Evaluation of characteristics of periodontal probes

Aim: This study aimed to evaluate the millimeter distances and active tip diameters of different periodontal probes. Methods: Two types of periodontal probes were analyzed (North Carolina (15-UNC) and PCP-12). Two manufacturers were selected for each probe type. Digital images of the probes were obtained and the distances were measured using a software program. The diameter of the active tip was measured using a digital caliper. Both variables were measured by two trained and calibrated examiners. The data were analyzed using the Bland-Altman method and two-way ANOVA with Tukey's post-hoc test. Statistical significance was set at p<0.05. Results: A comparison of measurements between the 15UNC and PCP-12 probes showed a significant difference in all millimeter markings. The 15-UNC probe showed differences between the 3 and 12 mm markings. The PCP-12 probe only showed differences between the marks at the 12 mm mark. The 15-UNC probe had a similar active tip diameter between the two manufacturers. The PCP-12 probe showed a significant difference between the two manufacturers. Both types of probes had similar active tip diameters when compared by the two manufacturers. Conclusion: There was no standardization in relation to millimeter marks and tip diameters of the two types of periodontal probes produced by the two different manufacturers. The probe types exhibited little variability

Evaluation of an open access generic 3D software for Orthodontic diagnosis and treatment planning

Aim: To evaluate the accuracy and the validity of orthodontic diagnostic measurements, as well as virtual tooth transformations using a generic open access 3D software compared to OrthoAnalyzer (3Shape) software; which was previously tested and proven for accuracy. Methods: 40 maxillary and mandibular single arch study models were duplicated and scanned using 3Shape laser scanner. The files were imported into the generic and OrthoAnalyzer software programs; where linear measurements were taken twice to investigate the accuracy of the program. To test the accuracy of the program format, they were printed, rescanned and imported into OrthAnalyzer. Finally, to investigate the accuracy of editing capabilities, linear and angular transformation procedures were performed, superimposed and printed to be rescanned and imported to OrthoAnalyzer for comparison. Results: There was no statistically significant difference between the two groups using the two software programs regarding the accuracy of the linear measurements (p>0.05). There was no statistically significant difference between the different formats among all the measurements, (p>0.05). The editing capabilities also showed no statistically significant difference (p>0.05). Conclusion: The generic 3D software (Meshmixer) was valid and accurate in cast measurements and linear and angular editing procedures. It can be used for orthodontic diagnosis and treatment planning without added costs

Acurácia da análise da discrepância de Bolton proposta por método manual e digital com softwares ortodônticos / ccuracy of Bolton discrepancy analysis proposed by manual and digital method with orthodontic software

objetivo desse estudo foi avaliar o desempenho diagnóstico da Análise da Discrepância de Bolton (DB) anterior e total proposta pelo programa ClinCheck®, bem como dos softwares ortodônticos Dolphin Imaging® e 3D Slicer, comparado com mensurações manuais realizados em modelos impressos tridimensionalmente. Cinquenta e cinco pares de modelos digitais da fase inicial de pacientes tratados com sistema Invisalign® (Align, San Jose, Califórnia, EUA) foram impressos tridimensionalmente por estereolitografia e usados para mensuração da DB por método manual, com paquímetro digital, por um operador previamente calibrado. Os valores da DB fornecidos pelo software de planejamento ClinCheck® foram tabulados e os arquivos da amostra em formato STL foram medidos utilizando os softwares Dolphin Imaging® e 3D Slicer. Para avaliar a confiabilidade das análises usadas como referência das comparações seguintes, o erro do método foi calculado utilizando vinte por cento da amostra, com intervalo de 2 semanas. A análise estatística foi executada no software Jamovi (versão 2.0) e um nível de significância de 5% foi adotado. Os dados em milímetros foram avaliados pelo coeficiente de correlação intraclasse (ICC), fórmula de Dahlberg, teste t pareado e método de Bland-Altman. Os resultados indicaram que os três métodos evidenciaram medidas confiáveis (ICC ≥ 0,7), sendo a DB anterior ligeiramente mais confiável. No entanto, apenas as medidas da DB anterior realizadas pelo ClinCheck e Dolphin Imaging® foram acuradas (p>0,5, sem viés de proporção). Para o DB total, todos os programas pesquisados apresentaram diferença estatisticamente significativa em relação ao método manual (p<0.001), embora essas diferenças não tenham implicação clínica relevante. Conclui-se que as ferramentas disponíveis apresentam validade para aplicação no diagnóstico e planejamento ortodôntico no que diz respeito a DB, especialmente as medidas indicadas pelo ClinCheck® e Dolphin Imaging® para região anterior do arco. (AU)

This study aimed to evaluate the diagnostic performance of the analysis of anterior and overall Bolton Discrepancy (BD) proposed by the ClinCheck® program, as well as the orthodontic software Dolphin Imaging® and 3D Slicer, compared with manual measurements performed on three-dimensionally printed models. Fifty-five pairs of early-stage digital models of patients treated with the Invisalign® system (Align, San Jose, California, USA) were three-dimensionally printed by stereolithography and used to measure BD by manual method with a digital caliper by a previously calibrated operator. DB values provided by ClinCheck® planning software were tabulated and sample files in STL format were measured using Dolphin Imaging® and 3D Slicer software. To assess the reliability of the analyzes used as a reference for the following comparisons, the method error was calculated using twenty percent of the sample, with an interval of 2 weeks. Statistical analysis was performed using the Jamovi software (version 2.0) and a significance level of 5% was adopted. Data in millimeters were evaluated using the intraclass correlation coefficient (ICC), Dahlberg formula, paired t-test, and the Bland-Altman method. The results indicated that the three methods showed reliable measurements (ICC ≥ 0.7), with the anterior BD slightly more reliable. However, only anterior BD measurements performed by ClinCheck® and Dolphin Imaging® were accurate (p>0.5, without proportion bias). For overall BD, all programs surveyed showed a statistically significant difference from the manual method (p<0.001), although these differences have no relevant clinical implications. The available tools studied are valid for application in the diagnosis and orthodontic planning concerning BD, especially the measures indicated by ClinCheck® and Dolphin Imaging® for the anterior region of the arch. (AU)

Avaliação sobre aderência das clínicas odontológicas aos softwares de gestão / Evaluation of the adherence of dental clinics to management software

Com o avanço da tecnologia, diversos softwares de gestão Enterprise Resource Planning (ERP) foram desenvolvidos para auxiliar os cirurgiões dentistas na gestão das clínicas odontológicas. O objetivo desta dissertação foi avaliar a aderência das clínicas odontológicas aos softwares de gestão. Para metodologia foi desenvolvido um questionário eletrônico validado por especialistas com 22 perguntas direcionadas a 200 cirurgiões dentistas da cidade de São José dos Campos no estado de São Paulo. Finalizado o prazo de envio das respostas de 90 dias, obteve-se 56 questionários respondidos por completo. O tamanho da amostra foi redefinido por meio de cálculos estatísticos e o critério de seleção utilizado foi o método de conveniência. Todas as respostas foram analisadas e após correlação: 85,7% dos dentistas responderam que os softwares atendem às principais necessidades, das clínicas odontológicas, porém 55,4% afirmaram que as empresas dos softwares não oferecem treinamento suficiente aos usuários, talvez por isso, 73,2% dos entrevistados consideraram que seus colaboradores apresentam algum tipo de dificuldade para operar os softwares. Foi identificado correlação positiva entre a deficiência de suporte e treinamento, e facilidade de operação ou praticidade. 60,7% dos entrevistados desconhecem a segurança dos softwares e 64,3% desconhecem a conformidade dos softwares com as normas e legislação vigente. 82,1% dos entrevistados consideram a possibilidade de trocar o seu software por outro. Confirmou-se que os dentistas mais jovens têm mais facilidade de encontrar e utilizar os softwares. Concluiu-se que a baixa aderência está relacionada à falta de softwares de gestão mais práticos e eficientes que permitam ao dentista utilizá-los sem aumentar a sua carga de trabalho. Para as empresas desenvolvedoras de softwares sugere-se a necessidade de maior transparência na divulgação dos produtos e o oferecimento de treinamento e manual ou tutorial eficiente, além da necessidade de desenvolver softwares mais práticos e eficientes que permitam ser utilizados sem aumentar a carga de trabalho da equipe odontológica. (AU)

With the advancement of technology, several Enterprise Resource Planning (ERP) management software were developed to assist dental surgeons in the management of dental clinics. The aim of this dissertation was to evaluate the adherence of dental clinics to management software. For methodology, an electronic questionnaire validated by specialists was developed with 22 questions addressed to 200 dentists in the city of São José dos Campos in the state of São Paulo. After the 90-day deadline for sending answers, 56 questionnaires were completely answered. The sample size was redefined through statistical calculations and the selection criterion used was the convenience method. All responses were analyzed and after correlation: 85.7% of dentists responded that the software meets the main needs of dental clinics, but 55.4% said that software companies do not offer enough training to users, perhaps because of this, 73.2% of respondents considered that their employees have some type of difficulty operating the software. A positive correlation was identified between lack of support and training, and ease of operation or practicality. 60.7% of respondents are unaware of software security and 64.3% are unaware of software compliance with current standards and legislation. 82.1% of respondents consider the possibility of exchanging their software for another. It was confirmed that younger dentists find it easier to find and use software. It was concluded that low adherence is related to the lack of more practical and efficient management software that allow the dentist to use them without increasing their workload. For software development companies, it is suggested the need for greater transparency in the dissemination of products and the provision of training and efficient manuals or tutorials, in addition to the need to develop more practical and efficient software that can be used without increasing the company's workload dental team. (AU)

Reliability of a digital system for models measurements in BBO grading: A pilot study

ABSTRACT Introduction: Currently, no method is considered effective for the evaluation of digital models in the Certification Examination of the Brazilian Board of Orthodontics (BBO), considering the parameters of the currently used manual method. Objective: Thus, the aim of this study is to verify the reliability of an evaluation method for digital models that could be used in the BBO exam, compared to the gold standard. Methods: Measurements were performed by five previously calibrated examiners. Samples of ten sets of plaster models of the final phase of orthodontic treatment were measured using a manual method (Objective Grading System, OGS). These models were digitized using a 3D scanner and exported to Geomagic Qualify software, in which the measurements were made with the proposed digital method. These measurements were repeated using five models, after fifteen days. The intra-examiner performance with this method was analyzed with a paired t-test, whereas the inter-examiner analysis was carried out with analysis of variance and Tukey's test. To compare the manual and digital methods, a paired t-test and Pearson's correlation analysis were performed. Results: A statistically significant difference was found. The results showed that, when compared to the manual method, the digital method was effective in measuring the OGS in four of the seven variables studied: Marginal Ridge, Overjet, Occlusal Contact, and Interproximal Contact. The variables Alignment, BL inclination, and Occlusal Relationship showed a great amount of dispersion in the findings. Conclusion: Further studies are needed to develop an adequate digital methodology that can be used for all OGS variables.

RESUMO Introdução: Ainda não há um método considerado eficaz para análise dos modelos digitais no exame do Board Brasileiro de Ortodontia (BBO), considerando-se os parâmetros do método manual atual. Objetivo: Assim, o presente estudo objetiva verificar a confiabilidade de um método de avaliação em modelos digitais para o exame do BBO, comparando com o padrão-ouro. Métodos: As medições foram realizadas por 5 examinadores, previamente calibrados. A amostra de 10 pares de modelos de gesso da fase final do tratamento ortodôntico foi medida no método manual (Sistema Objetivo de Avaliação, SOA). Os modelos foram digitalizados por meio de um scanner 3D e exportados para o software Geomagic Qualify, onde foram feitas as medidas no método digital proposto. As medidas foram refeitas em 5 modelos após 15 dias. A análise intraexaminador desse método foi realizada por meio do teste t pareado; já a interexaminadores, feita com ANOVA e teste de Tukey, sendo encontrada diferença estatisticamente significativa. Para a comparação dos métodos manual e digital, foram utilizados o teste t pareado e a correlação de Pearson. Resultados: Uma diferença estatisticamente significativa foi encontrada. Os resultados mostraram que, comparada ao método manual, a metodologia digital mostrou-se eficaz para medição do SOA em quatro das sete variáveis estudadas: Margem interproximal, Sobressaliência, Contato oclusal e Contato interproximal. As variáveis Alinhamento, Inclinação V-L e Relação oclusal mostraram muita dispersão nos achados. Conclusão: Mais estudos são necessários para o desenvolvimento de uma metodologia digital adequada em todas as variáveis do SOA.

Cone-beam computed tomography cinematic rendering: clinical, teaching and research applications

Abstract Cone-beam computed tomography (CBCT) is an essential imaging method that increases the accuracy of diagnoses, planning and follow-up of endodontic complex cases. Image postprocessing and subsequent visualization relies on software for three-dimensional navigation, and application of indexation tools to provide clinically useful information according to a set of volumetric data. Image postprocessing has a crucial impact on diagnostic quality and various techniques have been employed on computed tomography (CT) and magnetic resonance imaging (MRI) data sets. These include: multiplanar reformations (MPR), maximum intensity projection (MIP) and volume rendering (VR). A recent advance in 3D data visualization is the new cinematic rendering reconstruction method, a technique that generates photorealistic 3D images from conventional CT and MRI data. This review discusses the importance of CBCT cinematic rendering for clinical decision-making, teaching, and research in Endodontics, and a presents series of cases that illustrate the diagnostic value of 3D cinematic rendering in clinical care.

Influence of mandibular positioning on the accuracy and reliability of linear measurements on cone beam CT using different voxels and two software programs / Influência do posicionamento mandibular na acurácia e confiabilidade de medidas lineares em tomografia computadorizada de feixe cônico utilizando diferentes voxels e dois softwares

Objetivo: este estudo avaliou a acurácia e confiabilidadedas medidas lineares em exames detomografia computadorizada de feixe cônico(TCFC), em dois softwares, utilizando diferentesvoxels e variando o posicionamento da mandíbula.Material e Métodos: 10 imagens de TCFC demandíbulas humanas com 25 pontos foram obtidas,usando diferentes protocolos de aquisição(0.250, 0.300, 0.400-mm voxels) e orientações damandíbula (centralizada, rotacionada 10° lateralmentepara direita e esquerda, inclinada 10° para cima e para baixo); 14 medidas foram realizadasnas reconstruções multiplanares nos softwares XoranCate OsiriX. Os achados foram comparadoscom as medidas físicas através de um paquímetrodigital. O teste ANOVA e o coeficiente de correlaçãoforam utilizados com p < 0,05. Resultados:não houve diferença estatisticamente significantequando as medidas foram comparadas em aquisiçõescom diferentes tamanhos de voxels emambos os softwares. A posição da mandíbula nãoinfluenciou nas medidas. Nenhuma diferença foiencontrada quando os valores foram comparadosentre os softwares e o paquímetro digital. Conclusão:as medidas lineares em ambos os softwaresforam confiáveis e acurados comparados a mensuraçãofísica em todos os protocolos. A acuráciae a confiabilidade das mensurações não influenciaramde acordo com as variações de posicionamentoda mandíbula.(AU)

Objective: this study evaluated the accuracy and reliability of linear measurements on cone beam CT (CBCT) scans in two software programs, using different voxels and varying mandible positioning. Material and methods: CBCT images of 10 human mandibles with 25 markers were obtained using different acquisition protocols (0.250, 0.300, 0.400-mm voxels) and mandible orientations (centered, rotated 10° laterally to right and left, tilted 10 up and down); fourteen measurements were carried out on the multiplanar reconstructions in XoranCat and OsiriX Lite software programs. The findings were compared to physical measurements using a digital caliper. ANOVA and correlation coefficient tests were used, at α = 0.05. Results: there was no statistically significant difference when the measurements were compared in acquisitions with different voxel sizes analysed in both software programs. Mandibular positioning changes did not influence the measurements. No differences were found when the values were compared between the software programs and the digital caliper. Conclusion: linear measurements in both programs were reliable and accurate compared with physical measurements when using all acquisition protocols. The accuracy and reliability of the measurements were not influenced by variations in the mandible positioning.(AU)

Evaluation of stability of three different mini-implants, based on thread shape factor and numerical analysis of stress around mini-implants with different insertion angle, with relation to en-masse retraction force

ABSTRACT Objectives: Assess the stability of three different mini-implants, based on thread shape factor (TSF), and evaluate stresses at the mini-implant site and surrounding cortical bone on application of retraction force, at two different insertion angles. Methods: Mini-implants of three different diameters (M1 - Orthoimplant, 1.8mm), (M2 - Tomas, 1.6mm) and (M3 - Vector TAS, 1.4mm) and length of 8mm were used. Using scanning electronic microscopy, the mean thread depth, pitch and relationship between the two (TSF) were calculated. The mini-implants were loaded into a synthetic bone block and the pull-out strength was tested. One way ANOVA and Tukey post-hoc tests were used to compare the pull-out strength of mini-implants. P values < 0.05 were considered statistically significant. Finite element models (FEM) were constructed with insertion angulation at 90° and 60°, with retraction force of 150 g. The results were analyzed using ANSYS software. Results: Statistically significant difference was found among all the three mini-implants for thread depth and pitch (< 0.001). Statistically significant higher pull-out force value was seen for Orthoimplant. The stress distribution level in mini-implant and surrounding bone was observed to be smaller for Orthoimplant. Conclusion: Orthoimplant mini-implants have more favorable geometric characteristics among the three types, and less stress with 90°angulation.

RESUMO Objetivos: Avaliar a estabilidade de três diferentes tipos de mini-implantes, com base no fator formato da rosca (thread shape factor, TSF), e avaliar a tensão no local de inserção e no osso cortical ao redor dos mini-implantes inseridos com dois ângulos diferentes, durante a aplicação de força para retração. Métodos: Foram usados três diferentes diâmetros de mini-implantes, sendo eles 1,8 mm (M1, ORTHO Implant), 1,6 mm (M2, Tomas) e 1,4 mm (M3, Vector TAS), todos com comprimento de 8 mm. Por meio da microscopia eletrônica de varredura, foram calculados a profundidade da rosca, o passo da rosca (distância entre os filetes da rosca) e a relação entre os dois (TSF). Para realização do teste de tração (pull-out), os mini-implantes foram inseridos em um bloco de osso sintético. Os testes ANOVA de uma via e post-hoc de Tukey foram usados para comparar as forças de resistência à tração dos mini-implantes, considerando-se estatisticamente significativos valores de p< 0,05. Modelos de elementos finitos (MEF) foram gerados com ângulos de inserção dos mini-implantes a 90° e 60°, com força de retração em 150g. Os resultados foram analisados usando-se o software ANSYS. Resultados: Diferenças estatisticamente significativas foram encontradas entre os três mini-implantes quanto à profundidade da rosca e o passo da rosca (p< 0,001). O ORTHO Implant apresentou a maior força de resistência à tração, com significância estatística. O nível de distribuição das tensões no mini-implante e no osso circundante também foi menor para o ORTHO Implant. Resultados: Entre os diferentes tipos de mini-implantes analisados, o ORTHO Implant apresentou as características geométricas mais favoráveis e a menor tensão com o ângulo de inserção de 90°.

Potential of a new cone-beam ct software for blooming artifact reduction

Abstract This study evaluated the dimensions of intraradicular posts using a new cone beam CT (CBCT) software, and verified the potential of blooming artifact reduction. Sixty-three single-rooted human teeth were shaped, obturated, prepared for intracanal post placement and distributed into three groups: G1: anatomically customized prefabricated glass fiber posts; G2: low-fusion alloy posts; G3: gold alloy posts. After post fabrication and luting with RelyX U200®, specimens were sectioned axially at 9 mm from the root apex, and markings were made on the root surfaces (X-, Y- and Z-axes). The dimensions of the original posts (control group) were measured using a digital micrometer. CBCT scans of the teeth were obtained using a PreXion 3D Elite® scanner. Posts were measured on CBCT scans using DICOM files and the e-Vol DX software. A specific filter, Blooming Artefact Reduction (BAR), was developed to analyze intracanal posts. Statistical data were evaluated using the Van de Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5%. The measures of the anatomical prefabricated, low-fusion alloy and gold alloy intracanal posts obtained using the e-Vol DX CBCT software and a micrometer were not significantly different (p>0.05). The use of the BAR filter of the e-Vol DX software application did not induce any dimensional differences on CBCT scans of intracanal posts when compared with measurements made with a micrometer on original posts. The use of the BAR filter eliminated blooming artifacts.

Resumo Este estudo avaliou as dimensões de pinos intrarradiculares usando um novo software de tomografia computadorizada de feixe cônico (TCFC) e um micrômetro digital, e verificou o potencial da redução do artefato de contraste do branco. Sessenta e três dentes humanos unirradiculares foram modelados, obturados, preparados para colocação de pinos e distribuídos em três grupos: G1: pino de fibra de vidro pré-fabricado anatômico; G2: pino metálico de liga de baixa fusão; G3: pino metálico de liga de ouro. Após a confecção e cimentação dos pinos com RelyX U200®, os espécimes foram cortados no sentido axial a 9 mm do ápice radicular, sendo efetuadas marcações em suas superfícies radiculares (eixos X, Y e Z) para orientação das medidas e sincronizações das imagens. Foi utilizado um micrômetro digital para a mensuração das dimensões dos pinos originais (grupo controle) associado ao microscópio operatório. Posteriormente, as imagens em TCFC foram obtidas usando o PreXion 3D Elite®. Para a mensuração dos pinos nas imagens de TCFC utilizou-se o arquivo DICOM e a ferramenta de medida do software e-Vol DX, configurada para medidas milesimais, com o filtro BAR (Blooming Artifact Reduction). Os dados estatísticos foram avaliados com a análise de variância não-paramétrica de Van der Waerden, seguida pelo Teste de Tukey aplicado aos dados normalizados. O nível de significância foi de α = 5%. Os resultados mostraram que as medidas dos diâmetros dos pinos intrarradiculares (fibra de vidro anatômico, metálico liga de baixa fusão, e em liga de ouro) usando o software e-Vol DX e o micrômetro não mostram diferenças significativas entre si. O uso do filtro BAR do software e-Vol DX não induziu diferenças dimensionais nas imagens de TCFC dos pinos quando comparadas às medidas realizadas com o micrômetro sobre os pinos originais. O uso do filtro BAR eliminou artefatos de contraste do branco.

Lateral luxation of incisor - a case report of using a new cone-beam computed tomography software and reposition guideline

Abstract Lateral luxation injuries are one of the most severe periodontal injuries in dental trauma. The correct diagnosis followed by repositioning of the tooth on the right position is fundamental for the periodontal ligament healing. This study reported a clinical case of lateral luxation of maxillary central incisor involving a new cone beam computed tomography (CBCT) software for reconstruction (e-Vol DX) to confirm the lateral luxation after no conclusive dental trauma injury definition by using conventional exam. The lateral luxation injury was digitally reduced by insertion of tooth back to its alveolus, and at the same session, the tooth was stabilized with a rigid splint and further changed to a semi-rigid nylon splint. During the pulpal status monitoring, the pulp was diagnosed necrotic, then the root canal was treated to prevent root resorption. External office-bleaching and restorative procedure was performed. The 4-years follow up and new imaging exam and digital reconstruction confirmed bone healing and no complication. CBCT images analyzed by eVol DX can be used to determine and to guide lateral luxation treatment.

Resumo Lesões de luxação lateral são uma das lesões periodontais mais graves no traumatismo dental. O diagnóstico seguido do reposicionamento do dente na posição correta é fundamental para o reparo do ligamento periodontal. Este estudo relata um caso clínico de luxação lateral do incisivo central superior envolvendo um novo software de reconstrução (e-Vol DX) por tomografia computadorizada de feixe cônico (TCFC) para confirmar a luxação lateral após nenhuma definição de lesão por trauma dental conclusivo pelo exame convencional. A lesão de luxação lateral foi reduzida digitalmente pela inserção do dente de volta ao seu alvéolo e, na mesma sessão, o dente foi estabilizado com uma contenção rígida e posteriormente trocada para uma contenção de nylon semirrígida. Durante o monitoramento da condição pulpar, foi diagnosticada necrose da polpa e, em seguida, o canal radicular foi tratado para evitar a reabsorção radicular. Procedimento externo de clareamento e restauração foi realizado. O acompanhamento de 4 anos e o novo exame de imagem e reconstrução digital não confirmaram reparo ósseo e nenhuma complicação. Imagens de TCFC analisadas pelo e-Vol DX podem ser utilizadas para determinar e orientar lesão de luxação lateral.

Avaliação digital tridimensional da movimentação dentária com alinhadores transparentes / Three-dimensional digital assessment of tooth movement with transparent aligners

O objetivo deste estudo foi avaliar a concordância das medidas obtidas em modelos sobrepostos em dois programas com as medidas propostas pelo software ClinCheck; além de avaliar a eficácia da movimentação dentária obtida por alinhadores dentários, por meio de sobreposições de modelos digitais. Sete pacientes foram submetidos a tratamento ortodôntico com o sistema Invisalign. Os modelos digitais iniciais e finais fornecidos pela Align Technology foram sobrepostos nos programas 3D Slicer 4.6.2 e GOM Inspect 2017 para mensurar as movimentações dentárias e comparar com as que foram propostas pelo software ClinCheck; os modelos iniciais e finais obtidos clinicamente foram digitalizados e sobrepostos no software GOM Inspect 2017 para mensurar os movimentos dentários obtidos clinicamente e comparar com as medidas propostas pelo software ClinCheck. Posteriormente, os dados das sobreposições dos modelos iniciais e finais fornecidos pelo Align Technology foram comparados pela Análise de Concordância de BlandAltman. No programa GOM Inspect 2017, houve concordância em dois dos seis movimentos avaliados; já no programa 3D Slicer 4.6.2, foi encontrada concordância em três dos seis movimentos. Já os dados das sobreposições dos modelos iniciais e finais obtidos clinicamente foram comparados pelo teste de Wilcoxon. Os movimentos de extrusão, translação vestibular e translação mesial na maxila não apresentaram diferença estatisticamente significativa. Todos os movimentos na mandíbula e os movimentos de intrusão, translação lingual e translação distal na maxila apresentaram diferença estatisticamente significante. Apesar de clinicamente a diferença encontrada entre os softwares analisados e o ClinCheck ser desprezível, não podemos substituir o ClinCheck por outros softwares. Desta forma, para substituir um método por outro, o ideal seria que todas as análises apresentassem concordância com o software ClinCheck. Já para a comparação da movimentação dentária obtida clinicamente com a que foi proposta pela Align Technology, percebemos que movimentos dentários na mandíbula são imprecisos. Os movimentos de extrusão, translação vestibular e translação mesial na maxila foram identificados como precisos. As diferenças obtidas foram clinicamente desprezíveis considerando os movimentos isolados, mas significantes quando consideramos todos os movimentos propostos para um grupo de dentes. (AU)

The aim of this study was to evaluate the agreement of measures obtained by superimposition of models in two different programs with the measures proposed by the ClinCheck software; besides evaluating the efficacy of tooth movement obtained by dental aligners, through superimposition of digital models. Seven patients underwent orthodontic treatment with the Invisalign system. The initial and final digital models provided by Align Technology were superimposed on 3D Slicer 4.6.2 and GOM Inspect 2017 software to measure dental movements and compare with those proposed by the ClinCheck software; the initial and final models clinically obtained were digitized and superimposed on the GOM Inspect 2017 software to measure clinically obtained dental movements and compare with the measures proposed by the ClinCheck software. Subsequently, the superimposition data of the initial and final models provided by Align Technology were compared by the Bland-Altman Concordance Analysis. In the GOM Inspect 2017 software, there was agreement in two of the six movements evaluated; nevertheless, in the 3D Slicer 4.6.2 program, concordance was found in three of the six movements. The superimposed data of the initial and final models obtained clinically were compared by the Wilcoxon test. The movements of extrusion, vestibular translation and mesial translation in the maxilla did not present a statistically significant difference. All mandible tooth movements and the movements of intrusion, lingual translation and distal translation in the maxilla presented a statistically significant difference. Although clinically the difference found between the analyzed software and ClinCheck is negligible, we can not replace ClinCheck with other software. Thus, to substitute one method for another, ideally all analyzes would agree with ClinCheck software. In order to compare the dental movement obtained clinically with that proposed by Align Technology, we noticed that dental movements in the mandible are imprecise. The movements of extrusion, vestibular translation and mesial translation in the maxilla were identified as accurate. The differences obtained were clinically negligible considering the isolated movements, but significant when considering all the proposed movements for a group of teeth. (AU)

Implantação de um software para controle da central de esterilização do curso de Odontologia da Universidade Positivo / Implantation of software to control the sterilization department of the Dental School of Positivo University

O objetivo deste trabalho foi descrever um método de controle de esterilização dos materiais utilizados pelos acadêmicos de Odontologia, bem como comparar a sua eficiência frente ao antigo método de controle. Um software foi criado pela Gestão de Tecnologia da Informação da Universidade Positivo, a partir de uma demanda interna do curso, a fim de aprimorar o controle da central de esterilização. O novo método permite que etiquetas com código de barras sejam colocadas externamente em todas as caixas dos alunos, controlando todo o fluxo de entrada e saída de materiais, gerando maior segurança e agilidade do processo de esterilização. Além disso, o sistema permite que o professor tenha acesso à lista de todo o material esterilizado pelo aluno, bem como a data, horário e número da autoclave na qual o material foi esterilizado. Para avaliar a satisfação com o método foram entregues questionários para os estudantes do último ano do curso de Odontologia, contendo perguntas subjetivas sobre o novo e sobre o antigo método de controle. De acordo com o questionário aplicado, demonstrou-se que novo método utilizado diminui os atrasos para atendimento e o número de materiais danificados e perdidos, aumenta a segurança e acelera o tempo para a colocação e retirada dos materiais (p0,05). Na avalição geral, o método também se mostrou melhor quando comparado ao antigo (p0,001). Assim, conclui-se que o método implantado para o controle da esterilização proporcionou maior satisfação e segurança para os alunos (AU).

This study aims to describe a method for controlling the sterilization of materials used by dentistry students and to compare its efficiency against the former control method. A software was developed by the Information Technology Management Department at the Positivo University, motivated by an internal demand to improve the sterilizing department control. The new method allows the placement of labels with bar codes on the external surface of the students' boxes, controls the entire entrance-and-exit flow of materials and provides greater safety and agility for the sterilization process. Furthermore, the system allows professors to access the list of materials sterilized by students, and the date, time, and number of the autoclave in which the material was sterilized. Questionnaires including subjective questions about the new and former method of control were administered to final-year dentistry students to evaluate their satisfaction toward the methods. The new method decreases delays in patient care and the number of damaged and lost materials, increases safety, and reduces the time spent in material drop-off and withdrawal (p  better when compared to the former one (p  t the method implemented to control sterilization resulted in greater student satisfaction and provided greater safety (AU).

Estudo comparativo entre dois programas de computador (Dolphin Imaging® e Nemotec®) e método manual para análises cefalométricas de pacientes com deformidade dentofacial Padrão II / Comparative study of two computer software programs (Dolphin Imaging® and Nemotec®) and a manual method of cephalometric analysis for patients with dentofacial deformity Class II

Este estudo analisou traçados digitais obtidos por dois programas de computador (Dolphin Imaging® e Nemotec®) em comparação aos obtidos pelo método manual nas análises cefalométricas SNA, SNB, Co-A, Co-Gn, altura facial anterior, A-Nperp, Pg-Nperp e plano mandibular. 30 pacientes leucodermas, portadores de retrognatismo mandibular, foram avaliados e submetidos à cirurgia ortognática para correção da deformidade por meio da osteotomia sagital do ramo mandibular. Os traçados cefalométricos foram realizados em telerradiografias laterais obtidas uma semana antes da cirurgia. O método Manual e o Nemotec® apresentaram excelente confiabilidade em todas as medidas. Por outro lado, o método Dolphin Imaging® apontou baixa confiabilidade nas medidas altura facial anterior, Co-A e Co-Gn. Nas medidas A-Nperp, Pg-Nperp, Plano md, SNA e SNB, não houve diferença entre três métodos estudados. Na medida altura facial anterior, houve diferença entre os métodos Dolphin Imaging® e Nemotec®, mas não foram observadas diferenças em relação ao método manual. Nas medidas Co-A e Co-Gn, foi observado que o método Dolphin Imaging® apresentou média significativamente inferior aos demais métodos estudados. No método manual, somente as medidas Co-Gn, Pg-Nperp e SNB confirmaram o diagnóstico de retrognatismo mandibular, tendo o programa Nemotec® apresentado resultados melhores que o programa Dolphin Imaging®... (AU)

This study analyzed digital tracings obtained by two different computer software programs (Dolphin Imaging® and Nemotec®) and compare them to the manual method using cephalometric measurements SNA, SNB, Co-A, Co-Gn, anterior facial height, A-Nperp, Pg-Nperp and mandibular plane. Thirty Caucasian patients exhibiting mandibular retrognathia were analyzed and were submitted to orthognathic surgery to correct the deformity by bilateral sagittal split osteotomy. The cephalometric tracings were performed with lateral radiographs that were obtained a week prior to the surgery. The manual method and the Nemotec® software exhibited an excellent reliability in all measurements. However, the Dolphin Imaging® method exhibited low reliability in the anterior facial height, Co-A and Co-Gn measurements. For the measurements of A-Nperp, Pg-Nperp, Mandibular plan, SNA and SNB, there were no significant differences between the three methods studied. For the anterior facial height measurement, a statistically significant difference was found between the Dolphin Imaging® and Nemotec® methods, although not in relation to the manual method. For the Co-A and Co-Gn measurements, the Dolphin Imaging® method exhibited a significantly lower mean than the other methods studied. In manual method, only the Co-Gn, Pg-Nperp and SNB measurements confirmed the diagnosis of mandibular retrognathia and Nemotec® software provided better results than Dolphin Imaging®... (AU)

Use of Artificial Neuron Network to Predict Dental Arch Form

Objective: To develop diagnostic reference for arch form using Artificial Neuron Network (ANN) from tooth size and arch dimension variables on scanned-dental cast from patients with class I malocclusion treated orthodontically. Material and Methods: One hundred and ninety pairs of dental cast pre-post orthodontic treatment gathered from Orthodontic clinics were scanned and then all dimension variables were measured using Image Tool (gender, tooth size and arch dimension). The multivariate data were analyzed statistically using Stata (Lakeway Drive, College Station, Texas USA). The statistic results were compiled to build the neuron network software for analyzing arch form. Results: Gender and all variables from pre-treatment do not influence arch form. Intercanine width, canine depth, intermolar width, and molar depth are variables that influence arch form. The result of the statistical analyses can be used to develop software based on artificial neural network. Output program is the arch form, such as oval, square or tapered. The software can describe arch form with the accuracy of 76.31%. Conclusion: A software using Artificial Neuron Network to describe arch form can be used for diagnostic reference to Class I malocclusion.

Automatic cephalometric analysis: is it time to switch to a hands-free method?

Aim: To evaluate the reliability of the automatic cephalometric analysis in relation to the semi-automatic method. Methods: Fifty lateral cephalometric radiographs were selected and two dental surgeons performed the Steiner and Tweed analyses independently using the semi-automatic method on the Radiocef Studio 2® software suite (Radiomemory, Belo Horizonte, MG, Brazil), and the automatic method on the Kodak Dental Imaging Software (Carestream Health, Rochester, NY, USA). After thirty days, 30% of the sample was re-evaluated to assess intra-observer agreement. Ten angular and linear measurements of both analyses were selected, averaged for both observers and compared using Student's t-test with a significance level of 5% (α=0.05). Intra and inter-observer agreement were assessed through Intraclass Correlation Coefficient. Results: Intra-observer reproducibility was excellent for all measurements and inter-observer reproducibility was excellent for most of them. Significant differences (p<0.05) were found between automatic and semi-automatic methods for all measurements. Most of the measurements were significantly higher (p<0.05) with the automatic method. Conclusion: Semi-automatic cephalometric analysis can not be replaced with a completely automatic method

Volumetric reconstruction and determination of minimum crosssectional area of the pharynx in patients with cleft lip and palate: comparison between two different softwares

Abstract Objective: The aim of this study was to assess the accuracy of volumetric reconstruction of the pharynx by comparing the volume and minimum crosssectional area (mCSA) determined with open-source applications (ITK-Snap, www.itksnap.org ; SlicerCMF) and commercial software (Dolphin3D, 11.8, Dolphin Imaging & Management Solutions, Chatsworth, CA, USA) previously validated in the literature. Material and Methods: The sample comprised of 35 cone-beam computed tomography (CBCT) scans of patients with unilateral cleft lip and palate, with mean age of 29±15. Three-dimensional volumetric models of the pharynx were reconstructed using semi-automatic segmentation using the applications ITK-Snap (G1) and Dolphin3D (G2). Volumes and minimum cross-sectional areas were determined. Inter- and intra-observer error were calculated using ICC test. Comparison between applications was calculated using the Wilcoxon test. Results: Volumes and minimum crosssectional area were statistically similar between applications. ITK-Snap showed higher pharynx volumes, but lower mCSA. Visual assessment showed that 62.86% matched the region of mCSA in Dolphin3D and SPHARM-PDM. Conclusion: Measurements of volume and mCSA are statistically similar between applications. Therefore, open-source applications may be a viable option to assess upper airway dimensions using CBCT exams.

A forensic identification case and DPid - can it be a useful tool?

Abstract Objective The aim of this study was to show DPid as an important tool of potential application to solve cases with dental prosthesis, such as the forensic case reported, in which a skull, denture and dental records were received for analysis. Material and Methods Human identification is still challenging in various circumstances and Dental Prosthetics Identification (DPid) stores the patient's name and prosthesis information and provides access through an embedded code in dental prosthesis or an identification card. All of this information is digitally stored on servers accessible only by dentists, laboratory technicians and patients with their own level of secure access. DPid provides a complete single-source list of all dental prosthesis features (materials and components) under complete and secure documentation used for clinical follow-up and for human identification. Results and Conclusion If DPid tool was present in this forensic case, it could have been solved without requirement of DNA exam, which confirmed the dental comparison of antemortem and postmortem records, and concluded the case as a positive identification.

Avaliação da previsibilidade do planejamento virtual da cirurgia ortognática / Evaluation of predictability of orthognathic surgery performed according to the virtual planning

O objetivo dos autores foi avaliar a previsibilidade da cirurgia ortognática realizada segundo o planejamento virtual tridimensional. Para o presente estudo, foram selecionadas 28 tomografias computadorizadas de feixe cônico (14 pré cirúrgicas e 14 pós cirúrgicas) referentes à 14 pacientes que se submeteram ao tratamento ortodôntico com cirurgia ortognática realizada a partir do planejamento virtual. Após orientação das imagens, 3 pontos dentários foram marcados em cada arcada nas imagens tomográficas dos tempos pré e pós-cirúrgicos, assim como no planejamento. Os valores que representam a localização no espaço de cada um dos pontos foram tabelados. Foi realizado o cálculo do desvio quadrático médio entre dados do planejamento e da movimentação real e, utilizando o Teste T pareado ou Wilcoxon, a depender a distribuição dos dados, foram comparados os dados dos tempos pré e pós-cirúrgicos e o valor real de deslocamento com o planejado. O desvio quadrático médio foi acima de 2mm no eixo anteroposterior para os dentes 21 e 16 nos casos em que era planejado avanço mandibular. Analisando-se os tempos pré e pós cirúrgicos, houve diferença estatisticamente significativa no eixo anteroposterior para os pontos demarcados em dentes superiores. Em relação à comparação entre o deslocamento real obtido e o que foi planejado, não houve diferença estatisticamente significativa. O planejamento virtual tridimensional mostrou-se como ferramenta válida para planejamento e realização de cirurgias ortognáticas, trazendo resultados dentro do limite do que consideramos clinicamente aceitável. (AU)

The objective of the authors was to evaluate the predictability of orthognathic surgery performed according to the virtual three-dimensional planning. For the present study, 28 concomitant CT scans (14 preoperative and 14 postoperative) were selected for 14 patients who underwent orthodontic treatment with orthognathic surgery performed through virtual planning. After orientation of the images, 3 dental landmarks were delimited in each dental arch in the tomographic images of pre and post-surgical times, as well as in the planning. The values representing the location in the space of each of the points were tabulated. The mean square deviation between planned and actual movement data was calculated and, using the paired TTest or Wilcoxon, the pre and post-surgical data were compared, as well as the actual displacement value to the planned one. The mean square deviation was above 2mm in the anteroposterior axis for teeth 21 and 16 in cases where mandibular advancement was planned. Analyzing the pre and post surgical times, there was a statistically significant difference in the anteroposterior axis for maxillary teeth. Regarding the comparison between the actual displacement obtained and what was planned, there was no statistically significant difference. The threedimensional virtual planning proved to be a valid tool for planning and performing orthognathic surgeries, bringing results within the limits of what we consider to be clinically acceptable. (AU)

Confecção de pilares metal free com o uso do sistema CAD/CAM / Fabrication of CAD/CAM metal free dental implant abutments 174 PRÓTESENEWS

Nos últimos anos tivemos um aumento signifi cativo de trabalhos metal free, tanto para restaurações cerâmicas totais e/ou parciais como o surgimento de materiais metal free para construção de pilares (abutments) sobre implantes. A zircônia mostra-se o material com maior longevidade clínica, com resultados excelentes para estabilizar tanto a restauração cerâmica como o tecido mole em torno do conjunto pilar/ implante. O surgimento de novas tecnologias, como os sistemas CAD/CAM, facilita a confecção de pilares metal free para o clínico. Este trabalho apresentou um caso clínico mostrando o uso do sistema CAD/CAM para confecção de pilar e coroa cerâmica sobre implante.

Utilização de softwares livres para visualização e análise de imagens 3D na Odontologia / The use of free softwares for 3D image analysis in Dentistry

Softwares livres são programas computacionais, disponíveis gratuitamente na internet, fornecidos aos usuários com a liberdade de executar e repassar sem custo, ou seja, sem a necessidade de se pagar a licença de direitos autorais. Visando aumentar a percepção de Cirurgiões--Dentistas a respeito de vantagens do uso desses softwares como ferramenta de diagnóstico por meio da geração e análise de reconstruções 3D, procuramos introduzir a metodologia da análise computacional em exames de imagem processadas por softwares livres. Adicionalmente,cinco softwares de segmentação e reconstrução 3D serão apresentados.

Free softwares are computer programs, available for free in the internet, provided to the users to execute without cost, in other words, without the necessity to pay the copyright license. Aiming to enhance the dentists’ perception related to the advantages of using these softwares as diagnostic tool through 3D analysis, we are introducing methodologies of computer analysis in images processed by free softwares. Additionally, five free softwares of segmentation and 3D reconstruction are presented.