Influência do posicionamento vertical e horizontal do objeto nos valores de cinza dentro do FOV de um aparelho de TCFC / Influence of vertical and horizontal positioning of the object on the gray values within the FOV of a TCFC

O objetivo deste estudo foi avaliar a influência do posicionamento vertical e horizontal do objeto dentro da área do campo de visão nos valores de cinza de imagens obtidas no aparelho de Tomografia computadorizada de feixe cônico Kodak 9500. Foi utilizado um simulador com 17 corpos de prova padronizados e de densidade homogênea. Foram realizadas aquisições tomográficas ao longo de todo o campo de visão do aparelho com variação da altura do posicionamento do simulador a cada 5mm, para avaliação de variações verticais e horizontais dos tons de cinza obtidos a cada exame. Ao final das aquisições, os valores de cinza foram medidos no software Image J e os dados foram analisados estatisticamente pelo teste de ANOVA-1 way e o teste posthoc utilizado foi teste de Tukey, com nível de significância de 5%. Em relação ao posicionamento vertical dentro do campo de visão, as médias das medidas nas diferentes alturas apresentaram diferença estatística (p<0,001). As alturas (cm) 10 e 10,5, que correspondem à região externa ao campo de visão, não diferem apenas das médias das alturas 5,5 e 6, enquanto estas alturas diferem das alturas de 3,5 cm a 6,5cm e de 7,0 a 8,5. Já na análise do posicionamento horizontal dos corpos de prova no FOV, foi significativo o valor de p (p<0,001) e notam-se que os valores de cinza das regiões externas do simulador não diferem entre si, porém, essas áreas diferem das médias dos valores de cinza da região central e intermediária do simulador. Podemos concluir que variações na posição do objeto vertical e horizontalmente, dentro dos limites da área do FOV, influenciam nos valores de cinza obtidos por meio de exames de tomografia computadorizada de feixe cônico. (AU)

The aim of this study was to evaluate the influence of vertical and horizontal positioning of the object within the field of view in gray values of images obtained in the Kodak 9500 Cone beam computed tomography device. It was used a phantom with 17 standard samples with homogeneous density. Tomographic acquisitions were made throughout the FOV of the device diversifying the height of the phantom positioning every 5 mm. At the end of the acquisitions, gray values were measured by Image J software, the statistical analysis was done by ANOVA-1 way test and the post-hoc test used was a Tukey test, with 5% significance level. Regarding the vertical positioning within the FOV, the means of measurements at different heights presented statistical difference (p <0.001). The heights (cm) 10 and 10.5 only do not differ from the means of the heights 5, 5 and 6, while these areas differ from the areas 3,5 cm to 6,5cm and from 7,0 to 8,5cm. In relation to horizontal positioning of the test specimens in the FOV, the p value was significant (p <0.001), it is observed that gray values of the external regions do not differ among them, however, these areas differ from the mean values of gray of the central and intermediate regions of the object. We conclude that vertical and horizontal variations in the position of the object, within the limits of the FOV area, influence the values of gray obtained from cone beam computed tomography exams. (AU)

Effects of cervical mobilization and exercise on pain, movement and function in subjects with temporomandibular disorders: a single group pre-post test

ABSTRACT Objective To investigate the effect of a rehabilitation program based on cervical mobilization and exercise on clinical signs and mandibular function in subjects with temporomandibular disorder (TMD). Material and Methods: Single-group pre-post test, with baseline comparison. Subjects Twelve women (22.08±2.23 years) with myofascial pain and mixed TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. Outcome measures Subjects were evaluated three times: twice before (baseline phase) and once after intervention. Self-reported pain, jaw function [according to the Mandibular Functional Impairment Questionnaire (MFIQ)], pain-free maximum mouth opening (MMO), and pressure pain thresholds (PPTs) of both masseter and temporalis muscles were obtained. Baseline and post-intervention differences were investigated, and effect size was estimated through Cohen’s d coefficient. Results Jaw function improved 7 points on the scale after the intervention (P=0.019), and self-reported pain was significantly reduced (P=0.009). Pain-free MMO varied from 32.3±8.8 mm to 38±8.8 mm and showed significant improvement (P=0.017) with moderate effect size when compared to the baseline phase. PPT also increased with moderate effect size, and subjects had the baseline values changed from 1.23±0.2 kg/cm2 to 1.4±0.2 kg/cm2 in the left masseter (P=0.03), from 1.31±0.28 kg/cm2 to 1.51±0.2 kg/cm2 in the right masseter (P>0.05), from 1.32±0.2 kg/cm2 to 1.46±0.2 kg/cm2 in the left temporalis (P=0.047), and from 1.4±0.2 kg/cm2 to 1.67±0.3 kg/cm2 in the right temporalis (P=0.06). Conclusions The protocol caused significant changes in pain-free MMO, self-reported pain, and functionality of the stomatognathic system in subjects with myofascial TMD, regardless of joint involvement. Even though these differences are statistically significant, their clinical relevance is still questionable.

Avaliação da postura e posições de trabalho do cirurgião-dentista destro e da auxiliar odontológica em procedimentos restauradores / Evaluation work of posture and positions of the right hand dentist and chairside assistant in restorative procedure

O presente estudo analisa a postura e posições do cirurgião-dentista destro e da auxiliar odontológica, bem como a posição da cabeça do paciente, para restaurações em amálgama e resina composta, usando os princípios ergonômicos no trabalho. As observações foram realizadas nos dentes anteriores e posteriores, tanto na maxila como na mandíbula. Para atingir este objetivo, para todas as restaurações realizadas, foram registrados fotograficamente: a) a postura e as posições para o cirurgião-dentista destro; b) a postura e posições para a auxiliar odontológica; c) o posicionamento da cabeça do paciente; d) a região de apoio das mãos do cirurgião-dentista; e) o afastamento de tecidos moles quando realizado pelo dentista. De acordo com as observações, julga-se oportuno concluir que: a) as posições ideais para o cirurgião-dentista são de 9 e 11 horas; b) a posição ideal para a auxiliar atuar diretamente na boca do paciente é a de 3 horas; c) o posicionamento da cabeça do paciente está diretamente relacionado à região da boca onde está sendo realizada a restauração; d) a mão direita do cirurgião-dentista manteve-se apoiada no polegar esquerdo; a mão esquerda realiza o afastamento de lábios e bochecha

In this study an analysis about the work postura and positions of the right-hand operator and of the chairside assistant was made, as well as the patient's head position, for amalgam and composite restoration using ergonomic principles in the work. The observations were done for anterior and buccal teeth of either the maxilla or the mandible. To reach this objective, for all restorations the following situations were photographed: a) the right hand dentist's posture and positions; b) the chairside assistant's posture and positions; c) the patient's head position; d) the rest position of the operator's hands; e) the separation of the soft tissue when performed by the dentist. According to the observations the following conclusions were drawn: a) the ideal positions for dentist are the 9 and 11 o'clock; b) the ideal position for chairside assistant to operate directly on the patient's mouth is the position of 3 o'clock; c) the positioning of the patient's head is directly associated with the area of the mouth in which it is being performed the restoration; d) the right hand of the dentist had been supported by the left thumb; the left hand separates the lipas and bucca