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      Validation of dental X-ray by cytokine RANTES – comparison of X-ray findings with cytokine overexpression in jawbone

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          Abstract

          Introduction

          There is a need to clarify the extent to which the most common diagnostic tool in dentistry – two-dimensional panoramic tomography (2D-OPG) – is suitable for identifying fatty degenerative osteolysis of jawbone (FDOJ).

          Materials and methods

          To obtain a qualitative assessment of edentulous jawbone sections, the results from 2D-OPG with a defined X-ray density (XrDn), expression of the cytokine RANTES (regulated on activation, normal T-cell expressed and secreted), and a transalveolar ultrasound system for measuring jawbone density were compared.

          Results

          The difference in the XrDn of healthy jawbone and FDOJ are minimal, whereas RANTES is up to 25-fold higher in FDOJ. In contrast to 2D-OPG, transalveolar ultrasound showed coincidental findings in FDOJ areas.

          Discussion

          Comparisons of the data revealed a discrepancy between the XrDn of 2D-OPGs and the medullary osteopathies in the jawbone like FDOJ.

          Conclusion

          The data suggest that there is a critical attitude toward the use of 2D-OPG as a sole imaging diagnostic tool for assessing chronic inflammatory processes in the jawbone. Specifically, 2D-OPG is objectively not suitable for depicting FDOJ.

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          Most cited references19

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          Correlation of tissue and plasma RANTES levels with disease course in patients with breast or cervical cancer.

          The beta-chemokine RANTES was measured in plasma in 43 patients with breast cancer and in 23 patients with cervical cancer, and the RANTES content in primary tumors, tumor metastatic to lymph nodes, and clinically normal skin or pelvic mucosa was measured. In addition, plasma levels were determined in all of the patients for the platelet-derived chemokine beta-thromboglobulin (beta-TG) and for IFN-gamma, interleukin (IL)-2, IL-4, IL-5, and IL-10, along with serum IgE levels and blood eosinophils. Plasma RANTES levels were found to be higher in order of stages IV, III, II, and I of each cancer except for stage I. A marked increase in plasma RANTES level (> 10,000 pg/ml) was found in 27% of patients with progressive malignancy but in none of those in clinical remission. The platelet RANTES content was correspondingly decreased in those patients with increased plasma RANTES levels. Beta-TG showed a pattern similar to RANTES both in plasma and platelets, but with much less dramatic differences between patients with different stages of disease. Other allergic parameters, IgE, eosinophils and plasma IFN-gamma, IL-2, -5, and -10, were not elevated in the cancer patients. The RANTES content was markedly elevated in the primary tumor and metastatic lesions (lymph node or skin) from all of the patients with breast or cervical cancer, irrespective of the plasma RANTES level. In addition, in patients with progressive breast or cervical cancer, but not in patients thought to be cured of these tumors, the RANTES content was markedly increased in clinically normal tissue taken from near the operative site several months postoperatively, as well as in intact skin or mucosa taken perioperatively near the excised tumor. This study suggests an as-yet-undefined but important role played by RANTES in carcinogenesis, as well as the possibility that a RANTES assay in tissue surrounding a tumor or postoperative tumor site may help predict prognosis in these patients.
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            Detection of periapical bone defects in human jaws using cone beam computed tomography and intraoral radiography.

            To compare the diagnostic accuracy of intraoral digital periapical radiography with that of cone beam computed tomography (CBCT) for the detection of artificial periapical bone defects in dry human jaws. Small and large artificial periapical lesions were prepared in the periapical region of the distal root of six molar teeth in human mandibles. Scans and radiographs were taken with a charged couple device (CCD) digital radiography system and a CBCT scanner before and after each periapical lesion had been created. Sensitivity, specificity, positive predictive values, negative predictive values and Receiver Operator Characteristic (ROC) curves as well as the reproducibility of each technique were determined. The overall sensitivity was 0.248 and 1.0 for intraoral radiography and CBCT respectively, i.e. these techniques correctly identified periapical lesions in 24.8% and 100% of cases, respectively. Both imaging techniques had specificity values of 1.0. The ROC Az values were 0.791 and 1.000 for intraoral radiography and CBCT, respectively. With intraoral radiography, external factors (i.e. anatomical noise and poor irradiation geometry), which are not in the clinician's control, hinder the detection of periapical lesions. CBCT removes these external factors. In addition, it allows the clinician to select the most relevant views of the area of interest resulting in improved detection of the presence and absence of artificial periapical lesions.
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              The unexpected pleiotropic activities of RANTES.

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                Author and article information

                Journal
                Clin Cosmet Investig Dent
                Clin Cosmet Investig Dent
                Clinical, Cosmetic and Investigational Dentistry
                Clinical, Cosmetic and Investigational Dentistry
                Dove Medical Press
                1179-1357
                2014
                21 August 2014
                : 6
                : 71-79
                Affiliations
                Clinic for Integrative Dentistry, Munich, Germany
                Author notes
                Correspondence: Johann Lechner, Clinic for Complementary Dentistry, 10A Gruenwalder St, 81547 Munich, Germany, Tel +49 89 697 0055, Fax +49 89 692 5830, Email drlechner@ 123456aol.com
                Article
                ccide-6-071
                10.2147/CCIDE.S69807
                4144985
                31afabe5-3c05-4b4f-bf30-cdab8e1e4732
                © 2014 Lechner. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Categories
                Original Research

                osteonecrotic jawbone,silent inflammation,rantes,bone density measurement

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