Radiographic diagnosis of proximal caries is not affected by exposure protocols and presence of high-density material on systems with automatic exposure compensation.

OBJECTIVES: To investigate the performance of radiographic systems with automatic exposure compensation (AEC) on the caries diagnosis in images acquired with different exposure parameters and in the presence of high-density material. Also, the image quality was assessed. METHODS: Forty posterior teeth (80 proximal surfaces) were radiographed using a phosphor plate and a CMOS system. Images were acquired with different exposure times (0.06, 0.10 and 0.16 s) and kilovoltages (60 and 70kVp), in the absence and presence of high-density material in the X-rayed region (control and high-density groups). Five radiologists assessed the caries using a 5-point scale. Diagnostic values were compared using two-way ANOVA. RESULTS: For both radiographic systems, there were no significant differences in the area under the ROC curve (0.60-0.73), sensitivity (0.79-0.87) and specificity (0.29-0.48) between the control and high-density groups, exposure times or kilovoltages (p > 0.05). For image quality, scores assigned to the control and high-density groups were similar in each exposure protocol in both systems. CONCLUSIONS: The presence of high-density material, exposure time and kilovoltage did not affect the caries diagnosis in any of the systems tested. It is recommended to use protocols with lower doses to reduce the patient's exposure.

Tobacco Use, Attitudes, Knowledge, and Perception About Smoking Cessation Counseling Among Brazilian Dental Students: a Cross-Sectional Study.

The aim of this study was to evaluate the prevalence of tobacco use, exposure to secondhand smoke, and knowledge and perception about smoking cessation counseling among dental students in Brazil. A cross-sectional study was performed at the School of Dentistry, Universidade Federal de Pernambuco, Brazil. The Global Health Professions Student Survey (GHPSS) research instrument was used. In the second half of 2017, students from the 5th to the 10th semester were recruited to answer the anonymous and self-administered survey in classrooms. The data were tabulated and analyzed, and information about the variables was presented using descriptive statistics. The association between the variables was determined through the Chi-square test and binary logistic regression. Two hundred and twenty-four students answered the survey. More than 40% of the students had tried cigarettes at least once and 8.9% were current smokers. About 28% of the participants reported having been exposed to secondhand smoke in their home and 57.1% in other environments. Most students recognized that they are role models for society and believed they should receive training in smoking cessation counseling. However, only 12.5% of the students reported having received some formal training in this subject. In conclusion, although dental students are aware of the harmful effects of tobacco, there is still a lack of training in smoking prevention and control among these future professionals.

Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography.

PURPOSE: Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. RESULTS: An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, 1.1±0.8 mm). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). CONCLUSION: In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.

Human identification by FSS system adapted to cephalometric radiographs.

The aim of this study was to verify the applicability and reproducibility of the FSS system [8] adapted for frontal and lateral cephalometric radiographs of the frontal sinus for human identification purposes. Eighty lateral and frontal digital cephalometric radiographs from a private Dental Radiology service's database were evaluated. Evaluations were performed in a dimmed lighting room, using a 4.200 lux lightbox with mask, ultrafan paper and pencil with a 0.5 diameter tip. The sheet of paper was superimposed on the radiograph to obtain the outlines of the frontal sinus and two examiners made the drawings independently at two different times, with a minimum period interval between evaluations. To obtain the linear physical measurements of the frontal sinus, a digital pachymeter was used. Later, all the discrete variables were codded for the statistical analysis. All variables were tested by means of the Cohen's Kappa test. The intraexaminer agreement ranged from good to perfect (p<0.001), while the interexaminer agreement ranged from regular to perfect (p<0.001). The use of frontal and lateral cephalometric radiographs was found to be reproducible and reliable for human identification by an adaptation of FSS system.

Comparative study of a wireless digital system and 2 PSP digital systems on proximal caries detection and pixel values.

This study compared the radiographic image quality of 2 photostimulable phosphor (PSP) plate systems with a radiographic system against a complementary metal oxide silicon (CMOS) system. Using the 3 digital systems, 160 approximal surfaces were radiographed under standardized conditions. Using a 5-point scale, 6 observers scored the resulting images for the presence of caries. The presence of caries was validated histologically, and the image receptors were evaluated using receiver operating characteristic curve analysis. The digital systems were used to take radiographs of an aluminum step wedge for objective analysis with pixel density measurements. The mean pixel values were analyzed statistically using the Kruskal-Wallis test and Dunn multiple comparison test (P < 0.01). The performance of the new CMOS system was comparable to the PSP plate systems and radiographic film.

Evaluación de la calidad de las radiografías periapicables obtenidas en la clínica de endodoncia por alumnos de pre-grado / Evaluation of the quality of periapical x-rays obtained by students on the graduate endodontic clinic

Fue analizada la calidad de las radiografías periapicales de pacientes atendidos, en la Clínica de Endodoncia de la Universidad Federal de Paraíba, donde se verificó la influencia de la región radiografiada y de la etapa del tratamiento endodóncico. Las radiografías fueron analizadas por un especialista en radiología. Para el estudio del efecto de la etapa del tratamiento y para el estudio de la región, en relación a las fallas de la técnica radiográfica, fue utilizado el test chi?cuadrado (p = 0,05). De las 427 radiografías, 81.73% presentaron fallas, 16.9% fueron fallas de la técnica, 30.6% provenientes de errores del procesamiento, 3.7% mostraron fallas de causa indefinida y 48.7% presentaron fallas en más de una etapa de obtención. Las más frecuentes fueron: distorsión por angulación vertical insuficiente, falta de encuadramiento y posicionamiento incorrecto del punto (19.7%). Manchas marrones y radiografías rasguñadas fueron más frecuentes, siendo la imagen clara más frecuente para las causas indefinidas. No hubo diferencia significante entre las radiografías con fallas de la técnica, en relación a las etapas del tratamiento endodóncico (p = 0.188). La presencia de fallas en relación a las regiones radiografiadas fue más baja en la región de los incisivos inferiores que en la región de los caninos superiores (p < 0,05). Fallas radiográficas son posibles de suceder durante el tratamiento endodóncico, causando imágenes de calidad dudosa. Las regiones radiografiadas influencian la calidad de las radiografías, mientras que las etapas del tratamiento no la influencian y, las dificultades impuestas por el aislamiento absoluto pueden ser superadas respetando los principios técnicos radiográficos

The aim of the present research was to evaluate the quality of the periapical radiographic image of x-rays from patients at the Graduate Endodontic Clinic of the Federal University of Paraiba - Brazil. The influence of the region of the body to be radiographed and the phase of the endodontic treatment were evaluated. A radiologist evaluated the x-rays. Of the total of 427 radiographs, 81.73% failed, while 16.9% showed failures of technique, 30.6% had failures due to errors in processing, 3.7% showed failures of undefined phase and 48.7% Radiographs showed failures of more than one stage of obtainment. The most frequent failures were: distortion by insufficient vertical angle, lack of context and incorrect positioning of the film (19.7%). Brown spots and scratched radiographs were the most frequent failures. Clear images were the most common failures for the phase undefined. Chi-square test at the level of significance of 0.5% showed no statistical significant differences between radiographs with technical errors, taking into account the phases of the endodontic treatment (p = 0,188). The presence of failures on the radiographed regions was lower in the region of the lower incisors when compared to the region of upper canines (p <0.05). Radiographic failures can occur during endodontic treatment that leads the obtainment of images with poor quality. Radiographed regions influences the quality of radiographs, whereas the phases of endodontic treatment does not influence the quality of the periapical x-ray's obtainment during the endodontic treatment. In addition, the difficulties imposed by the rubber dam can be surpassed if the requirements of obtaining the radiographs are followed

Detection of non-cavitated approximal caries lesions in digital images from seven solid-state receptors with particular focus on task-specific enhancement filters. An ex vivo study in human teeth.

The aim of this study was to compare detection of non-cavitated approximal caries lesions in images from seven solid-state intraoral digital receptors, with particular focus on two task-specific enhancement filters. One hundred and sixty approximal non-cavitated surfaces were radiographed under standardized conditions using the following seven intraoral solid-state digital receptors: two CMOS systems, Schick CDR-APS, and Kodak RVGui; and five CCD systems: Visualix, VistaRay, Dixi2, Sidexis, and Dr. Suni Plus. The Kodak RVGui digital images were captured with two task-specific, predefined enhancement filters ("dento-enamel" and "periodontal"). Eight observers examined the digital images for the presence or absence of approximal carious lesions. The teeth were subsequently sectioned for histological analysis, which served as the "gold standard" for the radiographic examination and allowed for a calculation of sensitivity, specificity, and overall accuracy. Both RVG modalities obtained the highest sensitivity values, which were significantly higher than with Visualix, Sidexis, and VistaRay images (all P0.05).

A comparison of older and newer versions of intraoral digital radiography systems: diagnosing noncavitated proximal carious lesions.

BACKGROUND: The authors conducted a study to compare the accuracy of an older and newer version of two intraoral digital systems in terms of radiographic detection of proximal carious lesions. METHODS: Under in vitro and standardized conditions, the authors obtained radiographs of 160 noncavitated proximal surfaces using the Digora FMX (Soredex, Tuusula, Finland), the Digora Optime, the Schick CDR (Schick Technologies, Long Island City, N.Y.) and the Schick CDR Wireless (Schick Technologies) systems. Eight observers recorded proximal carious lesions on a five-point confidence scale. The presence of caries was validated histologically. RESULTS: The new digital systems (Digora Optime and Schick CDR Wireless) had significantly higher sensitivities than their predecessors. The authors found no significant differences in specificity among the Digora FMX, Schick CDR and Schick CDR Wireless systems, all of which had a significantly higher specificity than did the Digora Optime system (P < .02). The positive predictive value for the Digora Optime system was affected by its high sensitivity and low specificity, and it was lower than that for the two CDR systems (P < .02). CONCLUSIONS: Regarding overall accuracy, the difference between the older and newer versions of the photostimulable storage phosphor and complementary metal oxide semiconductor systems was not statistically significant. However, the authors found more false-positive diagnoses made with the Digora Optime system than with the Digora FMX system. CLINICAL IMPLICATIONS: Though the difference in specificities was statistically significant, the authors question whether the difference between the Digora Optime and the other systems is clinically relevant. Therefore, dentists can purchase any of these systems after considering factors other than those evaluated in this study.

Errores en radiografias intrabucales realizadas en la Facultad de Odontología de Pernambuco-Brasil / Intrabucal radiographs errors made at Pernambuco dental school-Brazil

The quality of the radiographic image is essential for the diagnosis and conservation of x-rays in archive. However, there are some Dental specialties that, for force of the execution, require the attainment of x-rays with bigger brevity, being common professionals and students exist to appeal the procedures that cause the damage of its quality with the justification of time profit. Because of this, this work had the intention to emphasize the optimization importance of the radiographic image through the analysis of imperfections in x-rays taken by students. For such, 572 x-rays, proceeding from archives of patients taken care by the students of the ninth period of the 1999 first semester at the Polyclinic of Pernambuco Dental School -UPE, were analyzed simultaneously by two observers and out of these, 75% presented imperfections. Related to the type of imperfection, the execution of the technique had prevalence in the referring errors (58%), followed by the processing errors (19%). Framing of the exposed region (35%) and elongation of the image (35,7%) were the most prevalent errors in the phase of execution of the technique, while yellowish images (33%) and lacerated x-rays (23%) demonstrated to be the occurred imperfections most frequent during processing.

La calidad de la imagen radiográfica es esencial para el diagnóstico y conservación de radiografías en archivo. Así mismo, hay especialidades odontológicas que, por fuerza de la ejecución, necesitan obtener radiografías con mayor brevedad, siendo común que profesionales y alumnos recurran a procedimientos que perjudican su calidad con la justificación de ganar tiempo. De esta forma, este trabajo tuvo el propósito de enfatizar la importancia de optimizar la imagen radiográfica a través del análisis de errores en radiografías obtenidas por alumnos. Con este propósito fueron analizadas 572 radiografías provenientes de archivos de pacientes atendidos por los alumnos del 9º semestre de 1999, de la Clínica Integrada de la Facultad de Odontología de Pernambuco-UPE. Las radiografías fueron analizadas simultáneamente por dos observadores y de esas, 75% presentaron errores. Los errores asociados a la técnica radiográfica correspondieron a 58%, siendo de mayor prevalencia los errores de elongación de la imagen (35,7%) y encuadramiento de la región radiografiada (35%). Los errores que más ocurrieron durante el procesamiento fueron imágenes "amarillentas" (33%) y radiografías rasguñada (23%).