RESUMEN
PURPOSE: The aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks. MATERIALS AND METHODS: Twenty digital lateral cephalometric radiographs were evaluated by two groups of dental specialists, and 17 cephalometric landmarks were identified. The x and y coordinates of each landmark were recorded. The mean value for each landmark was considered the best estimate and used as the standard. Variation in measurements of the distance between landmarks and measurements of the angles associated with certain landmarks was also assessed by a subset of two observers, and intraobserver and interobserver agreement were evaluated. RESULTS: Intraclass correlation coefficients were excellent for intraobserver agreement, but only good for interobserver agreement. The least reliable landmark for orthodontists was the gnathion (Gn) point (standard deviation [SD], 5.92 mm), while the orbitale (Or) was the least reliable landmark (SD, 4.41 mm) for dentomaxillofacial radiologists. Furthermore, the condylion (Co)-Gn plane was the least consistent (SD, 4.43 mm). CONCLUSION: We established that some landmarks were not as reproducible as others, both horizontally and vertically. The most consistently identified landmark in both groups was the lower incisor border, while the least reliable points were Co, Gn, Or, and the anterior nasal spine. Overall, a lower level of reproducibility in the identification of cephalometric landmarks was observed among orthodontists.
RESUMEN
Granulomas de células gigantes (GCCG) são lesões benignas intra-ósseas proliferativas. Estas lesões podem aparecer na região anterior da maxila ou da mandíbula, porém mais frequentemente encontradas na mandíbula. A etiopatogenia permanece desconhecida, no entanto, alguns autores consideram como uma resposta reparadora, ao invés de uma condição neoplásica. Clinicamente, o CGCG é assintomático, podendo causar expansão com desvio ou a proliferação da cortical óssea. Esta condição é geralmente unifocal. A remoção cirúrgica é, na maioria dos casos, o tratamento de escolha. Embora, os métodos de tratamento não-cirúrgicos, tais como injeções intralesionais de corticoesteróides, administração sistêmica de calcitonina e interferon foram relatados. Este artigo descreve as características radiográficas de um CGCG extenso na região anterior mandibular em um paciente de 09 anos de idade. O tratamento incluiu ressecção óssea com substituição por tíbia e aplicação de fatores de crescimento ósseo.
Central giant cell granulomas (CGCG) are benign intraosseous proliferative lesions. Usually located are at the anterior region of the maxilla ormandible, although are more frequently found in the mandible. Etiopathogenesis of these lesions has remained unknown, however, some consider them as reparative response rather than neoplastic condition. Clinically CGCG present as asymptomatic, with expansive swelling causing deviation or proliferation of cortical bone. This condition is usually unifocal. Surgical removal is often the preferred treatment. Although nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. This article describes the radiographic features of a large CGCG in the anterior mandibular region seen in a9 year-old patient. Treatment of this lesion included resection of the anterior region of the mandible and replacement by tibia with bone growth factors.