RESUMO
Background: Considering the limitations of visualization that occur even with the use of radiographs, the cone beam computed tomography (CBCT) becomes more attractive to diagnose and propose an assertive treatment plan. This study aimed to evaluate intra and interobserver reproducibility, and concordance of 31 reference points we described considering visualization tools and the three planes of space in a bimaxillary CBCT. Methods: Three observers located in triplicate the 31 reference points in the CBCT of six healthy patients. Friedman test was used to compare intraobserver paired samples, and interobserver concordance was determined by the intraclass correlation coefficient (ICC) with ranges>0.75 (excellent), between 0.60 and 0.74 (good), between 0.40 and 0.59 (sufficient) and<0.40 (poor). The P value was set at<0.05. Results: A high ICC (>0.75%) was obtained by comparing the x, y, and z values at the location of landmark points. Excellent ICC>0.75 was for 81.7% and poor<0.40 was 7.5% in the interobserver evaluation. Data showed that 25 points had excellent concordance on the x-plane, 25 on the y-plane, and 26 on the z-plane (0.75%). Conclusion: Intraobserver concordance analysis indicated that location of anatomical reference points on bimaxillary CBCT is performed with great reproducibility by interpreting their location with a clear description in the three planes of space. Complexity of achieving a good precision degree in the manual marking of reference points caused by convexities of the anatomical structures involved, might explain the variability found. The systematized location of the reference points would contribute to reduce such variability.
RESUMO
Resumen El control periódico en un tratamiento de Ortodoncia permite establecer una buena secuencia de tratamiento sin riesgos para el paciente. Un tratamiento sin la vigilancia adecuada puede llegar a generar daños irreversibles. Sin embargo, por la pandemia de COVID-19 que enfrenta el mundo actualmente y los riesgos en el área de la salud, se han suspendido temporalmente los servicios no vitales y potencialmente expuestos a contagios como lo son los servicios odontológicos de consulta programada. Teniendo en cuenta esta situación, y que este virus puede llegar a ser endémico en la población humana, se hace necesario establecer protocolos de bioseguridad que permitan reactivar las prácticas odontológicas, y a su vez genear garantías para operadores, personal de apoyo, pacientes y el entorno de los mismos. En este contexto, es de gran importancia desarrollar un protocolo con profesionales expertos en tratamientos ortodóncicos y en el manejo de la pandemia, para delinear procesos de calidad que garanticen un ambiente seguro y minimicen los riesgos de contagio.
Abstract Periodic control in an Orthodontic treatment allows establishing a good treatment sequence without risks for the patient. Treatment without proper monitoring can lead to irreversible damage. However, due to the COVID-19 pandemic facing the world today and the risks in the health area, non-vital and potentially contagious services such as scheduled consultation dental services have been temporarily closed. Taking into account this situation, and that this virus will end up being endemic, it is necessary to establish biosafety protocols that allow reactivating dental practices, and in turn generate guarantees for operators, support staff, patients and the environment of the themselves. In this context, it is of great importance to develop a protocol carried out with expert professionals in orthodontic treatments and in the pandemic, to outline the quality protocol that guarantees a safe environment and minimizes the risks of infection.
Resumo O controle periódico em um tratamento ortodôntico permite estabelecer uma boa sequência de tratamento sem riscos para o paciente. O tratamento sem monitoramento adequado pode levar a danos irreversíveis. No entanto, devido à pandemia do COVID-19 que o mundo enfrenta atualmente e aos riscos na área da saúde, serviços não vitais e potencialmente contagiosos foram temporariamente suspensos, como serviços odontológicos agendados para consultas. Considerando essa situação e que esse vírus pode se tornar endêmico na população humana, é necessário estabelecer protocolos de biossegurança que permitam reativar as práticas odontológicas e, por sua vez, gerar garantias aos operadores, pessoal de apoio, pacientes e meio ambiente. Dos mesmos. Nesse contexto, é de grande importância o desenvolvimento de um protocolo com profissionais especialistas em tratamentos ortodônticos e no manejo da pandemia, para delinear processos de qualidade que garantam um ambiente seguro e minimizem os riscos de infecção.
