Influence of kilovoltage-peak and the metal artifact reduction tool in cone-beam computed tomography on the detection of bone defects around titanium-zirconia and zirconia implants.

Purpose: The aim of this study was to assess the influence of kilovoltage-peak (kVp) and the metal artifact reduction (MAR) tool on the detection of buccal and lingual peri-implant dehiscence in the presence of titanium-zirconia (Ti-Zr) and zirconia (Zr) implants in cone-beam computed tomography (CBCT) images. Materials and Methods: Twenty implant sites were created in the posterior region of human mandibles, including control sites (without dehiscence) and experimental sites (with dehiscence). Individually, a Ti-Zr or Zr implant was placed in each implant site. CBCT scans were performed using a Picasso Trio device, with variation in the kVp setting (70 or 90 kVp) and whether the MAR tool was used. Three oral radiologists scored the detection of dehiscence using a 5-point scale. The area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity were calculated and compared by multi-way analysis of variance (α=0.05). Results: The kVp, cortical plate involved (buccal or lingual cortices), and MAR did not influence any diagnostic values (P>0.05). The material of the implant did not influence the ROC curve values (P>0.05). In contrast, the sensitivity and specificity were statistically significantly influenced by the implant material (P<0.05) with Zr implants showing higher sensitivity values and lower specificity values than Ti-Zr implants. Conclusion: The detection of peri-implant dehiscence was not influenced by kVp, use of the MAR tool, or the cortical plate. Greater sensitivity and lower specificity were shown for the detection of peri-implant dehiscence in the presence of a Zr implant.

Automatic exposure compensation in intraoral digital radiography: effect on the gray values of dental tissues.

BACKGROUND: This study aimed to investigate the effect of automatic exposure compensation (AEC) of intraoral radiographic systems on the gray values of dental tissues in images acquired with or without high-density material in the exposed region using different exposure times and kilovoltages. The influence of the distance of the high-density material was also investigated. METHODS: Radiographs from the molar region of two mandibles were obtained using the RVG 6100 and the Express systems, operating at 60 and 70 kV and 0.06, 0.10, and 0.16 s. Subsequently, a titanium implant was inserted in the premolar's socket and other images were acquired. Using the ImageJ software, two regions of interest were determined on the enamel, coronary dentine, root dentine, and pulp of the first and second molars to obtain their gray values. RESULTS: In the RVG 6100, the implant did not affect the gray values (p > 0.05); the increase in kV decreased it in all tissues (p < 0.05), and the exposure time affected only the root dentine and pulp. In the Express, only enamel and coronary dentine values changed (p < 0.05), decreasing with the implant presence and/or with the increase in exposure factors. The distance of the implant did not affect the results (p > 0.05). CONCLUSIONS: AEC's performance varies between the radiographic systems. Its effect on the gray values depends not only on the presence or absence of high-density material but also on the kV and exposure time used.

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

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

Self-regulated learning perception of undergraduate dental students during the COVID-19 pandemic: A nationwide survey in Brazil.

BACKGROUND: This study aimed to evaluate the perception of self-regulated learning of Brazilian undergraduate dental students during the COVID-19 pandemic. MATERIAL AND METHODS: A nationwide cross-sectional survey was conducted. Data were collected in 2020, through an anonymous self-administered virtual questionnaire, which comprised an initial section related to the students' sociodemographic data, category of educational institution where they enrolled, and the possible impacts of COVID-19 pandemic on family income, teaching activities (maintained remotely or totally suspended), and self-perception of academic performance during e-learning. The second part comprising 31 questions related to the adapted Self-Regulated Learning Perception Scale (SRLPS). For statistical analysis, Student's t-test of independent samples, Kruskal-Wallis, and Mann-Whitney U test were used, considering a significance of 5%. RESULTS: From 779 students, 425 (54.6%) reported distance learning activities during the pandemic, and 354 (45.4%) experienced complete interruption of teaching activities. Students with good performance during e-learning were more skilled in self-regulated learning when compared to those who reported regular (p = 0.026), bad (p = 0.000), and very bad (p = 0.000) performance. In addition, students who stated a good performance during e-learning were more skilled in self-regulated learning than those with fully suspended teaching activities (p = 0.000). CONCLUSIONS: E-learning performance of undergraduate dental students during COVID-19 pandemic influenced the self-regulated learning perception. In addition, the pandemic negatively impacted the self-regulated learning of students who experimented full suspension of teaching activities. Changes in family's income did not affect their self-regulated learning. Key words:Dental education, community health, e-learning, learning, pandemics.

Positioning errors of dental implants and their associations with adjacent structures and anatomical variations: A CBCT-based study.

PURPOSE: The objective of the present study was to evaluate the prevalence of dental implants positioning errors and their associations with adjacent structures and anatomical variations by means of cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images of 207 patients (584 dental implants) were evaluated by 2 oral radiologists. The distance between the implant and the adjacent teeth/implants was measured and classified as adequate (≥1.5 mm and ≥3 mm, respectively) or inadequate. The presence of thread exposure, cortical perforation, implant dehiscence, implant penetration into adjacent structures, and anatomical variations was also recorded. The incisor canal diameter and the depth of the concavity of the submandibular fossa were measured in order to evaluate their correlations with the frequency of implant penetration in these structures. Descriptive analyses, the Fisher exact test, and Spearman correlation analysis were performed (α=0.05). RESULTS: The overall prevalence of positioning errors was 82.9%. The most common error was the inadequate distance between the implant and the adjacent teeth/implants. The presence of anatomical variations did not significantly influence the overall prevalence of errors (P>0.05). There was a positive correlation between the diameter of the incisor canal and the frequency of implant penetration in this structure (r=0.232, P<0.05). CONCLUSION: There was a high prevalence of dental implant positioning errors, and positioning errors were not associated with the presence of anatomical variations. Professionals should be aware of the space available for implant placement during the preoperative planning stage.

Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ.

This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5x5, 6x8 and 8x15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV.

Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ

Abstract This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5x5, 6x8 and 8x15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV.

Resumo O objetivo deste estudo foi estimar a dose absorvida em exames de tomografia computorizada de feixe cônico (TCFC) de acordo com diferentes parâmetros de exposição, tamanho e posição do campo de visão (FOV, do inglês field of view). Além disso, comparou-se a dose absorvida em uma única aquisição com FOV grande com aquela em duas aquisições com FOVs menores para avaliação de estruturas bilaterais como a articulação temporomandibular (ATM). As aquisições de TCFC foram obtidas no aparelho OP300 Maxio, variando o modo de aquisição (standard, high e endo), bem como o tamanho (5x5, 6x8 e 8x15 cm) e o posicionamento do FOV. Com o FOV pequeno, foram escaneadas diferentes áreas (maxila ou mandíbula, anterior ou posterior e ATM). As doses absorvidas foram determinadas por meio da utilização de dosímetros termoluminescentes na superfície da pele em órgãos sensíveis de um phantom antropomórfico. O modo endo mostrou a dose mais alta, seguido pelos modos high e standard em todas as posições dos FOVs. Com um FOV pequeno, as doses foram maiores na região posterior, especialmente na mandíbula. A redução da dose ocorreu quando foram utilizados pequenos FOVs; contudo, essa redução não foi proporcional à redução do tamanho do FOV. Para a ATM, a dose em uma única aquisição com FOV grande foi maior que duas aquisições com FOV pequeno, porém inferior à dose de duas aquisições com FOV médio (6x8 cm). Em conclusão, o modo de aquisição, o tamanho e a posição do FOV têm grande influência na dose absorvida. FOVs pequenos apresentaram doses mais baixas em relação aos FOVs grandes, entretanto não há uma relação linear entre o tamanho do FOV e a dose absorvida. Para estruturas bilaterais como a ATM, a dupla aquisição com FOV pequeno representa uma diminuição na dose absorvida em relação a uma aquisição com FOV grande.