Influence of the presence of dental implants on the accuracy and difficulty level of diagnosis of furcation involvement in molars: An in vitro CBCT study.

OBJECTIVE: The aim of this study was to investigate the possible interference of image artifacts (IA) generated by dental implants in the evaluation of furcation involvement (FI) in molars. METHODS: Tomographic scans of first molars (1M) were performed in dry skulls in the absence and presence of titanium (TI) and zirconia (ZI) dental implants. FI grades were simulated in the alveoli of the 1Ms. Diagnostic accuracy of FI and level of difficulty were verified. Chi-squared test and logistic regression analysis were used. RESULTS: There was no difference in the diagnostic accuracy of FI between the arches (p = .117). The highest diagnostic accuracy value for the implant variable was found in the absence of implants (88.3%) and the lowest in the presence of two ZI implants (66.7%). The highest diagnostic accuracy value for FI was observed in grade 0 (G0). There was no significant difference between the arches regarding the evaluators' perception of difficulty (p > .05). Assessments were considered difficult in 12.7% of the TI implants and in 29% of the ZI implants. Regarding the number of dental implants, assessments were considered difficult in 24.4% cases including one implant and 17.4% cases including two implants. The logistic regression model showed a significant p-value only for one and two ZI implants (p = .0061 and p = .0096, respectively). CONCLUSION: The presence of dental implants in the region adjacent to the area of investigation of FI decreased the diagnostic accuracy while increasing the perception of difficulty by the examiners, especially in cases with ZI implants.

Teaching Dental Students to Understand the Temporomandibular Joint Using MRI: Comparison of Conventional and Digital Learning Methods.

The aims of this study were to evaluate and compare the performance of dental students in interpreting the temporomandibular joint (TMJ) with magnetic resonance imaging (MRI) scans using two learning methods (conventional and digital interactive learning) and to examine the usability of the digital learning object (DLO). The DLO consisted of tutorials about MRI and anatomic and functional aspects of the TMJ. In 2014, dental students in their final year of study who were enrolled in the elective "MRI Interpretation of the TMJ" course comprised the study sample. After exclusions for nonattendance and other reasons, 29 of the initial 37 students participated in the study, for a participation rate of 78%. The participants were divided into two groups: a digital interactive learning group (n=14) and a conventional learning group (n=15). Both methods were assessed by an objective test applied before and after training and classes. Aspects such as support and training requirements, complexity, and consistency of the DLO were also evaluated using the System Usability Scale (SUS). A significant between-group difference in the posttest results was found, with the conventional learning group scoring better than the DLO group, indicated by mean scores of 9.20 and 8.11, respectively, out of 10. However, when the pretest and posttest results were compared, both groups showed significantly improved performance. The SUS score was 89, which represented a high acceptance of the DLO by the users. The students who used the conventional method of learning showed superior performance in interpreting the TMJ using MRI compared to the group that used digital interactive learning.

Imaging evaluating of the implant/bone interface-an in vitro radiographic study.

OBJECTIVES: To analyze the diagnostic accuracy of conventional and digital radiographic images and the impact of digital filters in evaluating the bone-implant interface. METHODS: Titanium implants were inserted into 74 fresh bovine ribs blocks, 37 fitting tight to the bone walls (simulating the existence of osseointegration) and 37 with a gap of 0.125 mm (simulating a failure in the osseointegration process). Periapical radiographs were taken with conventional film and two phosphor plate systems [VistaScan® (Dürr Dental, Bietigheim-Bissingen, Germany) and Express® (Instrumentarium, Tuusula, Finland)]. Digital radiographs were investigated with and without enhancement filters. Three blinded examiners assessed the images for the presence of juxtaposition in the bone-implant interface using a five-point Likert scale. Sensitivity, specificity and the area under the receiver-operating characteristic curve (AUC) and its 95% confidence interval (CI) were calculated for each variable. Intraexaminer and interexaminer agreements were analyzed using Kendall's concordance test. RESULTS: Intraexaminer and interexaminer agreements were >0.80 for both digital and conventional images. Conventional radiographs (AUC = 0.963/CI = 0.891 to 0.993) and digital images with high enhancement filters such as Caries2 (AUC = 0.964/CI = 0.892 to 0.993), Endo (AUC = 0.952/CI = 0.875 to 0.988) and Sharpen3 (AUC = 0.894/CI = 0.801 to 0.954) showed the greatest accuracy for evaluating the bone-implant interface. Original images from both digital systems and the further enhancement filters tested showed low sensitivity for the diagnosis task tested. CONCLUSIONS: Conventional radiographs or digital radiographs with high-pass filters could help enhance diagnosis on implant-bone interface.

Diagnostic reproducibility of temporomandibular joint using magnetic resonance imaging at 05 and 15 Tesla

Magnetic resonance imaging is described as the reference standard for the evaluation of temporomandibular joint soft tissues; however, the literature shows conflicting results regarding the reproducibility of this method. Objective: this study aimed to assess the reproducibility of temporomandibular joint diagnoses using magnetic resonance imaging at 0.5 and 1.5 Tesla. Methods: a trained observer analyzed 212 temporomandibular joint images (134 at 0.5T and 78 at 1.5T) and diagnosed the presence or absence of nine conditions. Results: overall agreement was over 80% in both magnetic resonance units, with no significant differences (P > 0.05). Images at 0.5T and 1.5T provided excellent reproducibility for anterior disc displacement without reduction (κ = 0.82 and 0.80, respectively), hypermobility (κ = 0.84 and 0.90), and hypomobility (κ = 0.80 and 0.95), while fair to moderate values were obtained for anterior disc displacement with reduction (κ = 0.48 and 0.42) and disc shape changes (κ = 0.45 and 0.37). Conclusion: magnetic resonance imaging diagnoses at 0.5T and 1.5T presented good agreement. However, the lowest reproducibility for anterior disc displacement with reduction and disc shape change reveals the difficulty to diagnose these disorders.

A comparative study of lateral cephalograms and cone-beam computed tomographic images in upper airway assessment.

The purpose of this study was to evaluate the accuracy of airway measurements from lateral cephalograms, cone-beam computed tomographic (CBCT) lateral reconstructions, and CBCT axial planes, as well as to correlate these findings with area measurements acquired with the latter imaging method. Landmarks were defined for the measurements of naso- and oropharynx of 30 patients (12 males and 18 females, mean age 17.5 years), for different planes, using linear antero-posterior measurements and the corresponding area. Analysis of variance showed significant differences in the linear measurements of the oropharynx between the two methods, although all measurements assessed corresponded to the respective areas. The linear measurements of the airway space obtained using the different techniques correlated positively with the respective area measurements, which demonstrate the reliability of the investigated techniques.