Artificial intelligence-integrated optical coherence tomography for screening and early detection of oral cancer

Early detection of oral cancer is essential for improving patient survival rates and leads to higher chances of successful treatment, reduced cost of complex treatments, and improved quality of life of patients. Oral cancer often arises from oral potentially malignant disorders (OPMDs), among which leukoplakia is the most common. Numerous chairside diagnostic aids and imaging modalities have been reviewed for screening detection of OPMDs and oral cancer, but these techniques have limitations. Novel optical diagnostic modalities work on the assumption that neoplastic and dysplastic tissues have different absorbance and reflectance properties when exposed to specific wavelengths of light. Optical coherence tomography (OCT) imaging is a promising new technology in the field of oral oncology. The ability of OCT to provide real-time, nondestructive, high-resolution, radiation-free images makes it an ideal modality for screening and detection of neoplastic changes in the oral mucosa, but interpretation of OCT images requires training and expertise. To overcome this limitation, artificial intelligence-based diagnostic algorithms are being combined with OCT imaging to assist professionals in achieving high-accuracy interpretation of OCT images. This review highlights the applications and scope of artificial intelligence in OCT imaging for the screening and detection of early-stage oral cancer.

Effectiveness of photodynamic therapy (PDT) in the management of symptomatic oral lichen planus -A systematic review

Background

Oral Lichen Planus (OLP) is a chronic mucocutaneous inflammatory disease of unknown aetiology characterized by T cell mediated autoimmune response which trigger apoptosis of basal cells of an oral epithelium. Corticosteroids are the primary therapeutic option for symptomatic OLP however treatment of lesions unresponsive to corticosteroids that tend to recur are becoming challenging for the clinicians. Currently photodynamic therapy (PDT) is being explored as a new curative option for reduction of pain and/or burning sensation associated with OLP lesions.

Aims and objective

The aim of this systematic review was to analyse studies from literature on the therapeutic effectiveness of PDT in management of symptomatic OLP unresponsive to corticosteroid therapy.

Methods

The electronic retrieval systems and databases PUBMED [MEDLINE], EMBASE, SCOPUS, WEB OF SCIENCE, GOOGLE SCHOLAR, and SCIENCE DIRECT were searched independently by two authors for relevant articles from January 2015 till July 2021. Primary studies focussed on the role of PDT in treatment of symptomatic OLP and published in English were included.

Results

Out of the 370 articles, only ten studies met the selection criteria. Included studies demonstrated PDT as an effective alternative modality to treat symptomatic OLP with no drop outs. In all studies, with PDT reduction in lesion size and VAS score was observed during each follow up sessions and after treatment (approx. 12 weeks) when compared to pre-treatment level (p < 0.001). Four studies noted PDT to be more effective than topical corticosteroids in reduction of signs and symptoms of OLP (p = 0.001).

Conclusion

In the future, long-term studies on larger population should be conducted to establish the clinical effectiveness in PDT in symptomatic OLP. Studies should take into consideration different sources of light and photosensitizers to determine the ideal parameters of PDT treatment for OLP. Wavelength is the most important factor in all types of photo therapies, so the most appropriate wavelength should be selected to obtain better outcome.

Postural Disharmony Causing Myofacial Pain: A Case Report and Review of Literature of the Treatment

Myofacial pain, a chronic painful condition of muscle origin, has numerous precipitating factors, if undiagnosed or left untreated could lead to compromised function and poor quality of life. In this case report, a female patient giving a history of 10 years of pain in the head and neck region was eventually diagnosed with myofacial pain secondary to bowing posture. The patient was successfully treated with combination of treatment modalities (TENS therapy, exercises, occlusal splint, etc.), which resulted in relief from chronic pain and improvement in quality of life.

Systemic effect of arecoline on the gastrointestinal system in oral submucous fibrosis affected wistar rats

Background

The intestine plays an important role in the digestion and absorption of ingested food and the elimination of undigested food, microbes, and microbial products. The functional reliability of the intestinal mucosal epithelial cells depends on the organised regulation of the epithelial cells, mucus layer, the intercellular tight junction, host innate and acquired immune response. The mucus layer of the gastrointestinal tract is the first line of innate host defense, essentially because of the secretory products of intestinal cells.

Aim

Present study was conducted to evaluate the effect of arecoline on the gastrointestinal system due to systemic absorption of the drug during the induction period of oral submucous fibrosis (OSMF) in Wistar rats.

Methods

Oral submucous fibrosis was induced by submucosal injection of arecoline in the buccal mucosa. Arecoline hydrochloride at a dosage of 10 mg/kg was injected into the submucosa of right buccal mucosa in experimental animals over a period of 3 months on every alternate day. After which, right buccal mucosa, gastrointestinal tract organs like stomach, large intestine, small intestine and liver were dissected, subjected to histopathological evaluation of the healthy and experimental Wistar rats were subjected to histopathological evaluation.

Results

On histological evaluation, OSMF was seen to affect Wistar rats showed significant changes in oral mucosa, decrease number of goblet cells in the small intestine as well in the large intestine and deranged hepatocytes. These marked changes indicated a definite effect on the gastro intestinal system by arecoline.

Conclusion

The study has highlighted the effect of arecoline due to systemic absorption during the induction process of OSMF in Wistar rats.

Challenges in the Diagnosis and Treatment of Patients with Rare and Orphan Diseases

Orphan diseases are diverse group of disorders that have not gained much of public attention as they are rarely reported worldwide. The term orphan and rare diseases are often used interchangeably when describing diseases that fall into an orphan or rare category. Around 80% of orphan diseases are chronic, serious, or life threatening, are of genetic origin, and are more prevalent in children and in adults above 40 years of age. Due to rarity, lack of financial support and specific drug to treat these diseases, diagnosis, and treatment becomes challenging. Diagnosis is usually delayed, and patient continues to suffer by seeking multiple specialist opinion. Nonavailability of specific drug and lack of financial funding or waivers to conduct to conduct clinical trial for invention of new orphan drug are the obstacles for targeted treatment. Hence, there is need for comprehensive integrative approach to manage orphan disease patients and pharmaceutical companies should be encouraged for invention of drugs at a reasonable cost for orphan diseases. In addition, community education through genetic-based learning modules is essential to increase awareness of population about risk factors and early diagnosis of orphan diseases, and to take opinion of specific specialist for thorough clinical evaluation. This review discusses challenges faced by the specialists toward diagnosis and treatment of orphan disease for well-being of an individual living with the disorder.

Clinical applications and performance of intelligent systems in dental and maxillofacial radiology: A review

Intelligent systems (i.e., artificial intelligence), particularly deep learning, are machines able to mimic the cognitive functions of humans to perform tasks of problem-solving and learning. This field deals with computational models that can think and act intelligently, like the human brain, and construct algorithms that can learn from data to make predictions. Artificial intelligence is becoming important in radiology due to its ability to detect abnormalities in radiographic images that are unnoticed by the naked human eye. These systems have reduced radiologists' workload by rapidly recording and presenting data, and thereby monitoring the treatment response with a reduced risk of cognitive bias. Intelligent systems have an important role to play and could be used by dentists as an adjunct to other imaging modalities in making appropriate diagnoses and treatment plans. In the field of maxillofacial radiology, these systems have shown promise for the interpretation of complex images, accurate localization of landmarks, characterization of bone architecture, estimation of oral cancer risk, and the assessment of metastatic lymph nodes, periapical pathologies, and maxillary sinus pathologies. This review discusses the clinical applications and scope of intelligent systems such as machine learning, artificial intelligence, and deep learning programs in maxillofacial imaging.

Digitization in forensic odontology: A paradigm shift in forensic investigations

Forensic dentistry deals with proper handling, examination, and evaluation of dental records, which are then presented in the interest of law for justice. It plays a major role in identification of deceased individuals who cannot be identified visually or by other means after mass disasters or crimes. Digital forensics has revolutionized the traditional forensic investigations in terms of acquisition, analysis, and reporting of forensic evidence and its application is becoming common in the mass disasters, earthquakes, and terrorism. Sophistication of software and advent of digital technologies such as computers, computer-aided design computer-aided manufacturing systems, digital records, facial reconstruction, touch-free autopsy, and virtopsy has resulted in quick identification and extraction of a large amount of data with reduced sampling bias. This paper focuses on the evolution of forensic dentistry for effective detection and resolution of medico-legal matters and also highlights the use of comparison microscopes and new robotic tools by few forensic laboratories for automation of deoxyribonucleic acid sampling processes for human identification.

Association of OLP and thyroid disorder: Case report and review of literature

Oral lichen planus is a chronic T cell mediated inflammatory condition with multifactorial etiology. Being autoimmune mediated condition, it has been associated with other autoimmune disorders. This case report discusses the possible presentation of oral lichen planus in hypothyroid patients as a marker of severity of the thyroid deficient status and the possible pathogenetic link between both the conditions.

Clinical evaluation of photodynamic therapy for the treatment of refractory oral Lichen planus - A case series

Oral lichen planus (OLP) is a chronic inflammatory, immune mediated mucocutaneous disorder of uncertain etiology. Psychologic stress has been found to be a main contributing factor in onset and progression of lesions. Most erosive OLP patients are refractory to available therapies, even corticosteroids, and report remarkable side effects. As photodynamic therapy (PDT) has proved it to be an effective and safe alternative treatment of abnormal or neoplastic cells we employed PDT for this diagnosis. Due to limited literature on application of this method for treatment of refractory erosive OLP, we present a series of 10 cases of bilateral erosive LP treated by 5 -Aminolevulinic acid mediated PDT. Outcome of our clinical cases showed remarkable improvement in lesions with reduction in Reticulation, Erythema, Ulceration (REU) score (from 5 to 3) and burning sensation as recorded by Visual Analogue Scale (Pretreatment VAS ranged from 5 to 8, posttreatment VAS was 0-1). PDT could be used as a complementary treatment method for symptomatic resistant OLP lesions, although our findings necessitate further research to validate the efficacy of this method for control of resistant oral lichen planus.

Natural agents in the management of oral mucositis in cancer patients-systematic review

INTRODUCTION

Oral mucositis is most severe complication of cancer therapy characterized by ulcerative lesions of oral mucosa causing negative impact on patient's quality of life. Wide variety of therapeutic agents are available to reduce the lesions of mucositis. Currently, natural herbal remedies have become popular in treating this condition due to fewer side effects than synthetic drugs.

AIM

The aim of this systematic review is to compile evidence based studies to evaluate the effectiveness of natural agents in the management of oral mucositis induced by chemotherapy or radiotherapy in cancer patients.

MATERIALS AND METHOD

Computerized literature searches were performed to identify all published articles in the subject. The following databases were used: PUBMED [MEDLINE], SCOPUS, COCHRANE DATABASE, EMBASE and SCIENCE DIRECT using specific keywords. The search was for limited articles published in English which were read in full by two authors.

RESULTS

Twenty six randomized controlled trials satisfied our inclusion criteria. Most studies showed statistically significant result demonstrating the efficacy of natural agents with minimal side effects except manuka honey which was not tolerated by few patients.

CONCLUSION

Natural agents proved to be promising in healing cancer induced oral mucositis but future demands further randomized controlled clinical trials on these agents which should also be focused on drug interactions of the natural remedies.

Design and Development of Real Time Patient Monitoring System with GSM Technology

Technology keeps evolving every second. Humans receive all the essential information with just one touch. Be it the weather forecast or ordering any grocery or communicating with one's peers, everything happens so easily and efficiently. It is undoubtedly user friendly. When the same technology associates itself with the medical equipment it becomes easier to fetch and process the patient's data in real time. It also helps to make several life-saving, spontaneous decisions for the critical care. This paper talks about the patient monitoring system. The physiological parameters of the patient are continuously monitored in real time using sensors. The data that is obtained from the sensor is then sent to an Arduino Uno microcontroller where it is analyzed. If the patient's data differs from the required threshold values, an emergency message is sent to the assigned doctor's mobile. This is done using the GSM module which is interfaced with the microcontroller. Verifying the system in software is done using Proteus.

Assessment of the Accuracy of Whole Blood/Serum Rapid Point-of-Care HIV Three Dot Test for Oral Fluid Specimens

BACKGROUND

Saliva rapid point of care HIV tests have proven advantages over blood-based HIV tests in terms of quality, rapidity and convenience.

AIM

To assess the sensitivity, specificity and reproducibility of saliva samples using the serum/ whole blood rapid test and to compare it with serum specimens.

MATERIAL & METHODS

52 seropositive and 52 seronegative patients were included in the study. Stimulated and unstimulated saliva samples were collected and tested using the serum/ whole blood signal HIV THREE DOT rapid test (span diagnostics).

RESULTS

The sensitivity, specificity, positive predictive value and negative predictive value of the test was found to be 100% for saliva samples.

CONCLUSION

Saliva samples can be used as a substitute to serum/whole blood for HIV testing. It can be done using the serum/whole blood kits which are cheaper and readily available thus broadening the reach of testing programs in resource limited settings.

Molecular and genetic aspects in the etiopathogenesis of ameloblastoma: An update

Ameloblastoma is the second most common benign epithelial odontogenic tumor and though it is of a benign nature, it is locally invasive, has a high recurrence rate and could potentially become malignant. Many theories have been proposed to explain the pathogenesis of ameloblastoma. Proper understanding of the pathogenic mechanism involved in ameloblastoma and its proliferation aids in constituting proper treatment of choice at an early stage, preventing morbidity associated with extensive therapy. An attempt has been made to discuss the current concepts related to molecular and genetic changes that occur in ameloblastoma as these could affect treatment plan and prognosis.

Efficacy of light based detection systems for early detection of oral cancer and oral potentially malignant disorders: Systematic review

Background

Earlier detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is essential for dental professionals to improve patient survival rates. The aim of this systematic review is to to evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of OSCC and OPMD.

Material and Methods

The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE] and Science direct. The search was for limited articles published in English or with an English abstract and articles published during the period from January 2005 to April 2014. Clinical trials utilized ViziLite, Microlux TM/DL and Visual Enhanced Light scope (VELscope) for early detection of OPMD and OSCC.

Results

Twenty primary studies published satisfied our criteria for selection - 10 utilised chemiluminescence and 10 tissue autofluorescence. Senstivity of Vizilite for detecting OSCC nad OPMD ranged from 77.1 % to 100% and specificity was low that ranged from 0% to 27.8%.Most have shown that chemiluminescence increases the brightness and margins of oral mucosal white lesions and thus assist in identification of mucosal lesions not considered under Conventional visual examination. However, it preferentially detects leukoplakia and may fail to spot red patches. Clinical trials demonstrated that sensitivity of VELscope in detecting malignancy and OPMD ranged from 22 % to 100 % and specificity ranged from 16 % to 100%. Most studies concluded that VELscope can help the experienced clinician to find oral precursor malignant lesions. But it couldnot differentiate between dysplasia and benign inflammatory conditions.

Conclusions

Both devices are simple, non-invasive test of the oral mucosa but are suited for clinicians with sufficient experience and training. More clinical trials in future should be conducted to establish optical imaging as an efficacious adjunct tool in early diagnosis of OSCC and OPMD.

Key words:Oral cancer, early diagnosis, potentially malignant disorders, chemiluminescence, tissue autofluorescence, VELscope, ViziLite plus.

Oral pH in gastroesophageal reflux disease

AIMS AND OBJECTIVES

The aim of this study is to compare surface pH in various parts of the oral cavity between patients with gastroesophageal reflux disease (GERD) and healthy controls.

METHODS

Using a flat pH meter sensor, fixed electrode pen type digital pH meter, oral pH levels were assessed at different mucosal sites among 34 GERD patients and 32 healthy controls. Salivary flow rates and buffering capacity were also assessed in them. A thorough oral examination was performed to screen for any oral and dental changes.

RESULT

A significantly lower pH of 6.65 ± 0.13 (mean ± SD) was found in the GERD group compared to control group 7.23 ± 0.12 (p < 0.05). Least pH was found in the floor of the mouth 6.594 ± 0.17 and highest in the lower labial mucosa among the GERD patients. Salivary flow rate and buffering capacity were low in these patients. Significant changes were noticed in the hard and soft tissues of the oral cavity among the GERD group.

CONCLUSION

Oral mucosal pH is altered in GERD patients and may contribute to effects on the oral cavity.

Is dosimetry still a necessity in current dental practice?

Today, dentists have a wide range of imaging modalities to choose from, the film based techniques, digital techniques, and the recent introduction of 3D volumetric or cone beam computed tomography (CBCT). The inherent design features of the new generation dental x-ray equipment has significantly improved over the years with no evidence of substandard x-ray units in operation. In dental facilities radiological workload is comparatively low, newer radiation equipments and accessories follow safety guidelines and employ better radiation protection measures for the patient and the operator. Dentists' knowledge and expertise in radiation protection measures is good, enabling them to carry out riskfree radiation procedures in their practice. Therefore, the present study is aimed at assessing the need for dosimeters in current dental scenario. 'Is there currently a significant risk from dental radiography to merit the use of personal dosimetery in dental practice. 'Dental health professionals (Oral radiologists) and radiographic assistants of fourteen dental colleges in Karnataka state participated in this questionnaire study. The questionnaire consisted of the following questions--the make, type, year of manufacture of radiographic machines used in their setup, number of radiographs made per day in the institution, type of receptors used, number of personnel at risk for radiation exposure, radiation protection measures used, regular monitoring by personal dosimeters, equivalent dosage readings for the past 12 months and whether the reading of thermoluminescent dosimeters (TLD) for any personnel had exceeded the recommended exposure value in the last 3 years. Dosimetry records of the radiology staff in the last three years shows doses no more than 1.50 mSv per year. The various institutions' dose (person mSv) was in the range of 3.70 mSv-3.90 mSv. Personal monitoring for Dentists can be omitted in the dental colleges since the estimated dose of oral radiologists contributed less than 0.01 mSv to the total average annual effective dose equivalent. Hence personal monitoring services (TLD Badges) for dentists employed in dental colleges should not be made mandatory.

Rhinocerebral Mucormycosis Among Diabetic Patients: An Emerging Trend

Mucormycosis is an acute necrotic fungal infection with a fulminant course. Earlier considered a rare entity, mucormycosis is being reported with increasing frequency in recent years, possibly due to the increase in immunocompromised population especially diabetic patients. We report three cases of rhinocerebral mucormycosis among poorly controlled diabetic patients. This article emphasizes the need for further awareness of this disease, early diagnosis, and treatment to counter this opportunistic infection.

Age estimation using pulp/tooth area ratio in maxillary canines-A digital image analysis

INTRODUCTION

Determination of age of a subject is one of the most important aspects of medico-legal cases and anthropological research. Radiographs can be used to indirectly measure the rate of secondary dentine deposition which is depicted by reduction in the pulp area.

MATERIALS AND METHODS

In this study, 200 patients of Karnataka aged between 18-72 years were selected for the study. Panoramic radiographs were made and indirectly digitized. Radiographic images of maxillary canines (RIC) were processed using a computer-aided drafting program (ImageJ). The variables pulp/root length (p), pulp/tooth length (r), pulp/root width at enamel-cementum junction (ECJ) level (a), pulp/root width at mid-root level (c), pulp/root width at midpoint level between ECJ level and mid-root level (b) and pulp/tooth area ratio (AR) were recorded. All the morphological variables including gender were statistically analyzed to derive regression equation for estimation of age.

RESULTS

It was observed that 2 variables 'AR' and 'b' contributed significantly to the fit and were included in the regression model, yielding the formula: Age = 87.305-480.455(AR)+48.108(b). Statistical analysis indicated that the regression equation with selected variables explained 96% of total variance with the median of the residuals of 0.1614 years and standard error of estimate of 3.0186 years.

CONCLUSION

There is significant correlation between age and morphological variables 'AR' and 'b' and the derived population specific regression equation can be potentially used for estimation of chronological age of individuals of Karnataka origin.

Relationship between femur bone mineral density, body mass index and dental panoramic mandibular cortical width in diagnosis of elderly postmenopausal women with osteoporosis

OBJECTIVES

To measure and determine mandibular cortical width (MCW) on the panoramic radiographs, to evaluate the usefulness of the method in identifying postmenopausal women with low femoral bone mineral densities (f- BMD) and to correlate the radiographic findings on panoramic radiographs with the f-BMD assessed by dual X-ray absorptiometry (DXA) to predict the efficacy of the radiographic method in diagnosing osteoporosis.

MATERIALS AND METHODS

One hundred and twenty postmenopausal women (60 normal and 60 osteoporotic) in the age group of 50-75 y with f-BMD assessed by DXA had undergone panoramic radiographic examination. The patients were classified as normal (T-score ≥ -1.0) and osteoporotic (T-score ≤ -2.5). MCW on panoramic radiographs was measured bilaterally at the mental foramen region with a caliper and their mean was used as the exposure measure in the analysis.

RESULTS

Student t-test showed that mean f-BMD, BMI and MCW was found be less in osteoporotic patients as compared to normal group with a statistically significant p-value < 0.001. Pearson correlation coefficient test revealed that MCW correlated positively with f-BMD and showed a significant decrease with age of the patient.

CONCLUSION

Postmenopausal women with low f-BMD had thinner mandibular cortex at the mental foramen region when compared to normal subjects and are more susceptible to femoral neck fractures. Mandibular inferior cortical width at the mental foramen region could be used to identify postmenopausal women with low f- BMD. Hence, dental panoramic radiographs serve as a useful screening tool for early diagnosis of osteoporotic fractures.

Oral and salivary changes among renal patients undergoing hemodialysis: A cross-sectional study

We wanted to assess oral and salivary changes in end stage renal disease (ESRD) patients undergoing hemodialysis (HD) and to understand the correlation of such changes with renal insufficiency. The cross-sectional study was performed among 100 ESRD patients undergoing HD. Among these, 25 patients were randomly selected to assess the salivary changes and compared with 25 apparently healthy individuals who formed the control group. Total duration of the study was 15 months. Oral malodor, dry mouth, taste change, increased caries incidence, calculus formation, and gingival bleeding were the common oral manifestations. The flow rates of both unstimulated as well as stimulated whole saliva were decreased in the study group. The pH and buffer capacity of unstimulated whole saliva was increased in the study group, but stimulated whole saliva did not show any difference. ESRD patients undergoing HD require special considerations during dental treatment because of the various conditions inherent to the disease, their multiple oral manifestations and the treatment side-effects.

Langerhans cell histiocytosis with oral manifestations: a rare and unusual case report

Langerhans cell histiocytosis (LCH), is a rare, proliferative disorder in which the accumulation of pathologic Langerhans cells leads to local tissue infiltration and destruction. We present a case of a 32 years old, completely edentulous female patient who presented with erythema of hard palate, maxillary alveolar mucosa and mucosa over the distobuccal part of mandibular alveolar ridge with foci of ulcerations. Histopathologic features were suggestive of LCH which was confirmed by immunohistochemistry which was CD1a positive, confirmatory for LCH. Bone scan revealed multiple bone involvement. At this stage, disease had already progressed to multisystem involvement with endocrinal abnormalities (primary hypothyroidism and hyperprolactinemia), requiring aggressive treatment. Therefore, this case is a reminder of the possibility of occurrence of this rare disease in the oral cavity which might manifest itself in multiple presentations thus easily leading to the misdiagnosis and therefore, it could be easily overlooked by dentists.

Key words:Langerhans cell histiocytosis, immunohistochemistry, bone scan.

Evaluation of the accuracy, precision and validity of hydrophilic vinyl polysiloxane impression material for bite mark analysis

The present study was undertaken to assess the accuracy, precision and validity of hydrophilic Vinyl Poly Siloxane [VPS] impression material for bite mark documentation and analysis. Medium body VPS impressions of maxillary and mandibular anterior teeth among thirty subjects were taken and dental stone casts prepared. Hollow volume overlays were made and metric analysis was done using advanced imaging software like Adobe Photoshop - 9 and Image J. These values were compared to the measurements taken from bite mark impressions of the same 30 individuals on wax wafers using light body VPS material. The mean differences in the parameters measured by the different techniques were compared using Intra Class Correlation Coefficients [ICCC]. Additionally validity parameters such as sensitivity, specificity, positive and negative predictive value were computed.

Comparison of the efficacy of conventional radiography, digital radiography, and ultrasound in diagnosing periapical lesions

OBJECTIVES

The aim of this study was to evaluate the efficacy of conventional radiography, digital radiography and ultrasound imaging in diagnosing periapical lesions.

STUDY DESIGN

Twenty-one patients aged between 15 and 45 years with well defined periapical radiolucency associated with anterior maxillary or mandibular teeth requiring endodontic surgery or extraction were selected and consented to the study. Preoperative intraoral periapical radiographs and digital images using charge-coupled device obtained by paralleling technique were assessed by 3 specialist observers who gave their diagnosis of the periapical lesions. Then ultrasound examination was performed and the images were assessed for size, contents, and vascular supply by 3 ultrasonographers. It was followed by curettage of periapical tissues to enable histopathologic investigation, which is the gold standard in diagnosis. The data were statistically analyzed using SPSS, analysis of variance, and kappa statistics.

RESULTS

The percentage accuracy of diagnosing periapical lesions using conventional radiography was 47.6%, digital radiography 55.6%, and ultrasound 95.2%. Ultrasound had the highest sensitivity and specificity: 0.95 and 1.00, respectively.

CONCLUSION

Conventional and digital radiography enable diagnosis of periapical diseases, but not their nature, whereas ultrasound provides accurate information on the pathologic nature of the lesions, which is of importance in predicting the treatment outcome. Therefore ultrasound can be used as an adjunct to conventional or digital radiography in diagnosing periapical lesions.

Removal of lead from aqueous solution using Syzygium cumini L.: equilibrium and kinetic studies

The biosorption of lead ions from aqueous solution by Syzygium cumini L. was studied in a batch adsorption system as a function of pH, contact time, lead ion concentration, adsorbent concentration and adsorbent size. The biosorption capacities and rates of lead ions onto S. cumini L. were evaluated. The Langmuir, Freundlich, Redlich-Peterson and Temkin adsorption models were applied to describe the isotherms and isotherm constants. Biosorption isothermal data could be well interpreted by the Langmuir model followed by Temkin model with maximum adsorption capacity of 32.47 mg/g of lead ion on S. cumini L. leaves biomass. The kinetic experimental data were properly correlated with the second-order kinetic model.