Influence of the presence of dental implants on the accuracy and difficulty level of diagnosis of furcation involvement in molars: An in vitro CBCT study.

OBJECTIVE: The aim of this study was to investigate the possible interference of image artifacts (IA) generated by dental implants in the evaluation of furcation involvement (FI) in molars. METHODS: Tomographic scans of first molars (1M) were performed in dry skulls in the absence and presence of titanium (TI) and zirconia (ZI) dental implants. FI grades were simulated in the alveoli of the 1Ms. Diagnostic accuracy of FI and level of difficulty were verified. Chi-squared test and logistic regression analysis were used. RESULTS: There was no difference in the diagnostic accuracy of FI between the arches (p = .117). The highest diagnostic accuracy value for the implant variable was found in the absence of implants (88.3%) and the lowest in the presence of two ZI implants (66.7%). The highest diagnostic accuracy value for FI was observed in grade 0 (G0). There was no significant difference between the arches regarding the evaluators' perception of difficulty (p > .05). Assessments were considered difficult in 12.7% of the TI implants and in 29% of the ZI implants. Regarding the number of dental implants, assessments were considered difficult in 24.4% cases including one implant and 17.4% cases including two implants. The logistic regression model showed a significant p-value only for one and two ZI implants (p = .0061 and p = .0096, respectively). CONCLUSION: The presence of dental implants in the region adjacent to the area of investigation of FI decreased the diagnostic accuracy while increasing the perception of difficulty by the examiners, especially in cases with ZI implants.

Oral, dental, and craniofacial features in chronic acid sphingomyelinase deficiency.

The aim of this study was to evaluate the oral, dental, and craniofacial features of individuals affected by the chronic forms of acid sphingomyelinase deficiency (ASMD). This study comprised a sample of adult and pediatric patients (n = 8) with chronic ASMD. The individuals underwent oral examinations to evaluate the occurrence of caries, as well as full-mouth periodontal examinations, to assess the occurrence and severity of periodontal diseases. Panoramic and profile radiographs were obtained to analyze dental conditions and craniofacial parameters. Participants also answered questionnaires to identify systemic impairment, parafunctional habits, and bruxism. Dental anomalies of size, shape, and number were found, with agenesis and microdontia being the predominant findings. The average of caries experience was 11.75 (±8.1). Only one patient had periodontal health and all adult individuals had periodontitis at different stages and degrees. Bruxism was found in 87.5% of the sample. The convex profile and maxillary and mandibular retrusion were the most relevant findings in the cephalometric analysis. It is concluded that individuals with chronic ASMD, in addition to several systemic manifestations, present significant modifications in their oral health, from a greater occurrence of dental anomalies, caries, periodontal disease, in addition to skeletal changes.

Teaching Dental Students to Understand the Temporomandibular Joint Using MRI: Comparison of Conventional and Digital Learning Methods.

The aims of this study were to evaluate and compare the performance of dental students in interpreting the temporomandibular joint (TMJ) with magnetic resonance imaging (MRI) scans using two learning methods (conventional and digital interactive learning) and to examine the usability of the digital learning object (DLO). The DLO consisted of tutorials about MRI and anatomic and functional aspects of the TMJ. In 2014, dental students in their final year of study who were enrolled in the elective "MRI Interpretation of the TMJ" course comprised the study sample. After exclusions for nonattendance and other reasons, 29 of the initial 37 students participated in the study, for a participation rate of 78%. The participants were divided into two groups: a digital interactive learning group (n=14) and a conventional learning group (n=15). Both methods were assessed by an objective test applied before and after training and classes. Aspects such as support and training requirements, complexity, and consistency of the DLO were also evaluated using the System Usability Scale (SUS). A significant between-group difference in the posttest results was found, with the conventional learning group scoring better than the DLO group, indicated by mean scores of 9.20 and 8.11, respectively, out of 10. However, when the pretest and posttest results were compared, both groups showed significantly improved performance. The SUS score was 89, which represented a high acceptance of the DLO by the users. The students who used the conventional method of learning showed superior performance in interpreting the TMJ using MRI compared to the group that used digital interactive learning.

Imaging evaluating of the implant/bone interface-an in vitro radiographic study.

OBJECTIVES: To analyze the diagnostic accuracy of conventional and digital radiographic images and the impact of digital filters in evaluating the bone-implant interface. METHODS: Titanium implants were inserted into 74 fresh bovine ribs blocks, 37 fitting tight to the bone walls (simulating the existence of osseointegration) and 37 with a gap of 0.125 mm (simulating a failure in the osseointegration process). Periapical radiographs were taken with conventional film and two phosphor plate systems [VistaScan® (Dürr Dental, Bietigheim-Bissingen, Germany) and Express® (Instrumentarium, Tuusula, Finland)]. Digital radiographs were investigated with and without enhancement filters. Three blinded examiners assessed the images for the presence of juxtaposition in the bone-implant interface using a five-point Likert scale. Sensitivity, specificity and the area under the receiver-operating characteristic curve (AUC) and its 95% confidence interval (CI) were calculated for each variable. Intraexaminer and interexaminer agreements were analyzed using Kendall's concordance test. RESULTS: Intraexaminer and interexaminer agreements were >0.80 for both digital and conventional images. Conventional radiographs (AUC = 0.963/CI = 0.891 to 0.993) and digital images with high enhancement filters such as Caries2 (AUC = 0.964/CI = 0.892 to 0.993), Endo (AUC = 0.952/CI = 0.875 to 0.988) and Sharpen3 (AUC = 0.894/CI = 0.801 to 0.954) showed the greatest accuracy for evaluating the bone-implant interface. Original images from both digital systems and the further enhancement filters tested showed low sensitivity for the diagnosis task tested. CONCLUSIONS: Conventional radiographs or digital radiographs with high-pass filters could help enhance diagnosis on implant-bone interface.

Severity and presence of atherosclerosis signs within the segments of internal carotid artery: CBCT's contribution.

OBJECTIVES: This study aims to assess with cone-beam computed tomography the distribution and interrelation of the presence of calcifications along the course of the internal carotid artery and to associate their severity with their allocation within the segments of internal carotid artery, gender, and age. STUDY DESIGN: Using a documented visual scale, 161 cone-beam computed tomography scans were evaluated on the allocation and severity of intracranial calcifications within the segments of the internal carotid artery. RESULTS: Calcifications were detected along the petrous (C2: 11.8%), lacerum (C3: 23.6%), cavernous (C4: 92.5%), and ophthalmic-clinoid (C5/C6: 65.8%) segments. The Friedman test showed significant differences in severity distribution among these segments; the highest degree was found in the C4 segment (P < .05). The Wilcoxon signed-rank test showed no significant differences between calcifications on the right or left side or between severities within the C1 (extracranial) and C5/C6 segments. The Chi-square test showed that the severity and allocation of calcifications are not influenced by gender; it also showed that their severity increases with age (P < .05). CONCLUSIONS: In the cohort studied, the incidence of calcifications increased throughout the C1, C5/C6, and C4 segments. More severe calcifications were found at the C4, C1, and C5/C6 segments in decreasing order but increased with age, regardless of gender.

The presence of calcifications along the course of internal carotid artery in Greek and Brazilian populations: a comparative and retrospective cone beam CT data analysis.

OBJECTIVES: We aimed to retrospectively compare the prevalence of soft tissue calcifications (STCs) depicted incidentally along the extra- and intracranial course of the internal carotid artery (ICA) on cone beam computed tomography examinations in 2 different populations (Greeks and Brazilians). METHODS: The cohort consisted of examinations of 232 Greeks and 174 Brazilians, for a total of 406 patients. The scans were evaluated for the presence of STCs along the course of the ICA, with data analyzed in each ethnic group according to gender and age criteria. RESULTS: In total, 355 STCs were recorded; 78 (22.0% of all STCs) and 58 (16.3%) were extracranials, and 128 (36.1%) and 91 (25.6%) were intracranials for Greeks and Brazilians, respectively. The χ(2) test indicated no statistical differences between Greeks and Brazilians in the occurrence of STCs; however, their prevalence differed between genders in those populations. The presence of lesions, both extra- and intracranially, was found to increase with age (P < .05). The odds ratios were estimated at 2.23 (95% CI, 1.81-2.74) and 3.26 (95% CI, 2.56-4.16) for extracranial and intracranial lesions, respectively, with increasing age. CONCLUSIONS: We found an equal distribution for both extra- and intracranial STCs among Greeks and Brazilians. The prevalence of lesions differed between genders within both populations. Aging was found to be a risk factor for STCs, as the odds ratio increased significantly.