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SUMMARY: CariesCare International ™ practical guide is a tool for the comprehensive assessment and treatment of caries that synthesizes clinical and radiographic diagnosis and risk factors, classifying the severity, progression, and activity of lesions. The objective of this study was to analyze the validity and prediction characteristics of the proposed dental caries classification in the CariesCare International ™ practical guide as a reference through clinical and radiographic evaluation versus histological evaluation. Ninety-seven permanent posterior teeth were evaluated, and clinical and radiographic diagnoses were determined according to parameters defined in the CariesCare International™ guide as a reference. Subsequently, histological evaluation was performed to compare each stage of dental caries progression, and statistical analysis was applied. When comparing the validity and prediction values between radiographic and clinical diagnoses in relation to histological evaluation, a low sensitivity and high specificity relationship was found. The sensitivity and specificity percentages between the clinical and radiographic methods show that the clinical method has a lower number of false negatives. Histological changes in dental tissue were evident from the earliest stages of lesions, even in those not related to the caries process, indicating that the dentist should be careful when deciding on a treatment plan and take into account all variables involved in the caries process, as proposed by the CariesCare International ™ guide.
La guía práctica CariesCare International™ es una herramienta para la evaluación y tratamiento integral de la caries que sintetiza el diagnóstico clínico y radiográfico y los factores de riesgo, clasificando la gravedad, progresión y actividad de las lesiones. El objetivo de este estudio fue analizar la validez y características de predicción de la clasificación de caries dental propuesta en la guía práctica CariesCare International™ como referencia a través de la evaluación clínica y radiográfica versus la evaluación histológica. Se evaluaron noventa y siete dientes posteriores permanentes y se determinaron diagnósticos clínicos y radiográficos según parámetros definidos en la guía CariesCare International™ como referencia. Posteriormente se realizó una evaluación histológica para comparar cada etapa de progresión de la caries dental y se aplicó análisis estadístico. Al comparar los valores de validez y predicción entre los diagnósticos radiológicos y clínicos en relación con la evaluación histológica, se encontró una relación de baja sensibilidad y alta especificidad. Los porcentajes de sensibilidad y especificidad entre el método clínico y radiográfico muestran que el método clínico tiene un menor número de falsos negativos. Los cambios histológicos en el tejido dental fueron evidentes desde las primeras etapas de las lesiones, incluso en aquellas no relacionadas con el proceso de caries, lo que indica que el odontólogo debe tener cuidado al decidir un plan de tratamiento y tener en cuenta todas las variables involucradas en el proceso de caries, tal como propone la guía CariesCare International™.
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Humanos , Dentição Permanente , Cárie Dentária/classificação , Cárie Dentária/diagnóstico por imagem , Estudos Transversais , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Guias de Prática Clínica como Assunto , Cárie Dentária/patologia , Esmalte Dentário/patologia , Esmalte Dentário/diagnóstico por imagem , Dentina/patologia , Dentina/diagnóstico por imagemRESUMO
[This corrects the article DOI: 10.3389/fnins.2024.1348066.].
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Objective and background: This study focuses on the atlas, a pivotal component of the craniovertebral junction, bridging the cranium and spinal column. Notably, variations in its arches are documented globally, necessitating a thorough assessment and categorization due to their significant implications in clinical, diagnostic, functional, and therapeutic contexts. The primary objective is to ascertain the frequency of these anatomical deviations in the atlas arches among a Colombian cohort using cone-beam computed tomography (CBCT). Methodology: Employing a descriptive, cross-sectional approach, this research scrutinizes the structural intricacies of the atlas arches in CBCT scans. Analytical parameters included sex distribution and the nature of anatomical deviations as per Currarino's classification. Statistical analyses were conducted to identify significant differences, including descriptive statistics and Chi-square tests. A systematic review of the literature was conducted in order to enhance the current Currarino's classification. Results: The study examined 839 CBCT images, with a nearly equal sex distribution (49.7% female, 50.3% male). Anatomical variations were identified in 26 instances (3%), displaying a higher incidence in females (X2 [(1, N = 839) = 4.0933, p = 0.0430]). The most prevalent variation was Type A (2.5%), followed by Type B (0.4%), and Type G (0.2%) without documenting any other variation. The systematic review yielded 7 studies. A novel classification system for these variations is proposed, considering global prevalence data in the cervical region. Conclusion: The study highlights a statistically significant predominance of Type A variations in the female subset. Given the critical nature of the craniovertebral junction and supporting evidence, it recommends an amendment to Currarino's classification to better reflect these clinical observations. A thorough study of anatomical variations of the upper cervical spine is relevant as they can impact important functional aspects such as mobility as well as stability. Considering the intricate anatomy of this area and the pivotal function of the atlas, accurately categorizing the variations of its arches is crucial for clinical practice. This classification aids in diagnosis, surgical planning, preventing iatrogenic incidents, and designing rehabilitation strategies.
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Background: Considering the limitations of visualization that occur even with the use of radiographs, the cone beam computed tomography (CBCT) becomes more attractive to diagnose and propose an assertive treatment plan. This study aimed to evaluate intra and interobserver reproducibility, and concordance of 31 reference points we described considering visualization tools and the three planes of space in a bimaxillary CBCT. Methods: Three observers located in triplicate the 31 reference points in the CBCT of six healthy patients. Friedman test was used to compare intraobserver paired samples, and interobserver concordance was determined by the intraclass correlation coefficient (ICC) with ranges>0.75 (excellent), between 0.60 and 0.74 (good), between 0.40 and 0.59 (sufficient) and<0.40 (poor). The P value was set at<0.05. Results: A high ICC (>0.75%) was obtained by comparing the x, y, and z values at the location of landmark points. Excellent ICC>0.75 was for 81.7% and poor<0.40 was 7.5% in the interobserver evaluation. Data showed that 25 points had excellent concordance on the x-plane, 25 on the y-plane, and 26 on the z-plane (0.75%). Conclusion: Intraobserver concordance analysis indicated that location of anatomical reference points on bimaxillary CBCT is performed with great reproducibility by interpreting their location with a clear description in the three planes of space. Complexity of achieving a good precision degree in the manual marking of reference points caused by convexities of the anatomical structures involved, might explain the variability found. The systematized location of the reference points would contribute to reduce such variability.
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La Articulación temporomandibular (ATM) cumple funciones importantes para la vida; su adecuado funcionamiento se puede alterar por trastornos temporomandibulares (TTM). La sintomatología de los TTM es variada, entre ellos se encuentra dolor en los músculos masticatorios, ruidos articulares y con menos frecuencia algunos pacientes refieren síntomas auditivos, lo que sugiere la existencia de una relación entre la ATM y el oído medio; sin embargo, esta relación no es clara. En consecuencia, el presente estudio tiene como propósito realizar una revisión de literatura para identificar los aspectos conocidos, desconocidos y controvertidos sobre la relación entre la ATM y el oído medio en niños y fetos. Se efectuó una búsqueda de la literatura en bases de datos utilizando los operadores booleanos (AND/OR) y los términos clave en inglés y en español. Se identificaron inicialmente 1080 artículos, se eliminaron los artículos duplicados y se aplicaron los criterios de inclusión y exclusión. Finalmente, se seleccionaron un total de 14 artículos que se revisaron a texto completo. Los estudios encontrados se enfocan en el desarrollo histoembriológico de la ATM y cómo ese desarrollo se da en conjunto con los componentes del oído medio. Adicionalmente, se identificaron investigaciones sobre el origen, la morfología y función del ligamento discomaleolar, el ligamento esfenomandibular y la fisura petrotimpánica como estructuras que conectan la ATM y el oído medio, pero los resultados han sido controvertidos. Se concluye que son necesarios más estudios para determinar cualquier relación anatómica y fisiológica que pueda existir entre la ATM y el sistema auditivo en fetos y niños.
SUMMARY: The temporomandibular joint (TMJ) has important functions for life; its proper functioning can be altered by temporomandibular disorders (TMD). The symptomatology of TMD is varied, including pain in the masticatory muscles, joint noises and less frequently some patients report auditory symptoms, suggesting the existence of a relationship between the TMJ and the middle ear; however, this relationship is not clear. Consequently, the present study aims to conduct a literature review to identify the known, unknown and controversial aspects of the relationship between TMJ and the middle ear in children and fetuses. A literature search was performed in databases using Boolean operators (AND/ OR) and key terms in English and Spanish. A total of 1080 articles were initially identified; duplicate articles were eliminated and inclusion and exclusion criteria were applied. Finally, a total of 14 articles were selected and reviewed in full text. The studies found focus on the histoembryological development of the TMJ and how that development occurs in conjunction with the middle ear components. Additionally, research on the origin, morphology, and function of the discomalleolar ligament, sphenomandibular ligament, and petrotympanic fissure as structures connecting the TMJ and middle ear was identified, but the results have been controversial. It is concluded that further studies are necessary to determine any anatomical and physiological relationship that may exist between the TMJ and the auditory system in fetuses and children.
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Humanos , Feminino , Gravidez , Criança , Articulação Temporomandibular/anatomia & histologia , Orelha Média/anatomia & histologia , Transtornos da Articulação Temporomandibular , Feto/anatomia & histologiaRESUMO
SUMMARY: It has been demonstrated that the teaching and learning process of human anatomy is influenced by different external factors that can affect, in the short and long term, the academic and professional performance of medical students. In this sense, the present work aims to determine the relationship between sociodemographic factors and the academic performance of students belonging to the program of Medicine and Surgery of the Universidad del Valle, in Cali-Colombia, who were enrolled in the course of Human Gross Anatomy. Based on the organization of the course plan, the average grades obtained by the students in the different exams taken in the course were compared. Through a survey, sociodemographic data that have been reported as influential factors in academic performance were asked. The first stage of the analysis consisted of identifying the characteristics of the variables, then the correlation of the sociodemographic variables with the students' academic performance, and finally, a multiple linear regression model was implemented. Although the results did not show statistically significant correlations between the variables analyzed, a close relationship was observed with the sex and place of origin of the students, obtaining that women and students from other towns and cities presented lower academic performance compared to their peers. This highlights the importance of including activities to strengthen the learning process, as well as guiding support programs to maintain academic performance and reduce the inequality gap.
Se ha demostrado que en el proceso de enseñanza y aprendizaje de la anatomía humana inciden diferentes factores externos que pueden afectar, a corto y largo plazo, el desempeño académico y profesional de los estudiantes de Medicina. En este sentido, el presente trabajo tiene como objetivo determinar la relación existente entre los factores sociodemográficos y el rendimiento académico de los estudiantes que pertenecen al programa de Medicina y Cirugía de la Universidad del Valle, en Cali-Colombia, matriculados en la asignatura de Anatomía Macroscópica Humana. A partir de la organización del plan del curso, se comparó el promedio de las notas obtenidas por los estudiantes en los diferentes exámenes realizados en la asignatura. A través de una encuesta, se preguntaron algunos datos sociodemográficos que han sido reportados como factores influyentes en el rendimiento académico. La primera etapa del análisis consistió en identificar las características de las variables, a continuación, la correlación de las variables sociodemográficas con el desempeño académico de los estudiantes y, finalmente, se implementó un modelo de regresión lineal múltiple. Si bien los resultados no arrojaron correlaciones estadísticamente significativas entre las variables analizadas, sí se observó una estrecha relación con el sexo y el lugar de procedencia de los estudiantes, obteniendo que las mujeres y los estudiantes foráneos presentaron menor rendimiento académico en comparación con los demás compañeros. Esto resalta la importancia de incluir actividades que permitan fortalecer el proceso de aprendizaje, así como guiar programas de apoyo para mantener el rendimiento académico y disminuir la brecha de desigualdad.
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Humanos , Masculino , Feminino , Estudantes de Medicina , Desempenho Acadêmico , Anatomia/educação , Universidades , Inquéritos e Questionários , Colômbia , Fatores SociodemográficosRESUMO
The aim of this paper was to determine the frequency of Canalis Sinuosus (CS) and its anatomic variations. A total of 236 cone beam computed tomography (CBCT) images were studied. Characteristics of the canal such as its form, pathway and diameter were analyzed. The CS was clearly visualized in 100 % of the images with variations in the canal observed in up to 46 % of the cases. In 79 % of the cases the variation was found to be bilateral. The most common variation was an increase in the diameter (> 1mm) of the CS. Considering that the anterior region of the middle third of the face is a common place for clinical interventions, this study supports the need to perform a thorough evaluation of the maxillary region prior to clinical interventions in order to prevent complications such as direct or indirect injury to the anterior superior alveolar neurovascular bundle contained within the CS.
El objetivo de este trabajo fue determinar la frecuencia de Canalis Sinuosus (CS) y sus variaciones anatómicas. Se estudiaron un total de 236 imágenes de tomografía computarizada de haz cónico (CBCT). Se analizaron las características del canal, como su forma, vía y diámetro. El CS se visualizó claramente en el 100 % de las imágenes, observándose variaciones en el canal en hasta el 46 % de los casos. En el 79 % de los casos la variación fue bilateral. La variación más común fue un aumento en el diámetro (> 1 mm) de la CS. Teniendo en cuenta que la región anterior del tercio medio de la cara es un lugar común para las intervenciones clínicas, este estudio apoya la necesidad de realizar una evaluación exhaustiva de la región maxilar antes de las intervenciones clínicas para prevenir complicaciones como lesiones directas o indirectas a el haz neurovascular alveolar superior anterior contenido dentro de la CS.