. Accordingly, for optimal patient outcomes and treatment planning, it is imperative to include a search pattern for extracranial sites and to assess accurately the character and extent of these diverse lesions. Of particular importance to radiologists are lesions arising from each extracranial site, the search patterns, and relevant information important to convey to the referring clinician. Copyright © 2013 Elsevier Inc. All rights reserved.

Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue

PubMed Central

Karlsson, Lena

2010-01-01

A conservative, noninvasive or minimally invasive approach to clinical management of dental caries requires diagnostic techniques capable of detecting and quantifying lesions at an early stage, when progression can be arrested or reversed. Objective evidence of initiation of the disease can be detected in the form of distinct changes in the optical properties of the affected tooth structure. Caries detection methods based on changes in a specific optical property are collectively referred to as optically based methods. This paper presents a simple overview of the feasibility of three such technologies for quantitative or semiquantitative assessment of caries lesions. Two of the techniques are well-established: quantitative light-induced fluorescence, which is used primarily in caries research, and laser-induced fluorescence, a commercially available method used in clinical dental practice. The third technique, based on near-infrared transillumination of dental enamel is in the developmental stages. PMID:20454579

Imaging of cerebellopontine angle lesions: an update. Part 1: enhancing extra-axial lesions.

PubMed

Bonneville, Fabrice; Savatovsky, Julien; Chiras, Jacques

2007-10-01

Computed tomography (CT) and magnetic resonance (MR) imaging reliably demonstrate typical features of vestibular schwannomas or meningiomas in the vast majority of mass lesions in the cerebellopontine angle (CPA). However, a large variety of unusual lesions can also be encountered in the CPA. Covering the entire spectrum of lesions potentially found in the CPA, these articles explain the pertinent neuroimaging features that radiologists need to know to make clinically relevant diagnoses in these cases, including data from diffusion and perfusion-weighted imaging or MR spectroscopy, when available. A diagnostic algorithm based on the lesion's site of origin, shape and margins, density, signal intensity and contrast material uptake is also proposed. Part 1 describes the different enhancing extra-axial CPA masses primarily arising from the cerebellopontine cistern and its contents, including vestibular and non-vestibular schwannomas, meningioma, metastasis, aneurysm, tuberculosis and other miscellaneous meningeal lesions.

Accuracy in clinically evaluating pigmented lesions.

PubMed Central