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.

Direct and virtual measurements of abdominal aortic aneurysms: three-dimensional printed models.

OBJECTIVE: To validate the use of a three-dimensional printing system for metric and volumetric analysis of the segments of an abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: In patients scheduled to undergo endovascular AAA repair, the computed tomography angiography (CTA) measurements obtained during the preoperative assessment of the patients were compared with those obtained by computed tomography of individualized three-dimensional biomodels. RESULTS: The volumetric assessment showed a discrepancy of 3-12%, and the difference between the areas was 10-16%. CONCLUSION: Computed tomography measurements of 3D-printed biomodels of AAAs appear to be comparable to those of threedimensional CTA measurements of the same AAAs, in terms of the metric and volumetric dimensions.

OBJETIVO: Validar a aplicação do método de impressão tridimensional de biomodelos para aferição métrica e volumétrica de segmentos de aneurisma de aorta abdominal. MATERIAIS E MÉTODOS: Compararam-se as medidas obtidas por tomografia computadorizada dos biomodelos tridimensionais com as realizadas no planejamento pré-operatório de pacientes submetidos a correção endovascular de aneurisma de aorta abdominal. RESULTADOS: A avaliação da volumetria demonstrou discrepância de 3% a 12% e a diferença entre as áreas foi de 10% a 16%. CONCLUSÃO: A tomografia computadorizada dos biomodelos impressos é compatível nas aferições métricas e volumétricas com as imagens tridimensionais da angiotomografia do paciente.

Direct and virtual measurements of abdominal aortic aneurysms: three-dimensional printed models / Medidas de aneurisma da aorta abdominal: modelos tridimensionais impressos e virtuais

Abstract Objective: To validate the use of a three-dimensional printing system for metric and volumetric analysis of the segments of an abdominal aortic aneurysm (AAA). Materials and Methods: In patients scheduled to undergo endovascular AAA repair, the computed tomography angiography (CTA) measurements obtained during the preoperative assessment of the patients were compared with those obtained by computed tomography of individualized three-dimensional biomodels. Results: The volumetric assessment showed a discrepancy of 3-12%, and the difference between the areas was 10-16%. Conclusion: Computed tomography measurements of 3D-printed biomodels of AAAs appear to be comparable to those of threedimensional CTA measurements of the same AAAs, in terms of the metric and volumetric dimensions.

Resumo Objetivo: Validar a aplicação do método de impressão tridimensional de biomodelos para aferição métrica e volumétrica de segmentos de aneurisma de aorta abdominal. Materiais e Métodos: Compararam-se as medidas obtidas por tomografia computadorizada dos biomodelos tridimensionais com as realizadas no planejamento pré-operatório de pacientes submetidos a correção endovascular de aneurisma de aorta abdominal. Resultados: A avaliação da volumetria demonstrou discrepância de 3% a 12% e a diferença entre as áreas foi de 10% a 16%. Conclusão: A tomografia computadorizada dos biomodelos impressos é compatível nas aferições métricas e volumétricas com as imagens tridimensionais da angiotomografia do paciente.

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)

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)

Use of Flowchart for Automation of Clinical Protocols in mHealth.

For healthcare professionals to use mobile applications we need someone who knows software development, provide them. In healthcare institutions, health professionals use clinical protocols to govern care, and sometimes these documents are computerized through mobile applications to assist them. This work aims to present a proposal of an application of flow as a way of describing clinical protocols for automatic generation of mobile applications to assist health professionals. The purpose of this research is to enable health professionals to develop applications from the description of their own clinical protocols. As a result, we developed a web system that automates clinical protocols for an Android platform, and we validated with two clinical protocols used in a Brazilian hospital. Preliminary results of the developed architecture demonstrate the feasibility of this study.

Locally Adaptive Operators for Red Lesions Detection in Eye Fundus Images.

One of the major features required by automated software tools of screening for diabetic retinopathy is the detection of red lesions. This paper presents a new automatic method in order to locate red lesions in color eye fundus images. The method relies on mathematical morphology operators and has a coarse and a fine detection stages, respectively. The former detection stage detects structures of low-intensity values in the retina, such as microaneurysms, hemorrhages, blood vessels and the fovea center. Additionally, the latter stage proposes to improve the detection of red lesions identified in the previous stage. For experiments, we use the well-known publicly available DIARETDB1 database. The results indicate that our method detected red lesions with 75.81% and 93.48% of mean sensitivity and mean specificity, respectively.

Automatic Identification of Glaucoma Using Deep Learning Methods.

This paper proposes an automatic classification method to detect glaucoma in fundus images. The method is based on training a neural network using public image databases. The network used in this paper is the GoogLeNet, adapted for this proposal. The methodology was divided into two stages, namely: (1) detection of the region of interest (ROI); (2) image classification. We first used a sliding-window approach combined with the GoogLeNet network. This network was trained using manually extracted ROIs and other fundus image structures. Afterwards, another GoogLeNet model was trained using the previous resulting images. Then those images were used to train another GoogLeNet model to automatically detect glaucoma. To prevent overfitting, data augmentation techniques were used on smaller databases. The results demonstrated that the network had a good accuracy, even with poor quality images found in some databases or generated by the data augmentation algorithm.

CTdBem - A New Protocol for Ultra Low Radiation Dose MDCT.

This study describes a novel method of obtaining low-dose computed tomography (CT) scans followed by imaging postprocessing that provides diagnostic quality to such low-dose exams. In addition, we compared the Total Radiation Doses (DLP) of the 64-channel MDCT x 16-channel MDCT for a new Dental CT - CTdBem protocol for hospital use. DLP data obtained from 20 patients using 16-channel MDCT was compared with 20 other patients using 64-channel MDCT. In both tomographic (Aquilion 64 and Brightspeed 16) FOV was approximately 160(V) x 130(H) mm. An imaging postprocessing algorithm was used to provide diagnostic quality to the obtained low-dose CT scans. Imaging postprocessing included imaging smoothing, multiplanar reconstruction (MPR), and volume rendering (VR), as well as surface rendering (SR) to allow three-dimensional printing of the desired scans. The average DLPs were of 28,5 mGy.cm and 54,65 mGy.cm, using the 64-channel MDCT and 16-channel MDCT, respectively. The effective radiation dose (DLP) from the 64-channel MDCT statistically differs from the DLP data from 16-channel MDCT, resulting in a value of p < 0.05 for all comparisons. A novel low-dose CT protocol for dentomaxillofacial assessment using imaging postprocessing techniques is described. The authors concluded that although the DLP values differ statistically (p < 0.05), both equipment (64 and 16-channel MDCT) produce tomographic images of patients with low radiation doses. The greater the number of detectors, the lower the mAs product and, consequently, the amount of X-radiationproduced.

Three Dimensional Virtual Planning Through Cone Beam Computed Tomography for Surgical Guidance Production.

This paper describes a methodology through digital planning and computed tomography for the purpose of making surgical guides for insertion of skeletal anchorage devices in dentistry. Mini-orthodontic screws for anchorage are inserted virtually in the region of interest located between the teeth of the second premolar and first molar bilaterally. DICOM images were converted to STL format and overlaid by scanning the upper plaster model in order to plan the surgical guide virtually.

Comparative assessment of the effects of Gates-Glidden, Largo, LA-Axxess, and New Brazilian Drill CPdrill on coronal pre-enlargement: cone-beam computed tomographic analysis.

INTRODUCTION: The removal of dentin interferences from the cervical third of root canals is essential for their correct cleaning and shaping and to facilitate access of endodontic instruments to the critical apical region. In mandibular molars, the concavity observed in the furcation area reduces dentin thickness, making this region more susceptible to perforation. The present ex vivo study used cone-beam computed tomographic imaging to compare 3 rotary burs with a new rotary bur recently launched in Brazil (ie, CPdrill; Helse Industry and Commerce Ltda, Santa Rosa, São Paulo, Brazil) regarding the amount of dentin removal from the distal wall of the mesial root of mandibular first molars. METHODS: A total of 40 root canals were selected and randomly divided into 4 groups for cervical preparation: Gates-Glidden burs #2 and #3 (Dentsply Maillefer, Ballaigues, Switzerland), Largo burs #1 and #2 (Dentsply Maillefer), LA-Axxess burs #1 and #2 (SybronEndo, Glendora, CA), and CPdrill burs (1-size only). Dentin thickness in the distal wall of mesial canals at 2 mm from the furcation was measured using I-CATvision software before and after cervical preparation. RESULTS: There was no statistically significant difference between groups regarding residual dentin thickness after instrumentation with the drills (P = .684). CONCLUSIONS: It was concluded that CPdrill is safe for use in cervical preparation of the mesial root of mandibular first molars because it did not promote excessive dentin removal on distal walls.

Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software.

OBJECTIVE: This study has two aims: 1) to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2) to compare, with Adobe Photoshop, the ability of a new software (Regeemy) in superposing and subtracting images. MATERIAL AND METHODS: Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature) underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection). Canals were prepared up to F2 (ProTaper) and 24.04 (Wizard CD Plus) instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time. RESULTS: The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>0.05). ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>0.05). CONCLUSION: Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop.

Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software

OBJECTIVE: This study has two aims: 1) to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2) to compare, with Adobe Photoshop, the ability of a new software (Regeemy) in superposing and subtracting images. MATERIAL AND METHODS: Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature) underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection). Canals were prepared up to F2 (ProTaper) and 24.04 (Wizard CD Plus) instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time. RESULTS: The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>0.05). ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>0.05). CONCLUSION: Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop. .

A methodology to standardize the evaluation of root canal instrumentation using cone beam computed tomography

The evaluation of root canal instrumentation is important to observe the action of endodontic instrumentsin the root canal walls. Aim: This study introduces a method to standardize the acquisition of imagesbefore and after preparing root canals by using cone-beam computed tomography (CBCT). Methods:Sixteen mandibular molars were included in acrylic resin blocks. Samples were inserted in a stablewood box, which was filled with plaster and served as a guide to reinsert the samples. The apparatuswas used for the CBCT examination before and after cervical flaring of root canals. The softwareIcatVision® was used to equalize the images before and after instrumentation with two computersoperating at the same time. The measurements between root canal center and the furcation areawere determined. The statistical analysis was performed using the t-test for paired samples (á=0.05).Results: The values for dentin thickness in the risk zone before and after root canal flaring withGates-Gliden drills were 1.096 (± 0.27) mm and 0.742 (± 0.24) (p<0.01), respectively. Conclusions:The proposed method assures the same positioning of the samples before and after root canalpreparation. It is extremely important, as any mesiodistal or buccolingual movement can producea different topogram for comparison procedures.

Avaliação clínica e por subtração digital fotográfi cados efeitos do ultrassom e massoterapia em fi brosetecidual tardia pós-operatória à lipoaspiração / Clinical and digital picture assessment of the effects of ultrasound and massotherapy in postoperative tissue fi brosis after liposuction

O objetivo deste estudo foi verifi car o efeito do ultrassom e damassoterapia sobre a fi brose tecidual no pós-operatório de lipoaspiração.Foram investigadas duas mulheres submetidas à lipoaspiraçãode abdome e fl ancos, as quais receberam aplicação de ultrassom emassoterapia na região fi brosada 4 vezes por semana. Foi aplicadauma fi cha de avaliação composta por questões abertas e fechadas,constando hábitos de vida, tempo de pós-cirurgia, presença de dor,uso de medicamentos, tratamentos estéticos já realizados, inspeçãoda pele, perimetria e palpação da região fi brosada pelo método PANFIC,sendo esta aplicada na primeira e última sessão. Para melhorcomprovação dos resultados realizou-se exame de ultrassonografi a efotodocumentação antes da aplicação do protocolo de tratamento,e na última sessão de fi sioterapia. As pacientes apresentaram diminuiçãonos níveis de fi brose no pós-teste e mudança de trofi smomuscular abdominal. Também observou-se redução de medidas deambas, percebidas na reavaliação das pacientes, inspeção, palpação,perimetria, exame de ultrassonografi a e fotodocumentação. Concluímosque o uso de massoterapia associada ao ultrassom apresentaefi cácia no tratamento de fi brose tecidual pós-lipoaspiração, inclusiveno pós-operatório tardio...

Th e aim of this study was to investigate the eff ect of ultrasoundand massage therapy on tissue fi brosis in postoperative liposuction.Two women who underwent liposuction of abdomen and fl anksand received application of ultrasound and massage therapy in thefi brotic region 4 times a week were investigated. Evaluation wasperformed through a questionnaire composed of open and closedquestions about lifestyle, time after surgery, pain, medication use,aesthetic treatments already performed, skin inspection, perimetryand palpation of the fi brotic region with method PANFIC, appliedin the fi rst and last session. Th e patients showed a decrease in thelevels of fi brosis in the post-test and changes in abdominal musclemass. We also observed a reduction of measures of both perceivedin the reassessment of patients, inspection, palpation, perimetryand ultrasound photo documentation. We conclude that the useof massage therapy combined with ultrasound is eff ective in thetreatment of tissue fi brosis after liposuction, including the latepostoperative period...

Desconforto e dor após aumento de coroa clínica realizado com instrumentos rotatórios e manuais / Pain and discomfort after crow lengthening performed with rotatory and manuals instruments

0 objetivo do estudo foi avaliar os aspectos relacionados a percepções subjetivas do paciente, relacionadas aos procedimentos cirúrgicos após a cirurgia de aumento de coroa clínica (ACC), com necessidade de osteotomía realizada com instrumentos rotatórios (OR) e manuais (OM). O estudo apresentou um ensaio clínico randomizado com grupos em paralelo. Participaram do estudo 34 pacientes de ambos os sexos, necessitando de cirurgia de ACC, que aleatoriamente foram divididos em dois grupos: primeiro grupo (16 pacientes), a osteotomía realizada com instrumentos rotatórios, e o segundo grupo (18 pacientes) com instrumentos manuais. Imediatamente após a cirurgia e após sete dias foi avaliado através de uma escala analógica visual (VAS) o desconforto durante o procedimento e dor pós-operatória, respectivamente. O tempo cirúrgico foi também registrado. Os resultados indicaram não haver diferenças estatisticamente significantes entre o tempo cirúrgico (90,8 versus 99,1 minutos) para OR e OM, respectivamente. O desconforto e a dor pós-operatória foram (7,5 e 11,1 versus 14,8 e 19,9) para o grupo OR e OM, respectivamente, sem diferenças estatísticas entre os grupos. Portanto, o tipo de osteotomía parece não influenciar nas percepções subjetivas do paciente e no período clínico de cirurgia. Entretanto, estudos com maiores amostras são necessários para confirmar ou refutar estes achados.

Avaliação da alteração dimensional de guias cirúrgicos prototipados após autoclavagem / Dimensional alteration of prototyped surgical guides after autoclave sterilization

O propósito desse trabalho foi avaliar a estabilidade dimensional de guias cirúrgicos prototipados após esterilização em autoclave. Os procedimentos metodológicos envolveram a mensuração de 14 pontos em dois guias cirúrgicos prototipados superior e inferior, antes e após a esterilização em autoclave, utilizando como instrumento de aferição um paquímetro digital calibrado. Utilizou-se o método de subtração de imagens por meio do software Image Tool 3.0. Para a análise do resultado, utilizou-se o teste t com nível de significância de 95%. Foram realizadas duas medidas (t0 e t1) nos guias antes e após a autoclavagem, com intervalos de sete dias entre cada um, a fim de analisar o erro intraexaminador. O teste utilizado para avaliar o grau de concordância entre as medidas foi o Kappa. Com base na realização do estudo e segundo o teste t, concluiu-se que, tanto pelo método de subtração digital quanto por meio de medida direta, não houve alteração dimensional estatisticamente significativa nos guias cirúrgicos prototipados após a autoclavagem, garantindo assim, maior segurança para o profissional e para o paciente.

The purpose of that work was to evaluate the dimensional stability of prototyped surgical guides after autoclave sterilization. Fourteen points were measured in two prototyped surgical guides for maxillary and mandibular arches, before and after sterilization, using a digital caliper rule. All measures were repeated seven days later to compare interexaminer agreement (Kappa´s test). Also, additional analysis was performed using a subtraction process (Image Tool 3.0). Results were compared using a t test (significance level of 95%). No statistically significant differences were observed before and after sterilization regardless of the methods used for measurement.

Dental anomalies in patients with Down syndrome.

The purpose of the present study was to evaluate the incidence of dental anomalies in Brazilian patients with Down syndrome. A sample with 49 panoramic x-rays of syndromic patients aged 3 to 33 years (22 male and 27 female) was used. The characteristics of dental anomalies were observed in the panoramic radiographs in both the primary and permanent dentition, according to the ICD (International Classification of Diseases). The corresponding tables and percentile analysis were elaborated. There was a high incidence of syndromic patients with different types of anomalies, such as taurodontism (50%), proven anodontia (20.2%), suspected anodontia (10.7%), conic teeth (8.3%) and impacted teeth (5.9%). In conclusion, patients with Down syndrome presented a high incidence of dental anomalies and, in most cases, the same individual presented more than one dental anomaly.

Dental anomalies in patients with down syndrome

The purpose of the present study was to evaluate the incidence of dental anomalies in Brazilian patients with Down syndrome. A sample with 49 panoramic x-rays of syndromic patients aged 3 to 33 years (22 male and 27 female) was used. The characteristics of dental anomalies were observed in the panoramic radiographs in both the primary and permanent dentition, according to the ICD (International Classification of Diseases). The corresponding tables and percentile analysis were elaborated. There was a high incidence of syndromic patients with different types of anomalies, such as taurodontism (50 percent), proven anodontia (20.2 percent), suspected anodontia (10.7 percent), conic teeth (8.3 percent) and impacted teeth (5.9 percent). In conclusion, patients with Down syndrome presented a high incidence of dental anomalies and, in most cases, the same individual presented more than one dental anomaly.

O objetivo do presente estudo foi avaliar a incidência de anomalias dentárias em indivíduos brasileiros portadores de síndrome de Down. A amostra constou de 49 radiografias panorâmicas de indivíduos portadores com idade entre 3 e 33 anos, 22 do sexo masculino e 27 do sexo feminino. As características radiográficas das radiografias panorâmicas das anomalias dentárias foram observadas tanto nos dentes decíduos quanto permanentes de acordo com CID (Classificação Internacional de Doenças). Foi encontrada uma alta incidência dos mais variados tipos de anomalias, tais como taurodontismo (50 por cento), anodontia comprovada (20,2 por cento), suspeita de anodontia (10,7 por cento), dentes cônicos (8,3 por cento), dentes retidos (5,9 por cento) e outras. Pela análise dos resultados pode-se observar que os indivíduos portadores de síndrome de Down apresentaram uma alta incidência de anomalias dentárias e, na maioria dos casos, um mesmo indivíduo apresentou mais de uma anomalia associada.

Ressonância magnética: instrumento auxiliar no diagnóstico de má formação da articulação temporomandibular - caso clínico / Magnetic resonance imaging: an auxiliary for the temporomandibular joint bad formation diagnosis - case report

Relato de caso clínico de um indivíduo do sexo feminino com 32 anos de idade, o qual apresenta sinais e sintomas de desordem temporomandibular. A mesma foi avaliada por meio de técnicas radiográficas convencionais e também por imagens de ressonância magnética, na qual pode-se observar a presença de hipoplasia condilar unilateral