Influence of notebook computers screens and undergraduate level of dental students in the radiographic detection of carious lesions

Aim: To evaluate the influence of notebook computers screens and undergraduate level of dental students in the radiographic detection of carious lesions. Methods: Bitewing digital radiographs were presented to 3rd and 5th year dental students in three different notebooks computers: Notebook 1 with anti-glare screen (1366×768 pixels), Notebook 2 without anti-glare screen (1366×768 pixels), and Notebook 3 with anti-glare screen (1920×1080 pixels). A reference standard based on a consensus analysis was set by three senior professors of Oral Radiology and Cariology. Sensitivity, specificity and accuracy values were measured and submitted to two-way ANOVA at a significance level of 5%. Results: Notebook 2 provided significantly lower sensitivity values (Mean 56.5% ± 2.94) than notebook 3 (71.1% ± 2.82) (p = 0.002). We found no statistically significant differences between the two undergraduate years (p > 0.05). Conclusion: The anti-glare screen of notebook computers screens can influence the radiographic detection of carious lesions, but the undergraduate level of dental students does not influence this diagnostic task

Influência do tipo de compósito e tempo de exposição aos raios-x na produção de artefatos radiográficos em modelo de restaurações classe II / Influence of the composite type and exposure time to x-rays on the production of radiographic artifacts in a class II restoration model

Aim: To evaluate the effect of the exposure time and the type of composite in the production of radiographic artifact at the tooth / restorative interface. Materials and Methods: In 20 healthy bovine incisors, cavity preparations and class II restorations were made using composite resins Filtek Bulk Fill One (group 1) and Filtek Z350 (group 2). Then, the teeth were exposed to obtain digital radiographs, varying the exposure time by 0.07, 0.10, 0.14, 0.20 and 0.25s. The images were evaluated for investigation of the presence of artifact through the analysis of the modified number of pixels (QPXD) and the average gray value in class II (MGVR) restorations, using the Image J software (National Health Institute). Results: The presence of artifact was observed in all evaluated samples, regardless of the type of restorative material and the exposure time employed. There was no statistically significant difference in QPXD and MGVR between the resins used (ANOVA 2 factors, p p> 0.05). The MGVR analysis indicated that there were no statistically significant differences between resins or between exposure times (p> 0.05). There was a correlation between QPXD and MGVR (r = 0.29) for Filtek Bulk Fill One resin. Discussion: This study reveals the importance of attention to the region of the tooth-restoration interface by the Surgeon-Dentist, who must combine the radiographic findings diagnosed using digital tools to clinical signs in order to compose a unique therapeutic project with a real need for intervention, if there is such need. Conclusion: The presence of altered pixels on dentin in the region of the tooth-restoration interface was identified in all specimens. The variation in the exposure time as well as the type of the restorative composite did not influence the increase or decrease of QPXD and neither in MGVR. However, there was a correlation between QPXD and MGVR for Filtek Bulk Fill One resin.

Objetivo: Avaliar o efeito do tempo de exposição e do tipo de compósito na produção de artefato radiográfico na interface dente/material restaurador. Materiais e Métodos: Em 20 incisivos bovinos hígidos foram feitos preparos cavitários e restaurações classe II utilizando resinas compostas Filtek Bulk Fill One (grupo 1) e a Filtek Z350 (grupo 2). Em seguida, os dentes foram expostos para obtenção das radiografias digitais, variando o tempo de exposição em 0,07, 0,10, 0,14, 0,20 e 0,25s. As imagens foram avaliadas para investigação da presença de artefato através da análise do número de pixels modificado (QPXD) e do valor médio de cinza nas restaurações de classe II (MGVR), utilizando o software Image J (Instituto Nacional de Saúde, Bethesda, MD, EUA). Resultados: Observou-se a presença de artefato em toda amostra avaliada, independente de tipo de material restaurador e tempo de exposição empregado. Não se observou diferença estatisticamente significativa na QPXD e nos MGVR entre as resinas utilizadas (ANOVA 2 fatores, p p>0,05). A análise do MGVR indicou que não houve diferenças estatisticamente significativas entre as resinas nem entre os tempos de exposição (p>0,05). Observou-se uma correlação entre a QPXD e o MGVR (r=0,29) para a resina Filtek Bulk Fill One. Discussão: Como significado clínico, o presente estudo revela a importância da atenção à região da interface dente-restauração por parte do Cirurgião-Dentista, o qual deve aliar os achados radiográficos diagnosticados com o auxílio de ferramentas digitais aos sinais clínicos, para compor um projeto terapêutico singular com uma real necessidade de intervenção, caso haja. Conclusão: Foi identificado a presença de pixels alterados sobre a dentina na região da interface dente-restauração em todos os corpos de prova. A variação do tempo de exposição como também o tipo do compósito restaurador não influenciou no aumento ou diminuição do QPXD e nem tão pouco no MGVR. Contudo houve correlação entre o QPXD e o MGVR para a resina Filtek Bulk Fill One.

Niveles de referencia diagnósticos en equipos de radiografía dental en Bogotá, Colombia

Introducción: Las radiografías dentales son una de las exposiciones médicas más frecuentes a la radiación ionizante. El uso de radiación ionizante está asociado a un riesgo probable de desencadenar efectos biológicos adversos y posibles daños a la salud del paciente. Para evitar que los pacientes reciban dosis innecesariamente altas durante estas exposiciones, la Comisión Internacional de Protección Radiológica recomienda la utilización de los niveles de referencia para diagnóstico, como una herramienta efectiva de ayuda a la optimización de la protección radiológica de los pacientes. Objetivo: Estimar los niveles de referencia para diagnóstico en radiografía dental intraoral y panorámica en la ciudad de Bogotá, D. C. Metodología: Se evaluaron los parámetros de exposición radiográficos de los equipos y la calidad de imagen en 68 equipos de radiografía dental periapical y 23 equipos de radiografía panorámica. Se estimaron las magnitudes dosimétricas de kerma incidente en aire (Kai) en equipos intraorales para la radiografía de un maxilar molar de un adulto y el producto kerma aire-área (PKA) en equipos de radiografía panorámica en un examen de un adulto estándar. Resultados: El tercer cuartil de la distribución de kerma incidente en aire para radiografía intraoral fue de 3,3 mGy y del producto kerma aire-área para radiografía panorámica fue de 103,9 mGycm2. En la distribución de frecuencias de kerma incidente en aire para radiografía intraoral, el porcentaje más alto de equipos estuvo en el rango de 2,0-3,0 mGy. En la distribución de frecuencias del producto kerma aire-área para los equipos de radiografía panorámica, el porcentaje más alto de equipos estuvo en el rango de 60 a 80 mGycm2. Discusión: Las instituciones consideradas para establecer los Niveles de Referencia para Diagnóstico en este estudio contaron con una adecuada calidad de la imagen evaluada con un maniquí dental, pero las variaciones en las dosis de radiación entre instituciones señalan la necesidad de implementar herramientas que contribuyan a la optimización de las prácticas. Conclusiones: Se recomienda usar los valores de los niveles de referencia para diagnóstico encontrados en esta investigación para optimizar la protección radiológica en las exposiciones radiológicas dentales, y se espera que este estudio sirva de base para nuevas investigaciones en las demás ciudades del país.

Introduction: Dental X-rays are one of the most frequent medical exposures to ionizing radiation. The use of ionizing radiation is associated with a probable risk of triggering adverse biological effects and possible damage to the patient's health. To prevent patients from receiving unnecessarily high doses during these exposures, the International Commission on Radiological Protection recommends the use of diagnostic reference levels as an effective tool to help optimize radiological protection for patients. Objective: To estimate diagnostic reference levels in intraoral and panoramic dental radiography in the city of Bogotá, D.C. Methodology: In 68 periapical dental radiography equipment and 23 panoramic radiography equipment, the radiographic exposure parameters of the equipment and image quality were evaluated. The dosimetric magnitudes of incident air kerma (Ka,i) in intraoral equipment for the radiography of a maxillary molar of an adult and the air kerma-area product (PKA) in panoramic radiography equipment in a standard adult examination were estimated. Results: The third quartile of the incident air kerma distribution for intraoral radiography was 3,3 mGy and the air kerma-area product for panoramic radiography was 103,9 mGycm2. In the frequency distribution of incident air kerma for intraoral radiography, the highest percentage of equipment was in the range of 2,0-3,0 mGy, and in the frequency distribution of the air kerma-area product for equipment of panoramic radiography, the highest percentage of the equipment was in the range of 60 to 80 mGy cm2. Discussion: The institutions considered to establish the diagnostic reference levels in this study had an adequate quality of the image evaluated with a dental phantom, but the variations in radiation doses between institutions indicate the need to implement tools that contribute to the optimization of the practices. Conclusions: It is recommended to use the values of the diagnostic reference levels found in this research to optimize radiological protection in dental radiological exposures, and it is expected that this study will serve as a basis for further research in other cities of the country.

A Importância dos Métodos de Determinação das Idades Esquelética e Dentária na Ortodontia e Odontopediatria ­ uma Revisão de Literatura / The Importance of Methods for Determination of Squeletal and Dental Age in Orthodontics and Pediatric Dentistry ­ a Literature Review

O estágio de desenvolvimento humano é intimamente relacionado à sua maturidade óssea ou dentária, sendo essencial para a escolha do tratamento de alterações dentofaciais em crianças e adolescentes por ortodontistas e odontopediatras. Existem diversos indicadores biológicos para determinar a maturação do indivíduo, como a idade cronológica e as alterações hormonais, porém esses indicadores podem sofrer interferências. Visando uma determinação de desenvolvimento e dos picos de crescimento mais precisa, para um melhor diagnóstico e plano de tratamento, foram desenvolvidos diversos métodos para determinar a idade esquelética e a idade dentária, sendo estes a avaliação da maturação carpal, da morfologia das vértebras cervicais, da fusão óssea da sincondrose esfeno-occipital e da sutura palatina mediana, bem como dos estágios da calcificação dentária. A avaliação das radiografias de mão e punho é o padrão ouro da predição da idade esquelética, e sua correlação com outros métodos já é evidente. Sendo assim, é possível utilizar a avaliação das vértebras cervicais e das idades dentárias de Nolla e Demirjian.

The stage of human development is closely related to bone or dental maturity, being essential for the choice of treatment for dentofacial changes in children and adolescents by orthodontists and pediatric dentists. There are several biological indicators to determine an individual's maturation, such as chronological age and hormonal changes, but these indicators can suffer interference. Aiming at a more accurate determination of development and growth peaks, for a better diagnosis and treatment plan, several methods have been developed to determine skeletal age and dental age, these being the assessment of carpal maturation, the morphology of the cervical vertebrae, bone fusion of the spheno-occipital synchondrosis and the median palatal suture, as well as the stages of dental calcification. The evaluation of hand and wrist radiographs is the gold standard for predicting skeletal age, and its correlation with other methods is already evident. Therefore, it is possible to use the assessment of cervical vertebrae and dental ages by Nolla and Demirjian.

Avaliação da profundidade da cárie proximal nos exames radiográfico convencional e digitalizado / Evaluation of the size of proximal caries in radiography and digitized

Introdução: A cárie dentária é uma doença multifatorial que compreende vários fatores biológicos e sociais. A superfície proximal dos dentes é uma região de difícil visualização que pode esconder pequenas lesões cariosas no esmalte dentário, impossibilitando o diagnóstico através de inspeções visuais e táteis. Objetivo: O objetivo deste trabalho foi avaliar a profundidade da cárie proximal nos exames radiográficos convencionais e digitais, comparando as profundidades das lesões consideradas nestes exames às do exame histológico. Método: Foram utilizados exames radiográficos interproximais de 40 dentes humanos, 20 pré-molares e 20 molares, com alterações clínicas em uma das superfícies proximais, como lesões de mancha branca ou acastanhada e pequenas cavitações. Três profissionais especializados em radiologia odontológica com mais de cinco anos de experiência clínica mediram a profundidade das lesões pelos exames radiográfico e digital das amostras. Para obter os resultados, utilizou-se a técnica de análise de variância (ANOVA). Resultados: Constatou-se um nível de significância de 5% nas mensurações dos exames radiográficos convencionais e digitalizados, mostrando a fidelidade das imagens radiográficas em relação a real profundidade da lesão. Conclusão: Conclui-se que os exames de imagem avaliados foram eficientes na determinação da profundidade das lesões de cárie proximal.

Introduction: Dental caries is a multifactorial disease that comprises several biological and social factors. The proximal surface of the teeth is a region of difficult visualization that can hide small carious lesions in the dental enamel, making diagnosis through visual and tactile inspection infeasible. Objective: The objective of this study was to evaluate the depth of proximal caries in the conventional and digitized radiographic examinations, comparing the depths of the lesions considered in these examinations to those of the histological examination. Method: Interproximal radiographic examinations of 40 human teeth, 20 premolars and 20 molars, with clinical alterations on one of the proximal surfaces, such as white or brown spot lesions and small cavitations, were used. Three professionals specialized in dental radiology with more than five years of clinical experience measured the depth of the lesions by radiographic examination of the samples. To obtain the results, we used the technique of analysis of variance (ANOVA). Results: A level of significance of 5% was found in conventional and digitized radiographic measurements, showing the fidelity of the radiographic images in relation to the actual depth of the lesion. Conclusion: It was concluded that the imaging tests evaluated were efficient in determining the depth of proximal caries lesions.

Radiolucent image in lower third molar: hidden caries or pre-eruptive resorption?: a case report / Imagem radiolucente em terceiro molar inferior: cárie oculta ou reabsorção pré-eruptiva?: um relato de caso

ABSTRACT Caries is a multifactorial disease due to the imbalance of the de/re-mineralization process. Complementary radiographic examinations are able to detect hidden caries. The purpose of this short communication was to investigate the radiolucent image suggestive of hidden caries in lower third molar. The extraction of the tooth, decalcification, inclusion and preparation were performed for histological analysis of the lesion. Histological findings revealed a pre-eruptive resorption, and the etiological factors of this coronary resorption were undefined. The professional should be aware of the occurrences of these lesions to early diagnose and propose appropriate treatment to avoid future complications to the patient.

RESUMO A cárie é conceituada como uma doença multifatorial condicionada ao desequilíbrio no processo de desmineralização e remineralização das estruturas dentárias. O propósito desse trabalho foi investigar a imagem radiolúcida sugestiva de cárie oculta em terceiro molar. Foi realizado a exodontia do elemento dentário, descalcificação e confecção de lâminas para posterior estudo histológico da lesão. O achado histológico conclui-se tratar de uma reabsorção pré-eruptiva. O profissional deve estar atento às ocorrências dessas lesões para diagnosticar precocemente e propor o tratamento adequado, evitando complicações futuras ao paciente.

Factors Influencing Anxiety Levels During Dental Radiographic Examination Among Dental Students

@#Introduction: : Dental anxiety was found to be related to the radiographic procedure and can be influenced by sociodemographic characteristics of patients such as age, gender, level of education, and provoking factors such as past dental examination experience. Evaluating the anxiety regarding dental radiographic examination could be beneficial in ensuring the procedure’s continuance. This study aimed to measure the radiology knowledge among dental students and its association with anxiety due to dental radiographic examination. Methods: A cross-sectional study was conducted to collect the data using a questionnaire packet that included a knowledge and anxiety questionnaire, demographic data, and information about the experience of dental radiographic examination. A total sampling of 1st and 2nd year undergraduate and clerkship dental students at the Faculty of Dentistry, Universitas Gadjah Mada, Indonesia was selected based on inclusion and exclusion criteria. Anxiety-related factors were assessed using descriptive statistics and multiple linear regression conducted with STATA 15.1. Results: Results showed that knowledge and anxiety were negatively correlated but the correlation was not statistically significant. Gender, radiographic technique, and presence/absence of a companion during the examination were not correlated with anxiety. Meanwhile, the anxiety level was negatively and significantly correlated with age and examination frequency (p < 0.05). Multiple linear regression results showed strong evidence that age and examination frequency were the main factors for predicting anxiety. Conclusion: Although age, radiographic examination frequency, and educational level are significant bivariate predictors of anxiety, subsequent regression analysis indicated that only age and radiographic examination frequency influence anxiety.

Calidad radiográfica obtenida por estudiantes de Odontología mediante la técnica de bisectriz

Objetivo: Evaluar la calidad radiográfica mediante técnica de la bisectriz ejecutada por estudiantes de Odontología de tercer año. Material y Método: Estudio observacional descriptivo. Se evaluaron 220 radiografías ejecutadas por 55 estudiantes de Odontología de tercer año. La calidad radiográfica fue evaluada por dos investigadores, mediante una pauta creada con cuatro parámetros: posición de la película, angulación horizontal, angulación vertical y rayos X centrado. Fue comparada la calidad según sector radiográfico, anterior y posterior. Se realizó estadística descriptiva y prueba de chi-2 para establecer diferencias entre calidad y sector radiográfico, con un valor de significancia estadística de p0.05. Conclusión: Las radiografías periapicales tomadas mediante técnica de la bisectriz por estudiantes de Odontología de tercer año, son mayoritariamente de calidad inaceptable, sin diferencias significativas entre sectores.

Objective: To evaluate radiographic quality using the bisecting angle technique performed by third-year dental students. Material and Method: Descriptive observational study. 220 radiographs were evaluated, performed by 55 third-year dental students. Radiographic quality was evaluated by two researchers, using a guideline created with four parameters: film position, horizontal angulation, vertical angulation and centered X-ray (conecut). The quality was compared according to the radiographic sector, anterior and posterior. Descriptive statistics and chi-2 test were applied to establish differences between radiographic sector and radiographic quality, setting a value of statistical significance of p 0.005. Conclusions: The periapical radiographs taken by third-year dental students using the bisecting angle technique is mostly of unacceptable quality, with no significant differences between sectors.

Materiales de restauración dental / Dental restorative materials

Objetivo: Identificar los efectos que producen la utilización de materiales restauradores en los tejidos dentarios luego de utilizarlos como una solución funcional y estética ante los problemas provocados por cualquier tipo de microorganismo es necesario. Método: de tipo bibliográfica mediante una búsqueda de artículos en base PubMed y Scielo. Resultados: Se encontraron 30 artículos, de los cuales solo se pudieron utilizar 15 de ellos, ya que contribuyeron a cumplir con el objetivo de esta investigación y el resto no. Conclusiones: Los materiales dentales son la base fundamental de la odontología restauradora, protésica y de varias especialidades y procedimientos realizados por parte del odontólogo. Por lo tanto, es necesario tener conocimientos de cómo actúa cada uno de estos materiales restaurativos, con base en su estructura interna, para poder ver cuál va a ser su comportamiento físico, mecánico y fisicoquímico en su uso odontológico.

Objective: To identify the effects produced by the use of restorative materials on dental tissues after using them as a functional and esthetic solution to the problems caused by any type of microorganism. Method: bibliographic type by means of a search of articles in PubMed and Scielo databases. Results: 30 articles were found, of which only 15 of them could be used, since they contributed to fulfill the objective of this research and the rest could not. Conclusions: Dental materials are the fundamental basis of restorative dentistry, prosthetic dentistry and various specialties and procedures performed by the dentist. Therefore, it is necessary to have knowledge of how each of these restorative materials acts, based on their internal structure, in order to be able to see what their physical, mechanical and physicochemical behavior will be in their dental use.

Evaluation of the microstructure, chemical composition, and image quality of different PSP receptors

Abstract This study aimed to assess the microstructure, chemical composition, and image quality of different photostimulable phosphor plates (PSP). Four PSP systems, Express®, Digora®, VistaScan®, and Apixia,® were assessed. Five radiographs of a homogeneous acrylic phantom were obtained with the PSP of each system, to acquire a total of 20 images. The images were objectively evaluated for uniformity using mean grey and standard deviation (SD) of their grey values. PSP receptors were analyzed using scanning electron microscopy (SEM) to determine the thickness of the granule layer and the size of the granules. The chemical composition of the PSP receptors was analyzed using total reflection X-ray fluorescence (TXRF). VistaScan showed more uniform and higher density images than the other tested systems (p < 0.05), as well as the lowest SD of grey values (p < 0.05). Regarding the microstructure of the receptors, Digora and VistaScan had thicker granule layers than Express and Apixia, and VistaScan had smaller granules than Digora and Express (p < 0.05). Fourteen chemical elements were detected in the receptors, with barium being the element with the highest concentration in all PSP systems. The microstructure, chemical composition, and image quality varied among all four PSP receptors studied. VistaScan receptors showed the smallest variation in granule size, one of the thickest granule layers, and the most uniform and least noisy images.

Imaginologic resources used in diagnosis of root resorptions: comparative study / Recursos imaginológicos utilizados no diagnóstico de reabsorções radiculares: estudo comparativo

ABSTRACT Objective: Compare the accuracy of early diagnosis of simulated internal root resorptions and external root resorption, using digital periapical radiography and cone beam computed tomography. Methods: Root resorption were simulated in extracted human teeth by demineralization with 5% nitric acid solution and 8% Sodium Hypochlorite in different periods (1 and 5 days). For the group external root resorption (n=12) composite resin cylinders were positioned on middle third of buccal surface of roots, to delimit application of demineralization substances. In group internal root resorptions (n=12) the teeth were sectioned longitudinally, and the composite resin cylinders were positioned in the middle third of root canals. The teeth were mounted in a dry mandible and evaluated by digital radiography and tomography. The images were evaluated by two examiners. Results: Analyzing the tomographic images in period of 1 day, the examiner 2 identified internal root resorptions that were not identified in radiographic images (p<0.05). No examiner was capable of diagnosing external root resorption irrespective of exam, in the group of 1 day (p>0.05). In 5 day period of induction, both exams identified internal root resorptions (p>0.05), however, the tomographic images were more effective in identifying external root resorption (p <0.05) for both examiners. Conclusion: Cone beam computed tomography was shown to be more effective than digital periapical radiography for detecting internal root resorptions with 1 day of induction. The imaginological resources used in this study were not able to early detect external root resorption.

RESUMO Objetivo: Comparar a acurácia do diagnóstico precoce de reabsorções radiculares interna (RRI) e reabsorções radiculares externa (RRE) simuladas, por meio de radiografia periapical digital e tomografia computadorizada de feixe cônico. Métodos: Reabsorções radiculares foram simuladas em dentes humanos extraídos utilizando a desmineralização com ácido nítrico 5% e hipoclorito de sódio 8% em diferentes períodos (1 e 5 dias). Para o grupo reabsorções radiculares externa (n=12) cilindros de resina composta foram posicionados no terço médio das faces vestibulares das raízes, delimitando a aplicação das substâncias de desmineralização. No grupo reabsorções radiculares interna (n=12) os dentes foram seccionados longitudinalmente, e os cilindros de resina posicionados no terço médio dos canais radiculares. Os dentes foram montados em mandíbula seca e avaliados por meio de radiografia digital e tomografia por dois examinadores. Resultados: Nas imagens tomográficas no período de 1 dia, o examinador 2 identificou reabsorções radiculares interna as quais não foram identificadas nas radiografias (p<0,05). Nenhum examinador foi capaz de diagnosticar as reabsorções radiculares externa independente do exame no grupo de 1 dia (p>0.05). No período de indução de 5 dias ambos os exames identificaram as reabsorções radiculares interna (p>0,05), entretanto, as tomografias foram mais eficazes na identificação das reabsorções radiculares externa (p<0,05) para ambos os examinadores. Conclusão: A tomografia computadorizada de feixe cônico mostrou-se mais eficaz do que a radiografia periapical digital na detecção de reabsorções radiculares interna com 1 dia de indução. Os recursos imaginológicos utilizados neste estudo não foram capazes de detectar precocemente a reabsorção radicular externa.

In Vivo Detection of External Apical Root Resorption Induced by Apical Periodontitis Using Periapical Radiography and Cone-Beam Computed Tomography

Abstract Objective: To compare the accuracy of periapical radiography (PR) and cone-beam computed tomography (CBCT) for the detection of external apical root resorption (EARR) due to root canal contamination. Material and Methods: Dog's teeth with experimentally induced root resorption due to root canal contamination underwent or not root canal treatment (n=62). True positives (TP), false positives (FP), true negatives (TN), and false negatives (FN) in PR and CBCT diagnoses were determined using histopathologic findings as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (TP + TN) in the diagnosis of EARR were calculated. Data were compared using chi-squared test (α=0.05). Results: EARR was detected in 35% of roots by PR, in 47% by CBCT, and in 50% of the roots by microscopy (p=0.03 PR versus microscopy; p=0.67 CBCT versus microscopy). Overall, CBCT produced more accurate diagnoses than PR (p=0.008). PR and CBCT allowed the identification of large resorption in 100% of the cases and showed the same accuracy. However, for small resorptions, PR showed an accuracy of 0.83, whereas CBCT showed an accuracy of 0.96 (p=0.003). Conclusion: Cone-beam computed tomography showed higher accuracy in detecting external apical root resorption of endodontic origin.

Diagnóstico de reabsorção radicular: influência da resolução espacial de captura de imagens digitais periapicais / Root resorption diagnostic: influence of periapical digital image scanning

Introdução: a detecção da reabsorção da raiz dentária é realizada por meio de exames de imagens, pois frequentemente não apresenta sinal e sintoma clínicos. Dentre os exames de imagem disponíveis, o exame radiográfico periapical, é indicado para diagnóstico, prognóstico e acompanhamento da reabsorção radicular. Objetivo: o estudo tem como objetivo investigar a relação de diferentes resoluções espaciais com o diagnóstico de reabsorção radicular. Metodologia: foram realizados desgastes simulando reabsorção externa no terço apical e vestibular de 15 (quinze) incisivos inferiores, radiografados em crânio seco, antes e depois do desgaste. A técnica radiográfica foi realizada utilizando o sistema VistaScan (Durr Dental, Bietigheim-Bissingen, Germany), aparelho CS 2200 (Carestream Dental LLC, Atlanta-GA, USA) usando tempo de exposição de 0,15 segundos e escaneadas sob diferentes protocolos de resolução espacial, a saber, 20 pares de linhas por milímetro (pl/mm) e 40 pl/mm. Posteriormente dois avaliadores experientes fizeram análises das referidas imagens sem conhecimento prévio da resolução de escaneamento. Resultados: 75% das radiografias realizadas com 20 pl/mm foram classificadas como excelentes pelos avaliadores, contra 33% com 40 pl/mm, estatisticamente significativa. Discussão: ao avaliar a reabsorção radicular, obteve-se uma acurácia diagnóstica igual para os dois protocolos sem distinção, estatisticamente significativa, entre localização ou profundidade. Conclusão: tendo em vista que para os examinadores imagens com 20 pl/mm foram satisfatórias, com percentual de qualidade maior quando comparado a imagens obtidas com 40 pl/ mm, este estudo indica o emprego de imagens com 20 pl/mm para avaliação inicial de suspeita de reabsorções nas raízes dentárias.

Introduction: the detection of tooth root resorption is carried out by means of imaging tests, as it often does not present a clinical sign and symptom. Among the imaging tests available, the periapical radiographic examination is indicated for diagnosis, prognosis and monitoring of root resorption. Objective: the study aims to investigate the relationship of different spatial resolutions in the diagnosis of root resorption. Methods: Artificial external root resorptions were simulated using burs by drilling to the entire depth in different locations at the apical and buccal thirds of 15 (fifteen) lower incisors were worn, radiographed on a dry skull, before and after wear. The radiographic technique was performed using the VistaScan system (Durr Dental, Bietigheim-Bissingen, Germany), CS 2200 device (Carestream Dental LLC, Atlanta-GA, USA) using an exposure time of 0.15 seconds and scanned under different resolutions protocols, namely, 20 pairs of lines per millimeters (pl/mm) and 40 pl/mm. Subsequently, two experienced evaluators performed analyzes of these images without prior knowledge of the scanning resolution. Results: seventy-five percent of the radiographs taken at 20 pl/mm were rated as excellent by the evaluators, against 33% at 40 pl/mm, a statistically significant difference. Discussion: When assessing root resorption, a similar diagnostic accuracy was obtained for the two protocols without a statistically significant distinction between location or depth. Conclusions: Considering that for examiners images with 20 pl/mm were satisfactory, with a percentage of quality greater than 40 pl/mm, this study indicates the use of 20 pl/mm for initial evaluation of suspected root resorption.

Accuracy of digital bitewing radiographs with and without applying horizontal tube shift in the diagnosis of residual excess cement around dental implants: an in vitro study / Precisión de las radiografías digitales bitewing con y sin aplicación de desplazamiento horizontal del tubo en el diagnóstico del exceso de cemento residual alrededor de los implantes dentales: un estudio in vitro

Purpose: This study was designed to evaluate the diagnostic value of digital Bitewing (BW) radiographs with and without horizontal tube shift in detecting Residual excess cement (REC) on the proximal and non-proximal surfaces of implant restorations. Material and Methods: Eight mandibular models were fabricated with two implants placed on each side in the premolar and first molar positions. Excess cement was applied to either proximal or non-proximal surfaces of the restorations intentionally during the process of crown cementation. BW radiographs with and without applying horizontal tube shift were acquired. Three maxillofacial radiologists were asked to determine the presence and location of REC in the radiographs. Sensitivity and specificity of the radiographic technique were assessed according to the restoration surface that contained REC. Results: Sensitivity of BW radiographs was 100% for the detection of REC on the proximal surfaces and 41-18, 80% on the non-proximal surfaces. Specificity of the technique was 85.71%-100% for the proximal surfaces and 75-94. 12% for the non-proximal areas. Specificity of the radiographic method was generally greater than its sensitivity for the non-proximal surfaces while in the proximal areas, the two variables had quite similar values. Conclusion: Digital BW radiography is generally more useful for detection of REC on the proximal surfaces. Higher specificity of this technique for the bucco-lingual surfaces suggests more reliability of the negative diagnoses in the non-proximal areas.

Objetivo: Evaluar el valor diagnóstico de las radiografías digitales bitewing (BW), con y sin desplazamiento horizontal del tubo, para detectar el exceso de cemento residual (ECR) en las superficies proximales y no proximales de las restauraciones con implantes. Material y Métodos: Se fabricaron ocho modelos mandibulares con dos implantes colocados a cada lado en las posiciones premolar y primer molar. El exceso de cemento se aplicó intencionalmente en las superficies proximales o no proximales de las restauraciones durante el proceso de cementación de la corona. Se adquirieron radiografías BW con y sin aplicación de desplazamiento horizontal del tubo. Se pidió a tres radiólogos maxilofaciales que determinaran la presencia y ubicación de ECR en las radiografías. La sensibilidad y la especificidad de la técnica radiográfica se evaluaron según la superficie de restauración que contenía ECR. Resultados: La sensibilidad de las radiografías de BW fue del 100% para la detección de ECR en las superficies proximales y del 41,18-80% en las superficies no proximales. La especificidad de la técnica fue 85-71, 100% para las superficies proximales y 75-94, 12% para las áreas no proximales. La especificidad del método radiográfico fue generalmente mayor que su sensibilidad para las superficies no proximales, mientras que en las áreas proximales, las dos variables tuvieron valores bastante similares. Conclusión: La radiografía digital BW es generalmente más útil para la detección de ECR en las superficies proximales. La mayor especificidad de esta técnica para las superficies buco-linguales sugiere una mayor confiabilidad de los diagnósticos negativos en las áreas no proximales.

Análise de erros radiográficos em clínica de odontopediatria de uma instituição de ensino superior de Teresina - Piauí / Analysis of radiographic errors in the pediatric dentistry clinic of a higher education institution in Teresina, Piauí, Brazil

Objetivo: Avaliar a prevalência de erros radiográficos em radiografias periapicais de uma clínica de Odontopediatria em uma instituição de ensino superior de Teresina-Piauí. Métodos: Tratou-se de estudo transversal retrospectivo. Foram coletados dados sociodemográficos e radiográficos (localização e presença de erros de técnica radiográfica, processamento e armazenamento). As radiografias foram analisadas por um único examinador calibrado (kappa > 0,80). Foi realizada análise descritiva dos dados, teste Qui-Quadrado, razão de prevalência não-ajustadas (RPnãoajust) e intervalos de confiança (IC 95%). Considerou-se significativo valor de p < 0,05. Resultados: Das 208 radiografias analisadas, 187 (89,9%) possuíam algum tipo de erro. O erro mais prevalente foi de técnica radiográfica (n = 115; 55,3%). Entre esses, a radiografia tremida foi o mais frequente (n = 57; 28,4%). O erro de processamento mais frequente foi presença de digitais (n = 37; 17,8%). Todos os erros de armazenamento (n = 89; 100%) estavam relacionados a não identificação do paciente. O erro de técnica esteve associado com os pacientes de idade menor que 5 anos (RPnãoajus = 1,2 IC95% 1,1-1,3) comparando com idade entre 6 e 10 anos. Não houve associação entre tipo de erro radiográfico e a dentição avaliada nas radiografias (p > 0,05). Conclusão: A quantidade de erros detectados neste estudo foi alta e o mais frequente foi quanto à técnica radiográfica mal executada. Todos os erros de armazenamento observados foram devido a não identificação do paciente. Há uma maior frequência de erros de técnica radiográfica em pacientes com menos de 5 anos se comparados aos de 6 a 10 anos.

Aim: To evaluate the prevalence of radiographic errors in periapical radiographs of a pediatric dentistry clinic in a higher education institution in Teresina, Piauí, Brazil. Methods: This work is a retrospective cross-sectional study. Sociodemographic and radiographic data (location and presence of radiographic technique errors, processing, and storage) were collected. The radiographs were analyzed by a single calibrated examiner (kappa > 0.80). Descriptive analysis of the data, chi-square test, unadjusted prevalence ratio (PRnon-adjusted), and confidence intervals (95% CI) were performed. A p-value < 0.05 was considered significant. Results: Of the 208 radiographs analyzed in this study, 187 (89.9%) presented some type of error. The most prevalent error was the radiographic technique (n = 115; 55.3%). Among these, shaky radiography was the most frequent (n = 57; 28.4%). The most frequent processing error was the presence of fingerprints (n = 37; 17.8%). All storage errors (n = 89; 100%) were related to failure to identify the patient. The technical error was associated with patients younger than 5 years of age (PRnon-adjusted = 1.2; 95% CI 1.1-1.3) compared with 6 to 10 years of age. No association was observed between the type of radiographic error and the dentition assessed on the radiographs (p > 0.05). Conclusion: The number of errors detected in this study was high and the most frequent concerned the poorly performed radiographic technique. All storage errors observed in this study were due to the failure to identify the patients. Children under 5 years of age proved to be more prone to technical radiographic errors than those of 6 to 10 years of age.

Qualitative Analysis of Root Canal Treatments performed by Undergraduate Students: A Retrospective Study

ABSTRACT Objective: Toanalyze the technical quality of endodontic treatment carried out at the undergraduate dental clinics. Material and Methods: Random radiographic records of 92 patients' were selected who received endodontic treatment by the undergraduate students from June 2018 to July 2019. The quality of root canal filling was determined in relation to the adequate density, length, and taper. Statistical analysis was performed by using GraphPad (Prism 5), and to determine the association between different variables Chi-square test was used. Results: Adequate technical quality of canal obturation conducted by the undergraduate students was found in less than 65% of the cases. The frequency of adequate root canal taper was significantly greater in maxillary teeth (75%) as compared to mandibular teeth (33%); however, adequacy of acceptable density was found more in maxillary teeth (62%) as compared to mandibular teeth (55%).A statistically significant difference was seen in the quality of root canal fillings between anterior and posterior teeth (p=0.001). Conclusion: The root canal therapy performed by undergraduate students was less than optimum in terms of technical quality. Hence, it is suggested that the endodontic training courses delivered at pre-clinical and clinical levelsfor undergraduate students must be thoroughly revised.

Metodología para desarrollar la actividad docente clínico-radiográfica de la carrera de Estomatología / Methodology to develop the clinical-radiographic teaching activity of the dentistry major

RESUMEN Introducción: la actividad clínico-radiográfica cumple tareas de prevención, predicción, docencia, asistencial y gerencial, donde se establece la concatenación de disímiles normas y reglamentos asistenciales y universitarios que la elevan a un nivel integrador dentro del proceso docente educativo en la Enseñanza Superior. Objetivo: diseñar una metodología para desarrollar la actividad docente: clínico-radiográfica para la disciplina Estomatología General Integral de la carrera de Estomatología. Métodos: se realizó una investigación cualitativa para lograr el diseño de la metodología para desarrollar la actividad docente: clínico-radiográfica de la carrera de Estomatología, según lo establecido en normativas y documentos rectores para la Enseñanza Superior de las Ciencias Médicas, Plan D perfeccionado de la carrera de Estomatología, así como de las necesidades de docentes y estudiantes del territorio. Resultados: se estudiaron los documentos rectores del proceso, se realizaron talleres metodológicos con los profesores principales de las asignaturas que integran la Disciplina Rectora Estomatología General Integral, y se diseñó una guía para homogenizar los aspectos invariantes que deben ejecutarse en una actividad docente de clínica-radiográfica a partir de las particularidades del plan de estudio de la carrera de Estomatología y de las necesidades del territorio. Conclusiones: se diseñó una metodología para desarrollar la educación en el trabajo como actividad docente, en la modalidad: clínico-radiográfica para la disciplina rectora de la carrera de Estomatología.

ABSTRACT Introduction: the clinical-radiographic activity comprises tasks of prevention, prediction, teaching, assistance and management where the relationship of different assistance and university rules and regulations is established; reaching a comprehensive level within the teaching-learning process in Higher Education. Objective: to design a methodology to develop the teaching-learning activity of clinical-radiographic for the discipline of Comprehensive General Dentistry in Dentistry major. Methods: a qualitative research was carried out to achieve the design of a methodology to develop the teaching activity: clinical-radiographic of the Dentistry major, starting from the established standards and guiding documents for the Higher Education of Medical Sciences, with the improved Plan D of the Dentistry major, as well as the needs of professors and students of the territory. Results: the guiding documents of the process were studied, methodological workshops completed with the main professors of the subjects that integrate the Comprehensive Dentistry Governing Discipline, and a guide was designed to regulate the invariant aspects that must be implemented in a teaching activity of clinic-radiography, starting from the characteristics of the syllabus of the Dentistry major and the needs of the territory. Conclusions: a methodology was designed to develop in-service education as a teaching activity, in the modality: clinical-radiographic for the guiding discipline of the Dentistry major.

Comparison of the diagnostic accuracy of cone beam computed tomography and three intraoral radiographic systems in the diagnosis of carious lesions in vitro / Comparación de la precisión diagnóstica de la tomografía computarizada de haz cónico y tres sistemas radiográficos intraorales en la detección de lesiones de caries in vitro

Objective: The objective of the study was to compare the diagnostic accuracy of cone beam computed tomography and three intraoral radiographic systems in the detection of in vitro caries lesions. Material and Methods: One hundred teeth (46 molars and 54 premolars) were evaluated, including 176 proximal surfaces and 90 occlusal surfaces, with or without dental caries lesions. Digital images of all teeth were obtained using specific intraoral radiographs, VistaScan DürrDental®phosphor-plate radiography, XIOS XG Sirona® digital sensor radiography, and CBCT I-CATTM. Observers evaluated the images for the detection of caries lesions. The teeth were clinically sectioned and stereomicroscopy served as a validation tool. The relationship of sensitivity and specificity between all systems was determined through the ROC curve using Az values. Results: The values of the area under the curve (Az) selected for the CBCT I-CATTM system were 0.89 (0.84-0.93), for conventional radiography 0.71 (0.66-0.76), digital sensor radiography 0.74 (0.70-0.78) and digital radiography with phosphor-plates 0.73 (0.69-0.77). Statistically significant differences were found between the CBCT I-CATTM system and intraoral radiographic systems (p<0.01). The sensitivity and specificity values for the CBCT I-CATTM were 0.84 and 0.93 respectively. Conclusion: CBCT has a high sensitivity and specificity compared to intraoral radiographic systems for the diagnosis of dental caries lesions in vitro.

Objetivo: El objetivo del estudio fue comparar la precisión diagnóstica de la tomografía computarizada de haz cónico y tres sistemas radiográficos intraorales en la detección de lesiones de caries in vitro. Material y Métodos: Se evaluaron 100 dientes, 46 molares y 54 premolares; 176 superficies proximales y 90 superficies oclusales, con o sin lesión de caries dental. Se obtuvieron imágenes digitales de todos los dientes utilizando radiografías intraorales convencionales, radiografía con placas de fósforo VistaScan DürrDental®, radiografía con sensor digital XIOS XG Sirona® y CBCT I- C ATTM. Tres observadores evaluaron las imágenes para la detección de lesiones de caries. Los dientes se seccionaron clínicamente y la estereomicroscopía sirvió como herramienta de validación. Se determinó relación de sensibilidad y especificidad entre todos los sistemas a través de la curva ROC utilizando valores Az. Resultados: Los valores de área debajo de la curva (Az) obtenidos para el sistema CBCT I-CATTM fueron de 0.89 (0.84-0.93), para radiografía convencional 0.71 (0.66-0.76), radiografía con sensor digital 0.74 (0.70-0.78) y radiografía digital con placas de fósforo 0.73 (0.69-0.77). Se encontró diferencias estadísticamente significativas entre el sistema CBCT I-CATTM y todos los sistemas radiográficos convencionales y digitales (p<0.01). Los valores de sensibilidad y especificidad para el CBCT I-CATTM fueron 0.84 y 0.93 respectivamente. Conclusión: La CBCT tiene una alta sensibilidad y especificidad en comparación a los sistemas radiográficos intraorales en el diagnóstico de lesiones de caries dental in vitro.

Evaluación del éxito de tratamientos endodónticos realizados por estudiantes de pregrado en una universidad chilena / Evaluation of success rate of root canal treatment performed by undergraduate dental students in a Chilean university

El tratamiento endodóntico tiene como finalidad prevenir o lograr la ausencia de periodontitis apical post-tratamiento, logrando la mantención del diente en la boca de manera funcional. La realización de tratamientos endodónticos de baja complejidad en la formación de pregrado es transversal a todas las universidades chilenas. El objetivo del presente estudio es evaluar la frecuencia de éxito de tratamientos endodónticos realizados por estudiantes de pregrado entre los años 2014-2017 de la Escuela de Odontología, Universidad Austral de Chile (UACh), Valdivia, Chile. Se realizó un estudio observacional descriptivo donde fueron evaluados 74 tratamientos endodónticos en dientes uniradiculares de 63 pacientes seleccionados a través de un muestreo aleatorio simple, que cumplieran con los criterios de selección. Los parámetros usados para la evaluación clínica fueron: ausencia de dolor a la palpación y percusión, ausencia de fístula y diente en función. En la evaluación radiográfica se utilizaron los siguientes parámetros: longitud de obturación en relación al ápice dentario, conicidad, densidad del material obturador y reducción de la lesión periapical. De los tratamientos evaluados se reportó un 78 % de éxito clínico y un 41 % de éxito radiográfico. Finalmente, se concluye que los resultados obtenidos a nivel clínico y radiográfico son similares a los reportados en la literatura.

The objective of endodontic treatment is to prevent or achieve the absence of post-treatment apical periodontitis, thereby maintaining functionality of the tooth in the mouth. In Chilean universities undergraduate programs, training in endodontics is limited to low level complexity cases and is transversal throughout the universities. The objective of this study is to evaluate the frequency of success of endodontic treatments performed by undergraduate students between the years 2014-2017 of the School of Dentistry, Universidad Austral de Chile (UACh), Valdivia, Chile. A descriptive observational study was conducted where 74 endodontic treatments were evaluated in uniradicular teeth of 63 patients, selected through a simple random sampling, that met selection criteria. The criteria used for the clinical evaluation were: absence of pain on palpation and percussion, absence of fistula and function tooth. In the radiographic evaluation the following criteria were used: length of obturation in relation to the dental apex, taper, density of the obturator material and reduction of the periapical lesion. Of the treatments evaluated, 78 % clinical success and 41 % radiographic success were reported. Finally, it is concluded that the results obtained at clinical and radiographic level are similar to those reported in the literature.

Agreement Between Working Length Measurements in Primary Teeth Obtained by Radiographs or Apical Locators

Abstract Objective: To perform an in vivo evaluation on the agreement between measurements of working length obtained by conventional radiographic examinations and an apex locator in deciduous teeth with or without root resorption. Material and Methods: Nine canals of teeth from children ranging from 3 to 5 years old were selected. Endodontic access was performed with a spherical diamond tip, the pulp was removed with Kerr-type steel files, and the canal was irrigated with 1% sodium hypochlorite. A file, compatible with the channel gauge, was then used to measure the length of the root canal with the apex locator. Conventional radiographs were also performed and, using a millimeter endodontic ruler, the length of the canal was determined. The differences between the measurements obtained between the two methods were analyzed using the Student's t-test. Results: The mean canal length for conventional radiography was 9.83 mm and 9.67 mm for the apex locator. The results of this study did not show significant differences (p=0.641), independent of the presence or absence of physiological root resorption. Conclusion: The similarity in measurements obtained with X-ray or an apex locator indicates that it is not necessary to use X-rays as a complement to obtain the working length. The use of the apex locator can provide a quicker treatment, reducing the clinical time and stress of the child.