ABSTRACT
Objetivo: Este estudo avaliou a influência do método de visualização e análise do exame de tomografia computa-dorizada de feixe cônico (TCFC) no diagnóstico de afecções endodônticas. Materiais e métodos: Vinte casos clínicos contendo doze diferentes afecções endodônticas foram ana-lisados por dois especialistas em radiologia odontológica e um especialista em endodontia. Inicialmente, os avaliadores visualizaram os casos em Portable Document Format (PDF) contendo uma seleção de imagens digitais e, por consenso, descreveram suas hipóteses diagnósticas para cada caso. Após uma semana, os avaliadores reavaliaram os casos, desta vez utilizando reconstrução multiplanar em um visualizador de imagens no formato Digital Imaging and Communications in Medicine (DICOM). Novamente, por consenso, eles indicaram suas hipóteses diagnósticas. Resultados: Em 10% dos casos, houve discrepância entre os diagnósticos realizados utili-zando as seleções de imagens digitais em PDF e utilizando a reconstrução multiplanar. A visualização das imagens em PDF obteve sensibilidade de 0.714, especificidade de 0.966, e acurácia de 90%. Discussão: Na maioria destes casos, as afecções endodônticas identificadas utilizando o visuali-zador de imagens DICOM (reconstrução multiplanar) não foram detectadas quando visualizados os PDF de imagens pré-selecionadas. Conclusão: Embora mais estudos sejam necessários, os autores reiteram que a utilização de recons-truções multiplanares sempre são preferíveis comparadas à outras formas de análise da TCFC, para que se atinja o máximo potencial diagnóstico do exame de imagem.
Aim: This study evaluated the influence of the method used for visualization and analysis of cone-beam com-puted tomography (CBCT) on the diagnosis of endodontic conditions. Materials and methods: Twenty clinical cases containing twelve different endodontic conditions were analyzed by two specialists in dental radiology and one specialist in endodontics. Initially, the evaluators viewed the cases in Portable Document Format (PDF) containing a selection of digital images and, by consensus, described their diagnostic hypotheses for each case. One week la-ter, the evaluators reassessed the cases, this time using multiplanar reconstructions with a Digital Imaging and Communications in Medicine (DICOM) format image viewer. Once more, by consensus, they recorded their diagnostic hypotheses. Results: In 10% of the cases there was a discrepancy between the diagnoses made using preselected digital images in PDFs and by viewing multiplanar reconstructions. The visualization of the PDF images obtained a sensitivity of 0.714, specificity of 0.966, and 90% accuracy. Discussion: In the majority of these cases, endodontic conditions identified using the DICOM image viewer (multiplanar reconstruction) were not detected using the PDFs of preselected images. Conclusion: Although more studies are needed, the au-thors reiterate that using multiplanar reconstructions should always be preferred to other forms of analysis for CBCT, so that the maximum diagnostic potential of the imaging exam can be achieved.
Subject(s)
Diagnosis , Endodontics/methods , Cone-Beam Computed Tomography/methodsABSTRACT
Abstract This study analyzed the impact of CBCT on the level of confidence in diagnostic and treatment thinking in mandibular lower molar (M3M) clinical management. Thirty cases for which panoramic radiographs and CBTC images were available were selected and classified according to radiologic signs indicating the proximity of the M3M to the mandibular canal (interruption of the radiopaque borders of the canal of the mandibular canal wall, darkening of the roots, and diversion or narrowing of the canal, n = 10 for each classification). Twelve oral and maxillofacial surgeons (OMS) contributed to this study by answering two questionnaires. The first questionnaire contained a clinical description of the case and a panoramic radiograph. After 30 days, a second questionnaire with the same clinical illustrations and tomographic multiplanar reconstruction images was administered. Both questionnaires asked specialists to rate diagnostic confidence, the surgical complexity, chosen treatment, and surgical confidence. In approximately 40% of answers, CBCT images had a positive impact on ratings of diagnostic confidence and treatment thinking confidence, and in 24.4%, they increased the surgical complexity score. There was no change in the treatment plan following the use of CBCT, but the CBCT examination was a determining factor for diagnosis and treatment planning in 72.8% of the answers CBCT improved the confidence level in diagnostic and treatment thinking of the M3M management while also increasing the perceived level of surgical complexity. The findings of this study support the need to consider using CBCT in diagnosis and treatment planning for M3Ms with radiographic signs such as darkening of the roots, interruption of the radiopaque borders of the mandibular canal, or deviation of the mandibular canal and narrowing of the roots.
ABSTRACT
ABSTRACT: Central ossifying fibroma is a lesion in which diagnosis has proved intriguing and unclear for presenting clinical, radiographic, and even histopathological similarities to other types of lesions such as the fibrous dysplasia of bone and cement-bone dysplasia. It is a benign neoplasm of uncertain etiology and slow development in which the mandible is affected more frequently than the maxilla. We described a case of central cemento-ossifying fibroma involving the right mandible of a thirty-five-female patient by presenting its clinical, radiographic, and histological characteristic sand discussing some differential diagnoses.
RESUMEN: El fibroma cemento-osificante central es una lesión que requiere un diagnóstico diferencial ya que muestran similitud clínica, histológica y radiológica con la displasia fibrosa y con la displasia cemento-ósea. Esta lesión es un tumor benigno de etiología incierta, presenta crecimiento lento y afecta principalmente la mandíbula más que el maxilar. Se reporta un caso de un paciente de sexo femenino de 35 años, diagnosticada con fibroma cementoosificante central que le afectó el lado derecho de la mandíbula. Se describen las características clínicas, histológicas y radiológicas de la paciente y se discuten los diversos diagnósticos diferenciales.
Subject(s)
Humans , Female , Adult , Mandibular Neoplasms/surgery , Fibroma, Ossifying/diagnosis , Radiography, Panoramic , Tomography, X-Ray Computed , Diagnosis, Differential , Facial Asymmetry/etiology , Orthognathic Surgical Procedures , Jaw/anatomy & histologyABSTRACT
O objetivo deste artigo foi avaliar programas de imagens odontológicas disponíveis gratuitamente na internet como ferramentas para prática do cirurgião-dentista e que funcionam em computadores pessoais. Foi realizada uma pesquisa no Medline entre os anos de 2005 a 2014, com enfoque em software utilizado para visualizar imagens tomográficas na Odontologia. Para a pesquisa dos softwares foi realizado busca no site Google e em sites especializados por programas gratuitos disponíveis para windows. Foram utilizados as palavras chaves "free dicom viewer" e "dental software". De acordo com os critérios de inclusão e exclusão três softwares foram analisados. Conhecer a existência de softwares gratuitos e que dão um grande suporte para os profissionais é de extrema importância para a Odontologia atual.
The aim of this study was to review the dental imaging programs available for free on the Internet as tools to practice DDS and running on personal computers. A survey was conducted in Medline from 2005 to 2014, with focus on the software used to view tomographic images in dentistry. A research about the software was done at Google search site and specialized sites for free programs available for Windows. Key words were used "free dicom viewer" and "dental software." According to the criteria of inclusion and exclusion 3 softwares were analyzed. Knowing the existence of free softwares which are able to support professionals improve their jobs is a matter of great importance for the current dentistry.
Subject(s)
Image Processing, Computer-Assisted , Information Systems , Technology, RadiologicABSTRACT
Objetivo: descrever a importância da sedação com óxido nitroso como adjuvante em procedimentos odontológicos. Método: a literatura foi revisada nas bases de dados MEDLINE, LILACS, SCIELO, SCOPUS, utilizando como estratégia de busca os termos ?óxido nitroso?, ?odontologia?, ?sedação consciente?. Considerações finais: a sedação com óxido nitroso é muito valido dentro do consultório odontológico, em razão do seu potencial ansiolítico e relaxante, desde que seja utilizado por um profissional habilitado.
Objective: to describe the importance of sedation with nitrous oxide as an adjunct in dental procedures. Method: the literature was reviewed in MEDLINE, LILACS, SCIELO, SCOPUS, using as search strategy terms "nitrous oxide", "dentistry", "conscious sedation". Final Thoughts: the sedation with nitrous oxide is very valid in the dental office, because of its potential anxiolytic and relaxing, since it is used by a qualified professional.