Convex triangular vs. cylindrical field of view: how does the shape of the FOV affect radiation dose?

OBJECTIVE: To compare the dosimetry between convex triangular fields of view (FOV) and similar dimension cylindrical FOVs of two cone-beam computed tomography (CBCT) models. METHODS: Optically stimulated luminescence dosimeters (OSLDs) were placed in fiducial anatomical locations in an anthropomorphic phantom representing an adult head male for dosimetry scans. Convex triangular FOVs (100 × 80 mm/maxilla-mandible; 100 × 50 mm mandible; 100 × 50 mm/maxilla) from Veraviewepocs 3D R100 (J. Morita, Kyoto, Japan) (R100) and Veraview® X800 (J. Morita, Kyoto, Japan) (X800) and cylindrical FOVs from R100 and X800 (80 × 80 mm/maxilla-mandible; 80 × 50 mm/mandible; 80 × 50 mm/maxilla) were obtained, resulting in 12 different scan protocols. Equivalent doses for each relevant organ/tissue and the effective dose for each protocol were calculated. Mean effective doses were compared by the two-way analysis of variance (ANOVA) with Tukey's post hoc test to evaluate the effect of the FOV and device (α = 0.05). RESULTS: The effective doses ranged between 69 and 324 µSv for the convex triangular FOVs and 76 and 332 µSv for the cylindrical FOVs. Convex triangular FOVs from the R100 device had effective doses 2.3 to 15.3% lower than their corresponding cylindrical FOVs with similar height (p < 0.05), and that difference ranged between 8.8 and 11.8% for the X800 device (p < 0.05). CONCLUSION: Convex triangular fields of view delivered slightly lower effective doses than the cylindrical fields of view of similar dimensions in the R100 and X800 CBCT devices. CLINICAL RELEVANCE: Understanding the influence of the image geometry formation in effective dose allows optimization to reduce patient dose.

Comparison of the expression of the volumetric alteration artifact in cylindrical and triangular fields of view in two cone-beam computed tomography devices.

OBJECTIVE: To compare the expression of the volumetric alteration (VA) artifact between cylindrical and convex triangular fields of view (FOVs) using high-density materials in different positions in two cone-beam computed tomography (CBCT) devices. MATERIALS AND METHODS: Cylinders of five high-density materials (amalgam, chromium-cobalt, gutta-percha, titanium, and zirconium) with known physical volume were individually submitted to CBCT acquisition in four positions inside a polymethylmethacrylate phantom using two different FOV shapes (convex triangular and cylindrical) on the Veraviewepocs® R100 (R100) and Veraview® X800 (X800) devices. Two oral radiologists obtained the tomographic volumes by segmenting each cylinder. The difference between the tomographic and physical volumes corresponded to the VA. These values were analyzed by intraclass correlation coefficient and analysis of variance for repeated measures with Tukey post hoc test (α = 5%). RESULTS: The FOV influenced the VA only in the X800 device (p = 0.014): the VA in the triangular FOV was greater than in the cylindrical FOV. The VA in the triangular FOV of the X800 device was greater than the R100 device (p < 0.0001). The material influenced the expression of the VA only in the R100 device (p < 0.0001); gutta-percha presented the highest VA, being underestimated, and differing from the other materials (p < 0.01). CONCLUSION: The triangular FOV increased the VA of high-density materials in the X800 device. CLINICAL RELEVANCE: It is important to know if there is an influence on the volumetric alteration artifact of dental materials due to the different image formation geometry in the convex triangular FOV.

The effect of voxel and field of view size on the volumetric alteration artifact of high-density materials with 2 cone beam computed tomography devices.

OBJECTIVE: We investigated the influence of voxel and field of view (FOV) sizes on expression of the volumetric alteration artifact (VAA) of 5 high-density materials in 2 cone beam computed tomography (CBCT) devices. STUDY DESIGN: Cylinders of amalgam, cobalt-chromium, gutta-percha, titanium, and zirconium were individually positioned in a polymethyl methacrylate phantom. OP300 Maxio and ProMax 3D Classic CBCT devices were used to acquire images with varying voxel and FOV sizes, totaling 585 scans. Two evaluators segmented the high-density cylinder images to obtain the tomographic volumes. The difference between the tomographic and physical volume of each cylinder (i.e., volumetric alteration) was calculated. Statistical analysis was conducted with multiway ANOVA and the Tukey post hoc test (α = 5%). Evaluator reliability was measured with the intraclass correlation coefficient (ICC). RESULTS: All studied parameters and nearly all interactions influenced the VAA (P < .05). The post hoc test demonstrated less volumetric alteration for the smallest voxel sizes, 61 × 78 mm FOV, and gutta-percha for OP300, and for the smallest voxel sizes, 80 × 80 mm FOV, and gutta-percha and titanium for ProMax 3D (P < .05). The ICC demonstrated perfect reliability (1.00). CONCLUSIONS: Voxel and FOV sizes influenced VAA expression. Using smaller voxel sizes, the 61 × 78 mm FOV for OP300 and the 80 × 80 mm FOV for ProMax 3D, and materials with lower density and lower atomic number reduced VAA expression.

High-density objects in exomass affect the volume of high-density objects inside the field of view.

OBJECTIVES: To evaluate the effect of the presence and the number of high-density objects in the exomass on the volume of a high-density object in cone-beam CT (CBCT). METHODS: Cylinders of cobalt-chromium (Co-Cr), titanium (Ti), and zirconium (Zi) were inserted into a polymethylmethacrylate phantom in five different combinations of number and position: 1-no cylinder; 2-one cylinder in a posterior region; 3-one cylinder in an anterior region; 4-two cylinders in posterior regions; and 5-three cylinders in anterior and posterior regions. The phantom underwent CBCT scanning using OP300 and X800 systems, with the afore mentioned cylinders of the same composition placed in the exomass and an additional high-density cylinder placed in the centre of the field of view (FOV), corresponding to the left-anterior region. The tomographic volume of the cylinder inside the FOV was measured using semi-automatic segmentation. The volumetric alteration (VA) between the segmented and physical volumes, in percentage, was compared among the experimental groups using repeated measures ANOVA and Tukey post-hoc (α = 5%). RESULTS: The factors material, combination, and their interaction affected the volume or both CBCT systems. In OP300, more cylinders in the exomass reduced the VA, mainly for Co-Cr. In X800, more cylinders in the exomass tended to increase the VA inside the FOV, except for Zi. CONCLUSIONS: In general, the presence of high-density objects in the exomass influences the VA of the object inside the FOV, although this oscillates according to object composition, number and position in the exomass, and CBCT system.

Determination of the pubertal growth spurt by artificial intelligence analysis of cervical vertebrae maturation in lateral cephalometric radiographs.

OBJECTIVE: This study aimed to assess the performance of a convolutional neural network (CNN) model in detecting the pubertal growth spurt by analyzing cervical vertebrae maturation (CVM) in lateral cephalometric radiographs (LCRs). STUDY DESIGN: In total, 600 LCRs of patients from 6 to 17 years old were selected. Three radiologists independently and blindly classified the maturation stages of the LCRs and defined the difficulty of each classification. Subsequently, the stage and level of difficulty were determined by consensus. LCRs were distributed between training, validation, and test datasets across 4 CNN-based models. The models' responses were compared with the radiologists' reference standard, and the architecture with the highest success rate was selected for evaluation. Models were developed using full and cropped LCRs with original and simplified maturation classifications. RESULTS: In the simplified classification, the Inception-v3 CNN yielded an accuracy of 74% and 75%, with recall and precision values of 61% and 62%, for full and cropped LCRs, respectively. It achieved 61% and 62% total success rates with full and cropped LCRs, respectively, reaching 72.7% for easy-to-classify cropped cases. CONCLUSION: Overall, the CNN model demonstrated potential for determining the maturation status regarding the pubertal growth spurt through images of the cervical vertebrae. It may be useful as an initial assessment tool or as an aid for optimizing the assessment and treatment decisions of the clinician.

Does cone-beam CT convex triangular field of view influence the image shape distortion of high-density materials?

OBJECTIVES: To assess the distortion of high-density materials using two CBCT devices presenting convex triangular and cylindrical fields of view (FOVs). METHODS AND MATERIALS: Four high-density cylinders were individually placed in a polymethylmethacrylate phantom. 192 CBCT scans were acquired using the convex triangular and cylindrical FOVs of Veraviewepocs® R100 (R100) and Veraview® X800 (X800) devices. Using HorosTM's software, two oral radiologists determined the cylinders' horizontal and vertical dimensional alterations. Nine oral radiologists subjectively identified each cylinder's axial shape distortion. Statistical analysis comprised Multiway ANOVA (α = 5%), and the Kruskal-Wallis test. RESULTS: The distortion in the axial plane was greater in the convex triangular FOVs for both devices in almost all the materials (p < 0.05). The evaluators subjectively identified a shape distortion in both FOVs for R100 device (p < 0.001), while no distortion was identified for X800 device (p = 0.620). A vertical magnification of all materials was observed in both FOVs for both devices (p < 0.05). No differences among vertical regions (p = 0.988) nor FOVs (p = 0.544) were found for the R100 device, while all materials showed higher magnification in all regions in the cylindrical FOV (p < 0.001) of the X800 device. CONCLUSIONS: The convex triangular FOV influenced the axial distortion of the high-density materials in both devices. A vertical magnification was observed in both FOVs of both devices, but it was greater in the cylindrical FOV of the X800 device.

Does the shape of the field-of-view influence the magnitude of artefacts from high-density materials in cone-beam computed tomography?

OBJECTIVE: To compare cylindrical and convex triangular field-of-views (FOVs) concerning the magnitude of artefacts from high-density materials in cone-beam CT (CBCT). METHODS AND MATERIALS: Cylinders of amalgam, chromium-cobalt, titanium, and zirconia were individually placed in the anterior and posterior regions of a polymethylmethacrylate phantom and scanned using cylindrical and convex triangular FOVs of the Veraview X800 CBCT device. Using the Image J software, 15 square regions of interest (ROIs) were placed in the axial reconstruction around the middle level of the cylinder and at distances of 0.5, 1.0, and 1.5 cm from the centre of the cylinder. Mean grey value and standard deviation of each ROI were averaged for each distance and subtracted from the values of a control ROI to calculate the magnitude of the artefacts by the grey value mean difference (GVMD) and grey value standard deviation (GVSD). Multiway analysis of variance with Tukey post-hoc test with a significance level of 5% evaluated the effect of the shape of the FOV, position inside the FOV, high-density material, and the distance of the artefact from the material. RESULTS: The convex triangular FOV increased the GVSD for all materials in the anterior and posterior regions at 0.5 cm compared to the cylindrical FOV (p < 0.0001). The convex triangular FOV showed greater GVMD for chromium-cobalt and zirconium in the anterior region and all materials in the posterior region at all distances (p < 0.0001). CONCLUSION: The FOV shape influences the magnitude of artefacts from high-density materials. The convex triangular FOV showed greater artefact magnitude with variability among the high-density materials, region in the FOV, and distance from the material.

Reproducibility and diagnostic value of a new wedge-guided bitewing image receptor-holding device.

OBJECTIVE: To assess the reproducibility of a wedge-guided bitewing image receptor-holding device (IRHD-WG) compared to a commercially available bitewing image receptor-holding device (IRHD-XCP). METHODS AND MATERIALS: Ten operators randomly acquired bitewing radiographs of four posterior regions (Premolar, Molar 1, Molar 2, Molar 3) distributed in two dry bone skulls and mandibles using 2 IRHDs (IRHD-WG and IRHD-XCP). The radiographs corresponding to the same region and IRHD but acquired by different operators were paired for reproducibility comparison. A total of 360 pairs of radiographs were randomized for analysis. Objective analysis consisted of extracting the pixel values from each radiograph and comparing the values between each pair by intraclass correlation coefficient. For subjective analysis, the IRHDs images were digitally removed. Five oral radiologists blinded for the study conditions classified the radiograph pairs according to their similarity and diagnostic value. The answers' relative frequencies were compared by the chi-square test (α = 0.05). RESULTS: The IRHD-WG presented a higher reproducibility (Mean = 0.850; SD = 0.144) than the IRHD-XCP (Mean = 0.615; SD = 0.287) in the objective analysis. Radiographs acquired with the IRHD-WG were more similar than those acquired with the IRHD-XCP (p < 0.001). The diagnostic value of bitewing radiographs acquired with the IRHD-WG was considered superior to those acquired with the IRHD-XCP (p < 0.001). CONCLUSION: For the objective and subjective analyses of reproducibility, the IRHD-WG performed better than the commercial IRHD-XCP.

Does the angulation between the maxillary central incisors and the nasopalatine canal differ among sagittal and vertical skeletal patterns? A CBCT study.

OBJECTIVES: To assess the influence of sagittal and vertical skeletal patterns, and sex in the angulation and relationship between the maxillary central incisors and the nasopalatine canal. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) exams of 172 patients were classified into sagittal (class I, II, and III) and vertical skeletal patterns (mesofacial, brachyfacial and dolichofacial). Hard palate-nasopalatine canal and hard palate-long axis of maxillary central incisors angles were measured in sagittal reconstructions. The obtained angles were used to calculate the angulation between maxillary central incisors and nasopalatine canal by triangle geometric relationship. Analysis of variance (multi-way ANOVA) and Tukey post-hoc test were used for data analysis (α=5%). RESULTS: Sagittal and vertical skeletal patterns, and sex presented a low influence on the angulation of maxillary central incisors and nasopalatine canal. Dolichofacial class II women showed the greatest hard palate-nasopalatine canal angulations (P<0.05) and maxillary central incisors and nasopalatine canal angulations (P<0.05). Mesofacial class II and III men presented the lowest maxillary central incisors and nasopalatine canal angulations (P<0.05). CONCLUSIONS: The sagittal and vertical skeletal patterns, and sex have a low influence on the angulation of the maxillary central incisors and the nasopalatine canal.

Development and validation of two new image receptor-holding devices for overlapping reduction of proximal surfaces in bitewing radiography: a preclinical study.

OBJECTIVE: To create and validate two new Image Receptor-Holding devices (IRHDs) to reduce proximal surfaces overlapping in bitewing radiography in comparison to a regular well-established and commercially available IRHD. METHODS: Two IRHDs for bitewing radiographs with a wedge on the biting surface were designed and 3D-printed. These IRHDs, with a large wedge (Pr-Lw) and small wedge (Pr-Sw), were compared with a regular commercially available IRHD (Rinn XCP®) during image acquisition of bitewing radiographs of four posterior regions (one upper region and three lower regions) in two dry skulls and mandibles. A total of 156 interproximal regions on bitewing radiographs were radiographed by 13 oral radiology graduate students and independently assessed by two oral radiologists (10 years of experience). IRHDs were compared by Cochran's Q test regarding the number of overlapped proximal surfaces in the acquired radiographs with a significance level of 5%. RESULTS: The observers were in perfect agreement (κ = 1.0) to classify the proximal surfaces overlapping. The Pr-Lw IRHD presented the lowest number of surfaces overlapping (19.2%) followed by the Pr-Sw IRHD (48.1%) and the XCP®IRHD with the highest surfaces overlapping (71.2%). The Pr-Lw IRHD surfaces overlapping was statistically different from the XCP IRHD (p < 0.001), and the Pr-Sw IRHD (p = 0.014). CONCLUSIONS: The Pr-Lw IRHD demonstrated the most efficient performance in overlapping surfaces reduction, compared with the Pr-Sw IRHD and the XCP® IRHD in adult dry skulls and mandibles.

Actualización en equipos de Rayos X portátiles en odontología: revisión de literatura / Update on Hand-Held X-Ray Devices in Dentistry: a Literature Review

Resumen En las últimas dos décadas ha aumentado el uso de equipos portátiles de rayos X intraorales, los cuales son estabilizados por el operador. Si bien todos los equipos radiográficos presentan un riesgo inherente por el uso de radiación ionizante, el uso indebido de los equipos portátiles puede aumentar la exposición del operador. Se recomienda el uso de los equipos portátiles en un trípode o activados desde un área protegida. Sin embargo, en casos altamente justificados para su uso sin estos aditamentos, se debe seguir recomendaciones para disminuir la exposición del operador. Debido a que la radioprotección es fundamental al trabajar con rayos X, se debe favorecer el uso de equipos radiográficos dentales fijos sobre los equipos portátiles, ya que estos proporcionan una menor dosis de radiación al operador.

Abstract In the last two decades, the use of portable intraoral X-ray devices, stabilized by the operator, has increased. While all radiographic devices present an inherent risk from ionizing radiation, improper use of portable devices can increase operator exposure. Use of portable devices on a tripod or powered from a protected area is recommended. However, in highly justified cases, for using without these accessories, recommendations should be followed to reduce operator exposure. Because radioprotection is essential when using X-rays, fixed dental radiographic devices should be favored over portable equipment since the first provides a lower radiation dose to the operator.

Impact of COVID-19 pandemic on dental education: perception of professors and students / Impacto de la pandemia COVID-19 en educación dental: percepción de estudiantes y profesores

Abstract The objective of this study was to evaluate perception and feelings experienced by dentistry professors and students about distance learning during the COVID-19 pandemic. Fifty professors and fifty- two students reported the perceptions and implications of distance learning imposed by the pandemic of COVID-19. The participants' answers were analyzed using the qualitative-quantitative method of the collective subject's discourse. The answers were summarized in central ideas, distributed in absolute and relative frequency. The answers with similar central ideas were grouped, obtaining the discourse of the collective subject. The similar central ideas about distance learning addressed by professors and students were: suitable for didactic courses; limited laboratory and clinical courses, and internet access difficulties. Specifically for professors: a complement to classroom teaching; stress and learning with digital technologies; difficulty in reconciling classes with domestic activities; concerns with motivation and interaction with students; asynchronous lectures favor knowledge fixation, and synchronous lectures favor interaction with students; unreliable assessment methods; concern about returning to face-to-face classes. For the students: it was applied to all courses; demotivating; fundamental to guide studies; professors' commitment; long lectures; excessive school activities; difficult attendance control and evaluation; the comfort of being at home; impact on research. Professors considered distance learning as a learning opportunity on how to use digital technologies but too limited for lab and clinical activities and interaction with students. Students found it discouraging due to the absence of practical classes and excessive school activities.

Resumen: Evaluar la percepción y los sentimientos manifestados por profesores y estudiantes de odontología sobre la educación a distancia durante la pandemia por COVID-19. 50 profesores y 52 estudiantes informaron las percepciones e implicaciones del aprendizaje a distancia impuestas por motivo de la pandemia de COVID-19. Respuestas de los participantes fueron analizadas utilizando el método cualitativo-cuantitativo del discurso del sujeto colectivo. Respuestas se agruparon en ideas centrales, obteniendo el discurso del sujeto colectivo y fueron distribuidas en frecuencia absoluta y relativa. Ideas centrales similares entre profesores y estudiantes sobre el aprendizaje a distancia fueron: a) es adecuado para cursos didácticos; b) limitado para cursos de laboratorio y clínicos; c) presenta dificultades devido al acceso a Internet. Específicamente para profesores: a) complemento a la docencia en el aula; b) aumenta el estrés devido a la curva de aprendizaje con tecnologías digitales; c) dificultad para conciliar las clases con las actividades domésticas; d) preocupaciones con la motivación y la interacción con los estudiantes; e) las clases asincrónicas favorecen la fijación del conocimiento y las clases sincrónicas favorecen la interacción con los estudiantes; f) métodos de evaluación poco fiables; y g) preocupación por volver a las clases presenciales. Para los estudiantes: a) se aplicó a todos los cursos; b) desmotivador fundamental para orientar los estudios; c) compromiso de los profesores; d) conferencias largas; e) actividades escolares excesivas; f) difícil control y evaluación de asistencia; g) la comodidad de estar en casa; y h) impacto en la investigación. Profesores consideraron el aprendizaje a distancia como una oportunidad de aprendizaje sobre cómo utilizar las tecnologías digitales, pero demasiado limitado para las actividades de laboratorio y clínicas y la interacción con los estudiantes. Estudiantes lo encontraron desalentador debido a la ausencia de clases prácticas y al exceso de actividades escolares.

Valores de densidad en la escala de grises en Tomografía Computarizada de Haz Cónico: alcances y limitaciones / Grayscale Values in Cone Beam Computed Tomography: Scope and Limitations

ABSTRACT: Cone-beam computed tomography (CBCT) is a 3D imaging technique widely used in maxillofacial diagnosis. The grayscale value (GSV) is a number that represents the amount of attenuation of the X-ray beam by the material contained in each voxel or structural unit of the tomographic volume. Similarly, in computed tomography (CT) used in medical radiology, the attenuation values are standardized in the Hounsfield Unit (HU) scale. Although GSV may have interesting potential applications in maxillofacial diagnosis, it is essential to know that HU differ from GSV. The latter are susceptible to multiple technical factors during the tomographic acquisition, so their value can vary among different CBCT scanners or when technical parameters are modified. Hence, GSV should not be extrapolated between different CBCT machines, and their use should be cautious while more investigation is available considering various equipment and acquisition protocols.

RESUMEN: La tomografía computarizada de haz cónico (CBCT, por sus siglas en inglés) es una técnica de imagen 3D ampliamente usada en diagnóstico maxilofacial. El valor de densidad en la escala de grises (DEG) es una cifra que corresponde al grado de atenuación de los rayos x del material representado en cada vóxel o unidad estructural de la tomografía. De forma similar, en los sistema de tomografía computarizada de uso médico (CT) el valor de atenuación está estandarizado en las Unidades Hounsfield (UH). Aunque los valores de DEG pueden tener interesantes usos potenciales en el apoyo de diagnóstico en el área dentoalveolar, es importante conocer que los valores UH no son los mismos a los valores DEG, y que los valores de DEG son susceptibles a múltiples factores técnicos durante la adquisición de la tomografía, por lo que se pueden obtener resultados distintos entre equipos y al variar parámetros técnicos en las tomas. Por lo tanto sus valores no deben extrapolarse entre equipos y su uso debe ser cauteloso mientras se realiza mayor investigación específica para cada equipo y para cada protocolo de adquisición.

Digital technology in dental education during COVID-19 pandemic: worldwide experience of professors and students / Tecnología digital en la educación odontológica durante la pandemia por COVID-19: experiencia mundial de profesores y estudiantes

ABSTRACT: The objective of this study was to assess the use and experience with digital communication tools among dentistry professors and students to adapt to distance learning during the Covid-19 pandemic. Nine hundread and ninety five participants (479 dentistry professors and 516 students) from countries in North America, Latin America, Brazil, Europe, Asia, Oceania, and the Middle East answered a questionnaire about motivation/stress/anxiety; practice with digital technologies; synchronous/asynchronous communication technologies (difficulties/benefits), and which ones would they prefer using when returning to college. Data were analyzed by the Chi-square test and Fisher's exact (α=0.05). Motivation was more affected among the female professors, male students, and Brazilians (p<0.05). Concern about the academic future, was higher among female students, up to 30 years old, from Latin America and Brazil, and lower for European professors (p<0.05). Anxiety and stress were higher for undergraduate students up to 20 years old from Latin America and Brazil (p<0.05). European professors used more synchronous videoconferencing services for lectures/questions, while Brazilians used more text messaging applications for answering questions (p<0.05). Latin American professors used more surveys for evaluation (p<0.05). Brazilian professors indicated that they would use "online meetings" and "survey administration services" when returning to face-to-face activities and European professors/students would use "email" (p<0.05). Professors from Asia/Oceania/Middle East and professors/students from Brazil indicated "remote activities were important for students not to be inactive" (p<0.05). Efforts were made to adapt Dentistry's teaching to distance learning during the COVID-19 pandemic. However, the technologies used for this, feelings, and experiences differed between professors and students.

RESUMEN: El objetivo de este estudio fue evaluar el uso y la experiencia con herramientas de comunicación digital entre profesores y estudiantes de odontología para adaptarse al aprendizaje a distancia durante la pandemia Covid-19. Novecientos noventa y cinco participantes (479 profesores y 516 estudiantes de odontología) de países de diferentes regiones de América del Norte, América Latina, Brasil, Europa, Asia, Oceanía y Oriente Medio respondieron un cuestionario sobre motivación/ estrés/ansiedad; práctica con tecnologías digitales; tecnologías de comunicación sincrónicas/asincrónicas (dificultades/beneficios), y cuáles continuarían usando al regresar a la universidad. Los datos se analizaron mediante las pruebas Chi-cuadrado y exacta de Fisher (α=0,05). La motivación se vio más afectada entre las profesoras, estudiantes y brasileños (p<0,05). La preocupación por el futuro académico fue mayor entre las estudiantes, hasta los 30 años, de América Latina y Brasil, y menor para el profesorado europeo (p<0,05). El estrés fue mayor para el estudiantado de pregrado de Latinoamérica y Brasil hasta los 20 años (p<0.05). El profesorado europeo utilizó más servicios de videoconferencia sincrónica para clases y consultas, mientras que el brasileño utilizó más aplicaciones de mensajería de texto para consultas (p<0,05). El profesorado latinoamericano utilizó más encuestas para evaluación (p<0.05). El profesorado brasileño indicó que utilizaría "reuniones en línea" y "servicios de encuestas" cuando regresaran a la presencialidad, mientras que el profesorado/ estudiantado europeo utilizaría "correo electrónico" (p<0,05). El profesorado de Asia/ Oceanía/Medio Oriente y profesorado/estudiantado de Brasil indicó que "las actividades remotas eran importantes para que el estudiantado no estuviera inactivo" (p<0,05). Se relizaron esfuerzos para adaptar la enseñanza de la Odontología al aprendizaje a distancia durante la pandemia de COVID-19. Sin embargo, las tecnologías utilizadas y las experiencias difirieron entre profesores y estudiantes.

Oral and Maxillofacial Radiology During the Coronavirus Disease 2019 Pandemic: Recommendations for a Safer Practice / Radiología oral y maxillofacial durante la pandemia por Coronavirus 2019: recomendaciones para una práctica más segura

Abstract The Coronavirus 2019 disease (COVID-19), was declared a pandemic by the World Health Organization on March 11, 2020, and registered the first case in Costa Rica on March 6, 2020, and 105 days later reported 2058 cases, with a wide age range (0-92 years). Its etiologic agent is the beta coronavirus SARS-CoV-2 with confirmed human- to-human transmission, mainly by the respiratory route. The presence of asymptomatic carriers of the virus and its transmission even without the manifestation of symptoms challenges health professionals worldwide. For this reason, assuming all patients who need dental care as possible carriers of the SARS-CoV-2 is mandatory and consequently, applying biosecurity measures with strict criteria. In the present literature review, we aim to recommend biosecurity measures to be applied during imaging examinations of dental patients due to the Coronavirus-2019 pandemic. We found that in the absence of treatment for COVID-19 disease and because of its high transmissibility, the most effective measures to prevent its spread are those allowing its containment. Therefore, the authors recommend: 1) acquiring imaging exams just in case of dental urgencies or emergencies, 2) prioritizing the use of extraoral exams, such as panoramic radiography or CBCT, under the principle of ALADAI and 3) the intraoral exams should be used just in case of a lack of extraoral imaging devices, or because of the need to solve diagnostic tasks in which they have a superior diagnostic value than those of the extraoral examinations.

Resumen La enfermedad Coronavirus 2019, fue declarada pandemia por la Organización Mundial de la Salud el 11 de marzo de 2020; el primer caso registrado en Costa Rica fue el 6 de marzo de 2020, y 105 días después reportó 2058 casos, con un amplio rango de edad (0-92 años). Su agente etiológico es el beta coronavirus SARS- CoV-2. La transmisión de humano a humano está bien confirmada principalmente por la vía respiratoria. La presencia de portadores asintomáticos del virus y su transmisión, incluso sin la manifestación de síntomas, desafía a los profesionales de la salud. Por esta razón, es obligatorio asumir todos los pacientes que necesitan atención dental como posibles portadores del SARS-CoV-2 y, en consecuencia, aplicar medidas de bioseguridad con criterios estrictos. En la presente revisión de la literatura, nuestro objetivo es recomendar las medidas de bioseguridad que se aplicarán durante los exámenes de imágenes de pacientes dentales debido a la pandemia de Coronavirus-2019. Encontramos que en ausencia de tratamiento para la enfermedad de COVID-19 y debido a su alta transmisibilidad, las medidas más efectivas para prevenir su propagación son aquellas que permitan su contención. Por lo tanto, se recomienda: 1) adquirir exámenes por imágenes solo en caso de urgencias o emergencias dentales, 2) priorizar el uso de exámenes extraorales, como la radiografía panorámica o CBCT, bajo el principio de ALADAIP y 3) se deben usar los exámenes intraorales solo en caso de falta de dispositivos de imágenes extraorales, o por la necesidad de resolver tareas de diagnóstico en las que tienen un valor de diagnóstico superior al de los exámenes extraorales.