Pathologic Basis of Diseaseby Stanley L. Robbins is really the fourth edition of hisPathology. Appropriate updating and addition enhance the otherwise identical format, sequence, writing, and illustrations. So many medical students have benefited from this source that it may be the best known general book in the field. I recommend it even more now. Like his former texts, this will be enjoyed for its readability. He clearly lays out a great deal of information. When he includes minutiae, the reasons are clear and one feels that all the material is pertinent. Robbins keeps the whole field in perspective—that is, he does not dwell so long or so heavily on pathologic anatomy or pathogenesis as to tempt the reader to overlook clinical presentation or prognosis. A great strength of the subject of pathology is that it bonds strongly with many other medical sciences and specialties and thus occupies the

Pathologic Basis of Disease

Detection and diagnosis of dental caries using a deep learning-based convolutional neural network algorithm.

This study determined the occurrence and location of the mental foramen (MF) and accessory mental foramen (AMF) in Turkish patients using cone-beam computed-tomography (CBCT) with 3D-imaging software. CBCT scans of 386 sites in 193 (92 male, 101 female) patients were retrospectively analyzed to determine MF and AMF occurrence, sizes, and locations. Digital imaging and communications in medicine (DICOM) data were transferred to surface-rendering software to generate 3D images. Distances between the MF and AMF and from both foramina to the alveolar ridge and to the closest tooth were measured. Differences in AMF incidence by sex, side, and location were evaluated using chi-squared tests, and MF and AMF measurements were evaluated using Mann-Whitney U-tests. AMFs were observed in 6.5% of patients and were most commonly in an anteroinferior location. Mean AMF size did not differ significantly by sex or side [males: horizontal = 1.5 mm (1.0-2.4 mm), vertical = 1.4 mm (0.8-2.4 mm); females: horizontal = 1.5 mm (0.8-3 mm), vertical = 1.3 mm (0.8-2.1 mm); P > 0.05]. Males showed significantly greater mean vertical and horizontal MF dimensions compared with females [males: horizontal = 3.9 mm (1.0-7.0 mm), vertical = 3.6 mm (1.2-7.0 mm); females: horizontal = 3.5 mm (1.3-5.6 mm), vertical = 3.3 mm (0.8-5.8 mm); P < 0.05]. Awareness of the AMF is important to avoid mental nerve damage during surgical intervention and anesthetic applications. CBCT is useful for AMF detection, distributes less ionizing radiation, and allows 3D imaging.

Evaluation of the mental foramen and accessory mental foramen in Turkish patients using cone‐beam computed tomography images reconstructed from a volumetric rendering program

Introduction: Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE). Objective: The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA). Methods: All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained. Conclusion: It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.

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Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE).

The putative cardiovascular protective effects of hormone replacement therapy (HRT) are being increasingly questioned. Because the risk of both cardiovascular disease and osteoporosis increases markedly at the time of menopause, foods rich in phytoestrogens have been proposed for inhibiting bone loss and conferring cardiovascular protection by improving the lipid profile. This study examined the effects of flaxseed, a rich source of the phytoestrogens termed lignins, on lipid metabolism and bone turnover in postmenopausal women less than 65 years of age who were not receiving HRT. Using a parallel double-blind design, 58 such women were randomly assigned to 40 g daily of either ground whole flaxseed or a wheat-based control regimen for 3 months. All of the women received supplemental calcium (1000 mg) and vitamin D (400 IU) on a daily basis. A 1-week food frequency questionnaire was completed by interviewing at the outset and when the study ended. Twenty women receiving flaxseed and 16 control subjects completed the study. Body weight and body mass index tended to be higher after 3 months on the wheat-based regimen. Dietary intake was comparable in the two groups. Women given flaxseed had a significant 6% decrease in serum total and non-high density lipoprotein cholesterol levels. Serum low-density lipoprotein cholesterol decreased by 4.7% and triglycerides by 12.8%, but these changes were not statistically significant. High-density lipoprotein cholesterol levels were somewhat lowered by flaxseed consumption, and levels of apolipoprotein Al and B were significantly lowered. There were no significant changes in markers of bone turnover, and neither flaxseed nor the wheat-based regimen produced estrogenic effects. These findings indicate that postmenopausal women who consume flaxseed can anticipate reductions in total and non-high-density lipoprotein cholesterol as well as apolipoprotein B, all accepted risk factors for coronary heart disease. Sex hormone levels were not altered by this dietary measure, and it had no apparent effect on bone metabolism.

Flaxseed improves lipid profile without altering biomarkers of bone metabolism in postmenopausal women

Background: Information on the position of the mental foramen is important for dental surgeons. Variations in its position can be a cause of complications during local anesthesia or surgical procedures. The usual position of the mental foramen in an Iranian population has not been previously reported. Aims: The purpose of this study was to determine the most common location of the mental foramen in an Iranian population. We also analyzed gender differences and the symmetry of location within individuals. Materials and Methods : 400 panoramic radiographs were evaluated with regard to the location and symmetry of the mental foramina in male and female subjects. Results : We found that the mental foramen was located between the first and second premolars in 47.2% of patients and in line with the second premolar in 46%. In 49.2% of males, the mental foramen was in line with the second premolar. In 50.9% of females it was between the first and second premolars. It was symmetrical in 85.7%. Conclusions : Based on this study it appears that the most common position of mental foramen is either between the two premolars or in line with the second premolar. This is in concordance with previous studies.

Radiographic evaluation of the mental foramen in a selected Iranian population.

Background Radiography plays an important role in the detection of interproximal caries. Objectives The aim of the present study was to determine diagnostic accuracy of chargecoupled devices (CCD), Photo Stimulable Phosphor (PSP) and film radiography in detecting non-cavitated caries. Patients and methods Seventy-two non-cavitated approximal surfaces of extracted human posterior teeth were radiographed under standardized conditions using three intraoral modalities: CCD Dixi3 (Planmeca, Finland), PSP Digora PCT (Soredex, Finland),and E-speed film (Kodak, USA). Radiographs were interpreted by four observers and caries lesions were classified as sound (R0), restricted to enamel (R1), reaching the dentinoenamel junction (DEJ) and the outer half of the dentin (R2) and the inner half of the dentin (R3). The teeth were subsequently sectioned for histological analysis which served as the gold standard for radiographic examination. Results Microscopic examinations showed that the distribution of caries were 63.9% sound, 18.1% enamel, 9.7% DEJ and outer half of the dentin and 8.3% into the inner half of the dentin. The sensitivity and specificity of film, CCD and PSP for the detection of enamel caries were 38% and 98%; 15% and 96 %; and 23% and 98%, respectively. The sensitivity and specificity of film, CCD and PSP for the detection of both dentin and enamel caries were 55% and 100%; 45% and 100% ; and 55% and 100%, respectively. Conclusions The results demonstrated that the diagnostic accuracy of digital images is similar to that of conventional film radiography in the detection of non-cavitated approximal caries.

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Diagnostic accuracy of digital and conventional radiography in the detection of non-cavitated approximal dental caries.

Purpose: The aim of this study was to investigate the accuracy of cone-beam computed tomography (CBCT) in the diagnosis of vertical root fractures in a tooth with gutta-percha and prefabricated posts. Materials and Methods: This study selected 96 extracted molar and premolar teeth of the mandible. These teeth were divided into six groups as follows: Groups A, B, and C consisted of teeth with vertical root fractures, and groups D, E, and F had teeth without vertical root fractures; groups A and D had teeth with gutta-percha and prefabricated posts; groups B and E had teeth with gutta-percha but without prefabricated posts, and groups C and F had teeth without gutta-percha or prefabricated posts. Then, the CBCT scans were obtained and examined by three oral and maxillofacial radiologists in order to determine the presence of vertical root fractures. The data were analyzed using IBM SPSS 20.0 (IBM Corp., Armonk, NY, USA). Results: The kappa coefficient was 0.875±0.049. Groups A and D showed a sensitivity of 81% and a specificity of 100%; groups E and B, a sensitivity of 94% and a specificity of 100%; and groups C and F, a sensitivity of 88% and a specificity of 100%. Conclusion: The CBCT scans revealed a high accuracy in the diagnosis of vertical root fractures; the accuracy did not decrease in the presence of gutta-percha. The presence of prefabricated posts also had little effect on the accuracy of the system, which was, of course, not statistically significant. (Imaging Sci Dent 2014; 44 : 37-41)

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Assessment of vertical root fracture using cone-beam computed tomography.

Objective . The aim of this study was to evaluate the number and mor- phological characteristics of the roots and root canals in mandibular anterior teeth, using cone beam computed tomography. Methods and materials. In this cross-sectional study, 1053 anterior mandibular teeth from 200 CBCT scans were evaluated. The teeth were complete- ly developed and should have had no fillings in the root or crown. The teeth were investigated in terms of the number of roots and root canals, the location of the apical foramen, the distance of the apical foramen to the anatomical apex, root length, crown length, dilacera- tions and the type of canals according to Vertucci’s classification. Re- sults . 87.9% of teeth had one root canal and of all of the teeth, three canines (0.3%) were found that had two roots. In 80.3% (n: 848) of cases the foramen apical location was central, then the buccal (9.3%), lingual (3.9%), distal (3.8%), and mesial (2.7%). The type of root ca- nals, according to Vertucci’s classification, with respect to prevalence, included type I (88.2%), type III (8.1%), type II (3.3%), type V (0.3%), and type VI (0.1%), respectively. In terms of the characteristics inves- tigated, bilateral symmetry was observed. Dilaceration was not seen in any of the teeth. Conclusion . The root canal morphology of mandibu- lar anterior teeth has great diversity that may differ between different races, and should be considered by all dentists in order to achieve the best dental treatment.

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Sina Haghanifar

Papers

Radiographic evaluation of the mental foramen in a selected Iranian population.

Diagnostic accuracy of digital and conventional radiography in the detection of non-cavitated approximal dental caries.

Assessment of vertical root fracture using cone-beam computed tomography.

Morphologic assessment of mandibular anterior teeth root canal using CBCT

Assessment of dental maturity of children aged 7-15 years using demirjian method in a selected Iranian population.