Influence of file compression on radiographic diagnosis of periodontal bone loss on smartphones.

PURPOSE: To evaluate the influence of imaging compression on radiographic diagnosis of periodontal bone loss on smartphones. METHODS: 45 digital periapical radiographs with diverse periodontal bone loss patterns were selected. All radiographs were performed with a CMOS-type sensor and were exported from the acquisition software with two compressions: JPEG with a 10% compression rate and JPEG with a 90% compression rate. Images were shared using the WhatsApp application and three examiners evaluated all radiographs on the smartphone. The examiners' diagnostic agreement was evaluated using the Kappa index. The McNemar and Cochran's Q statistical tests were used to compare the impact of the image compression, examiner, and type of periodontal bone defect on the diagnosis. Statistical analysis was performed using the SPSS software. RESULTS: Kappa values were greater than 0.7 for all examiners and no statistically significant difference for the periodontal diagnosis, regardless of the image compression, the examiner background, and the type of periodontal bone defect. CLINICAL SIGNIFICANCE: The use of smartphones to analyze and share images has become very common in dentistry. This study shows that images can be shared and analyzed on smartphones without compromising periodontal diagnosis, regardless of their spatial resolution.

Impact of CBCT acquisition protocols and artifact reduction filters on diagnosing vertical root fractures.

AIM: To evaluate the impact of acquisition protocols and artifact reduction filters in cone beam computed tomography on diagnosing vertical root fractures in endodontically treated teeth with and without intraradicular posts. MATERIALS AND METHODS: We analyzed 480 tomographic images acquired from two J. Morita scanners (0.125- and 0.08-mm voxel sizes protocols), with application of a blooming artifact reduction filter. Three evaluators assessed these images for root fractures using a 5-point Likert scale. Diagnostic accuracy between filters and protocols was determined using generalized linear models with binomial distribution for the outcome, considering protocol, filter, and dental status. Sensitivity, specificity, positive predictive value, and negative predictive value were also estimated for the filters and protocols. RESULTS: The 0.08-mm voxel size protocol demonstrated a significantly higher percentage of accurate diagnosis compared to the 0.125-mm protocol (p = .001). No statistically significant differences (p ≥ .087) were observed for filter application, interaction between protocol and filter, or dental status. Accuracy, sensitivity, and specificity values were respectively: .93, .87, 1.00 (protocol 1); .99, .99, .99 (protocol 2); .98, .96, .99 (no filter); .95, .90, 1.00 (with filter). CONCLUSION: The new findings found for the two J Morita scanners used in our study were that images acquired using the voxel size of 0.08 mm showed an improvement in the diagnosis of root fractures and the filters in these devices have no relevance significant for the diagnosis.

New scenarios for training in oral radiology: clinical performance and predoctoral students' perception of 3D-printed mannequins.

OBJECTIVES: This study aimed to evaluate the impact of 3D-printed mannequins on the training of predoctoral students. METHODS: Two 3D-printed training models were developed: a traditional model that simulates a sound adult patient and a customized model with pathological and physiological changes (impacted third molar and edentulous region). Students accomplished their pre-clinical training divided into a control group (CG, n = 23), which had access to the traditional model, and a test group (TG, n = 20), which had access to both models. Afterward, they performed a full mouth series on patients and filled out a perception questionnaire. Radiographs were evaluated for technical parameters. Descriptive statistics and the Mann-Whitney test were used to compare the groups. RESULTS: Students provided positive feedback regarding the use of 3D printing. The TG reported a more realistic training experience than the CG (P = .037). Both groups demonstrated good clinical performance (CG = 7.41; TG = 7.52), and no significant differences were observed between them. CONCLUSIONS: 3D printing is an option for producing simulators for pre-clinical training in Oral Radiology, reducing student stress and increasing confidence during clinical care.

Influence of examiner calibration on clinical and MRI diagnosis of temporomandibular joint disc displacement: a systematic review and meta-analysis.

OBJECTIVES: This study aimed to verify the accuracy of clinical protocols for the diagnosis of disc displacement (DD) compared with MRI, considering examiners' calibration. METHODS: PubMed, Cochrane (Central), Scopus, Web of Science, LILACS, Embase, Science Direct, Google Scholar, and DANS EASY Archive databases were searched. Two reviewers independently screened and selected the studies. A meta-analysis was conducted using the R Statistical software. Results are shown using sensitivity and specificity, and 95% confidence intervals. RESULTS: Of the 20 studies included in the systematic review, only three were classified as low risk of bias. Seventeen studies were included in the meta-analysis. Compared to MRI, clinical protocols showed overall sensitivity and specificity of 0.75 (0.63-0.83) and 0.73 (0.59-0.84) for DD diagnosis, respectively. For DD with reduction, sensitivity was 0.64 (0.48-0.77) and specificity was 0.72 (0.48-0.87). For DD without reduction, sensitivity was 0.58 (0.39-0.74) and specificity 0.93 (0.83-0.97). Only 8 studies reported examiner calibration when performing clinical and/or MRI evaluation; nevertheless, calibration showed a tendency to improve the diagnosis of DD. CONCLUSION: The sensitivity and specificity of clinical protocols in the diagnosis of DD are slightly below the recommended values, as well as the studies lack calibration of clinical and MRI examiners. Examiner calibration seems to improve the diagnosis of DD.

Tomographic Planning of Dental Implants Using a Smartphone: Linear Measurements and Implant Selection-A Cross-Sectional Study.

PURPOSE: This study assessed the accuracy of linear measurements and dental implant selection performed in a smartphone application compared to a computer software. MATERIALS AND METHODS: Forty-four DICOM files from partially edentulous patients in the posterior region of the mandible were evaluated by three trained and calibrated examiners. Images were analyzed using three visualization methods: cross-sectional view (CScr) and coronal (CSco) plane using the CS 3D Imaging software, and coronal (DRco) plane using the DroidRender smartphone application. For the purpose of standardization, measurements of bone width and height were taken in the edentulous posterior region of the mandible, 10 mm posterior to the mental foramen. Dental implant selection was made according to Straumann® Standard implant catalog 2022/2023. Linear measurements were compared using the ANOVA test for repeated measurements and implant selection was compared using the Friedman test. Statistical analysis was performed using the SPSS software, considering a significance level of 5%. RESULTS: Linear measurements showed a statistically significant difference for bone width (p = 0.030), but not for height (p = 0.685). The choice of implant was not influenced by the visualization method (p = 0.614). CONCLUSION: It is possible to suggest the use of smartphone applications as an additional diagnostic tool for DICOM evaluation and dental implant planning in the posterior region of the mandible. Smartphone applications allow an assessment not limited to 2D images or to static environments. Therefore, information exchange and diagnostic opinion in emergency situations may be facilitated.

Being a woman influences the development of temporomandibular disorder: cross-sectional study / Ser mulher influencia no desenvolvimento de disfunção temporomandibular: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Although women seem to be more susceptible to pain, there are few studies comparing the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnoses between women and men. Thus, this study aimed to verify the influence of gender on Temporomandibular Disorders (TMD) and their comorbidities in a Brazilian sample. METHODS: Patients were assessed using the RDC/TMD. Diagnoses were obtained for Axis I (myofascial pain, disc displacement, and other joint conditions) and Axis II (depressive symptoms, chronic pain, somatization, and limitation of mandibular function). Logistic regression models were used to verify whether there is a difference in the prevalence and odds of developing TMD between women and men. RESULTS: The sample included 310 patients. Women had more myofascial pain and were more likely to develop it (73.04%; OR: 1.91; IC 95%: 1.08 - 3.39), as well as more joint disorders (54.78%; OR: 2.07; IC 95%: 1.08 - 3.99), in comparison to men. Furthermore, women composed the majority of the sample, more often sought treatment, and had more severe levels of depressive symptoms, somatization of pain, limitation of mandibular function, and myofascial pain. CONCLUSION: Women have more TMD and are more likely to develop it, and also show more severe levels of depressive symptoms, pain somatization, limited mandibular function, and myofascial pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: Embora as mulheres pareçam ser mais suscetíveis à dor, há poucos estudos comparando os diagnósticos obtidos por meio do Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) entre mulheres e homens. Assim, este estudo teve como objetivo verificar a influência do sexo nas disfunções temporomandibulares (DTM) e suas comorbidades em uma amostra brasileira. MÉTODOS: Os pacientes foram avaliados por meio do RDC/ TMD. Os diagnósticos foram obtidos para o Eixo I (dor miofascial, deslocamento de disco e outras condições articulares) e Eixo II (sintomas de depressão, dor crônica, somatização e limitação da função mandibular). Modelos de regressão logística foram utilizados para verificar se existe diferença na prevalência e nas chances de desenvolver DTM entre mulheres e homens. RESULTADOS: A amostra incluiu 310 pacientes. As mulheres apresentaram mais dor miofascial e foram mais propensas a desenvolvê-la (73,04%; OR: 1,91; IC 95%: 1,08 - 3,39), bem como mais distúrbios articulares (54,78%; OR: 2,07; IC 95%: 1,08 - 3,99), em comparação aos homens. Ademais, as mulheres compuseram a maioria da amostra, procuraram tratamento com maior frequência e apresentaram níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial. CONCLUSÃO: As mulheres apresentam mais DTM e são mais propensas a desenvolvê-la, bem como apresentam níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial.

Pior qualidade de sono está associada à disfunção temporomandibular e hábitos parafuncionais entre estudantes e profissionais de Odontologia / La peor calidad del sueño se asocia con disfunción temporomandibular y hábitos parafuncionales en estudiantes y profesionales de Odontología / Worse sleep quality is associated with temporomandibular disorders and parafunctional habits among dental students and professionals

Este estudo teve como objetivo avaliar a associação entre a qualidade do sono e a presença de disfunção temporomandibular (DTM) e hábitos parafuncionais em estudantes e profissionais de Odontologia durante a pandemia de COVID-19. Cirurgiões-dentistas, docentes e estudantes brasileiros de graduação e pós-graduação em Odontologia responderam a um questionário virtual composto pelos seguintes instrumentos: Índice de Qualidade do Sono de Pittsburgh, Lista de Verificação de Comportamentos Orais, Índice Anamnésico de Fonseca e questões socioeconômicas e demográficas. Os questionários foram disponibilizados online de agosto a novembro de 2020. A associação entre as variáveis preditoras e cada desfecho foi avaliada por meio da regressão de Poisson. A amostra foi composta por 449 participantes, sendo que 259 (59,5%) relataramdistúrbios do sono, 352 (78,4%) apresentavam DTM e 311 (69,3%) realizavam hábitos orais parafuncionais. Os distúrbios do sono foram associados à maior prevalência de hábitos orais parafuncionais (RP 1,61; IC 95% 1,36-1,91) e DTM (RP 1,16; IC 95% 1,04-1,29). Além disso, as mulheres apresentaram maior prevalência de DTM em relação aos homens, assim como indivíduos cuja renda era menor. Desta forma, os distúrbios do sono foram associados a hábitos orais parafuncionais e DTM em estudantes e profissionais de Odontologia durante a quarentena da COVID-19 (AU).

Este estudio tuvo como objetivo evaluar la asociación entre la calidad del sueño y la presencia de disfunción temporomandibular (DTM) y hábitos parafuncionales en estudiantes y profesionales de Odontología durante la pandemia de COVID-19. Odontólogos, profesores y estudiantes brasileños de pregrado y posgrado en Odontología respondieron un cuestionario virtual compuesto por los siguientes instrumentos: Índice de Calidad de Sueño de Pittsburgh, Lista de Verificación de Comportamiento Oral, Índice Anamnésico de Fonseca y preguntas socioeconómicas y demográficas. Los cuestionarios estuvieron disponibles virtualmente de agosto a noviembre de 2020. La asociación entre las variables predictoras y cada resultado se evaluó mediante regresión de Poisson. La muestra estuvo compuesta por 449 participantes, de los cuales 259 (59,5%) refirieron trastornos del sueño, 352 (78,4%) DTM y 311 (69,3%) hábitos orales parafuncionales. Los trastornos del sueño se asociaron con una mayor prevalencia de hábitos bucales parafuncionales (RP 1,61; IC 95% 1,36-1,91) y DTM (RP 1,16; IC 95% 1,04-1,29). Además, las mujeres tenían una mayor prevalencia de DTM que los hombres, así como las personas con ingresos más bajos. Así, los trastornos del sueño se asociaron con hábitos orales parafuncionales y DTM en estudiantes y profesionales de odontología durante la cuarentena por COVID-19 (AU).

This study aimed to assess the association between sleep quality and the presence of temporomandibular disorders (TMD) and parafunctional habits in dental students and professionals during the COVID-19 quarantine. Brazilian dentists, professors, and dental undergraduate and graduate students answered a virtual questionnaire composed of the following instruments: Pittsburgh Sleep Quality Index. Oral Behaviors Checklist, Fonseca Anamnestic Index, and socioeconomic and demographic questions. Questionnaires were available on-line from August to November 2020. The association between the predictor variables and each outcome were assessed using Poisson regression. The sample consisted of 449 participants, 259 (59.5%) of whom had sleep disorders, 352 (78.4%) had TMD, and 311 (69.3%) had parafunctional oral habits. Sleep disorders were associated with higher prevalence of parafunctional oral habits (PR 1.61; 95%CI 1.36-1.91) and TMD (PR 1.16; 95%CI 1.04-1.29). Furthermore, women showed a higher prevalence of TMD in comparison to men, as well as individuals with lower income. Sleep disorders were associated with parafunctional oral habits and TMD in dental students and professionals during COVID-19 quarantine (AU).

Apical periodontitis and associated factors in a rural population of southern Brazil: a multilevel analysis.

OBJECTIVES: This study aims to evaluate the association between apical periodontitis (AP) and sociodemographic/clinical factors in a probability sample of individuals living in a rural area of southern Brazilian. MATERIALS AND METHODS: A cross-sectional study was conducted involving 584 non-edentulous adult individuals who had undergone a full-mouth radiographic survey. Periapical status was analysed using the periapical index (PAI). Endodontic status was evaluated considering the occurrence of voids in the filling material and the root filling length. Crown status was classified based on the presence of caries, restorations, and prosthetic crowns. Sociodemographic variables, frequency of dental care, and periodontal disease were also registered. The data were analysed using hierarchical multilevel Poisson regression analysis. The multilevel structure was composed of three models: sociodemographic variables, clinical variables, and clinical variables adjusted by sociodemographic variables (α = 5%). RESULTS: The prevalence of AP in the sample was 60.45%. AP was significantly associated with age, skin colour, schooling, periodontal disease, and frequency of dental care (P < 0.005). Among the 10,396 teeth evaluated, 868 (8.35%) had AP, which was significantly associated with tooth group, dental arch, crown status, and endodontic treatment (P < 0.005). CONCLUSIONS: The prevalence of AP was high in the population studied. An older age, black/brown skin colour, low level of schooling, infrequent dental care, severe periodontal disease, mandibular teeth, posterior teeth, inadequate crown status, and having undergone endodontic treatment were significantly associated with the outcome. Clinical relevance This study about a rural probability sample reinforces that AP is still a recurrent oral health problem.

Three-Dimensional printed model for preclinical training in oral radiology.

INTRODUCTION: 3D printing is experiencing significant growth in the teaching and learning process. This study aims to present a 3D printed skull model for preclinical intraoral radiographic practice. MATERIALS AND METHODS: Two 3D printed mannequins were created. One mannequin used an STL file of a skull that was edited using two 3D modelling software (Meshmixer and Netfabb). The second mannequin was designed directly from a patient's segmented CBCT data and then converted into an STL file. Both mannequins were printed using fused deposition modelling (FDM) technology and polylactic acid (PLA) filament; teeth for the second mannequin were also printed using digital light processing (DLP). The printed skull bones were attached, the mandible was articulated to the articular fossa of the temporal bone, and the teeth were inserted into the alveoli. Intraoral radiographs of both mannequins were taken using a digital sensor (RVG 5100, Carestream). RESULTS: Both 3D printed mannequins showed satisfactory radiographic appearance, allowing geometric representation of each intraoral radiographic projection, regardless of STL file origin. Anatomical structures, such as the periodontal ligament space, zygomatic process of the maxilla and intermaxillary suture, were represented. The material cost of the first and second printed prototype was $34.00 and $39.00, respectively. CONCLUSIONS: The use of 3D printed models is presented as an alternative to artificial commercial phantoms for the preclinical training of intraoral radiographic techniques through the combined benefits of superior radiographic projection quality, the possibility of model manipulation and an affordable price.

Pathologic conditions associated with impacted third molars: A retrospective study of panoramic radiographs in a Southern Brazilian population.

Purpose: This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods: Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results: The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2 ± 11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion: The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.

Temporomandibular disorders and associated comorbidities among brazilian dental students during COVID-19

Aim: This study aimed to assess the prevalence of temporomandibular disorders (TMD) and psychosocial comorbidities in undergraduate dental students in a southern Brazilian university, during the COVID-19 pandemic. Also, it aimed to verify the association between psychosocial factors and TMD. Methods: Fonseca Anamnestic Index, Depression Anxiety Stress Scale (DASS-21), a socioeconomic questionnaire, and questions about academic performance and social distancing were applied. Poisson regression analysis was used to assess the association of predictive variables with TMD. Results: The prevalence of TMD was found to be 82.4%, and more than half of the students had some degree of stress, anxiety, and depression. Students who had symptoms of stress (RR 1.11; 95% CI 1.04-1.19), anxiety (RR 1.19; 95% CI 1.12-1.27) and reported academic performance worsening (RR 1.12; 95% CI 1.07-1.19) had higher TMD scores. Conclusion: The findings suggest that TMD was highly prevalent among dental students at a federal university in southern Brazil during the pandemic, being associated with high levels of stress, anxiety, poor academic performance, and greater social distancing

Outcome of endodontic treatments performed by Brazilian undergraduate students: 3- to 8-year follow up.

Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis.

The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.

Association among headache, temporomandibular disorder, and awake bruxism: A cross-sectional study.

OBJECTIVE: To evaluate the association between headache, myofascial temporomandibular disorder (TMD), and awake bruxism (AB). BACKGROUND: Bruxism seems to act as a risk factor for TMD and its associated comorbidities, such as headaches. METHODS: In total, 406 medical records of individuals who sought care at a university dental clinic were screened. The Research Diagnostic Criteria for Temporomandibular Disorders was used to assess and diagnose TMD, as well as to obtain self-reports of AB and headache. RESULTS: The sample consisted of 307 medical records. About 72.5% (221/305) of the sample reported having headaches, and 67.4% (180/267) and 68.4% (210/307) were diagnosed with AB and TMD, respectively. Individuals who reported having AB (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.09-4.7) and who were diagnosed with myofascial TMD (OR, 2.53; 95% CI, 1.15-5.5) were more likely to have had headaches in the past 6 months when compared with patients without myofascial TMD and bruxism. Also, individuals who self-reported headache were 2.27 times (95% CI, 1.09-4.7) more likely to have AB and 2.45 times (95% CI, 1.13-5.34) more likely to have myofascial pain than individuals without headaches. CONCLUSIONS: Individuals with myofascial TMD, headaches, or AB were more likely to have at least one of the other conditions.

Does marital status influence TMD-related chronic pain? A cross-sectional study.

BACKGROUND: Pain is a complex sensory experience and can be influenced by psychosocial factors, such as romantic relationships. OBJECTIVE: To evaluate the association between marital status and temporomandibular disorder-related chronic pain. METHODS: Patients diagnosed with temporomandibular disorder (TMD) through Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were assessed for chronic pain and marital and socioeconomic status, according to Axis II. Multinomial logistic regression models assessed the association between chronic pain and the predictive variables. RESULTS: Three hundred and ten patients were included in the sample, the majority being female (74.5%), single (52.3%), and diagnosed with chronic pain (85.1%). The adjusted analysis showed about a 5-time greater chance of chronic pain occurrence with high disability in individuals who were married or in a common-law marriage (OR 5.99; 95% CI 1.45-24.73). Also, women were 7.62 times more likely to develop chronic pain with high disability (OR 7.62; 95% CI 2.03-28.52). CONCLUSION: Marital status showed an impact on chronic pain, with married individuals and those in a common-law marriage being the most affected by high disability chronic pain.

Smartphone Use for Tomographic Evaluation: Application in Endodontic Diagnosis.

INTRODUCTION: Portable equipment that allows quick exchanges of information, such as smartphones, is increasingly important in dentistry. Thus, they have become frequently used, with the potential to contribute to the tomographic evaluation. This study aimed to evaluate the accuracy of smartphone applications for diagnosing the root canal system (RCS) and measuring the root canal length. METHODS: Digital Imaging and Communications in Medicine files of 92 lower incisor teeth were evaluated by 2 trained and calibrated examiners using CS 3D Imaging software (Carestream Health, Rochester, NY) and 2 smartphone applications (DroidRender; Startm, Zhubei, Taiwan and Horos Mobile; iCat Solutions Ltd, Norwich, United Kingdom). The RCS was assessed according to Vertucci's classification, and the tooth length was measured using linear cusp-apex measurements. The diagnostic reference standard was obtained by the mode and the mean of the evaluations made by 3 experienced examiners using the CS 3D Imaging software. The diagnostic performance of RCS was evaluated using sensitivity (Se), specificity (Sp), and overall accuracy (Ac). Bland-Altman analysis was used to assess the agreement of linear measurements. RESULTS: The diagnostic tests showed similar performance between the smartphone applications (DroidRender: Se = 1.00, Sp = .95, and Ac = 0.97; Horos: Se = 0.95, Sp = .94, and Ac = 0.95) and the computer software (Se = 0.97-0.95, Sp = .93-0.96, and Ac = 0.95-0.96). The smartphone applications showed discrepancies greater than 1.0 mm for the dental lengths, which may signal relevant differences in some clinical situations. CONCLUSIONS: Smartphone applications offered similar diagnostic performance in comparison with the computer software for the RCS evaluation.

O uso de smartphones como ferramenta de aprendizado por estudantes de Odontologia / The use of smartphones as a learning tool by dental students

As tecnologias podem ser potentes facilitadoras do processo de aprendizagem dos alunos, principalmente nas gerações atuais. Os smartphonessão ferramentas rotineiramente utilizadas a qualquer momento e em qualquer lugar na busca de variadas informações. Assim, a aquisição de conhecimento por meiodeste dispositivo móvel, alinhada com as perspectivas de ensino e resultados esperados para o aprendizado, parece fazer cada vez mais sentido. Neste contexto, este estudo foi proposto com o objetivo de conhecer o perfil do uso de smartphones como ferramenta de aprendizagem ativa e móvel por estudantes de Odontologia. Trata-se de um estudo transversal, realizado por meiode um questionário eletrônico, composto por perguntas objetivas e abertas, as quais avaliaram características sociodemográficas, tipo de aparelho e conexão, usogerale para aprendizado odontológico, bem como aatitude dos alunos em relação ao uso. Do total de estudantes elegíveis ao estudo, 169 alunos responderam ao questionário (taxa de resposta de 49,1%). A maioria dos participantes eram mulheres, com faixa etária de 19 a 21 anos. Todos os estudantes afirmaram ter smartphone, com conexão à internet. Os principais usos descritos foram relacionados à comunicação, gerenciamento de tempo e educação. As vantagens relatadas foram praticidade, flexibilidade de uso, acesso a diferentes conteúdos, capacidade de pesquisar informações e de se comunicar rapidamente. Os desafios identificados incluíram distração e excesso de uso. Os resultados permitiram concluir que os estudantes utilizam os smartphonescomo ferramenta de aprendizagem ativa, principalmente, para acessar e-books, artigos científicos, escutar podcasts,assistir livese visualizar publicações de conteúdos teóricos e práticos no Instagram (AU).

Technologies can be powerful and helpful tools for students' learning process, especially for the current generations. Smartphones are routinely used to search for a wide rangeof information, at anytime and anywhere. Thus, knowledge acquisition through this mobile device, for teaching and learning outcomes, seems to increasingly make more and more sense. Therefore, the aim of thisstudy was to understand the profile of the use of smartphones as an active learning tool by dental students. The data of this cross-sectional study was collected by an electronic questionnaire, with open and closed questions regarding the socio-demographic characteristics, type of device and connection, general use for dentallearning, as well as the students' attitudes towards the use of smartphone for learning. Out of the total number of students eligible for the study, 169 students responded to the questionnaire (response rate of 49.1%). Most participants were women, aged between 19 and 21 years. All students declaredtohave a smartphone, with internet connection. The main uses described were related to communication, time management,and education. The advantages pointed out by the participants were convenience, flexibility of use, access to different contents in different ways, ability to search for information,and rapid communication. The main challenges included distraction and overuse. The results of this study demonstrate that students use smartphones as an active learning tool, mainly to access e-books, scientific articles, to listen to podcasts, watch lives,and view publications of theoretical and practical content on Instagram (AU).

Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis

Abstract The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.

Avaliação do conhecimento dos estudantes de Odontologia da UFSM sobre DTM e bruxismo / Dental students' knowledge assessment of TMD and Bruxism at UFSM

Casos de bruxismo e disfunção temporomandibular (DTM) têm se tornado cada vez mais frequentes na prática clínica. Reconhecer seus mecanismos é necessário para o sucesso do controle e tratamento. O objetivo deste estudo piloto foi investigar o conhecimento e a percepção sobre DTM e bruxismo dos estudantesde Odontologia da Universidade Federal de Santa Maria (UFSM). Para isso um questionário com 15 questões foi aplicado a20 estudantes dessa instituição, sendo 10 do 7º e 10 do 10º semestre. Todos os estudantes avaliados relataram ouvir sobre DTM durante a graduação, mas 70% consideraram que possuíam pouca ou nenhuma base de conhecimento sobre o assunto. Noventa por cento dos estudantes relatou não conhecer a ferramenta utilizada em pesquisas para diagnóstico das DTM. Não houve diferença estatística entre os grupos avaliados e a média geral de acertos foi de 54%. Os dados evidenciam o pouco conhecimento sobre os assuntos abordados e a fragilidade do ensino destas alterações, especialmente pela não evolução do conhecimento sobre DTM e bruxismo ao longo do curso avaliado, pois o grupo de estudantes do 10º semestre apresentou resultados inferiores quando comparados ao do 7º semestre, que passaram recentemente pela Clínica de Oclusão, na qual os temas são abordados (AU).

Bruxism and temporomandibular disorders (TMD) have become increasingly frequent in clinical practice. Recognizing its mechanisms is necessary for successful management and treatment. The aim of this pilot study was to investigate the knowledge and perception about TMD and bruxism of dental undergraduate students from the Federal University of Santa Maria (UFSM). A questionnaire with 15 questions was applied to 20 students from this institution, 10 from the 7th and 10 from the 10th semester. All evaluated students reported hearing about TMD during the Dentistry course, but 70% considered that they had little or no knowledge on the subject. Ninety percent of students reported not knowing the instrument used in research to diagnose TMD. There was no statisticaldifference between the evaluated groups, and the overall average of correct answers was 54%. Data show little knowledge about the subjects and fragility regarding the teaching-learning process of these topics. Moreover, the non-evolution of knowledge about TMD and bruxism throughout the evaluated course is evident, as the group of students in the 10th semester showed poorer results when compared to the 7th semester, which have recently finished the discipline in which these themes are addressed (AU).