Pior qualidade de sono está associada à disfunção temporomandibular e hábitos parafuncionais entre estudantes e profissionais de Odontologia / La peor calidad del sueño se asocia con disfunción temporomandibular y hábitos parafuncionales en estudiantes y profesionales de Odontología / Worse sleep quality is associated with temporomandibular disorders and parafunctional habits among dental students and professionals

Este estudo teve como objetivo avaliar a associação entre a qualidade do sono e a presença de disfunção temporomandibular (DTM) e hábitos parafuncionais em estudantes e profissionais de Odontologia durante a pandemia de COVID-19. Cirurgiões-dentistas, docentes e estudantes brasileiros de graduação e pós-graduação em Odontologia responderam a um questionário virtual composto pelos seguintes instrumentos: Índice de Qualidade do Sono de Pittsburgh, Lista de Verificação de Comportamentos Orais, Índice Anamnésico de Fonseca e questões socioeconômicas e demográficas. Os questionários foram disponibilizados online de agosto a novembro de 2020. A associação entre as variáveis preditoras e cada desfecho foi avaliada por meio da regressão de Poisson. A amostra foi composta por 449 participantes, sendo que 259 (59,5%) relataramdistúrbios do sono, 352 (78,4%) apresentavam DTM e 311 (69,3%) realizavam hábitos orais parafuncionais. Os distúrbios do sono foram associados à maior prevalência de hábitos orais parafuncionais (RP 1,61; IC 95% 1,36-1,91) e DTM (RP 1,16; IC 95% 1,04-1,29). Além disso, as mulheres apresentaram maior prevalência de DTM em relação aos homens, assim como indivíduos cuja renda era menor. Desta forma, os distúrbios do sono foram associados a hábitos orais parafuncionais e DTM em estudantes e profissionais de Odontologia durante a quarentena da COVID-19 (AU).

Este estudio tuvo como objetivo evaluar la asociación entre la calidad del sueño y la presencia de disfunción temporomandibular (DTM) y hábitos parafuncionales en estudiantes y profesionales de Odontología durante la pandemia de COVID-19. Odontólogos, profesores y estudiantes brasileños de pregrado y posgrado en Odontología respondieron un cuestionario virtual compuesto por los siguientes instrumentos: Índice de Calidad de Sueño de Pittsburgh, Lista de Verificación de Comportamiento Oral, Índice Anamnésico de Fonseca y preguntas socioeconómicas y demográficas. Los cuestionarios estuvieron disponibles virtualmente de agosto a noviembre de 2020. La asociación entre las variables predictoras y cada resultado se evaluó mediante regresión de Poisson. La muestra estuvo compuesta por 449 participantes, de los cuales 259 (59,5%) refirieron trastornos del sueño, 352 (78,4%) DTM y 311 (69,3%) hábitos orales parafuncionales. Los trastornos del sueño se asociaron con una mayor prevalencia de hábitos bucales parafuncionales (RP 1,61; IC 95% 1,36-1,91) y DTM (RP 1,16; IC 95% 1,04-1,29). Además, las mujeres tenían una mayor prevalencia de DTM que los hombres, así como las personas con ingresos más bajos. Así, los trastornos del sueño se asociaron con hábitos orales parafuncionales y DTM en estudiantes y profesionales de odontología durante la cuarentena por COVID-19 (AU).

This study aimed to assess the association between sleep quality and the presence of temporomandibular disorders (TMD) and parafunctional habits in dental students and professionals during the COVID-19 quarantine. Brazilian dentists, professors, and dental undergraduate and graduate students answered a virtual questionnaire composed of the following instruments: Pittsburgh Sleep Quality Index. Oral Behaviors Checklist, Fonseca Anamnestic Index, and socioeconomic and demographic questions. Questionnaires were available on-line from August to November 2020. The association between the predictor variables and each outcome were assessed using Poisson regression. The sample consisted of 449 participants, 259 (59.5%) of whom had sleep disorders, 352 (78.4%) had TMD, and 311 (69.3%) had parafunctional oral habits. Sleep disorders were associated with higher prevalence of parafunctional oral habits (PR 1.61; 95%CI 1.36-1.91) and TMD (PR 1.16; 95%CI 1.04-1.29). Furthermore, women showed a higher prevalence of TMD in comparison to men, as well as individuals with lower income. Sleep disorders were associated with parafunctional oral habits and TMD in dental students and professionals during COVID-19 quarantine (AU).

Apical periodontitis and associated factors in a rural population of southern Brazil: a multilevel analysis.

OBJECTIVES: This study aims to evaluate the association between apical periodontitis (AP) and sociodemographic/clinical factors in a probability sample of individuals living in a rural area of southern Brazilian. MATERIALS AND METHODS: A cross-sectional study was conducted involving 584 non-edentulous adult individuals who had undergone a full-mouth radiographic survey. Periapical status was analysed using the periapical index (PAI). Endodontic status was evaluated considering the occurrence of voids in the filling material and the root filling length. Crown status was classified based on the presence of caries, restorations, and prosthetic crowns. Sociodemographic variables, frequency of dental care, and periodontal disease were also registered. The data were analysed using hierarchical multilevel Poisson regression analysis. The multilevel structure was composed of three models: sociodemographic variables, clinical variables, and clinical variables adjusted by sociodemographic variables (α = 5%). RESULTS: The prevalence of AP in the sample was 60.45%. AP was significantly associated with age, skin colour, schooling, periodontal disease, and frequency of dental care (P < 0.005). Among the 10,396 teeth evaluated, 868 (8.35%) had AP, which was significantly associated with tooth group, dental arch, crown status, and endodontic treatment (P < 0.005). CONCLUSIONS: The prevalence of AP was high in the population studied. An older age, black/brown skin colour, low level of schooling, infrequent dental care, severe periodontal disease, mandibular teeth, posterior teeth, inadequate crown status, and having undergone endodontic treatment were significantly associated with the outcome. Clinical relevance This study about a rural probability sample reinforces that AP is still a recurrent oral health problem.

Temporomandibular disorders and associated comorbidities among brazilian dental students during COVID-19

Aim: This study aimed to assess the prevalence of temporomandibular disorders (TMD) and psychosocial comorbidities in undergraduate dental students in a southern Brazilian university, during the COVID-19 pandemic. Also, it aimed to verify the association between psychosocial factors and TMD. Methods: Fonseca Anamnestic Index, Depression Anxiety Stress Scale (DASS-21), a socioeconomic questionnaire, and questions about academic performance and social distancing were applied. Poisson regression analysis was used to assess the association of predictive variables with TMD. Results: The prevalence of TMD was found to be 82.4%, and more than half of the students had some degree of stress, anxiety, and depression. Students who had symptoms of stress (RR 1.11; 95% CI 1.04-1.19), anxiety (RR 1.19; 95% CI 1.12-1.27) and reported academic performance worsening (RR 1.12; 95% CI 1.07-1.19) had higher TMD scores. Conclusion: The findings suggest that TMD was highly prevalent among dental students at a federal university in southern Brazil during the pandemic, being associated with high levels of stress, anxiety, poor academic performance, and greater social distancing

Pathologic conditions associated with impacted third molars: A retrospective study of panoramic radiographs in a Southern Brazilian population.

Purpose: This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods: Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results: The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2 ± 11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion: The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.

Outcome of endodontic treatments performed by Brazilian undergraduate students: 3- to 8-year follow up.

Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis.

The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.

Smartphone Use for Tomographic Evaluation: Application in Endodontic Diagnosis.

INTRODUCTION: Portable equipment that allows quick exchanges of information, such as smartphones, is increasingly important in dentistry. Thus, they have become frequently used, with the potential to contribute to the tomographic evaluation. This study aimed to evaluate the accuracy of smartphone applications for diagnosing the root canal system (RCS) and measuring the root canal length. METHODS: Digital Imaging and Communications in Medicine files of 92 lower incisor teeth were evaluated by 2 trained and calibrated examiners using CS 3D Imaging software (Carestream Health, Rochester, NY) and 2 smartphone applications (DroidRender; Startm, Zhubei, Taiwan and Horos Mobile; iCat Solutions Ltd, Norwich, United Kingdom). The RCS was assessed according to Vertucci's classification, and the tooth length was measured using linear cusp-apex measurements. The diagnostic reference standard was obtained by the mode and the mean of the evaluations made by 3 experienced examiners using the CS 3D Imaging software. The diagnostic performance of RCS was evaluated using sensitivity (Se), specificity (Sp), and overall accuracy (Ac). Bland-Altman analysis was used to assess the agreement of linear measurements. RESULTS: The diagnostic tests showed similar performance between the smartphone applications (DroidRender: Se = 1.00, Sp = .95, and Ac = 0.97; Horos: Se = 0.95, Sp = .94, and Ac = 0.95) and the computer software (Se = 0.97-0.95, Sp = .93-0.96, and Ac = 0.95-0.96). The smartphone applications showed discrepancies greater than 1.0 mm for the dental lengths, which may signal relevant differences in some clinical situations. CONCLUSIONS: Smartphone applications offered similar diagnostic performance in comparison with the computer software for the RCS evaluation.

O uso de smartphones como ferramenta de aprendizado por estudantes de Odontologia / The use of smartphones as a learning tool by dental students

As tecnologias podem ser potentes facilitadoras do processo de aprendizagem dos alunos, principalmente nas gerações atuais. Os smartphonessão ferramentas rotineiramente utilizadas a qualquer momento e em qualquer lugar na busca de variadas informações. Assim, a aquisição de conhecimento por meiodeste dispositivo móvel, alinhada com as perspectivas de ensino e resultados esperados para o aprendizado, parece fazer cada vez mais sentido. Neste contexto, este estudo foi proposto com o objetivo de conhecer o perfil do uso de smartphones como ferramenta de aprendizagem ativa e móvel por estudantes de Odontologia. Trata-se de um estudo transversal, realizado por meiode um questionário eletrônico, composto por perguntas objetivas e abertas, as quais avaliaram características sociodemográficas, tipo de aparelho e conexão, usogerale para aprendizado odontológico, bem como aatitude dos alunos em relação ao uso. Do total de estudantes elegíveis ao estudo, 169 alunos responderam ao questionário (taxa de resposta de 49,1%). A maioria dos participantes eram mulheres, com faixa etária de 19 a 21 anos. Todos os estudantes afirmaram ter smartphone, com conexão à internet. Os principais usos descritos foram relacionados à comunicação, gerenciamento de tempo e educação. As vantagens relatadas foram praticidade, flexibilidade de uso, acesso a diferentes conteúdos, capacidade de pesquisar informações e de se comunicar rapidamente. Os desafios identificados incluíram distração e excesso de uso. Os resultados permitiram concluir que os estudantes utilizam os smartphonescomo ferramenta de aprendizagem ativa, principalmente, para acessar e-books, artigos científicos, escutar podcasts,assistir livese visualizar publicações de conteúdos teóricos e práticos no Instagram (AU).

Technologies can be powerful and helpful tools for students' learning process, especially for the current generations. Smartphones are routinely used to search for a wide rangeof information, at anytime and anywhere. Thus, knowledge acquisition through this mobile device, for teaching and learning outcomes, seems to increasingly make more and more sense. Therefore, the aim of thisstudy was to understand the profile of the use of smartphones as an active learning tool by dental students. The data of this cross-sectional study was collected by an electronic questionnaire, with open and closed questions regarding the socio-demographic characteristics, type of device and connection, general use for dentallearning, as well as the students' attitudes towards the use of smartphone for learning. Out of the total number of students eligible for the study, 169 students responded to the questionnaire (response rate of 49.1%). Most participants were women, aged between 19 and 21 years. All students declaredtohave a smartphone, with internet connection. The main uses described were related to communication, time management,and education. The advantages pointed out by the participants were convenience, flexibility of use, access to different contents in different ways, ability to search for information,and rapid communication. The main challenges included distraction and overuse. The results of this study demonstrate that students use smartphones as an active learning tool, mainly to access e-books, scientific articles, to listen to podcasts, watch lives,and view publications of theoretical and practical content on Instagram (AU).

Factors related to apical periodontitis in a southern Brazilian population: a multilevel analysis

Abstract The aim of this cross-sectional study was to evaluate the effects of individual-level and tooth-level factors on apical periodontitis (AP) in an urban population in southern Brazil. A random sample of digital panoramic radiographs (n = 545) from a dental school database was evaluated. The diagnosis of AP was determined by using a dichotomous scale (yes/no). AP was assessed according to gender, age, presence and quality of endodontic treatment (ET), presence of an intracanal post, coronal condition, and dental group. Data were analyzed descriptively and through multilevel Poisson regression analysis, considering teeth characteristics (level 1) nested in individuals (level 2). In this sample of 545 participants, the prevalence of AP was 49.5% (n =2 70) and ET was 43.5% (n = 237). Considering 13,595 teeth, AP was identified in 596 (4.4%) and ET in 617 (4.5%). Of the teeth with ET, 153 (24.8%) presented AP. Among individual-level factors, the disease was not significantly associated with gender or age. For tooth-level factors, AP was significantly associated with ET quality: teeth with short fillings (< 3 mm) and teeth with over-fillings had 2.77 (CI: 1.95-3.94, p < 0.001) and 1.08 (CI: 0.39-2.98, p < 0.001) higher prevalence of AP, respectively. There was no association between AP and age, gender, dental group, coronal condition, or the presence of an intracanal post. AP was highly prevalent in this population, and multilevel analysis indicated a significant association with ET quality.

Avaliação do conhecimento dos estudantes de Odontologia da UFSM sobre DTM e bruxismo / Dental students' knowledge assessment of TMD and Bruxism at UFSM

Casos de bruxismo e disfunção temporomandibular (DTM) têm se tornado cada vez mais frequentes na prática clínica. Reconhecer seus mecanismos é necessário para o sucesso do controle e tratamento. O objetivo deste estudo piloto foi investigar o conhecimento e a percepção sobre DTM e bruxismo dos estudantesde Odontologia da Universidade Federal de Santa Maria (UFSM). Para isso um questionário com 15 questões foi aplicado a20 estudantes dessa instituição, sendo 10 do 7º e 10 do 10º semestre. Todos os estudantes avaliados relataram ouvir sobre DTM durante a graduação, mas 70% consideraram que possuíam pouca ou nenhuma base de conhecimento sobre o assunto. Noventa por cento dos estudantes relatou não conhecer a ferramenta utilizada em pesquisas para diagnóstico das DTM. Não houve diferença estatística entre os grupos avaliados e a média geral de acertos foi de 54%. Os dados evidenciam o pouco conhecimento sobre os assuntos abordados e a fragilidade do ensino destas alterações, especialmente pela não evolução do conhecimento sobre DTM e bruxismo ao longo do curso avaliado, pois o grupo de estudantes do 10º semestre apresentou resultados inferiores quando comparados ao do 7º semestre, que passaram recentemente pela Clínica de Oclusão, na qual os temas são abordados (AU).

Bruxism and temporomandibular disorders (TMD) have become increasingly frequent in clinical practice. Recognizing its mechanisms is necessary for successful management and treatment. The aim of this pilot study was to investigate the knowledge and perception about TMD and bruxism of dental undergraduate students from the Federal University of Santa Maria (UFSM). A questionnaire with 15 questions was applied to 20 students from this institution, 10 from the 7th and 10 from the 10th semester. All evaluated students reported hearing about TMD during the Dentistry course, but 70% considered that they had little or no knowledge on the subject. Ninety percent of students reported not knowing the instrument used in research to diagnose TMD. There was no statisticaldifference between the evaluated groups, and the overall average of correct answers was 54%. Data show little knowledge about the subjects and fragility regarding the teaching-learning process of these topics. Moreover, the non-evolution of knowledge about TMD and bruxism throughout the evaluated course is evident, as the group of students in the 10th semester showed poorer results when compared to the 7th semester, which have recently finished the discipline in which these themes are addressed (AU).

Smartphone use as an aid in evaluating conventional radiographs.

This study aimed to evaluate the accuracy of smartphones for digitizing, sharing, and viewing conventional radiographic images. Eighty conventional radiographs of 40 teeth with metallic mesio-occlusodistal restorations (40 radiographs showing perfectly adapted restorations and 40 showing restorations with a 0.4-mm proximal gap) were digitized using a smartphone and then evaluated using 2 viewing methods: a light box (LB) and a smartphone screen (SS). Three examiners assessed all radiographs for the presence of marginal gaps using a dichotomous yes/no scale. To analyze examiner reproducibility, 10% of the samples was reassessed. The sensitivity, specificity, and overall accuracy were calculated for each examiner and viewing method. The McNemar test was used to compare examiners' diagnoses based on the 2 viewing methods. The level of statistical significance was set at P < 0.05. The level of agreement was κ > 0.8 for all examiners and both viewing methods. The LB group presented greater sensitivity, specificity, and overall accuracy than the SS group, but no statistically significant differences were found between the methods (P > 0.05). The results achieved were promising, suggesting that the smartphone can be presented as a new aid for radiographic evaluation (LB accuracy, 0.899 to 0.911; SS accuracy, 0.823 to 0.873). Smartphones offer similar accuracy to the traditional viewing method for evaluation of metallic restorations on conventional radiographs.

Low-dose Multidetector Computed Tomographic and Cone-beam Computed Tomographic Protocols for Volumetric Measurement of Simulated Periapical Lesions.

INTRODUCTION: The purpose of this study was to evaluate the accuracy of low-dose multidetector computed tomographic (LD-MDCT) imaging for the volumetric measurement of simulated periapical lesions. METHODS: Eighteen monoradicular teeth were introduced in bone blocks, and periapical lesions were simulated at the periapical region of each tooth. All teeth were imaged using 4 acquisition protocols: large (dentoalveolar) field of view (FOV) cone-beam computed tomographic (CBCT) imaging (120 kV, 5 mA, and 0.2-mm voxel), small (dental) FOV CBCT imaging (90 kV, 10 mA, and 0.2-mm voxel), standard multidetector computed tomographic imaging (120 kV, 50 mA, and 0.62-mm voxel), and LD-MDCT imaging (120 kV, 10 mA, and 0.62-mm voxel). Tomographic images were evaluated by a single trained and calibrated examiner (intraclass correlation coefficient = 0.991) using ITK-SNAP segmentation software (University of Pennsylvania, Philadelphia, PA). The gold standard was obtained by the impressions of the lesions with regular fluid addition silicone and individual weighing using a precision analytical scale. Data were evaluated by the repeated measures analysis of variance test; the significance level was defined as P < .05. RESULTS: No statistical differences (P > .05) were found among the groups regardless of the device, milliamperage, FOV, or voxel size. CONCLUSIONS: LD-MDCT shows performance comparable with other standard reference methods for measuring the volume of periapical lesions and can be a useful and safe protocol in clinical situations in which CBCT imaging is not available, such as in cases of patients admitted to hospitals.

Utilização e percepção da tomografia computadorizada de feixe cônico por especialistas em cirurgia e traumatologia bucomaxilofacial para avaliação de terceiros molares inferiores impactados / Use and perception of cone beam computed tomography by oral & maxillofacial surgeons for impacted lower third molars evaluation

Objetivo: conhecer o perfil demográfico e as características que levam à solicitação de tomografia computa-dorizada de feixe cônico (TCFC) pelos especialistas em Cirurgia e Traumatologia Bucomaxilofacial (CTBMF) do estado do Rio Grande do Sul, para diagnóstico e planejamento cirúrgico de terceiros molares inferiores (3MI) impactados. Métodos: foram enviados questionários eletrônicos para todos os especialistas em CTBMF do RS. O questionário compreendia perguntas demográficas, clínicas e imaginológicas. O teste Qui-Quadra-do foi utilizado para verificar a associação entre as variáveis. Resultados: 115 questionários foram respondi-dos.O exame mais solicitado foi a panorâmica (95%). A TCFC foi solicitada por 50 especialistas (30 utilizam software). Localização do canal mandibular, dilaceração radicular e reabsorção do segundo molar são os aspectos mais avaliados na TCFC (P < 0,05); já o contato da raiz com o canal mandibular foi dito ser avaliado nos dois exames. Complicações permanentes foram relatadas por 21 especialistas, associadas a profissionais com maior tempo de graduação e/ou especialização (P < 0,05), mas não com o tipo de exame solicitado (P > 0,05). Na percepção dos especialistas, a TCFC tem papel importante em casos de alta complexidade. Con-clusão: a panorâmica ainda é o exame mais utilizado para avaliação de 3MI impactados pelos especialistas em CTBMF do RS, porém a TCFC tem sido solicitada para complementação do diagnóstico e planejamento e como meio de segurança jurídica do profissional.(AU)

Objective: to recognize the demographic profile and the characteristics that lead to the request of cone beam computed tomography (CBCT) by Oral & Maxillofacial (OMF) Surgeons in the state of RS for the diagnosis and surgical planning of impacted lower third molars (3LM). Methods: electronic questionnaires were sent to all OMF surgeons in RS. The questionnaire comprised demographic, clinical, and imaging questions. The chi-square test was used to verify the association between variables. Results: 115 questionnaires were answered. The most requested exam was the panoramic (95%). CBCT was requested by 50 specialists (30 use software). Localization of the mandibular canal, root dilaceration, and resorption of the second molar are the most evaluated aspects in the CBCT (P <0.05); the contact of the root with the mandibular canal was said to be evaluated in both exams. Permanent complications were reported by 21 OMF surgeons, and were related to the time of graduation and/or specialization (P < 0.05), but not to the type of exam (P > 0.05). In the OMF surgeons' perception, the CBCT has an important role in cases of high complexity. Conclusion: panoramic radiograph still is the most used exam for the assessment of impacted 3LM by OMF surgeons in RS, however, CBCT has been requested to complement the diagnosis and treatment plan, and as a means of professional legal security.(AU)

ULTRA Tomografia Computadorizada Multidetectores com ultra baixa dose de radiação e impressão 3D como auxiliares para cirurgia guiada em implantodontia / Ultra-low dose Multidetector CT and 3D printing as aids to guided implant surgery

Objetivo: relatar um caso clínico de reabilitação com implante dentário imediato realizado utilizando Tomografia Computadorizada Multidetectores (TCMD) com ultra baixa dose de radiação, software de código aberto para manipulação das imagens e impressão 3D de baixo custo do guia cirúrgico. Relato de caso: paciente, sexo masculino, 50 anos de idade, foi avaliado clinicamente relatando dor na região do dente 45, com suspeita de fratura radicular. Como complemento ao exame clínico, o paciente realizou TCMD com ultra baixa dose de radiação para avaliar a condição dentária e do tecido ósseo adjacente. Tendo sido diagnosticada fratura radicular vertical, procedeu-se ao planejamento virtual do implante e à confecção do guia cirúrgico. As imagens em formato DICOM da TCMD foram convertidas para formato STL (Stereolithography) para manipulação e confecção do guia cirúrgico virtual. Esse guia foi impresso em PLA (poliácido láctico) utilizando impressora 3D pelo método FDM (Fusão e Deposição de Material). Após a exodontia atraumática, o guia cirúrgico foi posicionado nos dentes adjacentes e o implante foi inserido. Clinicamente, o paciente encontra-se assintomático, o implante sem sinais clínicos de inflamação e a prótese em função. Uma segunda tomografia do paciente permitiu comparar de forma tridimensional a posição final do implante e o planejamento virtual, que se mostraram equivalentes. Considerações finais: a impressão 3D em PLA mostrou-se uma solução com custo acessível para a produção de guias cirúrgicos, fornecendo previsibilidade e segurança ao implantodontista.(AU)

Objective: to report a clinical case of rehabilitation with dental implant performed using ultra- -low dose Multidetector Computed Tomography (MDCT), open source software for image manipulation, and low cost 3D printing of the surgical guide. Case report: a 50-year-old male patient was clinically evaluated complaining of pain in the tooth 45, and a root fracture was suspected. As a complement to the clinical examination, the patient performed an ultra-low dose MDCT to assess the dental condition and the adjacent bone tissue. A vertical root fracture was diagnosed, and then the virtual planning of the implant and preparation of the surgical guide were performed. The DICOM images from the MDCT were converted into STL (Stereolithography) format for manipulation and confection of the virtual surgical guide. The surgical guide was printed on PLA using a 3D printer by the FDM (Fused Deposition Modeling) method. After atraumatic extraction, the surgical guide was placed in the adjacent teeth and the implant was inserted. Clinically, the patient is asymptomatic, the implant has no clinical signs of inflammation, and the prosthesis is in function. A second ultra- -low dose MDCT of the patient allowed a three-dimensional comparison of the final position of the implant and the virtual planning, which were shown to be equivalent. Final considerations: 3D PLA printing has proved to be an affordable solution for the production of surgical guides, providing predictability and safety for the implantologist.(AU)

The use of smartphones in radiographic diagnosis: accuracy on the detection of marginal gaps.

OBJECTIVE: To compare the accuracy of computer monitor and smartphone screen for radiographic diagnosis of marginal gap. MATERIALS AND METHODS: Forty teeth with mesial-occlusal-distal inlays (each tooth with a perfect fit and a 0.4-mm marginal gap restoration) were imaged with a phosphor plate system. Original digital radiographs were exported and analyzed with two different methods: computer monitor and smartphone screen; for the last method, images were shared with WhatsApp. Three examiners assessed all radiographs (n = 160) for the presence of marginal gap by using a dichotomous scale (yes/no). Diagnostic performance of each examiner and viewing method was evaluated by means of sensitivity (Se), specificity (Sp), and overall accuracy (Ac). Difference between the frequencies of gap detection of each method was analyzed using the McNemar test. Intra- and inter-examiner agreements were calculated using kappa statistics. RESULTS: Intra- and inter-examiner agreements were ≥ 0.80 for both methods. Similar diagnostic performance was found for computer monitor (Se = 0.87-1; Sp = 0.8-0.97; Ac = 0.84-0.99) and smartphone (Se = 0.77-1; Sp = 0.87-1; Ac = 0.88-0.95) viewing methods. No statistically significant differences in the frequency of gap detection were observed between the methods (P > 0.05). CONCLUSION: Diagnostic accuracy of smartphone screens was similar to that of computer monitor for marginal gap detection. CLINICAL RELEVANCE: Smartphones are becoming a common daily tool. In this sense, it might be an important new aid in Dentistry, including radiographic evaluation, which could benefit patients and dentists.

Imaging Factors Impacting on Accuracy and Radiation Dose in 3D Printing.

OBJECTIVES: To compare reconstructed area and surface roughness of 3D models acquired using nine image acquisition protocols. Radiation dose was also compared among acquisition protocols. METHODS: A dry craniofacial specimen was scanned using three CT devices (a cone beam CT, a 16-channel fan beam CT, and a 64-channel fan beam CT), with three different acquisition protocols each. Nine 3D models were manufactured using polylactic acid. Surface roughness and reconstructed area were determined for each 3D model. The radiation dose during acquisitions was measured using lithium crystals. ANOVA was used to compare the data among the 3D models. Linear function optimization techniques based on stochastic variables were applied to identify the most suitable protocol for use. RESULTS: For surface roughness, statistically significant differences were observed among all 3D models and the specimen. For reconstructed area, CBCT and one CT-16 channel protocols originated 3D models statistically significant different from the specimen. Higher radiation doses were observed with fan beam CT acquisitions. CONCLUSIONS: All three CT devices were suitable for 3D printing when used at full resolution. The highest reconstruct area vs. radiation dose ratio was found for 64-channel CT devices.

Accuracy of detecting and measuring buccal bone thickness adjacent to titanium dental implants-a cone beam computed tomography in vitro study.

OBJECTIVES: The aim of this study was to assess the accuracy of detecting and measuring buccal bone thickness (BBT) adjacent to titanium implants in cone beam computed tomography (CBCT) images. STUDY DESIGN: Titanium implants (1, 2, or 3), abutments, and metal-ceramic crowns were inserted into 40 bone blocks with various BBTs. CBCT images were acquired in various settings: Voxel sizes (0.2 and 0.13 mm) and reconstruction section thicknesses (2.0 and 5.0 mm) were assessed by 3 examiners. True BBT was measured in digital photographs of the bone blocks. Buccal bone detection was evaluated by sensitivity and specificity. BBT was evaluated by 1-way analysis of variance (ANOVA) between the true and the CBCT measurements and by calculating the difference between the true measurement and the CBCT measurement (Di-BBT). RESULTS: Detection of buccal bone exhibited high sensitivity (0.86-1) and low specificity (0.14-1). More implants in the field of view, large voxel size, and thick image reconstruction sections had a negative impact on buccal bone detection. ANOVA showed statistically significantly larger BBT for the CBCT measurements in all settings (1.07-1.21 mm) compared with the true measurements (0.85 mm). Di-BBT was mostly within 0.5 mm. CONCLUSIONS: BBT adjacent to titanium implants is overestimated when evaluated on CBCT cross-sectional images.

Validation of cone beam computed tomography as a clinical imaging method for dentin thickness measurement in the danger zone of mandibular molars / Validação da tomografia computadorizada de feixe cônico como um étodo de imagem clínico para mensuração da espessura dentinária na zona de risco de molares inferiores

Objective: to verify the accuracy of cone beam computedtomography (CBCT) for measuring dentin thicknessin the danger zone of mandibular molars in order to validatethis method to be used as a clinical auxiliary. Materialsand method: dentin thickness of the distal wall ofmesial canals was measured at 2 mm of furcation areain ten mandibular molars before and after preparation ofcervical and middle thirds. CBCT (0.25 mm voxel size)and stereomicroscopy images were acquired twice foreach sample. CBCT axial images and stereomicroscopeimages were evaluated by a calibrated examiner. Statisticalanalysis was performed using Mann-Whitney testin order to investigate whether CBCT images providedtrusted values. Results: mean values of initial (1.23 versus1.24 mm) and final measurements (0.88 versus 0.87mm) obtained with, respectively, CBCT and stereomicroscopemethods did not show statistical differences(P > 0.5). Conclusion: CBCT images provide high accuracyfor measuring dentin thickness in the danger zoneof mandibular molars. (AU)

Objetivo: avaliar a acurácia da tomografia computadorizada de feixe cônico (TCFC) para mensurar a espessura dentinária na zona de risco de molares inferiores e validar este método, a fim de usá-lo como um auxiliar clínico. Materiais e método: a espessura dentinária da parede distal dos canais mesiais foi medida a 2 mm da área de furca em dez molares inferiores, antes e após a preparação dos terços médio e cervical. Foram adquiridas imagens por TCFC (tamanho do voxel de 0,25 mm) e estereomicroscopia. Um examinador treinado e calibrado avaliou as tomografias no plano axial e as imagens de estereomicroscopia. A análise estatística foi realizada com o teste Mann-Whitney, para verificar se as imagens tomográficas forneceram valores comparáveis à estereomicroscopia. Resultados: a média dos valores obtidos, respectivamente, após as mensurações iniciais (1,23 versus 1,24 mm) e finais (0,88 versus 0,87 mm) das imagens de TCFC e estereomicroscopia não mostraram diferença estatisticamente significativa entre os métodos (P > 0,5). Conclusão: a TCFC produz imagens acuradas para a mensuração da espessura dentinária na zona de risco de molares inferiores. (AU)

Airway volume analysis: is there a correlation between two and three-dimensions?

Objectives: No consensus exists on the assessment of airway in CBCT scans. Two-dimensional measures remain the standard in the cephalometric analysis. This research aimed to evaluate linear and area measurements in two-dimensional views from specific airway regions of interest and compare these to the correspondent volume in CBCT exams. Materials and Methods: 250-selected CBCT scans were retrospectively analyzed. A trained and calibrated examiner performed the linear, area and volume measurements in specific sites for nasal cavity, nasopharynx and oropharynx compartments. Dolphin Software was used for the analysis. The correlations were performed using Pearson coefficient. Results: The highest positive correlations were observed in the nasopharynx and oropharynx sagittal areas and the most constricted area in the oropharynx. Nasopharynx linear measures and nasopharynx coronal area did not present correlation with whole volume. Two-dimensional measurements in the soft palate (width and sagittal area) showed very low positive correlations. Although nasal cavity presented highest volume means, changes in oropharynx contributed more to variations in total volume, compared with the other two sections. Conclusion: Airway sagittal areas, as well as the most constricted axial area in oropharynx remains a useful guide to correlate with airway volume in two-dimensional images.