SMART Monitoring computer program for oral and skin lesions measurements: analysis through clinical photography

Lesion evaluation through photographs is a common clinical practice and its performance using computational tools is encouraged. Objective: To assess the reliability of the computer program SMART Monitoring (SM) in giving adequate lesion measurements through clinical photography. Materials and methods: A cross-sectional study was conducted with 28 patients diagnosed with oral or skin flat lesions. Each lesion was measured twice: clinically and by photographic image. Photographs were taken using a 3D-printed scale as a reference for SM measurements of the total lesional area (mm²) and the two longest axes (length and width) by two different operators. The agreement was evaluated between the axis's measurements of the two operators with the clinic measurements by the Bland-Altman plot. Results: Both operators revealed excellent agreement (ICC=0.98) regarding measurements of the lesion's axes and the total lesional area with no difference between operators. Comparison of the axes' values from SM to clinical measurements were also not different (p=0.82 and p=0.43). The Bland-Altman plot revealed that most mean differences were within the 95% confidence interval. Conclusion: SMART Monitoring proved to be a reliable tool for measuring oral or skin flat lesions on clinical photographs, regarding length, width, and total area measurements. The values obtained using SMART Monitoring presented an excellent agreement with the clinical measurements. (AU)

Development and validation of a case study to aid in the diagnostic reasoning of nursing students and nurses.

PURPOSE: The aim of this study is to develop and validate a case study to aid in the diagnostic reasoning of nursing students and nurses. METHODS: It is a validation study using a case study based on Lunney's method including (1) content validation of the case study by nurse experts through the Delphi technique, (2) identification of nursing diagnoses (NDs) in the case, (3) evaluation of diagnostic accuracy, and (4) establishment of a priority diagnosis by nurse experts. FINDINGS: The case study was developed from the findings of a narrative literature review on the cues of the NDs with a prevalence > 50% in patients with peripheral arterial occlusive disease. Two rounds of expert evaluation were required to validate the case study. The experts identified 18 NDs with different degrees of accuracy. The highly accurate diagnoses most frequently identified by the experts were: Ineffective peripheral tissue perfusion (100%), impaired walking (83%), impaired comfort (50%), and chronic pain (50%). The diagnosis considered a priority by all experts was ineffective peripheral tissue perfusion. CONCLUSIONS: The case study was developed and had its content validated. High-accuracy diagnoses were identified, and a priority was determined. IMPLICATIONS FOR NURSING PRACTICE: The validated case study may be used by students and nurses to facilitate the development of diagnostic reasoning and critical thinking in practice, teaching or research.

Tip and taper compatibility of accessory gutta-percha points with rotary and reciprocating instruments.

Objectives: This study was conducted to evaluate and compare the tip and taper compatibility of accessory gutta-percha points (AGPs) with various rotary and reciprocating instruments. Materials and Methods: Using a profile analyzer, tip and taper measurements were taken of 10 AGPs of each of the 14 models available from Odous de Deus and the 4 models available from Dentsply-Maillefer. Diameter measurements were taken at 1-mm intervals, from 3 mm from the tip (D3) to 16 mm. Results: Based on the mean values obtained, 3-dimensional (3D) models of the AGPs were drawn in Autodesk Fusion 360 and superimposed on 3D models of each instrument selected (Mtwo, Reciproc, RaCe, K3, and ProDesign Logic) to determine the compatibility between the instrument and the AGP. Data corresponding to the tips and tapers of the various AGPs, as well as the tip and taper differences between the AGPs and the instruments, were analyzed using descriptive statistics. The tapers of the AGPs were subject to the American National Standards Institute/American Dental Association No. 57 standard. The Odous de Deus extra-long medium and extra-long extra-medium AGPs were shown to be compatible with Mtwo, K3, and ProDesign Logic instruments with taper 0.06 and tip sizes 25 and 30, while the Dentsply fine and fine medium cones were compatible with Mtwo, RaCe, and K3 instruments with conicity of 0.04 and tip sizes 35 and 40. Conclusions: Both the Odous de Deus and Dentsply commercial brands included 2 AGP models with tip (D3) and taper compatibility with Mtwo, RaCe, K3, and/or Prodesign Logic instruments.

Accuracy of wearable electronic device compared to manual and automatic methods of blood pressure determination.

Blood pressure (BP) is the main biomarker for monitoring patients, as its lack of control above values considered normal is a modifiable risk factor for target organ damage. The aim of this study is to evaluate the accuracy of the wearable electronic device photoplethysmography technology (PPG) Samsung Galaxy Watch 4 in determining BP in young patients compared to manual and automatic methods of BP determination. This is a quantitative and cross-sectional study, following validation protocols for wearable devices and BP measurement. It was carried out with twenty healthy young adults, in which BP was measured using four instruments, namely, standard sphygmomanometer device (manual), automatic arm oscillometric device (reference), wrist oscillometric device, and Smartwatch PPG. Eighty systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings were observed. SBP means manual 118 ± 2.20,arm 113 ± 2.54, wrist 118 ± 2.51, and PPG (smartwatch) 113 ± 2.58. Among means, arm and PPG difference is 0.15, arm and wrist 4.95, arm and manual 4.45 wrist with PPG. The mean DBP manual 76.7 ± 1.84, arm 73.6 ± 1.92, wrist 79.3 ± 1.87, and PPG 72.2 ± 1.38. Among means, the difference between the arm and PPG is 1.4 and arm and hand 3.5 mmHg. The correlation shows PPG with manual, arm, and wrist. There was a strong SBP correlation and a moderate DBP correlation between the methods tested, evidencing the accuracy of the PPG smartwatch in relation to the reference method.

Linear dimensional change of edentulous models made of high-density laboratory silicones at different storage times / Alteração dimensional linear de modelos edêntulos fabricados com silicones laboratoriais de alta densidade em diferentes tempos de armazenagem

ABSTRACT Objective: To evaluate the dimensional change of edentulous models made of high density laboratory silicones at different storagetimes. Methods: A metallic master model simulating an edentulous maxilla was used. The model had projections of 1.8 cm located in the regions of canines (A and B) and molars (C and D) allowing the linear measurement of distances AB, BC, CD, DA, AC and BD. A laboratory silicone mold was made for duplication of master model in the following materials (n = 10): G1: Zetalabor 85, G2: Titanium 95, G3: Platinum 95 and G4: Gypsum type III (control). The samples were photographed and measured using a software (Image J) at times T1 (baseline) and T2 (after one week of models fabrication). The data were statistically analyzed using Kruskal- Wallis and Dun non-parametric tests (α = 0.05). Results: The storage time influenced the behavior of the materials evaluated. All groups presented dimensional changes in both times and the group Tit95 presented the best results. Only Zet85 group showed a different behavior related to the region of the model. Conclusions: The high density laboratory silicones showed satisfactory results when compared to the gypsum group. Tit95 was the most stable material and it can be recommended as an edentulous model for total protheses.

RESUMO Objetivo: Avaliar a alteração dimensional de modelos edêntulos fabricados em silicone laboratorial de alta densidade em diferentes tempos de armazenagem. Métodos: Um modelo mestre metálico simulando uma maxila edêntula foi utilizado. O modelo possuía projeções oclusais de 1,8 cm localizadas nas regiões de caninos (A e B) e molares (C e D), permitindo a mensuração das distâncias lineares AB, BC, CD, DA, AC e BD. Um molde foi fabricado em silicone laboratorial para duplicação do modelo mestre com os seguintes materiais (n = 10): G1: Zetalabor 85, G2: Titanium 95, G3: Platinum 95 e G4: Gesso tipo III (controle). As amostras foram fotografadas e mensuradas com auxílio de um software (Image J) nos tempos T1 (baseline) e T2 (após uma semana de confecção). Os dados obtidos foram avaliados estatisticamente utilizando os testes não paramétricos de Kruskal- Wallis e Dunn (α = 0.05). Resultados: O tempo de armazenagem influenciou o comportamento dos materiais avaliados. Todos os grupos apresentaram alterações dimensionais em ambos os temos de avaliação e o G2 apresentou os melhores resultados. Apenas o grupo G1 mostrou alteração dimensional dependente da região mensurada. Conclusão: Silicones laboratoriais de alta densidade mostraram resultados satisfatórias de alteração dimensional quando comparados ao gesso tipo III. O material Titanium 95foi o mais estável e pode ser recomendado como alternativa para a confecção de modelos edêntulos.

Accuracy between intraoral and extraoral scanning: Three-dimensional deviation and effect of distance between implants from two scanning methods.

Aim: Evaluate the accuracy between the intraoral and extraoral scanning regarding the three dimensional (3D) deviation and distances between the implants, through 2 scanning methods. Settings and Design: An in vitro study. Materials and Methods: An edentulous mandibular model was used to install four implants and abutments, recommending 6 distances between the implants. Scans were performed using an intraoral (SI) and extraoral (SE) scanner for each studied group: Scanning with the scan bodies (SB) and device (SD) (n = 10). The files were imported into a surface evaluation program to assess 3D deviations and measure distances between implants. Statistical Analysis: Precision was assessed as the difference between files (Kruskal-Wallis test), while trueness was assessed from the difference between scans, applying the Wilcoxon and Mann-Whitney test. Results: As for the 3D deviations, SI showed accuracy, for the faces and positions of the implants in relation to the SE, in both scanning methods (P < 0.05). Regarding the capture of distances between implants, the SD scan obtained better trueness than the SB group (P < 0.05). Conclusion: We concluded that the type and scanning methods used did not influence the 3D deviations, while for distances, scanning with the device had better trueness.

Big Five Inventory-2-Short: Evidências de Validade e Confiabilidade na Segurança Pública / Big Five Inventory-2-Short: Evidence of Validity and Reliability in Public Safety

O presente estudo teve como objetivo reunir evidências de validade de construto, baseadas na estrutura interna, do Big Five Inventory-2-Short (BFI-2-S) para o contexto da segurança pública brasileira. Participaram do estudo 9.742 agentes da segurança pública de diferentes corporações de todas as unidades federativas do Brasil. A maioria dos participantes era do sexo masculino 80,1% (ƒ = 8.156), com idades entre 18 e 73 anos (M = 41,55; DP = 8,02) e com tempo de trabalho na corporação entre 1 e 45 anos (M = 14,51; DP = 8,46). Os agentes responderam ao teste de personalidade BFI-2-S e a um questionário sociodemográfico, por meio de questionário eletrônico. A amostra foi dividida aleatoriamente em duas subamostras para validação cruzada. Em ambas as subamostras foram realizadas análises fatoriais exploratórias que indicaram uma estrutura trifatorial da BFI-2-S, com índices de fidedignidade adequados. Foram identificados os fatores extroversão, neuroticismo e conscienciosidade. Os itens referentes aos fatores amabilidade e abertura à experiência não apresentaram cargas fatoriais satisfatórias. Apesar da estrutura fatorial ter sido divergente do modelo teoricamente proposto pelo instrumento, isto é, o modelo de cinco fatores, o BFI-2-S se mostrou como um instrumento adequado para a avaliação das dimensões de conscienciosidade, neuroticismo e extroversão em servidores da segurança pública brasileiros.(AU)

The present study aimed to gather evidence of construct validity, based on the internal structure, of the Big Five Inventory-2-Short (BFI-2-S) for the context of Brazilian public security. 10.885 public security agents from different police forces from all federal units in Brazil were recruited through an electronic questionnaire, most were male, 80.1% (ƒ = 8,156), aged between 18 and 73 years (M = 41.55; SD = 8.02), working in the organization between 1 and 45 years (M = 14.51; SD = 8.46). Agents completed the BFI-2-S personality test and a sociodemographic questionnaire. The responses obtained were split into two random subsamples and a cross-validation procedure was performed. Thus, in both subsamples Exploratory Factor Analysis was carried out, which indicated a structure composed of three factors, with adequate reliability. Despite differing from the model theoretically proposed by the instrument, the BFI-2-S proved to be an adequate instrument for assessing the dimensions of conscientiousness, emotional instability and extroversion in Brazilian police officers.(AU)

El presente estudio tuvo como objetivo recopilar evidencias de validez de constructo, con base en la estructura interna, del Big Five Inventory-2-Short (BFI-2-S) para el contexto de la seguridad pública brasileña. 10.885 agentes de seguridad pública de diferentes corporaciones de todas las unidades federales de Brasil, la mayoría eran hombres 80,1% (ƒ = 8.156), con edad entre 18 y 73 años (M = 41,55; SD = 8,02) y con tiempo de trabajo en la corporación entre 1 y 45 años (M = 14.51; SD = 8.46). Los agentes completaron el test de personalidad BFI-2-S y un cuestionario sociodemográfico a través de un cuestionario electrónico. Las respuestas obtenidas se dividieron en dos submuestras aleatorias y se realizó un procedimiento de validación cruzada. Así, en ambas submuestras se realizaron Análisis Factoriales Exploratorios, los cuales indicaron una estructura compuesta por tres factores, con índices de confiabilidad adecuados. A pesar de diferir del modelo propuesto teóricamente por el instrumento, el BFI-2-S demostró ser un instrumento adecuado para evaluar las dimensiones de escrupulosidad, inestabilidad y extroversión en policías brasileños.(AU)

Validation and comparison of volume measurements using 1 multidetector computed tomography and 5 cone-beam computed tomography protocols: An in vitro study.

Purpose: The purpose of this study was to compare volume measurements obtained using 2 image software packages on Digital Imaging and Communications in Medicine (DICOM) images acquired from 1 multidetector computed tomography and 5 cone-beam computed tomography devices, using different protocols for physical volume measurements. Materials and Methods: Four pieces of bovine leg were prepared. Marrow was removed from 3 pieces, leaving cortical bone exposed. The resulting space of 1 piece was filled with water, another was filled with propylene glycol, and the third was left unfilled. The marrow in the fourth sample was left fully intact. Volume measurements were obtained after importing DICOM images into the Dolphin Imaging 11.95 and ITK-SNAP software programs. Data were analyzed using 3-way analysis of variance with a generalized linear model to determine the effects of voxel size, software, and content on percentage mean volume differences between tomographic protocols. A significance level of 0.05 was used. Results: The intraclass correlation coefficients for intraobserver and interobserver reliability were, respectively, 0.915 and 0.764 for the Dolphin software and 0.894 and 0.766 for the ITK-SNAP software. Three sources of statistically significant variation were identified: the interaction between software and content (P=0.001), the main effect of content (P=0.014), and the main effect of software (P=0.001). Voxel size was not associated with statistically significant differences in volume measurements. Conclusion: Both content and software influenced the accuracy of volume measurements, especially when the content had gray values similar to those of the adjacent tissues.

Agreement among instruments of quantitative evaluation of the hard palate in children / Concordância entre instrumentos de avaliação quantitativa do palato duro em crianças

ABSTRACT Purpose To evaluate the agreement among instruments of the quantitative evaluation of hard palate. Methods This cross-sectional study was performed with a sample of 30 children aged 6 to 11 from Santa Maria, Southern Brazil. The instruments for palate measurements evaluated were: digital caliper, used directly in the oral cavity and in plaster casts, Korkhaus tridimensional bow, used directly in the oral cavity and in plaster casts, and Dolphin Imaging Software used for measurements in cone-beam computed tomography (CBCT). The agreement among different instruments was evaluated using the Intraclass Correlation Coefficient (ICC). Results The means of all transversal dimensions obtained by cone-beam computed tomography were lower than those of the other instruments - the agreement values in the width between the canines and in the width between the first molars were lower when comparing the cone-beam computed tomography and the other instruments. In the width between the first and second premolars, all comparisons showed acceptable agreement values. Good concordance values were obtained when comparing the palate depth at the second premolar region when using a bow divider inside the oral cavity and in the cast. Conclusion Most instruments presented satisfactory agreement in the measurements related to the transverse plane of the hard palate. However, when the vertical plane was evaluated, only the bow divider applied to both cast and oral cavity presented ideal agreement.

RESUMO Objetivo Avaliar a concordância entre instrumentos de avaliação quantitativa do palato duro. Método Este estudo transversal foi realizado com uma amostra de 30 crianças de 6 a 11 anos de Santa Maria, sul do Brasil. Os instrumentos de medidas do palato avaliados foram: paquímetro digital, utilizado diretamente na cavidade oral e em modelos de gesso, arco tridimensional Korkhaus, usado diretamente na cavidade oral e em modelos de gesso, e Dolphin Imaging Software utilizado para medições em tomografia computadorizada de feixe cônico (CBCT). A concordância entre os diferentes instrumentos foi avaliada por meio do Coeficiente de Correlação Intraclasse (ICC). Resultados As médias de todas as dimensões transversais obtidas pela tomografia computadorizada de feixe cônico foram menores do que as dos outros instrumentos - os valores de concordância na largura entre os caninos e na largura entre os primeiros molares foram baixos na comparação entre a tomografia computadorizada de feixe cônico e os demais instrumentos. Na largura entre o primeiro e o segundo pré-molar, todas as comparações apresentaram valores de concordância aceitáveis. Valores de concordância aceitáveis também foram obtidos ao comparar a profundidade do palato na região do segundo pré-molar com o uso de um divisor de arco dentro da cavidade oral e no gesso. Conclusão A maioria dos instrumentos apresentou concordância satisfatória nas medidas relacionadas ao plano transverso do palato duro. Porém, quando avaliado o plano vertical, apenas o divisor de arco aplicado tanto no gesso quanto na cavidade oral apresentou concordância ideal.

Precisão de réguas endodônticas milimetradas e orifício calibrador, e avaliação da regularidade da superfície do orifício calibrador / Accuracy of endodontic millimeter rulers and calibrator hole, and evaluation of the regularity of the calibrator hole surface

Objetivo: O objetivo desse artigo foi avaliar a precisão das porções milimetrada e calibradora das réguas endodônticas, e avaliar a regularidade da superfície dos orifícios calibradores. Métodos: A porção milimetrada das réguas Angelus, Maillefer, Maquira, Microdont e Prisma foi avaliada com paquímetro eletrônico digital. Os orifícios calibradores da Maillefer, Prisma e Angelus foram medidos com um projetor de perfil. A regularidade da superfície dos orifícios calibradores foi classificada em S1 ­ sem irregularidades ou S2 ­ com regularidades. A análise de precisão das porções milimetrada e calibradora foi realizada com o teste t (p=0,05); e as frequências dos tipos de superfície, com o teste do qui-quadrado (p<0,05). Resultados: A Maillefer foi a única régua endodôntica com precisão em todos os comprimentos e orifícios. A Prisma apresentou estatisticamente mais orifícios do tipo S2, quando comparada com outras réguas endodônticas avaliadas (p<0,05). Não houve diferença estatisticamente significativa entre Angelus e Maillefer (p>0,05). Conclusão: A Maillefer apresentou precisão nas porções milimetrada e calibradora. As réguas endodônticas da Angelus não foram precisas em nenhum comprimento da parte milimetrada e não foram precisas na maioria dos orifícios calibradores. A régua endodôntica Prisma mostrou significativamente mais orifícios calibradores com irregularidades na superfície do que Angelus e Maillefer. Destaca-se a necessidade de controle de qualidade e padrões específicos para fabricação das réguas endodônticas (AU).

Objective: The aim was to evaluate the accuracy of the millimeter and calibration portion and evaluate the regularity of the calibrator orifice surfaces of the endodontic rulers. Methods: The millimeter portion of the Angelus, Maillefer, Maquira, Microdont and Prisma rulers was evaluated with an electronic digital caliper. The calibration holes of the Maillefer, Prisma and Angelus were measured with Profile Projector. The surface regularity of calibration holes was evaluated and classified in S1- without irregularities and S2- with irregularities. The accuracy analysis of the millimeter and calibration was performed with T-Test (p=0.05) and the frequencies of the surface types with Chi-square (p<0.05). Results: The Maillefer was the only rulers with accuracy in all lengths and holes. Prisma presented statistically more S2 type holes when compared with other endodontic rulers evaluated (p <0.05). There was no statistically significant difference between Angelus and Maillefer (p> 0.05). Conclusion: The Maillefer presented accuracy in the millimeter and calibration portion. Angelus endodontic rulers were not accurate at any rated length of the millimeter portion and it was not accurate in most calibration holes evaluated. Prisma endodontic ruler showed significantly more calibration holes with irregular surfaces than Angelus and Maillefer. We emphasize the need for quality control and specific standards for endodontic rulers manufacturing (AU).

Does vaporized hydrogen peroxide sterilization affect the geometrical properties of anatomic models and guides 3D printed from computed tomography images?

BACKGROUND: Material extrusion is used to 3D print anatomic models and guides. Sterilization is required if a 3D printed part touches the patient during an intervention. Vaporized Hydrogen Peroxide (VHP) is one method of sterilization. There are four factors to consider when sterilizing an anatomic model or guide: sterility, biocompatibility, mechanical properties, and geometric fidelity. This project focuses on geometric fidelity for material extrusion of one polymer acrylonitrile butadiene styrene (ABS) using VHP. METHODS: De-identified computed tomography (CT) image data from 16 patients was segmented using Mimics Innovation Suite (Materialise NV, Leuven, Belgium). Eight patients had maxillary and mandibular defects depicted with the anatomic models, and eight had mandibular defects for the anatomic guides. Anatomic models and guides designed from the surfaces of CT scan reconstruction and segementation were 3D printed in medical-grade acrylonitrile butadiene styrene (ABS) material extrusion. The 16 parts underwent low-temperature sterilization with VHP. The dimensional error was estimated after sterilization by comparing scanned images of the 3D printed parts. RESULTS: The average of the estimated mean differences between the printed pieces before and after sterilization were - 0,011 ± 0,252 mm (95%CI - 0,011; - 0,010) for the models and 0,003 ± 0,057 mm (95%CI 0,002; 0,003) for the guides. Regarding the dimensional error of the sterilized parts compared to the original design, the estimated mean differences were - 0,082 ± 0,626 mm (95%CI - 0,083; - 0,081) for the models and 0,126 ± 0,205 mm (95%CI 0,126, 0,127) for the guides. CONCLUSION: This project tested and verified dimensional stability, one of the four prerequisites for introducing vaporized hydrogen peroxide into 3D printing of anatomic models and guides; the 3D printed parts maintained dimensional stability after sterilization.

Dimensional Accuracy Comparison of Physical Models Generated by Digital Impression/3D-Printing or Analog Impression/Plaster Methods / Comparación de Precisión Dimensional de Modelos Físicos Generados por Métodos de Impresión Digital/Impresión 3D o Impresión Analógica/Yeso

This study aimed to compare the trueness and precision of physical models manufactured chairside (intraoral scanner and 3D printed) or by plaster models obtained using impression with alginate or addition silicone. A full- arch stainless steel die was impressed to obtain ten physical models for each group. The models were measured in a stereomicroscope, considering four linear distances. To assess the precision accuracy, an analysis of the measurement variability was carried out, identified by the coefficients of variation and by the Levene's test to compare the groups. To analyze trueness, the data average was subtracted from the database and compared considering alpha as 5 %. Considering precision, the higher dispersion of data occurred in the models obtained with silicone impression. And for trueness, Kruskal Wallis and Dunn tests results did not indicate differences between the groups in the anteroposterior linear distances (p> 0.05). Only in anterior transverse distance obtained through TRIOS (0.31 mm), it presented lower accuracy compared to the models from silicone impression (0.13 mm); however, at transverse posterior distance, the models from silicone impression showed the lowest accuracy (p 0.05). The physical dental models obtained by digital and analog workflows showed acceptable dimensional accuracy expressed by high precision and trueness. There is no difference between the evaluated intraoral scanner systems and the impression materials for the full-arch impression.

Este estudio tuvo como objetivo comparar la veracidad y precisión de modelos físicos fabricados en la clínica dental (escáner intraoral e impreso en 3D) o por modelos de yeso obtenidos mediante impresión con alginato o silicona de adición. Una matriz de acero inoxidable de arco completo fue impresa para obtener diez modelos físicos para cada grupo. Los modelos se midieron en un estereomicroscopio, considerando cuatro distancias lineales. Se realizó un análisis de la variabilidad de la medida para evaluar la precisión, identificada por los coeficientes de variación y por la prueba de Levene para comparar los grupos. Para analizar la veracidad, el promedio de los datos se restó de la base de datos y se comparó considerando alfa como 5 %. Considerando la precisión, la mayor dispersión de datos ocurrió en los modelos obtenidos con impresión de silicona. Y para la veracidad, los resultados de las pruebas de Kruskal Wallis y Dunn no indicaron diferencias entre los grupos en las distancias lineales anteroposteriores (p> 0,05). Solo en la distancia transversal anterior obtenida mediante TRIOS (0,31 mm) presentó menor precisión en comparación con los modelos de impresión de silicona (0,13 mm); sin embargo, la distancia transversal posterior, los modelos de impresión de silicona mostraron la menor precisión (p 0,05). Los modelos dentales físicos obtenidos mediante flujos de trabajo digitales y analógicos mostraron una precisión dimensional aceptable expresada por alta precisión y veracidad. No se observó diferencia entre los sistemas de escáner intraoral evaluados y los materiales de impresión para la impresión de arco completa.

Extended-pour and conventional alginates: effect of storage time on dimensional accuracy and maintenance of details

ABSTRACT Objective: This study aimed to evaluate the dimensional stability and maintenance of details of conventional and high stability alginates up to 5-day storage. Methods: Two types of alginates were selected (n=10) for this study, conventional (Hydrogum) and high stability alginates (Hydrogum 5), which were produced with the aid of a cylindrical metal block and a ring-shaped metal mold (Specifications 18, 19, and 25, ANSI/ADA). Ten images were obtained from the molds for the dimensional stability test, which were taken immediately after their production and at each different storage periods (15 min, 24 h, 48 h, 72 h, 96 h, and 120 h) by a digital camera. The specimens were kept hermetically sealed in plastic bags (23°C) and then used to obtain 140 (n=70) dental stone models, used in the detail reproduction test, in which the angular accuracy of three grooves (20 µm, 50 µm, and 75 µm) was observed at each period. The details reproduction accuracy was classified using a predetermined score classification. Measurements of dimensional changes were made in the Corel DRAW X6 program. The data were submitted to the Student's t-test (α?#8197;= 0.05). Results: A statistically significant difference concerning the size of the matrix was observed after 24h for both alginates, and a statistically significant negative linear dimensional change (contraction) was verified after 24 h of storage (1.52% for the high stability alginate, and 1.32% for the conventional alginate). The high stability alginate kept the full details for 72 hours, while the conventional alginate, for 24 h. Both alginates reproduced the 75 µm groove at all storage periods. Conclusion: Impressions made with both alginates presented satisfactory clinical results when the alginates were immediately poured.

RESUMO Objetivo: O presente estudo teve como objetivo avaliar a estabilidade dimensional e manutenção de detalhes de alginatos convencionais e de alta estabilidade por até 5 dias de armazenamento. Métodos: Para esse estudo, foram selecionados dois tipos de alginatos: convencional (Hydrogum) (n = 10) e de alta estabilidade (Hydrogum 5) (n = 10), sendo produzidos com o auxílio de um bloco metálico cilíndrico e um molde metálico em forma de anel (especificações 18, 19 e 25, ANSI/ADA). Para o teste de estabilidade dimensional, dez imagens foram obtidas imediatamente e para cada tempo de armazenamento (15 min, 24, 48, 72, 96 e 120 horas), realizadas por câmera digital. As amostras foram mantidas hermeticamente fechadas em sacos plásticos (23°C). Para o teste de reprodução de detalhes, as amostras foram utilizadas para obter 140 (n = 70 por grupo) modelos de gesso, sendo observada a precisão angular de três sulcos (20 µm, 50 µm e 75 µm) para cada período. A precisão da reprodução de detalhes foi classificada usando uma classificação de pontuação predeterminada. As medições das mudanças dimensionais foram feitas no programa Corel DRAW X6. Os dados foram submetidos ao teste t de Student (α = 0,05). Resultados: Foi observada diferença estatística em relação à matriz após 24h para ambos os alginatos. Uma mudança dimensional linear negativa estatisticamente significativa (contração) foi verificada após 24 h de armazenamento (1,52% para alginato de alta estabilidade; 1,32% para alginato convencional). O alginato de alta estabilidade manteve os detalhes completos por até 72 horas, enquanto o alginato convencional, por 24 horas. Os alginatos reproduziram o sulco de 75 µm para todos os períodos. Conclusão: As impressões feitas com ambos os alginatos devem ser imediatamente vazadas para se ter resultados clínicos satisfatórios.

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)

Accuracy of the measurements from multiplanar and sagittal reconstructions of CBCT.

OBJECTIVES: The purpose of this study was to assess the accuracy of linear measurements performed in multiplanar reconstructions (MPR) and sagittal reconstructions (SR) of the left hemiface obtained from cone-beam computed tomography (CBCT) with 3D® Dolphin Imaging software by comparing them with the same measurements made on lateral cephalograms and on dry skulls. SETTING AND SAMPLE POPULATION: Lateral cephalograms and CBCT (with voxels of 0.25, 0.3 and 0.4 mm) were taken of 10 dry skulls. MATERIALS AND METHODS: Linear distances were measured using the software's electronic rulers. Measurements performed on dry skulls using a digital caliper were considered the gold standard. The measurements were performed twice by two evaluators. RESULTS: No significant difference was found in the measurements performed with the different imaging modalities and on the dry skulls. The highest mean error was observed in the lateral cephalograms, followed by MPR and SR. CONCLUSIONS: Cephalometric measurements performed on multiplanar and sagittal reconstructions from CBCT, with different spatial resolutions, are accurate when compared with the measurements obtained in lateral cephalograms.

Measurement of wound area for early analysis of the scar predictive factor / Mensuração da área de feridas para análise precoce do fator preditivo cicatricial / Medición del área de heridas para el análisis temprano del factor predictivo de cicatriz

Objective: to evaluate the use of the 2D-FlexRuler as a facilitating tool for the early calculation of the predictive scar factor of chronic wounds. Method: a descriptive study with a quantitative, experimental, longitudinal and prospective approach. The sample consisted of 22 outpatients. 32 chronic wounds were analyzed. The wound edges were identified and drawn on the 2D-FlexRuler. The calculations of the areas of chronic wounds were obtained by manual, traditional methods, by software and Matlab algorithm. These areas were compared with each other to determine the efficiency of the proposed ruler in relation to traditional methods. Results: the calculation of the wound area by the traditional method and Kundin's coefficient show average errors greater than 40%. The manual estimation of the area with the 2D-FlexRuler is more accurate in relation to traditional measurement methods, which were considered quantitatively disqualified. When compared with the reference method, for example, the Klonk software, the data obtained by 2D-FlexRuler resulted in an error of less than 1.0%. Conclusion: the 2D-FlexRuler is a reliable metric platform for obtaining the anatomical limits of chronic wounds. It facilitated the calculation of the wound area under monitoring and allowed to obtain the scar predictive factor of chronic wounds with precocity in two weeks.

Objetivo: avaliar o uso da régua 2D-FlexRuler como ferramenta facilitadora para o cálculo precoce do fator preditivo cicatricial de feridas crônicas. Método: estudo descritivo com abordagem quantitativa, experimental, longitudinal e prospectiva. A amostra foi de 22 pacientes ambulatoriais. Foram analisadas 32 feridas crônicas. As bordas das feridas foram identificadas e desenhadas na 2D-FlexRuler. Os cálculos das áreas das feridas crônicas foram obtidos pelos métodos manuais, tradicionais, por softwares e algoritmo Matlab. Essas áreas foram comparadas entre si para determinar a eficiência da régua proposta em relação aos métodos tradicionais. Resultados: o cálculo da área da ferida pelo método tradicional e coeficiente de Kundin demonstram erros médios maiores do que 40%. A estimativa manual da área com a 2D-FlexRuler é mais exata em relação aos métodos tradicionais de medição, os quais foram considerados quantitativamente desqualificados. Quando comparada com o método de referência, i.e., o software Klonk, os dados obtidos pela 2D-FlexRuler resultaram em um erro menor que 1,0%. Conclusão: a régua 2D-FlexRuler é uma plataforma métrica confiável para a obtenção dos limites anatômicos de feridas crônicas. Facilitou o cálculo da área da ferida sob monitoramento e permitiu obter o fator preditivo cicatricial de feridas crônicas com precocidade em duas semanas.

Objetivo: evaluar el uso de la regla 2D-FlexRuler como herramienta facilitadora para el cálculo temprano del factor predictivo de cicatrices en heridas crónicas. Método: estudio descriptivo con enfoque cuantitativo, experimental, longitudinal y prospectivo. La muestra consistió en 22 pacientes ambulatorios. Se analizaron 32 heridas crónicas. Los bordes de la herida fueron identificados y dibujados en 2D-FlexRuler. Los cálculos de las áreas de heridas crónicas se obtuvieron por métodos manuales, tradicionales, por software y algoritmo Matlab. Estas áreas se compararon entre sí para determinar la eficiencia de la regla propuesta en relación con los métodos tradicionales. Resultados: el cálculo del área de la herida por el método tradicional y el coeficiente de Kundin muestran errores promedio superiores al 40%. La estimación manual del área con 2D-FlexRuler es más precisa en relación con los métodos de medición tradicionales, que se consideraron descalificados cuantitativamente. Al ser comparados con el método de referencia, es decir, el software Klonk, los datos obtenidos por 2D-FlexRuler arrojaron un error de menos del 1,0%. Conclusión: la regla 2D-FlexRuler es una plataforma métrica confiable para obtener los límites anatómicos de las heridas crónicas. Facilitó el cálculo del área de la herida bajo monitoreo y permitió obtener el factor predictivo de cicatriz de heridas crónicas con precocidad en dos semanas.

Reliability of Two Methods of Evaluation of the Apical Limit of Obturation of Root Canals of Primary Teeth: A Pilot Study

Abstract Objective: To verify the concordance in the evaluation of the apical limit of obturation (ALO) in filled root canals of primary teeth between digital and visual methods. Material and Methods: Twenty periapical radiographs of endodontically treated primary teeth were digitalized and evaluated by an endodontics specialist (E1), a PhD pediatric dentist (E2), and a MSc general dentist (E3). Calibrated evaluators (Kappa = 1.00) analysed the images in a light-isolated environment two times (D1 and D2) with a one-week interval between evaluations. ALO scores were categorized as overfilled, flush-filled and underfilled. Results: The intra-rater reliability between methods was 0.82 (D1) and 0.75 (D2) for E1, 0.93 (D1 and D2) for E2, and 0.94 (D1 and D2) for E3. Inter-rater reliability ranged from 0.71 (E1 × E3) and 1.00 (E1 × E2) for the visual method to 0.76 (E1 × E3) and 0.88 (E1 × E2) for the digital method. Spearman correlation coefficients showed a similar ranking among the evaluators. There was greater disagreement among the underfilled and ideal scores. For all evaluators, the digital method favoured the identification of the ideal score. Conclusion: Both methods are suitable for the determination of the ALO of filled primary teeth and can be used in clinical practice.

Medidas abdominais adicionais são uma ferramenta útil para avaliar a composição corporal em mulheres obesas / Additional abdominal measurements are a useful tool to evaluate body composition in obese women

ABSTRACT BACKGROUND: During weight gain, most of the excess adipose tissue accumulates in the trunk. This alters the body shape and makes collection of anthropometric measurements, especially waist circumference (WC), difficult. OBJECTIVE: To evaluate the sensitivity and applicability of additional abdominal measurements in order to assess body composition of obese women. METHODS: A total of 30 women between 20 and 50 years of age and BMI above 30 kg/m² were assessed. Three WC measurements, were performed: at the umbilical scar designated as WC1 and at 8 and 16 cm above the umbilical scar, designated as WC2, and WC3 respectively. The correlation (r) between these anthropometric measurements and their sum was assessed against the parameters fat mass (FM), free fat mass (FFM), body fat percentage (%BF), and trunk fat percentage (%TF), obtained by total and trunk segmental bioelectric impedance analysis (BIA) as well as by the golden standard total and trunk dual energy X-ray absorptiometry (DXA). RESULTS: The measurements WC1, WC2, WC3, and their sum correlated strongly and moderately with the parameters FM, FFM, and %BF in total BIA and in both total DXA and trunk DXA. CONCLUSION: The results demonstrated a robust correlation between the sum of the three WC measurements and total and trunk DXA in obese women suggesting that such measurements may be a good indicator of body and trunk fat in women, actually superior to BIA results. The use of these three measurements may be an alternative for the assessment of body and trunk fat, in those cases in which the body shape due to adipose tissue trunk accumulation makes accurate classical measurement (WC1) difficult.

RESUMO CONTEXTO: O acúmulo de tecido adiposo excessivo no ganho de peso se dá em maior proporção no segmento do tronco, leva à alteração dos formatos corporais dificultando a tomada de medidas antropométricas, em especial a circunferência abdominal (CA). OBJETIVO: Avaliar a sensibilidade de medidas adicionais na região abdominal, considerando cada medida individualmente e sua somatória, e a aplicabilidade dessas medidas na avaliação da composição corporal de mulheres obesas. MÉTODOS: Foram avaliadas 30 mulheres com idade entre 20 e 50 anos e IMC acima de 30 kg/m² com a realização de três medidas de CA denominadas: CA1 padronizada na cicatriz umbilical, CA2 a 8 cm acima da cicatriz umbilical e CA3 a 16 cm acima da cicatriz umbilical. Foi avaliada a correlação (r) destas medidas antropométricas e de sua somatória com os parâmetros massa gorda (MG), massa livre de gordura (MLG), porcentagem de gordura corporal (%GC) e do tronco (%GT) obtidos por impedância bioelétrica (BIA) total e segmentar do tronco e por absorciometria de raios-X de dupla energia (DXA) total e do tronco, como padrão ouro. RESULTADOS: As medidas CA1, CA2, CA3 e a somatória das três tiveram correlação forte e moderada com os parâmetros MG, MLG e %GC tanto para BIA total como para DXA total e DXA do tronco. CONCLUSÃO: Os resultados deste estudo mostram forte correlação entre a soma das medidas de três pontos no abdome com DXA de tronco e total, em mulheres obesas, sugerindo serem estas medidas, um bom indicador de gordura corporal e de gordura da região do tronco, superior aos resultados obtidos por BIA. O uso dessas três medidas pode ser um indicador alternativo de avaliação da gordura corporal e de tronco, nos casos em que o formato corporal de acúmulo de gordura na região do tronco, dificultar a acurácia da medida clássica (CA1).

Dimensional Stability of Casts Derived from Three Types of Alginate at Different Times After Impression

Objective: To evaluate the dimensional changes in three types of alginate following three different delay times after casting. Material and Methods: In this laboratory study, a maxillary arch-shaped stainless steel model was prepared and three pins with similar and determined diameters and heights were placed (one at mid-line and two on the underside of the model) as reference points to compare the dimensional stability of the three types of alginates. A special metal tray was made from the main model. The main moldel was imprisoned by the metal tray, and these were kept for a specific time in a humid environment. Gypsum Type 4 was poured over the impression to obtain 90 gypsum casts for three types of alginate. The dimensions of casts obtained from each alginate were compared in two lateral and anterior-posterior dimensions, they were compared with each other, and the alginates were also compared to the main model. Results: At a time interval of 15 minutes, the dimensional accuracy of the casts obtained from the three types of alginates, with the main model in both anterior-posterior and transverse dimensions was not significantly different (p<0.05); but there was a significant difference at 60 minutes and 24 hours in both dimensions (p<0.05). Although there was no significant difference between the alginates in both dimensions and all three studied time periods, the least difference with the main model was related to Zhermack and the highest difference was related to Golchai alginates. Pairwise comparisons showed that none of the samples had a significant difference in terms of dimensions. Conclusion: The dimensional stability of alginate was a time-dependent type of alginate and had no significant effect on the dimensional accuracy of casts.

Mandibular condylar dimensions: Correlation between 3D tomography and dried skull measurements.

Objective Compare the anatomical dimensions of mandibular condyles with the same CBCT measurements. Methods Four landmarks were identified on the condyles of dried skulls and are measured with their corresponding areas in CBCT images: Right Width of Condyle (RW), Left Width of Condyle (LW), Right Length of Condyle (RL), and Left Length of Condyle (LL). Results With respect to direct measurements on the dry skulls, statistically significant differences were found between sexes (p < 0.001). When the real values were compared with the CBCT, it was observed that the bias depends on the magnitude of the measurement. It means that there is an underestimation for smaller values and an overestimation for larger values. Conclusion CBCT is reliable imaging modality, but when compared real measures of condyle length are more reliable then width.