El conocimiento y cumplimiento de las normas de protección sobre la radiación ionizante en una clínica dental docente

Introducción: El uso de radiografías como elemento complementario para el diagnóstico es fundamental para la práctica profesional de todo cirujano dentista. Por tanto, es importante conocer no solo los beneficios de la radiología oral y los fundamentos de protección radiológica, sino también determinar su nivel de aplicación o la adherencia frente al cumplimiento de los aspectos normativos que regulan el uso de la radiación ionizante en odontología. Objetivo: Relacionar el conocimiento sobre los cuidados en radiología bucal, las ventajas y los peligros en la toma de radiografías con el cumplimiento de las normas de protección radiológica y radiación ionizante en estudiantes de odontología de una clínica dental docente. Métodos: La población de estudio estuvo constituida por 180 estudiantes del cuarto año de la carrera de odontología, que emplearon los equipos radiológicos en la clínica docente asistencial durante los años 2019 (segundo semestre) y 2020 (primer trimestre). Se tomó como muestra representativa a 104 estudiantes, incorporados al estudio mediante muestreo aleatorio simple. Se aplicaron dos instrumentos de recolección de datos, uno para evaluar el conocimiento (cuestionario) y otro para verificar el cumplimiento de normas (lista de chequeo) sobre la protección radiológica y el diagnóstico por imágenes en la práctica odontológica. Para el análisis estadístico se aplicó la prueba estadística chi cuadrado con un nivel de significancia del 95 %. Resultados: No se encontró relación estadísticamente significativa (p = 0,30) entre el conocimiento teórico sobre la protección radiológica y el diagnóstico por imágenes, respecto el cumplimiento de las normas que regulan su aplicación (p > 0,05). El 90 % de participantes tienen conocimientos entre regulares y excelentes. Sin embargo, solo el 32 % cumple las normas técnicas de protección sobre radiación ionizante en su práctica clínica. Conclusión: Los estudiantes de odontología tienen suficiente conocimiento sobre protección radiológica y diagnóstico por imágenes. Sin embargo, este conocimiento no se refleja en prácticas adheridas a las normas.

Introduction: The use of radiographs as a complementary element for diagnosis is fundamental to the professional practice of every dental surgeon. Therefore, it is important to know not only the benefits of oral radiology and the fundamentals of radiological protection, but also to determine their level of application or adherence to compliance with the regulatory aspects that regulate the use of ionizing radiation in dentistry. Objective: To relate the knowledge of oral radiology care, the advantages and dangers in taking radiographs with compliance with the norms of radiological protection and ionizing radiation in dental students of a dental teaching clinic. Methods: The study population consisted of 180 fourth year dental students who used the radiological equipment in the teaching dental clinic during 2019 (second semester) and 2020 (first quarter). A representative sample of 104 students was taken, incorporated into the study by simple random sampling. Two data collection instruments were applied, one to evaluate knowledge (questionnaire) and the other to verify compliance with standards (checklist) on radiological protection and diagnostic imaging in dental practice. For the statistical analysis the chi-square statistical test was applied with a significance level of 95 %. Results: No statistically significant relationship was found (p = 0.30) between theoretical knowledge of radiological protection and diagnostic imaging with respect to compliance with the norms that regulate its application (p > 0.05). Ninety percent of participants have fair to excellent knowledge. However, only 32 % comply with the technical norms of ionizing radiation protection in their clinical practice. Conclusion: Dental students have sufficient knowledge of radiation protection and diagnostic imaging. However, this knowledge is not reflected in practices that adhere to the standards.

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.

Actualización en equipos de Rayos X portátiles en odontología: revisión de literatura / Update on Hand-Held X-Ray Devices in Dentistry: a Literature Review

Resumen En las últimas dos décadas ha aumentado el uso de equipos portátiles de rayos X intraorales, los cuales son estabilizados por el operador. Si bien todos los equipos radiográficos presentan un riesgo inherente por el uso de radiación ionizante, el uso indebido de los equipos portátiles puede aumentar la exposición del operador. Se recomienda el uso de los equipos portátiles en un trípode o activados desde un área protegida. Sin embargo, en casos altamente justificados para su uso sin estos aditamentos, se debe seguir recomendaciones para disminuir la exposición del operador. Debido a que la radioprotección es fundamental al trabajar con rayos X, se debe favorecer el uso de equipos radiográficos dentales fijos sobre los equipos portátiles, ya que estos proporcionan una menor dosis de radiación al operador.

Abstract In the last two decades, the use of portable intraoral X-ray devices, stabilized by the operator, has increased. While all radiographic devices present an inherent risk from ionizing radiation, improper use of portable devices can increase operator exposure. Use of portable devices on a tripod or powered from a protected area is recommended. However, in highly justified cases, for using without these accessories, recommendations should be followed to reduce operator exposure. Because radioprotection is essential when using X-rays, fixed dental radiographic devices should be favored over portable equipment since the first provides a lower radiation dose to the operator.

Consentimiento informado en radiología odontológica: un asunto pendiente / Informed consent in dental radiology: a pending matter

Introducción: En el ámbito odontológico es muy común el uso de radiografías intraorales, extraorales e incluso de tomografías computarizadas volumétricas. Las radiografías intraorales presentan una baja dosis de radiación en comparación con las tomografías computarizadas volumétricas que pueden emitir una mayor dosis de radiación con cierto grado de riesgo para los pacientes. A pesar de que se conoce sobre la importancia del uso del consentimiento informado y los riesgos durante estos procedimientos, muy poco se ha reportado sobre la utilización del consentimiento informado en radiología oral y maxilofacial. Objetivo: Analizar los beneficios y los retos de usar el consentimiento informado en radiología odontológica. Comentarios principales: Actualmente, no existe un consenso claro en la comunidad odontológica sobre si se debe obtener el consentimiento informado del paciente antes de que se someta a un examen de imagen con radiación ionizante. Su aplicación de manera repetitiva o prolongada podría afectar al paciente a largo plazo. Consideraciones globales: Existe un consenso universal en resaltar la importancia del consentimiento informado en todo el ámbito de la salud. Sin embargo, en la práctica, su realización puede conllevar ciertas dificultades, tales como la identificación del responsable de su realización, el tiempo que lleva ejecutarla y la preocupación por causar un miedo innecesario en el paciente. Si estas dificultades logran ser superadas, podremos ver los beneficios de tener un consenso claro para la utilización de un consentimiento informado en el área odontológica(AU)

Introduction: In the dental field, the use of intraoral, extraoral and even volumetric computed tomography is very common. Intraoral X-rays have a low dose of radiation compared to volumetric CT scans that can emit a higher dose of radiation with some degree of risk to patients. Although the importance of the use of informed consent and the risks during these procedures are known, very little has been reported about the use of informed consent in oral and maxillofacial radiology. Objective: Analyze the benefits and challenges of using informed consent in dental radiology. Main Comments: Currently, there is no clear consensus in the dental community on whether the patient's informed consent should be obtained before they undergo an imaging examination with ionizing radiation. Its application repetitively or prolongedly could affect the patient in the long term. Global considerations: There is a universal consensus to highlight the importance of informed consent in the entire field of health. However, in practice, its realization can lead to certain difficulties, such as the identification of the person responsible for its implementation, the time it takes to execute it and the concern to cause unnecessary fear in the patient. If these difficulties can be overcome, we can see the benefits of having a clear consensus for the use of informed consent in the dental area(AU)

Ameloblastoma Differential Radiographic Findings in Children and Adolescents

ABSTRACT: The aim of this research was to investigate the radiographic, clinical, and histological features of cases of ameloblastoma from a period of 17 years in a Brazilian center and to explore potential differences in children and adolescen ts in relation to adults. Seventy-five patients diagnosed with ameloblastoma from 2001 to 2018 were included. Data from each patient including gender, age, histologic type, location, and radiographic characteristics were reviewed and analyzed retrospectively. The association between the clinical, radiographic, and histologic findings was investigated. No differences regarding the histological pattern of the lesions were observed between groups. Children and adolescents presented well- defined lesions associated with an unerupted tooth compared to adults (p<0.05). The presence of an unerupted tooth was associated with cortical erosion and expansion and MC displacement (p<0.05). Despite similar histologic characteristics, differential radiographic appearance was observed between young patients and adults.

RESUMEN: El objetivo de este trabajo fue investigar las características radiográficas, clínicas e histológicas de casos de ameloblastoma en un período de 17 años, en un centro brasileño y explorar las posibles diferencias en niños y adolescentes en relación con los adultos. Se incluyeron 75 pacientes diagnosticados con ameloblastoma desde 2001 hasta 2018. Los datos de cada paciente, incluyendo el sexo, la edad, el tipo histológico, la ubicación y las características radiográficas, se revisaron y analizaron retrospectivamente. Se investigó la asociación entre los hallazgos clínicos, radiográficos e histológicos. No se observaron diferencias en cuanto al patrón histológico de las lesiones entre los grupos. Los niños y adolescentes presentaron lesiones bien definidas asociadas a un diente no erupcionado en comparación con los adultos (p<0,05). La presencia de un diente no erupcionado se asoció con erosión y expansión cortical y desplazamiento de MC (p<0,05). A pesar de las características histológicas similares, se observó una apariencia radiográfica diferente entre pacientes jóvenes y adultos.

Caries progression and need for reintervention on occlusal ICDAS 4 lesions after different treatments: a retrospective university-based study / Progressão de cárie e necessidade de reintervenção em lesões oclusais ICDAS 4 após diferentes tratamentos: um estudo retrospectivo de base universitária

Objective: To assess the caries progression and the need for reintervention on occlusal ICDAS 4 lesions after different treatments. Material and Methods: The sample consisted of records of children treated in a public setting who had at least an occlusal ICDAS 4 lesion in primary and/or permanent molars. The radiographic images of ICDAS 4 lesions at the first and last appointments were classified as absence of radiolucency, radiolucent image at the enamel­dentin junction, at the outer half or inner of the dentin. The need for retreatment after different treatments (non-invasive - topical fluoride applications, oral hygiene instructions and dietary guidance, micro-invasive - resin-based sealant, or invasive - restoration) was assessed by reviewing clinical and radiographic records. The need for retreatment was defined as any complication requiring mending (e.g., caries progression, total loss of sealant, or restoration failure). The Poisson regression model was used to investigate the association between individual and tooth-related variables and the outcome. Results: Among the 111 lesions in 81 patients, most (73.0%) lesions were in primary molars. Most lesions (52.3%) did not exhibit radiolucency, whereas 29.7% had radiolucency at the outer half of the dentin. The mean follow-up was 18.8 ± 6.5 months. After follow-up, 82.9% of the lesions did not require retreatment. The prevalence of ICDAS 4 lesions that did not need retreatment was higher among lesions with radiolucency at dentin (p=0.01). Conclusion: Most occlusal ICDAS 4 lesions did not require reintervention, especially those exhibiting radiolucency in the outer half of the dentin (AU)

Objetivo: Avaliar a progressão de cárie e a necessidade de reintervenção em lesões oclusais ICDAS 4 após diferentes tratamentos. Material e Métodos: A amostra consistiu de prontuários de crianças atendidas em ambiente público que apresentavam pelo menos uma lesão oclusal ICDAS 4 em molares decíduos e/ou permanentes. As imagens radiográficas de lesões ICDAS 4 na primeira e última consultas foram classificadas como ausência de radiolucidez, imagem radiolúcida na junção esmalte-dentina, em metade externa ou interna da dentina. A necessidade de retratamento após diferentes tratamentos (não invasivo ­ aplicações tópicas de flúor, orientações de higiene e dieta, micro-invasivo ­ selante resinoso ou invasivo ­ restauração) foi avaliada por meio da revisão dos registros clínicos e radiográficos. A necessidade de retratamento foi definida como qualquer complicação que requer intervenção (por exemplo, progressão da lesão, perda total do selante ou falha na restauração). O modelo de regressão de Poisson foi utilizado para investigar a associação entre as variáveis individuais e dentárias e o desfecho. Resultados: Entre as 111 lesões em 81 pacientes, a maioria (73,0%) das lesões eram em molares decíduos. A maioria das lesões (52,3%) não exibiu radiolucidez, enquanto que 29,7% apresentaram radiolucidez em metade externa de dentina. O tempo de acompanhamento médio foi de 18,8 ± 6,5 meses. Após o acompanhamento, 82,9% das lesões não necessitaram de retratamento. A prevalência de lesões ICDAS 4 que não necessitaram de retratamento foi maior entre as lesões com radiolucidez em dentina (p=0,01). Conclusão: A maioria das lesões oclusais ICDAS 4 não requerem reintervenção, especialmente aquelas que exibem radiolucidez em metade externa da dentina.(AU)

Vantagens e limitações em uma identificação odontológica radiográfica ­ relato de caso pericial / Advantages and limitations on a radiographic dental identification - forensic case report

A identificação de cadáveres carbonizados exige uma abordagem multidisciplinar, com finalidade de apontar características únicas de um indivíduo e possibilitar distingui-lo de todos os demais. Devido à dificuldade na inspeção visual e pelo método datiloscópico, a Odontologia Legal se torna fundamental, em virtude da singularidade relacionada aos arcos dentais. O objetivo do trabalho foi apresentar as vantagens e limitações encontradas durante a identificação odontológica radiográfica de um corpo carbonizado e a importância da odontologia legal, por meio de um relato de caso pericial, demonstrando a possibilidade de identificação do cadáver mesmo diante de entraves. O exame necroscópico odontolegal realizado em um Departamento Médico-Legal do Espírito Santo constatou que na maxila existia uma grande destruição dos dentes superiores e presença de prótese parcial removível superior, sendo que não foi possível realiza-lo na mandíbula por conta do estado de calcinação em que se encontrava. Por meio da comparação das características odontológicas entre uma radiografia panorâmica antemortem e radiografias periapicais postmortem, foi possível uma identificação positiva do cadáver carbonizado levando em consideração a quantidade e à qualidade dos achados odontológicos semelhantes encontrados nas imagens, associados à ausência de divergências inexplicáveis

Charred corpse identification requires a multidisciplinary approach, in order to identify unique characteristic and therefore make it possible to distinguish the corpse from everyone else. Due to the difficulty to use visual inspection and the fingerprint method, Forensic Dentistry becomes essential, due to the uniqueness related to dental arches. The objective of the study was to present the advantages and limitations found during the radiographic dental identification of a charred body and the importance of legal dentistry, through an expert case report, demonstrating the possibility of identifying the corpse even in the face of obstacles. The postmortem dental examination carried out in a Medical-Legal Department of Espirito Santo found that in the maxilla there was great destruction of the upper teeth and the presence of an upper removable partial prosthesis, and it was not possible to perform it in the mandible due to the state of calcination in which it was found. By comparing the dental characteristics between an ante-mortem panoramic radiograph and post-mortem periapical radiographs, it was possible to positively identify the charred cadaver taking into account the quantity and quality of similar dental findings in the images, associated with the absence of inexplicable divergences

Procedimentos de imagem em Odontologia no Sistema Único de Saúde e a expansão da atenção secundária: série entre 2000-2016 / Dental imaging procedures in the Unified Health System and the expansion of secondary care: series between 2000-2016

Resumo O objetivo foi analisar a série temporal de procedimentos de imagem em Odontologia realizados entre os anos de 2000 e 2016 no Sistema Único de Saúde (SUS). Os dados foram obtidos do Sistema de Informações Ambulatoriais (SIA-SUS). Foram analisadas a influência da Política Nacional de Saúde Bucal de 2004, da Portaria nº 600/2006 (institui o financiamento dos Centros de Especialidades Odontológicas - CEOs) e Portaria nº 1.234/2013 (Incentivo financeiro do Programa de Melhoria do Acesso e da Qualidade - PMAQ-CEO). Apresentou-se análises descritivas dos anos inicial e final da série temporal, avaliando tendências e sazonalidade em sete tipos de procedimentos. A série temporal das taxas de exames radiográficos periapicais/interproximais demonstrou tendência de aumento moderado e foi a única em que se observou o impacto da política de implementação financeira dos CEOs, mas não do PMAQ-CEO. Os exames extraorais como: radiografia panorâmica, Tomografia Computadorizada (TC) da face/Articulação Temporomandibular (ATM) e Ressonância Magnética (RM) da ATM possuem forte tendência de aumento apesar das taxas serem muito baixas. Conclui-se que entre os anos 2000 e 2016, a política de expansão da atenção secundária, aumentou o uso de exames de imagem periapical/interproximal.

Abstract The scope of this paper was to analyze the time series of dental procedures performed between 2000 and 2016 in the Brazilian Unified Health System (SUS). The data were obtained from the Outpatient Information System of the SUS (SIA-SUS). The influence of the 2004 National Oral Health Policy of Ordinance No. 600/2006 (which instituted the financing of Dental Specialty Centers - CEOs), and Ordinance No. 1,234/2013 (Financial incentive for the Program for Enhancement of Quality and Access - PMAQ-CEO) were analyzed. Descriptive analyses of the initial and final years of the time series were presented, assessing trends and seasonality in seven types of imaging procedures. The time series of rates of periapical/bitewing radiographic exams revealed a trend of moderate increase and was the only area in which the impact of the financial implementation policy of the CEOs was observed, though not of the PMAQ-CEO. Extraoral imaging exams, such as panoramic radiography, facial CT/TMJ and TMJ MRI revealed a strong upward trend, despite the very low rates. The conclusion reached is that between 2000 and 2016, the policy of expansion of secondary care increased the use of periapical/bitewing imaging exams.

Displasia dentinária Tipo I: relato de caso clínico / Dental dysplasia Type I: a clinical case report

As anomalias de desenvolvimento dos dentes, como a displasia dentinária, podem ser observadas durante os exames clínicos e radiográficos em alguns pacientes. O presente relato de caso discute sobre a Displasia Ectópica Dentinária (DD), sendo um distúrbio de desenvolvimento relacionado a formação da dentina que possui obliteração da polpa e defeito da formação da raiz. Descrita como uma condição rara e transmitida geneticamente. Ela pode ser dividida em tipos I e II, uma vez que ambas podem afetar as dentaduras decídua e permanente. O tratamento clínico transformou-se com o passar dos anos, sendo que o protocolo indicava a necessidade de exodontia para um tratamento menos invasivo, utilizando métodos que consistem na manutenção da higiene oral, a idade do paciente, a gravidade da doença, a extensão dos sintomas e atendimento odontológico regular. Este trabalho tem como objetivo apresentar o caso clinico de um menino de 8 anos, diagnosticado com displasia dentinária do tipo I e com presença de restaurações insatisfatórias na dentição mista. Dessa forma é significativo o planejamento adequado, em favor de melhorias na manutenção profilática... (AU)

Anomalies in the development of teeth, such as dentin dysplasia, can be observed during clinical and radiographic examinations in some patients. The present case report discusses Dentinal Dysplasia Ec topic (DD), being a developmental disorder related to the formation of dentin that has pulp oblitera tion and root formation defect. Described as a rare and genetically transmitted condition. It can be divided into types I and II, since both can affect deciduous and permanent dentures. Clinical treatment has changed over the years, and the protocol indicated the need for extraction for a less invasive treat ment, using methods that consist of maintaining oral hygiene, the age of the patient, the severity of the disease, the extent of symptoms and regular dental care. This paper aims to present the clinical case of an 8-year-old boy, diagnosed with type I dentin dysplasia and with the presence of unsatisfactory restorations in the mixed dentition. Thus, adequate planning is significant, in favor of improvements in prophylactic maintenance... (AU)

Levantamento de dados secundários de anomalias dentárias em crianças atendidas na Faculdade de Odontologia de Pernambuco / Survey of secondary data of dental anomalies in children attended at the Pernambuco Dentistry Faculty

Os distúrbios de crescimento e desenvolvimento dos dentes são alterações no número, tamanho ou forma dos dentes com origem multifatorial, sendo o objetivo desse estudo conhecer a frequência de anomalias dentárias. Trata-se de uma pesquisa quantitativa, descritiva e com delineamento transversal de dados secundários, utilizando registros dos prontuários de crianças dos 3 aos 12 anos de idade atendidas na Clínica de Atenção Básica Infantil da FOP/UPE. Foram coletadas informações referentes ao sexo, idade, presença, tipo e localização da anomalia. Realizamos uma análise estatística utilizando o Microsoft Excel e Epi Info v.3.5.3. O estudo teve uma amostra final de 197 prontuários, 52,8% do sexo feminino e 47,2% do sexo masculino. Foram identificadas 4,5% anomalias dentárias, sendo (77,8%) anomalia de número, localizada na região anterior (88,8%). A predominância foi maior no sexo feminino (N=6). As anomalias dentárias presentes foram: anodontia (55,5%), dentes supranumerários (22,3%), giroversão (11,1%) e fusão (11,1%). A frequência de anomalia dentária foi de 4,5%, sendo a anomalia de número mais frequente (77,8%), acometendo mais o sexo feminino e com média de idade de 8,5 anos... (AU)

Tooth growth and development disorders are changes in the number, size or shape of teeth with multifactorial origin, and the aim of this study is to know the frequency of dental anomalies. This is a quantitative, descriptive and cross-sectional study of secondary data, using records from the medical records of children aged 3 to 12 years attended at the Primary Child Care Clinic of FOP/UPE. Information regarding gender, age, presence, type and location of the anomaly was collected. We performed a statistical analysis using Microsoft Excel and Epi Info v.3.5.3. The study had a final sample of 197 medical records, 52.8% female and 47.2% male. 4.5% dental anomalies were identified, (77.8%) number anomaly, located in the anterior region (88.8%). Predominance was higher in females (N=6). The dental anomalies were: anodontics (55.5%), supernumerary teeth (22.3%), gyroversion (11.1%) and fusion (11.1%). The frequency of dental anomaly was 4.5%, being the most frequent number anomaly (77.8%), affecting the female sex more and with a mean age of 8.5 years... (AU)

Evaluación radiográfica de tratamientos endodónticos realizados por alumnos de grado. Una experiencia docente / Radiographic evaluation of endodontic treatments performed by undergraduate students: a teaching experience

Objetivo: Describir una experiencia de capacitación de alumnos de grado en la evaluación radiográfica de tratamientos endodónticos realizados ex vivo. Material y métodos: Participaron un docente y 13 alumnos, cada uno de los cuales evaluó radiográficamente 100 tratamientos endodónticos realizados ex vivo para determinar si estos eran correctos o incorrectos. Posteriormente, el mismo docente, en una clase teórica, presentó a los alumnos otras imágenes radiográficas a fin de calibrar qué debería considerarse correcto o incorrecto. Luego fueron proyectadas nuevamente las radiografías de los 100 casos, y los alumnos efectuaron una nueva valoración. Para cada alumno, se determinó la frecuencia de concordancia con el docente en los 100 casos, antes y después de la calibración. Se categorizó cada observación como sin cambio, positiva (precalibración sin concordancia y poscalibración con concordancia) y negativa (precalibración con concordancia y poscalibración sin concordancia). En cada caso se calcularon la frecuencia para cada categoría, la frecuencia de concordancia entre cada alumno y el docente antes y después de la calibración, y la diferencia entre frecuencias. Resultados: La frecuencia absoluta de casos con concordancia alumno/docente sin cambios fue entre 65 y 85; con cambio positivo, entre 14 y 29; y con cambio negativo, entre 1 y 8. La concordancia antes y después de la calibración resultó entre 37% y 79,2%. Conclusión: La calibración mejoró parcialmente la capacitación de los alumnos para la evaluación radiográfica de los tratamientos endodónticos (AU)

Aim: To describe one experience of calibration in the radiographic evaluation of 100 endodontic treatments performed ex vivo in undergraduate students. Material and methods: One professor and 13 undergraduate students participated in this study, who independently radiographically evaluated 100 ex vivo endodontic treatments and determined whether each case was correct or incorrect. Later, the same professor presented a theoretical class to the students with other radiographic images in order to calibrate the difference between correct and incorrect treatments. Then the radiographs of the same 100 cases were projected and the students made a new evaluation. The frequency of agreement with the teacher was determined for each student in the 100 cases before and after the calibration. Each observation was categorized as without change, with positive change (pre-calibration without agreement and post-calibration with agreement) and with negative change (pre-calibration with agreement and post-calibration without agreement). The frequency for each category was calculated for each student. In each of the cases, the frequency of students in which concordances with the teacher were observed before and after calibration, and the difference between both frequencies were calculated. Results: The absolute frequency of cases with agreement of the students/teacher without changes varied between 65 and 85, with a positive change between 14 and 29 and a negative change between 1 and 8. The concordance before and after calibration varied between 37.0% and 79.2%. Conclusion: Calibration partially improved the training of students in radiographic evaluation of endodontic treatments (AU)

Comparación entre trazados cefalométricos manual y digital en radiografías laterales del cráneo / Comparison between Manual and Digital Cephalometric Tracing in Side Radiographies of the Skull

Resumen Objetivo: Evaluar la diferencia del trazado cefalométrico manual con el digital en radiografías laterales de cráneo. Materiales y métodos: Inicialmente se realizó un piloto para calibrar al investigador principal, en donde se analizaron 10 radiografías pertenecientes a cinco pacientes del Servicio de Radiología del Centro Odontológico de nuestra institución para evaluar la concordancia entre los dos evaluadores y establecer el tamaño de la muestra. Finalmente, se analizaron 78 radiografías cefalométricas de 39 pacientes, en las que se realizó el trazado cefalométrico de Steiner manual y digital. Esas radiografías se analizaron en una escala 1:1 y posteriormente se evaluó la diferencia de las mediciones mediante el análisis univariado, se determinó en mediana e intervalo intercuartil por separado. En el análisis bivariado, se aplicó la prueba de signo de rangos de Wilcoxon y muestras pareadas para determinar la diferencia de las mediciones cefalométricas de Steiner entre el tipo del análisis cefalométrico. El nivel de significancia se fijó en p < 0,05 y confiabilidad al 95%, respectivamente. Resultados: No hubo diferencia significativa en la mayoría de las mediciones hechas de manera manual y digital, siendo el ángulo interincisal la única medición angular en la cual hubo diferencia significativa al obtener un resultado de p = 0,002. Mientras tanto, en las mediciones lineales, la única medición en la que hubo diferencia significativa fue en el segmento incisivo inferior - NB con p = 0,005. Conclusión: No se encuentran diferencias significativas entre el trazado cefalométrico manual y el digital. No obstante, es importante tener en cuenta que la muestra o población evaluada es reducida para definir conclusiones.

Abstract Objective: To evaluate the difference of the manual cephalometric tracing with the digital tracing on lateral cranial radiographs. Materials and Methods: Initially, a pilot study was carried out to calibrate the principal investigator, where 10 radiographs belonging to 5 patients of the Radiology Service of the Dental Center, were analyzed to evaluate the intraclass concordance between the two evaluators. To establish the size of the sample, finally, 78 cephalometric radiographs of 39 patients were analyzed, in which the manual and digital Steiner cephalometric tracing was performed. These radiographs were analyzed on a 1: 1 scale and then the difference of the measurements was evaluated using the univariate analysis, which was determined in the median and interquartile range, separately. In the bivariate analysis, the Wilcoxon rank sign test and paired samples were applied to determine the difference of Steiner's cephalometric measurements between the cephalometric analysis type. The level of significance was set at p < 0.05 and 95% reliability, respectively. Results: There was no significant difference in most of the measurements made manually and digitally. The interincisal angle the only angular measurement in which there was a significant difference when obtaining a result of p = 0.002, while, in the linear measurements, the only measurement in which there was significant difference was in the lower incisor segment - NB with p = 0.005. Conclusion: There is no significant difference between manual and digital cephalometric tracing, nevertheless it is important to keep in mind that the simple or population evaluated is reduced to define conclusions.

Assessment of technical quality of 9562 endodontic cases treated by undergraduate students and endodontics specialists / Avaliação da qualidade técnica de 9562 casos endodônticos tratados por estudantes de graduação e especialistas em endodontia

Objective: The aim of the study was to assessment of technical quality of 9562 endodontic cases treated by heterogeneous groups with different clinical experience. Material and methods: This retrospective study reviewed the dental records of 8590 patients (9562 endodontic cases and 13203 root canals including 3340 retreatment root canals) treated by fourth-year undergraduates, fifth-year undergraduates, endodontic program students, and endodontic specialists between December 2017 and December 2018 at the Department of Endodontics of Necmettin Erbakan University Faculty of Dentistry in Konya. The length, density, and taper of root fillings, the acceptable technical quality of the root filling criteria, and the presence of procedural errors, were recorded. Chi-square tests with a significance level at p=0.05 were used for statistical analysis. Results: Acceptable root fillings were found in 71.5% of endodontic cases. Clinical experience showed statistical differences in the root filling quality among fourth-year undergraduates, fifth-year undergraduates, endodontic program students, and specialists (52, 63.1, 77.9 and 86.5% respectively). Fractured instruments and missed canals were noted in 9.8% and 0.57% of cases treated by endodontic program students significantly more than the other clinical experiences. No statistical differences were found among the clinical experiences in other procedural errors. No statistically significant differences were found between age range and gender in additional root canals. Statistically significant differences were observed between the number of root canal retreatments in terms of age range and gender. Conclusions: Clinical experience affects the technical quality of root canal treatments. Fractured instruments and missed canals, especially by endodontic program students, should be given more attention. (AU)

Objetivo: O objetivo do estudo foi avaliar a qualidade técnica de 9562 casos endodônticos tratados por grupos heterogêneos com diferentes experiências clínicas. Material e métodos:Este estudo retrospectivo revisou os registros dentários de 8590 pacientes (9562 casos endodônticos e 13203 canais radiculares, incluindo 3340 canais radiculares de retratamento) tratados por graduandos do quarto ano, graduandos do quinto ano, estudantes do programa endodôntico e especialistas em endodontia, entre dezembro de 2017 e dezembro de 2018 no Departamento de Endodontia da Faculdade de Odontologia da Universidade Necmettin Erbakan em Konya. O comprimento, a densidade e a conicidade dos preenchimentos das raízes, a qualidade técnica aceitável dos critérios de preenchimento das raízes e a presença de erros processuais foram registrados. Os testes de qui-quadrado com nível de significância de p = 0,05 foram utilizados para análise estatística. Resultados:O preenchimento radicular aceitável foi encontrado em 71,5% dos casos endodônticos. A experiência clínica mostrou diferenças estatísticas na qualidade do preenchimento das raízes entre os alunos do quarto ano, do quinto ano, estudantes do programa endodôntico e especialistas (52, 63,1, 77,9 e 86,5%, respectivamente). Instrumentos fraturados e canais perdidos foram observados em 9,8% e 0,57% dos casos tratados pelos estudantes do programa endodôntico significativamente mais do que nas outras experiências clínicas. Não foram encontradas diferenças estatísticas entre as experiências clínicas em outros erros processuais. Não foram encontradas diferenças estatisticamente significantes entre faixa etária e sexo em canais radiculares adicionais. Foram observadas diferenças estatisticamente significantes entre o número de retratamentos do canal radicular em termos de faixa etária e sexo. Conclusões: A experiência clínica afeta a qualidade técnica dos tratamentos do canal radicular. Instrumentos fraturados e canais perdidos, especialmente por estudantes do programa endodôntico, devem receber mais atenção (AU)

Radiographic Diagnosis of Simulated External Root Resorption in Multi-Rooted Teeth: The Influence of Spatial Resolution / Diagnóstico radiográfico de reabsorção externa simulada em dentes multiradiculares: influência da resolução especial

ABSTRACT The aim of this study was to evaluate the influence of spatial resolution (line pairs per millimetre - lp/mm) on the diagnosis of simulated external root resorption (ERR) in multirooted teeth by using digital periapical radiography. Forty human mandibular molars (80 roots) were used. The roots were divided into the following groups (n = 10): control without root filling (WORF), control with root filling (WRF), small ERRWORF, small ERRWRF, moderate ERRWORF, moderate ERRWRF, extensive ERRWORF and extensive ERRWRF. Four digital radiographs (phosphor storage plates - PSP system) were taken of each tooth in three angulations. The PSPs were scanned with 10, 20, 25 and 40 lp/mm. All images were assessed by three endodontists who used a fivepoint scale for presence and absence of ERR and classified its location (cervical, middle or apical third). ROC curves and oneway ANOVA were performed (p < 0.01). Diagnosis of ERR in nonrootfilled teeth showed higher values of sensitivity for 20 lp/mm and higher values of both specificity and accuracy for 40 lp/mm. In rootfilled teeth, sensitivity and accuracy were higher for 25 lp/mm and spatial resolution had no influence on specificity. The best resolution for diagnosis of small and extensive ERR was 25 lp/mm, whereas for moderate ERR, it was 40 lp/mm. Cervical ERR was the most difficult to diagnose, regardless of the spatial resolution. Higher spatial resolutions have improved the radiographic diagnosis of simulated ERR in multirooted teeth and this should be considered when performing digital radiographs.

RESUMO O objetivo deste estudo foi avaliar a influência do número de pares de linhas em radiografia intraoral digital, na precisão da detecção de reabsorção radicular externa. Quarenta molares inferiores (n=80 raízes) foram submetidos ao preparo químico mecânico e em então, metade da amostra foi obturada. Em seguida, as raízes dos dentes foram aleatoriamente divididas de acordo com o tamanho da reabsorção radicular a ser simulada e com a presença e ausência de tratamento endodôntico. As RRE foram realizadas com brocas esféricas diamantadas de tamanhos 1/2, 1, 2. Executouse radiografias digitais por meio do sistema de aquisição semidireto com a utilização de placas de fósforo fotoestimuladas (PSP). Em cada dente, incidências orto, mésio e distorradial foram repetidas quatro vezes, para que pudessem ser digitalizadas com resoluções de 10, 20, 25, 40 pl/mm. Após análise, verificouse que dentes obturados apresentaram menores valores de sensibilidade com 10, 20 e 25 pl/mm e maiores valores de especificidade e acurácia para as mesmas resoluções. Dentes sem obturação registraram maiores valores de sensibilidade para resolução 20 e menor para 40; no entanto, a especificidade e a acurácia, foram maiores com 40 e menores em 10. Em RRE pequena, as resoluções 10 e 25 pl/mm foram respecti vamente menos e mais acuradas; RRE média, foi maior com 40 pl/mm e RRE grandes foram melhores identificadas com 25. Correlacionando acertos no diagnóstico com localização das RRE, verificouse que o terço cervical apresentouse menos detectável. Concluiuse que resolução espacial influenciou a detecção de RRE simuladas em radiografias periapicais digitais.

Prevalencia de agenesia dental en pacientes evaluados en ortodoncia, Santiago de Chile / Prevalence of dental agenesis in patients evaluated in orthodontics, Santiago de Chile

Resumen La agenesia dentaria es una anomalía frecuente de detectar en un examen odontológico. Objetivo: Determinar la prevalencia de agenesias en la población chilena actual, comparar según sexo, diente afectado y clase esqueletal, y registrar microdoncia de incisivos laterales superiores permanentes. Materiales y métodos: En este estudio descriptivo transversal, se contabilizó el número de agenesias dentarias presentes en 278 radiografías panorámicas de un total de 9207 pacientes, que ingresaron a tratamiento de ortodoncia durante el año 2017 en un centro clínico privado de Santiago de Chile. Resultados: Se obtuvo una prevalencia de agenesia del 3,02%, encontrando una mayor frecuencia de agenesia de segundos premolares inferiores, seguido de incisivos laterales superiores. Hubo una mayor cantidad de agenesias en pacientes de sexo femenino. Conclusión: Los segundos premolares son los dientes con mayor prevalencia de agenesias, no se evidenció la asociación de agenesias en alguna clase esqueletal específica, y se sugieren más estudios para describir la prevalencia de los terceros molares, debido a que este diente está en vías de dejar desarrollarse, según la teoría evolutiva.

Abstract Dental agenesis is a frequent anomaly detected in a dental examination. Objective: To determine the prevalence of agenesis in the current Chilean population, compare according to sex, affected tooth, skeletal class, and record microdontia of permanent upper lateral incisors. Materials and methods: In this cross-sectional descriptive study, the number of dental agenesis present in 278 panoramic radiographs of a total of 9207 patients who entered orthodontic treatment during 2017 in a private clinical center in Santiago de Chile was recorded. Results: A prevalence of agenesis of 3.02% was obtained, finding a higher frequency in lower second premolars, followed by upper lateral incisors. Females presented a higher amount of cases in comparison to males. Conclusion: The second premolars are the teeth with the highest prevalence of agenesis. The association of this alteration with some specific skeletal class was not evidenced. More studies are suggested to describe it´s prevalence in the third molars, beacause according to the evolutionary theory this tooth might eventually disappear.

Estudio comparativo del espacio aéreo faríngeo según deformidades dentofaciales en radiografías cefalométricas / Comparative study of pharyngeal airway space according to dentofacial deformities in cephalometric radiographs

RESUMEN Objetivo: Comparar la dimensión del espacio aéreo faríngeo superior e inferior en las deformidades esqueléticas clase I, II y III determinadas en radiografías cefalométricas. Material y métodos: Se realizó un estudio de tipo retrospectivo donde se analizó 106 radiografías cefalométricas, tomadas en el centro radiográfico del Centro Universitario de Salud de la Universidad Peruana de Ciencias Aplicadas entre los años 2011 y 2014. A través del programa Nemoceph® se marcaron los puntos y trazados cefalométricos principales para determinar la de-formidad esquelética (según Steiner) y la dimensión de las vías aéreas superior e inferior (según McNamara). Resultados: La mayor dimensión en promedio (17,68 mm), se encontró en el espacio aéreo faríngeo superior (EAFS) con en la deformidad dentofacial clase III (DDF clase III) y la menor dimensión en promedio (13,71 mm) en la DDF clase II. En el espacio aéreo faríngeo inferior (EAFI), el mayor promedio (15,98mm) se presenta en la DDF clase III y el menor promedio (13,19mm) en la DDF clase II. Al comparar la dimensión del espacio faríngeo (EAF) entre las DDF, se encontró que existe diferencias estadísticamente significativas entre el EAFS de las DDF II y III, con un valor de p = 0,001; y en el inferior entre DDF III con DDF I y DDF III con DDFII con valores de p=0,0236 y p=0,0042 respectivamente. Conclusiones: En este estudio se encontró que existe diferencias estadísticamente significativas en el espacio aéreo faríngeo superior e inferior entre las tres clases de deformidades esqueléticas.

SUMMARY Objectives: Compare the dimension of the upper and lower pharyngeal airspace between the skeletal deformities class I, II and III in cephalometric radiographs. Material and methods: A retrospective type of study was made where there were analyzed 106 side radiogra-phies, taken in the X-ray center of the University health Center of the Peruvian University of Applied Sciences UPC between the years 2011 and 2014. Through the program Nemoceph® the main cephalometrics points and tracings were marked to be able to obtain the skeletal deformity (Steiner) and the dimension of the upper and lower airspace (McNamara). Results: In the upper pharyngeal airspace it was found that the highest aver-age dimension was 17.68 mm founded in the dentofacial deformation class III, and the lowest in class II with a value of 13.71 mm. Fort the lower airspace, the highest average was 15.98mm and the lowest 13.19mm, also founded in skeletal deformation Class III and Class II respectively. While comparing the size of the pharyngeal space between classes of deformity, it was found that there is statistically significant difference between the upper airspace of skeletal deformities class II and III with a value of p = 0.001; and in the lower, between classes III - I and III - II with values of p=0.0236 and p=0.0042 respectively. Conclusions: In this study it was found that there is a statistically significant difference in the upper and lower pharingeal airspace between the three dentofacial skeletal deformities.

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

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 (gruo 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 significante 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. 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. Pesquisas adicionais são necessárias para determinar se o QPXD representa um artefato verdadeiro ou desajuste do material restaurador ou deficiência na aplicação sistema adesivo (AU).

Objective: 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. 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. Further research is needed to determine whether QPXD represents a true artifact or misfit of the restorative material or deficiency in the adhesive system application (AU).

The need for implant dentists to know about the method of forensic human identification using dental implants

The aim of this study is to present two cases in which dental implants greatly enhanced the forensic human identification and to show the important role of the implant dentist in this process. The skeletonized remains of two victims with dental implants were sent for exams. The morphological features (qualitative) and linear measurements (quantitative) of the implants were analyzed in the ante-mortem and postmortem radiographs. The points of coincidence observed in both the implants and teeth showed compatibility of findings that led the experts to determine the positive identification. The implants found in the bodies were decisive in the process of identification. This identification was only possible because the implant dentists presented complete documentation with good technical quality, enabling an efficient expert approach to comparison of the data. Therefore, it is important to make implant dentists aware of this significant role because they may be asked by the authorities or family members of the deceased to present a complete record chart.

O objetivo desse trabalho é apresentar dois casos em que os implantes foram essenciais no processo identificação e mostrar a importância do papel do implantodontista nesse processo. Dois corpos esqueletizados com implantes dentais foram encaminhados para exames. Foram analisadas as características morfológicas (qualitativas) e medidas lineares (quantitativas) dos implantes nas radiografias antemortem e postmortem. Os pontos de coincidência observados tanto nos implantes quanto nos dentes mostram a compatibilidade dos achados, o que levou os peritos a determinarem a identificação positiva. Os implantes encontrados nos corpos foram decisivos no processo de identificação. Essa identificação só foi possível porque os implantodontistas apresentaram uma documentação completa e com boa qualidade técnica, permitindo uma abordagem pericial segura no confronto dos dados. Portanto, é importante que os implantodontistas estejam cientes do seu papel já que podem ser solicitados pelas autoridades ou membros da família para apresentarem o prontuário da pessoa falecida

Cuantificación de la distorsión presente en la radiografía posteroanterior de cráneo / Quantification of the distortion present in the postero-anterior cephalogram

RESUMEN Introducción: Universalmente se acepta que la radiografía postero-anterior de cráneo presenta menor grado de distorsión que otras imágenes radiográficas, por lo que las mediciones en ella son consideradas confiables. Objetivo: Determinar el porcentaje de distorsión que se presenta en las diferentes regiones faciales de la radiografía posteroanterior de cráneo. Métodos: Treinta cráneos humanos con sus mandíbulas fueron divididos por tres planos horizontales y cuatro verticales en quince cuadrantes; resultaron diez en el cráneo y cinco en la mandíbula. En cada uno de ellos se colocó un alambre de acero en posiciones vertical y horizontal y se midió su longitud (medida real). A cada conjunto se le tomó una radiografía en proyección postero-anterior y se midió la longitud de los alambres en la imagen (medida radiográfica). Resultados: No fue posible medir en los cuadrantes laterales del cráneo. La medida horizontal en los cuadrantes intermedios inferiores derecho e izquierdo del cráneo y en los cuadrantes intermedio y lateral de ambos lados de la mandíbula no es confiable; en el cuadrante mediano de la mandíbula se minimiza; en los cuadrantes medianos superior e inferior e intermedios superiores derecho e izquierdo del cráneo se magnifica. Las medidas verticales en todos los cuadrantes son confiables; en los cuadrantes intermedios superiores derecho e izquierdo del cráneo y en los intermedios y laterales derechos e izquierdos de la mandíbula se magnifica; en los cuadrantes intermedios inferiores y medianos superior e inferior del cráneo y mediano de la mandíbula se minimiza. La menor distorsión para ambas medidas se presenta en el cuadrante mediano superior del cráneo. Se reportan los porcentajes de distorsión para cada cuadrante. Conclusiones: Se presenta distorsión en la radiografía postero-anterior de cráneo y esta varía de una región a otra de la cara(AU)

ABSTRACT Introduction: Universally, it has been accepted that the postero-anterior cephalogram presents less distortion than any other x-ray radiograph; for this reason, the measurements taken on it are considered reliable. Objective: To determine for a postero-anterior cephalogram, what percentage of distortion is present in different regions of the skull and mandible. Methods: Thirty human skulls with their mandibles were divided by three horizontal and four vertical planes in fifteen quadrants, resulting ten in the skull and five in the mandible. In each quadrant, one vertical and one horizontal steel wire were fixed and their lengths were measured (real value). To each set, a postero-anterior cephalogram was taken and the wire images were measured (radiograph value). Results: No measurement could be taken in the lateral quadrants of the skull. The horizontal measurement in the right and left intermediate inferior quadrants of the skull and in the right and left intermediate and lateral quadrants of the mandible is not reliable; in the median quadrant of the mandible it is minimized; in the median superior and inferior and intermediate superior right and left quadrants of the skull it is magnified. The vertical measurement in all the quadrants is reliable; in the right and left intermediate superior quadrants of the skull and right and left intermediate and lateral quadrants of the mandible it is magnified; in the right and left intermediate inferior and median superior and inferior quadrants of the skull and median quadrant of the mandible it is minimized. The minimum distortion for both measurements is present in the median superior quadrant of the skull. The percentage of distortion in each quadrant for both measurements is reported. Conclusions: Distortion is present in the postero-anterior cephalogram and it varies from one region to another of the face(AU)

Effect of different exposure times on caries detection and pixel value in a wireless digital system

Objectives: The aim of this study was to assess, using the CDR Wireless®, the effect of different exposure times on caries detection and pixel intensity values. Materials and Methods: Forty teeth were x-rayed using a Schick CDR Wireless sensor at eight different exposure times – 0.06, 0.10, 0.13, 0.16, 0.20, 0.25, 0.30, and 0.32 s. Four observers evaluated the images for presence of carious lesions scoring proximal surfaces of each tooth on a 5-point scale. Scores were compared to histological sections of the teeth. Accuracy was evaluated by means of ROC curve analysis. Radiographs of an aluminum step wedge were obtained using the same eight exposure times. Pixel intensity measurements were obtained, and mean pixel values were statistically analyzed using linear regression. Results: The Az for each exposure time varied from 0.53 to 0.62. Two-way analysis of variance and Tukey test demonstrated that the exposure time of 0.25 s presented the best result and was significantly higher than 0.30 s and 0.35 s. In regard to mean pixel values, two different behaviors were observed, and the exposure time of 0.20 s presented mean pixel values in both phases. Conclusion: The performance of the exposure times from 0.06 s to 0.25 s was satisfactory for proximal caries detection, and 0.25 s is the best as indicated for this finality. Clinical Relevance: Considering that a reduction of exposure time represents a reduction of patient exposure dose, and this reduction cannot neglect image quality, the behavior of any digital system must be carefully evaluated.