Retorno das atividades presenciais nos cursos de Odontologia brasileiros na pandemia de COVID-19: comparação entre instituições públicas e privadas / Retorno de las actividades presenciales en los cursos de Odontología brasileños durante la pandemia de COVID-19: comparación entre instituciones públicas y privadas / Return of on-site activities in Brazilian Dentistry courses during the COVID-19 pandemic: comparison between public and private institutions

Trata-se de estudo quanti-qualitativo que analisa o retorno das atividades presenciais nos cursos de Odontologia brasileiros, durante a pandemia de COVID-19, e as dificuldades enfrentadas, comparando instituições públicas e privadas. Um formulário on-line com questões abertas e fechadas foi encaminhado por e-mail aos representantes dos cursos de Odontologia, de março a junho de 2021. Foram incluídos os cursos cadastrados no sitee-MEC iniciados até 2017. A análise quantitativa utilizou os testes qui-quadrado, exato de Fisher e t de Student(p<0,05); uma questão aberta foi submetida à análise temática de conteúdo. Dos 329 cursos elegíveis, foram respondidos 83 formulários (21 públicos e 62 privados). Os cursos de instituições públicas apresentaram menor frequência de retorno das atividades presenciais até a data da coleta (p=0,038), inclusive com maior proporção de suspensão das atividades clínicas e laboratoriais (p≤0,001), mas sem diferença para aulas teóricas remotas (p>0,05). Os cursos privados demonstraram ter maior disponibilidade de recursos para o retorno presencial, tais como: estrutura, funcionários e docentes (p<0,001). Apesar das normas de biossegurança constituírem um desafio comum, as principais dificuldades relatadas nas instituições privadas diante do retorno das atividades presenciais foram a modulação ou escalonamento das turmas e ambientes de aula, controle do fluxo de pessoas e implantação de protocolos. Nas públicas, destacam-se dificuldades relacionadas à adequação da estrutura e aquisição de materiais. Conclui-se que a maioria dos cursos de Odontologia havia retomado às aulas no início de 2021, mas as instituições privadas apresentaram maior proporção de retorno às atividades laboratoriais e clínicas presenciais (AU).

Se trata de un estudio cuantitativo y cualitativo que analiza el retorno de las actividades presenciales en las carreras de Odontología brasileñas, durante la pandemia de COVID-19, y las dificultades enfrentadas, comparando instituciones públicas y privadas. Se envió por correo electrónico un formulario en línea con preguntas abiertas y cerradas a los representantes de los cursos de Odontología, de marzo a junio de 2021. Se incluyeron los cursos registrados en el sitio web de e-MEC que iniciaron hasta el año 2017. El análisis cuantitativo utilizó las pruebas chi-cuadrado, Fisher exacta y t de Student (p<0,05); se sometió una pregunta abierta al análisis de contenido temático. De los 329 cursos elegibles, se completaron 83 formularios (21 públicos y 62 privados). Los cursos de instituciones públicas mostraron una menor frecuencia de retorno a actividades presenciales hasta la fecha de cobro (p=0,038), incluyendo una mayor proporción de suspensión de actividades clínicas y de laboratorio (p≤0,001), pero sin diferencia para clases teóricas remotas (p >0.05). Los cursos privados demostraron mayor disponibilidad de recursos para el retorno presencial, tales como: estructura, personal y docentes (p<0,001). Si bien los estándares de bioseguridad constituyen un desafío común, las principales dificultades reportadas en las instituciones privadas ante el regreso de las actividades presenciales fueron modular o escalonar clases y ambientes de aula, controlar el flujo de personas e implementar protocolos. En las públicas destacan dificultades relacionadas con la adecuación de la estructura y adquisición de materiales. Se concluye que la mayoría de las carreras de Odontología habían retomado clases a inicios de 2021, pero las instituciones privadas tuvieron una mayor proporción de retorno a las actividades presenciales de laboratorio y clínicas (AU).

This is a quantitative-qualitative study analyzing the return of on-site activities in Brazilian dentistry undergraduate courses during the COVID-19 pandemic and the difficulties faced, comparing public and private institutions. An online form with open and multiple-choice questions was sent via e-mail to the representatives of dentistry courses from March to June 2021. The courses included were those registered on the e-MEC webpage that had started up to 2017. The quantitative analysis employed the chi-square, the Fisher exact, and the T student tests (p<0.05); the open question was subjected to thematic content analysis. Out of the 329 eligible courses, 83 forms were answered and returned (21 public and 62 private). Public institution courses showed lower frequency of return to on-site activities up tothe data collection (p=0.038), and presented higher proportion of suspension of clinical and laboratory activities (p≤0.001), but no difference regarding remote theoretical lessons (p>0.05). Private courses showed higher availability of resources supporting the return to on-site activities, namely, structure, workers, and professors (p<0.001). Although biosafety norms presented a common challenge, the main difficulties reported in private institutions related to the return to on-site activities were the modulation and schedule of the classes and lesson environments, controlling the flow of people, and the implementation of protocols. Public institutions highlighted difficulties related to adjustment of the structure and material acquisition. The results showed that most dentistry courses had returned to on-site lessons in the early 2021, but private institutions reported higher proportion of return to on-site laboratory and clinical activities (AU).

Bibliometric analysis and diagnostic efficacy of cone-beam computed tomography studies published in Imaging Science in Dentistry from 2011 to 2022.

Purpose: This bibliometric analysis aimed to provide a comprehensive overview of the characteristics, trends, and level of diagnostic efficacy of studies on cone-beam computed tomography (CBCT) published in Imaging Science in Dentistry (ISD) from 2011 to 2022. Materials and Methods: Publications related to CBCT identified in the electronic collection of ISD were selected according to eligibility criteria by 2 independent reviewers who collected data on the characteristics of the articles (year, authors, and country). The type and topic of studies were analyzed using VOSviewer v.1.6.18 (Centre for Science and Technology Studies, Leiden University, Leiden, Netherlands). The research articles were classified according to the hierarchical scale of diagnostic efficacy. Results: Of the 236 articles included, most were from South Korea and Brazil. Bong-Hae Cho and Yun-Hoa Jung were the most prolific authors on the topic of CBCT. The most frequently published types of studies were cross-sectional and laboratory-based. The most popular topics WERE related to the diagnosis of pathologies and/or alterations, as well as anatomical variations. On the diagnostic efficacy scale, most studies were rated level 1 (technical efficacy) or 2 (diagnostic accuracy efficacy). Conclusion: A steady increase was observed in publications related to CBCT, which are of both clinical and academic interest. The trends in these publications were analyzed, revealing that most are cross-sectional studies primarily exploring the capabilities of CBCT in diagnosing pathologies and/or changes in the oral and maxillofacial complex. These studies were typically classified as level 1 or 2 on the diagnostic efficacy scale.

Physicochemical properties of three bioceramic cements.

This study aimed to compare the physicochemical properties of MTA Angelus (MTA-A), MTA Repair HP (MTA-HP), and Biodentine (BD). Setting times (n = 7) were determined in accordance with ASTM C266-15. Solubility (n = 11), pH (n = 10), and calcium ion release (n = 10) were evaluated up to 28 days in accordance with ANSI/ADA specification no. 57. Radiopacity was assessed by ANSI/ADA (n = 10) and the tissue simulator method (n = 10). In both methods, the specimens were radiographed using an aluminum stepwedge and the digital radiographs were analyzed in Adobe Photoshop, determining the mean grayscale pixel values of the materials, of the 3-mm aluminum stepwedge, and of the dentin, the latter of which was analyzed on the tissue simulator. The data obtained from each test were statistically analyzed and compared (p < 0.05). MTA-A presented longer final setting time compared with the other materials. There were no significant differences in the mass values of materials during the experiment. All materials presented an alkaline pH. BD promoted greater calcium ion release in most of the experimental periods. All materials presented appropriate radiopacity. BD showed lower radiopacity than MTA-A in the tissue simulator method. All groups presented higher radiopacity in the tissue simulator when compared with the ANSI/ADA method. MTA-A, MTA-HP, and BD showed appropriate physicochemical properties and radiopacity, and were considered suitable to be used in clinical practice.

XP Endo Finisher-R and PUI as supplementary methods to remove root filling materials from curved canals.

This study assessed the ability of XP-endo Finisher R (FKG, La Chaux-de-Fonds, Switzerland) to remove filling remnants from curved mesiobuccal canals of maxillary molars, using the passive ultrasonic irrigation (PUI) technique as a comparison. Twenty-four curved main mesiobuccal canals (MB1) of maxillary molars were instrumented with Wave One (#25/07) and filled with gutta-percha points and AH Plus Sealer. Samples were then re-treated with a standardized protocol with Wave One (#35/06) as the master apical file. Micro-CT scans measured baseline volume of remaining filling material (in mm3). Samples were divided into two groups (n = 12) according to the supplementary cleaning approach: (PUI) or XP-endo Finisher R. Statistics compared baseline and final volume of filling material (within-group); and the percentage of filling material reduction (between-group). Mean baseline volumes, final volumes, and percentages of reduction (%) of filling material for XP-endo Finisher R and PUI were respectively: 0.060 mm3, 0.042 mm3, and 31.28%; and 0.064 mm3, 0.054 mm3, and 16.57%. Both tested protocols reduced the amount of filling material (p < 0.05). XP-endo Finisher R had higher percentage of reduction as compared to PUI (p < 0.05). XP-endo Finisher R and PUI used as supplementary cleaning protocols during re-treatment improved the removal of root filling material in curved canals; but XP-endo Finisher R was approximately twice more efficient. The complete filling material removal during re-treatment procedures is still a challenge. Supplementary cleaning protocols may help to remove the remaining material after the complete mechanical preparation of curved canals. XP-endo Finisher R was approximately twice more efficient than PUI.

Physicochemical properties of three bioceramic cements

Abstract: This study aimed to compare the physicochemical properties of MTA Angelus (MTA-A), MTA Repair HP (MTA-HP), and Biodentine (BD). Setting times (n = 7) were determined in accordance with ASTM C266-15. Solubility (n = 11), pH (n = 10), and calcium ion release (n = 10) were evaluated up to 28 days in accordance with ANSI/ADA specification no. 57. Radiopacity was assessed by ANSI/ADA (n = 10) and the tissue simulator method (n = 10). In both methods, the specimens were radiographed using an aluminum stepwedge and the digital radiographs were analyzed in Adobe Photoshop, determining the mean grayscale pixel values of the materials, of the 3-mm aluminum stepwedge, and of the dentin, the latter of which was analyzed on the tissue simulator. The data obtained from each test were statistically analyzed and compared (p < 0.05). MTA-A presented longer final setting time compared with the other materials. There were no significant differences in the mass values of materials during the experiment. All materials presented an alkaline pH. BD promoted greater calcium ion release in most of the experimental periods. All materials presented appropriate radiopacity. BD showed lower radiopacity than MTA-A in the tissue simulator method. All groups presented higher radiopacity in the tissue simulator when compared with the ANSI/ADA method. MTA-A, MTA-HP, and BD showed appropriate physicochemical properties and radiopacity, and were considered suitable to be used in clinical practice.

XP Endo Finisher-R and PUI as supplementary methods to remove root filling materials from curved canals

Abstract: This study assessed the ability of XP-endo Finisher R (FKG, La Chaux-de-Fonds, Switzerland) to remove filling remnants from curved mesiobuccal canals of maxillary molars, using the passive ultrasonic irrigation (PUI) technique as a comparison. Twenty-four curved main mesiobuccal canals (MB1) of maxillary molars were instrumented with Wave One (#25/07) and filled with gutta-percha points and AH Plus Sealer. Samples were then re-treated with a standardized protocol with Wave One (#35/06) as the master apical file. Micro-CT scans measured baseline volume of remaining filling material (in mm3). Samples were divided into two groups (n = 12) according to the supplementary cleaning approach: (PUI) or XP-endo Finisher R. Statistics compared baseline and final volume of filling material (within-group); and the percentage of filling material reduction (between-group). Mean baseline volumes, final volumes, and percentages of reduction (%) of filling material for XP-endo Finisher R and PUI were respectively: 0.060 mm3, 0.042 mm3, and 31.28%; and 0.064 mm3, 0.054 mm3, and 16.57%. Both tested protocols reduced the amount of filling material (p < 0.05). XP-endo Finisher R had higher percentage of reduction as compared to PUI (p < 0.05). XP-endo Finisher R and PUI used as supplementary cleaning protocols during re-treatment improved the removal of root filling material in curved canals; but XP-endo Finisher R was approximately twice more efficient. The complete filling material removal during re-treatment procedures is still a challenge. Supplementary cleaning protocols may help to remove the remaining material after the complete mechanical preparation of curved canals. XP-endo Finisher R was approximately twice more efficient than PUI.

Brazilian dentistry courses facing the COVID-19 pandemic / Cursos de Odontologia brasileiros frente à pandemia COVID-19

The study aimed to analyze the situation of Brazilian dental education considering the exceptionality of the COVID-19pandemic.An observational and analytical study was conducted with two cross-sections, using questionnaires sent to all course coordinators in Brazil, in the 1st semester of 2020 and in March 2021.At onset of the pandemic, the institutions interrupted on-site activities. There was significant association between private institutions and offering remote lectures and using these resources before the pandemic. The public sector was associated with not teaching remote lecturesand not using these resources previously. Public institutionshad a greater degree of difficulty in the use and access to technologies for online activitiesby professors and students, as well as a lower degree of preparation in relation to biosecurityprotocols to resume the clinical activities. Impacts were identified in different dimensions of dental education related to the development of practical activities and the establishment of new biosecurityprotocols. Nearly all private coursesdid not suspend activities or did it for less than one month and resumed clinical or laboratory activities at some point during the surveyed period, while public institutions required an average of 5 months for such reorganization.The COVID-19 pandemic substantially increased the use of digital media in Braziliandental education. From this assessment, there arefinancial limitations of the public sector to adapt the infrastructure to the requirements of the current biosecurityprotocols. In general, students are receiving support from the institutionand the coordinators identified negative impacts in different dimensions of dental education, notably in the establishment of new biosecurityprotocols, adequacy in the physical structure and teaching-learning process (AU).

O estudo teve como objetivo analisar a situação da educação odontológica brasileira considerando a excepcionalidade da pandemia COVID-19. Foi realizado um estudo observacional e analítico com dois cortes transversais, por meio de questionários enviados a todos os coordenadores de curso no Brasil, no 1º semestre de 2020 e em março de 2021. No início da pandemia, as instituições interromperam as atividades presenciais. Houve associação significativa entre as instituições privadas e a oferta de aulasremotas e o uso desses recursos antes da pandemia. O setor público foi associado a não ministrar aulasa distância e não utilizar esses recursos anteriormente. As instituições públicas apresentaram maior grau de dificuldade no uso e acesso às tecnologias para atividades on-line por professores e estudantes, bem como menor grau de preparo em relação aos protocolos de biossegurança para a retomada das atividades clínicas. Foram identificados impactos em diferentes dimensões da formação odontológica relacionadas ao desenvolvimento de atividades práticas e ao estabelecimento de novos protocolos de biossegurança. Quase todos os cursos privados não suspenderam as atividades ou o fizeram por menos de um mês e retomaram as atividades clínicas ou laboratoriais em algum momento do período pesquisado, enquanto as instituições públicas necessitaram em média de 5 meses para tal reorganização. A pandemia COVID-19 aumentou substancialmente o uso de recursosdigitaisna educação odontológica brasileira. Existem limitações financeiras do setor público para adaptar a infraestrutura aos requisitos dos atuais protocolos de biossegurança. Em geral, os estudantesestão recebendo apoio da instituição e os coordenadores identificaram impactos negativos em diferentes dimensões do ensino odontológico, notadamente no estabelecimento de novos protocolos de biossegurança, adequação da estrutura física e processo de ensino-aprendizagem (AU).

The effectiveness of rotary and reciprocating techniques in curved root canals retreatment: a micro- CT analysis

Introduction: Different NiTi rotary systems have been developed to improve efficiency and retreatment success rates. Aim: To evaluate the Protaper Universal retreatment system and WaveOne instrument in removing the filling material from curved canals during retreatment. Materials and Methods: Thirty mesial root canals of extracted human mandibular molar teeth were randomly allocated into 2 groups (n=15). In the PT group, retreatment was performed with ProTaper Universal Retreatment according to the manufacturer's instructions. In the WO group, was used WaveOne Primary. ProTaper Universal F2 and F3 were used to achieve the apical diameter in both groups. The samples were scanned by micro-computed tomography pre and postoperatively to evaluate the filling material remaining. The percentage of material filling was compared between groups using Student's T test and in the same group among thirds was compared using Kruskal-Wallis followed by Dunn's post hoc test. Results: The filling material remaining was not statistically different between the groups (p≥0.05). The apical third presented a greater amount of remaining filling material when compared with the cervical third for both groups (p<0.05). Conclusion: Rotary and reciprocating techniques can effectively, but not completely, remove the filling materials from the root canal system. The apical third presented a more significant amount of remaining filling material.

The unplanned and unequal expansion of Dentistry courses in Brazil from 1856 to 2020

Abstract: This study analyzed the consequences of the disordered expansion of Dentistry courses on the distribution of professionals, the job market, and limitations of the National System of Higher Education Assessment (SINAES) developed as a guarantee of education quality. This observational, descriptive, and analytical study used secondary data from several official databases. The number of courses was obtained from the e-MEC registry. From the Higher Education Census, the study collected historical series of courses offered, number of candidates per open seat, number of individuals who initiated and completed the course, and information about professors in the public and private schools. The reports related to Dentistry courses from the National Health Council were also analyzed. The performance of undergraduate students was assessed from synthesis reports of Enade from 2004 to 2016. The number of dentists and their regional distribution was based on the Federal Dental Council, and Brazilian population and gross domestic product were collected from the Brazilian Institute of Geography and Statistics. Dentistry courses in Brazil grew exponentially from 1856 to 2020; among the 544 authorized courses, 82 currently have not yet started their activities. The fast expansion of courses in Brazil has worsened the regional asymmetries in the supply of dentist, and the SINAES has not been able to fully assure the quality of Dentistry courses. Brazilian dentistry, which has increased its scientific and technological development since the 19th century, with outstanding intellectual production, is at risk of a collapse due to a plethora of dentists.

The unplanned and unequal expansion of Dentistry courses in Brazil from 1856 to 2020.

This study analyzed the consequences of the disordered expansion of Dentistry courses on the distribution of professionals, the job market, and limitations of the National System of Higher Education Assessment (SINAES) developed as a guarantee of education quality. This observational, descriptive, and analytical study used secondary data from several official databases. The number of courses was obtained from the e-MEC registry. From the Higher Education Census, the study collected historical series of courses offered, number of candidates per open seat, number of individuals who initiated and completed the course, and information about professors in the public and private schools. The reports related to Dentistry courses from the National Health Council were also analyzed. The performance of undergraduate students was assessed from synthesis reports of Enade from 2004 to 2016. The number of dentists and their regional distribution was based on the Federal Dental Council, and Brazilian population and gross domestic product were collected from the Brazilian Institute of Geography and Statistics. Dentistry courses in Brazil grew exponentially from 1856 to 2020; among the 544 authorized courses, 82 currently have not yet started their activities. The fast expansion of courses in Brazil has worsened the regional asymmetries in the supply of dentist, and the SINAES has not been able to fully assure the quality of Dentistry courses. Brazilian dentistry, which has increased its scientific and technological development since the 19th century, with outstanding intellectual production, is at risk of a collapse due to a plethora of dentists.

Efficacy of a thermally treated single file compared with rotary systems in endodontic retreatment of curved canals: a micro-CT study.

OBJECTIVES: This study aimed to compare WaveOne Gold with ProTaper and RaCe systems regarding remaining filling material, apical transportation (AT), and working time (WT) after (i) filling removal and (ii) shaping of curved canals. METHODS: Thirty mesiobuccal canals of maxillary molars were prepared and filled. After 30 days, they were randomly assigned into three groups (n = 10), according to the instruments used for filling removal and shaping, respectively: WOG-WaveOne Gold Primary and Medium; PTG-ProTaper Retreatment and ProTaper Next; RCG-D-RaCe and RaCe. Micro-CT analysis assessed the residual filling material and AT. WT was recorded. Data were statistically analyzed (α = .05). RESULTS: There was no significant difference between groups in the amount of filling material at any evaluated moment (P > .05). All groups presented low AT values. The WT was similar in all groups in filling removal (P > .05), and in shaping step WOG was faster than PTG and RCG (P < .05). CONCLUSIONS: Neither system could completely remove the filling material. The instruments evaluated were safe and the reciprocating system was faster than the rotary systems in shaping the canals. CLINICAL RELEVANCE: This study provided consistent information on filling material removal capacity of WaveOne Gold. Considering that all tested systems were safe, WaveOne Gold may be an alternative with cost-effectiveness and shorter learning curve for endodontic retreatment.

Validation method of research instruments for Dental Radiology curriculum study / Método de validação de instrumentos de pesquisa para estudo do currículo de Radiologia Odontológica

Dental radiology is an important subject to Dental undergraduate education. Along with other disciplines, it plays a key role in diagnostics, the starting point for patient care. In this way, a specific international guideline for Dental Radiology curriculum was published in 2007. The aim of this study was to develop and validate two distinct instruments, a self-administered online survey, and an interview script, both designed for dental radiology education research. The processes for developing and validating the instruments are described, and the final documents are presented. There were several steps in the validation process of the research instruments in this study, such as translation, cultural adaptation, expert evaluation, read-aloud sessions and pilot testing. This detailed process guarantees control of the variables and helps to avoid bias in regard to the interview and the quantitative/qualitative method analysis (AU).

Radiopacity Evaluation of Gutta-Percha Points in Thinner Samples than the ANSI/ADA Recommendation.

The aim of this study was to evaluate the radiopacity of different gutta-percha points (Endo Points®, Dentsply®, Tanari®, Meta®, Roeko® and Odous®) in samples of 1 mm thick as established by ANSI/ADA Specification #57 and ISO 6876/2001, in comparison with thinner samples. Twelve test specimens for each material, four for each thickness (0.3, 0.6, and 1 mm and diameter of 8 mm), were laminated and compressed between two polished glass plates until the desirable thickness. Digital radiographs were obtained along with a graduated aluminum stepwedge varying from 1 to 10 mm in thickness. The X-ray unit was set at 70 kVp, 10 mA and 0.4 s exposure time, at a focal distance of 36 cm. One calibrated observer quantified the average values of pixels with Adobe Photoshop® software. Data were analyzed using ANOVA and Tukey tests, at 5% significance level. At 0.6 and 1 mm thickness, all the tested materials showed radiopacity higher than 3 mm of aluminum (reference value). At 0.3 mm thickness, Odous and Tanari presented significantly less radiopacity than the reference, and the other materials showed similar radiopacity to the reference. The study concluded that the materials demonstrated different radiopacities and all had values above the minimum recommended by ANSI/ADA specification #57, being Odous and Tanari less radiopaque than the reference value in thinner samples (0.3mm).

Estimativa da idade com finalidade pericial em imagens axiais das duas primeiras vértebras cervicais ­ estudo piloto / Age estimation for forensic purposes in axial images of the two first cervical vertebrae ­ a pilot study

Introdução: A determinação do desenvolvimento esquelético é uma prática comum ao exercício da Odontologia, tanto para fins ortodônticos quanto forenses. Diversos métodos utilizam radiografias e, tendo em vista o crescente emprego da tomografia computadorizada, torna-se importante o conhecimento de todas as potencialidades destas imagens na prática pericial. Objetivo: O objetivo deste estudo foi descrever parâmetros morfológicos das vértebras cervicais C1 e C2 em imagens axiais de tomografia computadorizada por feixe cônico (TCFC) em cada um dos seis estágios maturacionais propostos por Hassel e Farman (1995) para a análise das vértebras no plano sagital. Material e Método: A partir de um banco de dados, foram avaliadas imagens de TCFC de 73 indivíduos de 8 a 18 anos, as quais foram classificadas no plano sagital. Em seguida, as vértebras C1 e C2 foram avaliadas no plano axial e suas características morfológicas registradas em um instrumento de coleta de dados. Foram, então, calculados os percentuais de cada característica dentro dos estágios maturacionais. Resultados: Observou-se na caracterização morfológica axial da C2 a tendência de fusionamento da sincondrose subdental nas fases de Maturação (5) e Finalização (6), ocorrendo em 90% e 66,6% dos casos, respectivamente. Conclusão: O estudo identificou padrões morfológicos axiais da C2 predominantes nas fases 5 e 6 de maturação das vértebras cervicais propostas por Hassel e Farman (1995), podendo contribuir para casos forenses de estimativa da idade.

Introduction: The skeletal development determination is a common practice in Dentistry, both for orthodontic and for forensic purposes. Several methods are based on radiographs, but considering the increase in computed tomography exams more contemporary investigations of these methods became important to explore their forensic purposes. Objective: This study aimed to describe the morphological parameters of the C1 and C2 vertebrae in axial cone beam computed tomography (CBCT) images, at each of the six maturational stages proposed by Hassel and Farman. Material and Method: From a database, CBCT images of 73 individuals aged 8 to 18 years were evaluated and classified in the sagittal plane. Then the C1 and C2 vertebrae were evaluated in the axial plane and their morphological characteristics were recorded in a data collection instrument. The percentage of each feature within the maturational stages was calculated. Results: In the axial morphological characterization of C2, the tendency of fusion of the subdental was marked in Maturation (5) and Finishing (6) phases, with 90% and 66.6% of cases, respectively. Conclusion: The study identified axial morphological patterns of C2 that predominate in phases 5 and 6 of maturation of the cervical vertebrae proposed by Hassel and Farman, and may contribute to age estimation in forensic cases.

Radiopacity Evaluation of Gutta-Percha Points in Thinner Samples than the ANSI/ADA Recommendation

Abstract The aim of this study was to evaluate the radiopacity of different gutta-percha points (Endo Points®, Dentsply®, Tanari®, Meta®, Roeko® and Odous®) in samples of 1 mm thick as established by ANSI/ADA Specification #57 and ISO 6876/2001, in comparison with thinner samples. Twelve test specimens for each material, four for each thickness (0.3, 0.6, and 1 mm and diameter of 8 mm), were laminated and compressed between two polished glass plates until the desirable thickness. Digital radiographs were obtained along with a graduated aluminum stepwedge varying from 1 to 10 mm in thickness. The X-ray unit was set at 70 kVp, 10 mA and 0.4 s exposure time, at a focal distance of 36 cm. One calibrated observer quantified the average values of pixels with Adobe Photoshop® software. Data were analyzed using ANOVA and Tukey tests, at 5% significance level. At 0.6 and 1 mm thickness, all the tested materials showed radiopacity higher than 3 mm of aluminum (reference value). At 0.3 mm thickness, Odous and Tanari presented significantly less radiopacity than the reference, and the other materials showed similar radiopacity to the reference. The study concluded that the materials demonstrated different radiopacities and all had values above the minimum recommended by ANSI/ADA specification #57, being Odous and Tanari less radiopaque than the reference value in thinner samples (0.3mm).

Resumo O objetivo deste estudo foi avaliar a radipacidade de diferentes pontas de guta-percha (Endo Points®, Dentsply®, Tanari®, Meta®, Roeko® e Odous®) em amostras de 1 mm de espessura, conforme estabelecido pela especificação #57 da ANSI/ADA e pela ISO 6876/2001, em comparação com amostras de menor espessura. Doze amostras de cada material, quatro para cada espessura (0,3, 0,6 e 1 mm; 8 mm de diâmetro), foram confeccionadas por meio de laminação e compressão entre duas lâminas de vidro polidas, até a espessura desejada. Radiografias digitais foram obtidas juntamente com uma escala de alumínio graduada, com espessuras variando de 1 a 10 mm. O aparelho de raios X foi ajustado para 70 kVp, 10 mA, 0,4s de tempo de exposição, com distância focal de 36 cm. Um observador calibrado quantificou a média dos valores de pixel no programa Adobe Photoshop®. Os dados foram analisados utilizando os testes ANOVA e Tukey, com nível de significância de 5%. Nas espessuras de 0,6 e 1 mm, todos os materiais testados apresentaram radiopacidade maior do que 3 mm de alumínio (valor de referência). Na espessura de 0,3 mm, Odous e Tanari apresentaram radiopacidade significativamente menor que a referência, e as outras marcas mostraram radiopacidade semelhante à referência. Conclui-se que os materiais apresentaram diferentes radiopacidades e todos mostraram valores acima do mínimo recomendado pela especificação #57 da ANSI/ADA, sendo Odous e Tanari menos radiopacos do que o valor de referência nas amostras mais finas (0.3 mm).

Apical Transportation, Centering Ratio, and Volume Increase after Manual, Rotary, and Reciprocating Instrumentation in Curved Root Canals: Analysis by Micro-computed Tomographic and Digital Subtraction Radiography.

INTRODUCTION: This study aimed to evaluate apical transportation (AT), centering ratio (CR), and volume increase (VI) produced after instrumentation of mesiobuccal canals of maxillary molars with hand files, rotary, and reciprocating instruments using micro-computed tomographic (micro-CT) imaging and to demonstrate the ability of digital subtraction radiography (DSR) to evaluate AT. METHODS: Forty-five canals were randomly assigned to either group K, manual K-files; PTN, ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland); or Rec, Reciproc (n = 15 for each group) for preparation. Master apical files were #25, X2 (#25/06), and R25 (#25/08), respectively. Micro-CT imaging was used to measure AT (mm) and CR (mm) at 3 different locations (1, 4, and 7 mm from the apex). VI (mm3) was measured for each root third and for the whole canal. DSR (mesiodistal and buccolingual projections) was used to measure AT at 1 mm from the apex. RESULTS: AT and CR values were statistically similar across the groups at 1, 4, and 7 mm. AT results obtained for the different locations were similar within each group; CR, in turn, showed statistically lower values at 1 mm. VI was statistically similar in all groups. Both DSR and micro-CT imaging showed that AT always occurred on the outside of canal curvature. The highest mean value obtained for AT was 0.215 mm. CONCLUSIONS: AT, CR, and VI were similar for the K, PTN, and Rec groups. AT results were clinically irrelevant. DSR was as effective as micro-CT imaging in AT analysis and could be considered as an alternative method for assessing this outcome.

Oral manifestations in pediatric patients receiving chemotherapy for leukemia / Manifestações bucais em pacientes pediátricos submetidos a quimioterapia para leucemia

Cross-sectional study of 36 children with acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Intraoral examination and oral hygiene assessment were performed in all patients. Information was also obtained from interviews of patients' mothers and a review of medical records. Results: The sample was largely composed of boys (58.3%), ages 5­9 years. The most commonly used chemotherapy regimen was the BFM-95 protocol. Most children (83.3%) had a record of some oral manifestation during treatment. On intraoral examination, 17 children (50%) were found to have at least one oral manifestation. The most frequent manifestation was also mucositis (26.5%), followed by gingival bleeding (23.4%). Lower maternal educational level was associated with increased frequency of mucositis, as were induction chemotherapy and maintenance chemotherapy after relapse. Conclusions: Oral abnormalities were common in children receiving chemotherapy and mucositis was the most prevalent manifestation. Oral lesions were associated with the induction phase of chemotherapy. Mucositis was not associated with oral health status.

Estudo transversal de 36 crianças com leucemia linfoblástica aguda (LLA) ou leucemia mieloide aguda (LMA). Exame intraoral e avaliação de higiene bucal foram realizados em todos os pacientes. A informação também foi obtida a partir de entrevistas com as mães dos pacientes e uma revisão dos registros médicos. Resultados: A amostra foi composta em grande parte dos meninos (58,3%), com idades entre 5-9 anos. O regime de quimioterapia mais comumente utilizado foi o protocolo BFM-95. A maioria das crianças (83,3%) teve um registro de alguma manifestação oral durante o tratamento. Ao exame intraoral, 17 crianças (50%) apresentaram ter pelo menos uma manifestação oral. A manifestação mais frequente foi mucosite (26,5%), seguido por sangramento gengival (23,4%). Baixa escolaridade materna foi associada com aumento da frequência de mucosite, assim como a quimioterapia de indução e quimioterapia de manutenção após recaída. Conclusões: Anormalidades orais são comuns em crianças que receberam quimioterapia e mucosite foi a manifestação mais prevalente. As lesões foram associados com a fase de indução da quimioterapia. Mucosite não foi associado com o estado de saúde oral.

Influência da conicidade dos instrumentos rotatórios de NiTi no transporte apical û um estudo comparativo com tomografia computadorizada / Influence of taper of NiTi rotary instruments in apical transportation: a comparative study with computed tomography

A proposta deste estudo foi avaliar, ex vivo, a influência da conicidade dos instrumentos rotatórios de níquel-titânio (NiTi) no transporte apical de canais radiculares curvos com tomografia computadorizada. Vinte primeiros molares superiores humanos extraídos foram selecionados e divididos em dois grupos. Os canais radiculares no GrupoHERO 642 (n=10) foram preparados com instrumentos rotatórios de NiTi do sistema HERO 642, conicidade 0,02. Os canais radiculares do Grupo EASY ProDesign (n=10) foram preparados com instrumentos rotatórios de NiTi EASY ProDesign, conicidades múltiplas. O transporte apical foi mensurado comparando imagens de tomografia computadorizada antes do preparo, após o preparo com instrumentos # 35/.02 (Grupo HERO 642) e instrumento # 35/.04 (Grupo EASY ProDesign), e após o preparo com instrumento # 45/.02 (Grupo HERO 642) e instrumento # 40/.04 (Grupo EASY ProDesign). Os dados foram analisados utilizando ANOVA e o nível de significância p. 05. Os valores médios de transporte apical em milímetros (mm) para o Grupo HERO 642 foram 0,93 ± 0,48 mm (#35/.02) e 1,48 ± 0,63 mm (# 45/.02) e para o Grupo EASY ProDesign foram 0,82 ± 0,85 mm (# 35/.04) e 1,03 ± 0,92 mm (# 40/.04). Os instrumentos rotatórios de NiTi de conicidade 0,02 e de múltiplas conicidades mostraram desempenho similar em relação ao transporte apical em canais radiculares curvos.

The aim of this study was to evaluate ex vivo the influence of the taper of nickel-titanium (NiTi) rotary instruments in apical transportation of curved root canals with computed tomography. Twenty extracted maxillary first molars were selected and divided into two groups. The mesiobuccal root canals in Group HERO 642 (n=10) were instrumented with HERO 642 rotary instruments, 0.02 taper. The mesiobuccal root canals in Group EASY ProDesing (n=10) were instrumented with EASY ProDesign rotary instruments, multiple tapers. Apical transportation was measured by comparing tomographic images before preparation, after the preparation with size 35, 0.02 taper (Group HERO 642) and size 35, 0.04 taper (Group EASY ProDesing), after the preparation with size 45, 0.02 taper (Group HERO 642) and size 40, 0.04 (Group EASY ProDesing). Data were analyzed using ANOVA, and significance was set at p.05. The preparation of curved root canals can be accomplished with instruments of diameters and taper larger than 0.02.

Development and evaluation of a learning object focused on factors that might interfere on the radiographic image / Desenvolvimento e avaliação de um objeto de aprendizagem sobre fatores que interferem na imagem radiográfica

Considering the difficulties to obtain good quality dental radiographic images taken by dental students, this study aimed to develop and to evaluate a Learning Object (LO), where the student is able to use a computer to simulate radiograph expositions, modifying the factors that interfere with the radiographic image quality. This study was exploratory and descriptive. For that, 48 periapical radiographs were obtained from the posterior region of a dried bone human jaw with different combinations of kVp/mA, film speed, focal distance, and time of exposition. Each radiograph received a "label" according to the factors used and also with a comment making a value judgment regarding its quality, its applicability for the diagnosis, and, if necessary, suggestions or questions about the required adjustments. In the LO screen students could simulate different situations (combination of factors) until obtaining the best result. Dental students (n=64) were divided into two groups. During the first week both groups participated in a theoretical lecture, and, subsequently, answered a test/assessment on the subject. In the following week Group 1 students solved practical exercises related to the subject, in the laboratory, and answered a second test/assessment. Students from Group 2 performed the activity with the LO in the laboratory. At the end of the activity, they also answered the test/assessment, and an open-ended questionnaire to evaluate the activity. At week3 the same activities from the week before were repeated, reversing the classes, and, then, a third test/assessment was applied. Statistical tests showed that there were no statistical differences in the groups' performance in any of the different moments of the evaluation. The use of the LO did not improved significantly the frequency of students' correctness (number of correct responses) in the tests/assessments. However, the LO methodology was considered very good, because, according to the participants, it was a tool that stimulates learning. The use of the LO, in addition to the practical exercises, contributed to the learning process on the factors that might interfere on the radiographic image (AU).

Considerando as dificuldades apresentadas pelos estudantes de odontologia na obtenção de imagens radiográficas de qualidade, o presente estudo teve por objetivos desenvolver e avaliar um objeto de aprendizagem (OA) no qual o usuário possa simular exposições radiográficas, modificando os fatores que interferem na qualidade da imagem radiográfica. Para este estudo exploratório descritivo, 48 radiografias periapicais foram obtidas da região posterior de uma mandíbula humana seca, com diferentes combinações de kVp/mA, sensibilidade do filme, distância focal e tempo de exposição. A cada imagem foi atribuído um texto sobre sua qualidade, aplicabilidade ao diagnóstico e, se necessário, sugestões ou questões sobre ajustes requeridos. Na tela do OA os estudantes podem simular situações combinando os diferentes fatores até que obtenham o melhor resultado. Para a avaliação do OA, 64 alunos de graduação foram divididos em dois grupos. Todos os alunos participaram da aula teórica e realizaram um teste. Na semana seguinte o Grupo 1 executou exercícios práticos e o Grupo 2 utilizou o OA, ambos respondendo a um segundo teste. Na terceira semana os grupos inverteram as atividades e foi aplicado o terceiro teste. Um questionário aberto foi respondido por todos os alunos com intuito de avaliar qualitativamente o OA. Não houve diferença estatisticamente significante quanto aos acertos nos testes entre os grupos. O OA não melhorou o desempenho dos estudantes em testes, porém foi considerado como uma metodologia muito boa, que estimula o aprendizado. A utilização do OA somou-se aos exercícios práticos, melhorando no aprendizado dos fatores que podem interferir na imagem radiográfica (AU).