Influence of surgeon experience on implant placement in guided surgeries: A systematic review and meta-analysis of randomized clinical trials.

STATEMENT OF PROBLEM: Guided surgical techniques in implant dentistry use virtual planning to accurately position implants. Understanding the effect of a surgeon's experience on guided surgery is essential to ensure successful outcomes. PURPOSE: The purpose of this systematic review and meta-analysis of randomized clinical trials was to evaluate the influence of a surgeon's experience on the accuracy of implant positioning in guided surgery for completely or partially edentulous patients. MATERIAL AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, searches were conducted in the PubMed, Scopus, Web of Science, EMBASE, Cochrane Library, SciELO, and nonpeer-reviewed literature databases. Studies that met the population, intervention, control, and outcome (PICO) strategy were included: a completely or partially edentulous maxilla or mandible, guided surgery performed by experienced and inexperienced surgeons, and assessing implant positioning accuracy. A random-effects meta-analysis with a 95% confidence interval was conducted using Stata 15.1. The risk of bias was assessed with the Cochrane risk-of-bias tool for randomized trials (RoB2), and evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022302288). RESULTS: Three articles from 2017 to 2020 encompassing 43 participants (22 men and 21 women) with a mean age of 61.2 years and a total of 150 implants were included. No significant difference was found between experienced and inexperienced surgeons in terms of angular, cervical, or apical deviations of the implants (95% confidence interval, P<.05). The difference between surgeons regarding positioning accuracy was less than 0.01 degrees for angular deviation, 0.35 mm for apical deviation, and 0.16 mm for cervical deviation. Low heterogeneity was observed for angular deviations (Q P=.021, I2=34%, and t2<.001) and cervical deviations (Q P=.18, I2=45%, and t2=.064). High heterogeneity was observed for apical deviations (Q P<.001, I2=87% and t2=.522). The overall bias risk was moderate, with the evidence certainty ranging from low to moderate. CONCLUSIONS: In guided surgery, the surgeon's experience did not significantly impact the occurrence of deviations in implant positioning.

On the forensic relevance of tattoos: distinguishing black inks with energy dispersive spectroscopy and backscattered scanning electron microscopy.

PURPOSE: This study aimed to analyze black tattoo inks by means of energy dispersive spectroscopy and backscattered scanning electron microscopy. METHODS: The sample consisted of five types of commercial tattoo pigments of the black colour (Easy Glow™, Electric Ink™, Iron Works™, Master Ink™, and Viper™). An Energy Dispersive Spectroscopy (EDS) detector (Silicon Drift Detector - SDD - type) attached to a Scanning Electron Microscope (SEM) device (Tescan Vega3 LMU, Libusina, Czech Republic) was used. X-ray characteristic signs were detected for each tattoo ink in an interval between 0 and 2.5 keV. The electron acceleration potential in the microscope was 15 keV. Two regions were analyzed for each sample (n = 10). On each region, a micrography of backscattered electrons (BSE) was obtained. Means and standard deviations (SD) of the weight percentages (Wt%) were calculated. RESULTS: C and O were predominant, with a mean O/C ratio between 2.69 and 2.74 Wt%. Electric Ink and Master Ink were the most similar pigments, while Easy Glow was the most distinctive - with agglomerates of Al that had a concentration 25 × higher than other specimens. Other compounds detected in the sample were Cl and Cu. CONCLUSION: EDS and SEM were efficient to distinguish black tattoo inks. These are our preliminary outcomes on the use of EDS and SEM to analyze black tattoo inks. Thus, careful interpretation is necessary to avoid rash applications in human identification practice.

Binary decisions of artificial intelligence to classify third molar development around the legal age thresholds of 14, 16 and 18 years.

Third molar development is used for dental age estimation when all the other teeth are fully mature. In most medicolegal facilities, dental age estimation is an operator-dependent procedure. During the examination of unaccompanied and undocumented minors, this procedure may lead to binary decisions around age thresholds of legal interest, namely the ages of 14, 16 and 18 years. This study aimed to test the performance of artificial intelligence to classify individuals below and above the legal age thresholds of 14, 16 and 18 years using third molar development. The sample consisted of 11,640 panoramic radiographs (9680 used for training and 1960 used for validation) of males (n = 5400) and females (n = 6240) between 6 and 22.9 years. Computer-based image annotation was performed with V7 software (V7labs, London, UK). The region of interest was the mandibular left third molar (T38) outlined with a semi-automated contour. DenseNet121 was the Convolutional Neural Network (CNN) of choice and was used with Transfer Learning. After Receiver-operating characteristic curves, the area under the curve (AUC) was 0.87 and 0.86 to classify males and females below and above the age of 14, respectively. For the age threshold of 16, the AUC values were 0.88 (males) and 0.83 (females), while for the age of 18, AUC were 0.94 (males) and 0.83 (females). Specificity rates were always between 0.80 and 0.92. Artificial intelligence was able to classify male and females below and above the legal age thresholds of 14, 16 and 18 years with high accuracy.

Influence of CBCT-derived panoramic curve variability in the measurements for dental implant planning.

OBJECTIVE: To investigate whether the curve markings performed prior to panoramic and cross-sectional reconstructions can influence the planning of oral implants. METHODS: Twenty oral radiologists landmarked the reference panoramic curves in 25 CBCT scans of the mandible. Bone height was measured on the resulting cross-sectional slices in the edentulous region of the lower first molar. The following data were recorded: (1) number of landmarks used to build each reference curve; (2) shape of the reference curve (inverted "U", inverted "V" or "horseshoe"); and (3) measurement in the first molar region. The data were assessed for variability based on the number of landmarks, the shape of the reference curve, and the measurements obtained. RESULTS: The number of landmarks used to guide the panoramic reconstruction varied among radiologists (p < 0.05), but most of them draw curves in inverted "U" shape (68-100%). The reproducibility of the measurements taken in the edentulous mandibular first molar region was excellent (84.7%). The number of landmarks and the shape of the curve did not have a significant influence on the reproducibility of the measurements (p > 0.05). CONCLUSION: Variations of the operator-dependent steps during the panoramic reconstructions occur but do not play a significant part changing the measurements taken for oral implant planning.

Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review

ABSTRACT BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

Knowledge and attitudes of rural healthcare providers regarding domestic violence against women: a systematic review.

BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S.

An integrative literature review of the potential technical challenges in Forensic Odontology practice ­ an exploratory study / Uma revisão integrativa da literatura sobre os potenciais desafios técnicos na prática da Odontologia Forense ­ um estudo exploratório

Forensic Odontology deals with the presentation of dental evidence in a court of law. An academic exploration revealed instances of technical challenges within the field. This study endeavours to delve into the spheres where these challenges occur, with the core objective of enhancing the quality of practice. An integrative literature review was conducted using the online platforms SCOPUS and Web of Science. Based on the selection criteria, 29 pertinent papers dated 2000-2023 were included. Quantitative analysis of the categories of selected articles was performed using Microsoft Excel 2019 (Microsoft Corp., Redmond, WA, USA). Technical concerns were reported in all facets of Forensic Odontology with the general role of expert witnesses being reported the most (n=8; 27.58%). Within the different facets of the field, age estimation was the most prominent area of concern (n=8; 27.58%) and child abuse and neglect (n=1; 3.57%) represented the least reported category. Findings indicate that there is a need to prioritize avenues to enhance the quality of practice in the general role of expert witnesses and the specific area of dental age estimation. To this end, increased support for researchers must be provided to help validate methodologies. It is advisable to institute mandatory formal training and proficiency testing within the field. Inadequate knowledge of dentists regarding child abuse and neglect has been noted, demonstrating the need for more dedicated quality training. Recommendations for Forensic Odontologists have been curated combining this study's results and the codes of ethics of various forensic organisations

A Odontologia Legal trata da apresentação de provas odontológicas em juízo. Uma exploração acadêmica revelou exemplos de desafios técnicos na área. Este estudo procura aprofundar as esferas onde estes desafios ocorrem, com o objetivo central de melhorar a qualidade da prática. Foi realizada uma revisão integrativa da literatura utilizando as plataformas online SCOPUS e Web of Science. Com base nos critérios de seleção, foram incluídos 29 artigos pertinentes datados de 2000-2023. A análise quantitativa das categorias dos artigos selecionados foi realizada no Microsoft Excel 2019 (Microsoft Corp., Redmond, WA, EUA). Preocupações técnicas foram relatadas em todas as áreas da Odontologia Legal, sendo o papel geral dos peritos o mais relatado (n=8; 27,58%). Dentro das diferentes áreas de atuação, a estimativa da idade foi a área de preocupação mais proeminente (n=8; 27,58%), e o abuso infantil e a negligência (n=1; 3,57%) representaram a categoria menos relatada. Os resultados indicam que há uma necessidade de priorizar caminhos para melhorar a qualidade da prática no papel geral dos peritos e na área específica da estimativa da idade dental. Para este efeito, deve ser prestado maior apoio aos investigadores para ajudar a validar metodologias. É aconselhável instituir treinamento formal obrigatório e testes de proficiência na área. Foi observado um conhecimento inadequado dos dentistas sobre abuso e negligência infantil, demonstrando a necessidade de uma formação mais dedicada e de qualidade. As recomendações para Dentistas Forenses foram selecionadas combinando os resultados deste estudo e os códigos de ética de várias organizações forenses.

Panoramic Radiography vs. CBCT in the Evaluation of the Maxillary Third Molar Roots.

Background and Objectives: A comprehensive understanding of the position of third molar roots and adjacent structures, such as the maxillary sinus (MS), is essential for safe extractions. Diagnostic imaging plays a fundamental role in achieving accurate treatment planning. This study aimed to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the evaluation of maxillary third molar roots and their relationship with the MS. Materials and Methods: Two trained radiologists evaluated third molar images. The number of roots, morphology (fused/conical, divergent, dilacerated, or atypical), and their relationship with the MS in PR and CBCT were registered. Descriptive and inferential statistics were performed using the weighted Kappa test. Results: Regarding the number and morphology of the roots, Kappa values showed moderate (κ = 0.42) and fair agreement (κ = 0.38), respectively. Regarding the proximity with the MS, most of the roots showed close contact (30.6%), or 1/3 of root superimposition (35%), in PR evaluation, while in CBCT, the third molars were in contact with the MS floor (32%), and with alveolar domes (27.2%). Conclusions: PR is a moderately reliable image technique to identify the number of roots and root morphology of maxillary third molars. PR, however, does not provide any radiographic signs that clearly indicate the anatomical relationship between the maxillary third molar roots and the maxillary sinus detected in CBCT images.

Biological profiling using the human mandible.

BACKGROUND: In the absence of soft tissue, skeletal remains are analyzed to identify the deceased. This assessment involves establishing the biological profile that aids medicolegal investigations and fulfils the right of the dead to be identified. Since the mandible is the strongest bone in the skull and easily identifiable, even when fragmented, this study aimed to systematically review its value in constructing the biological profile in the published literature. We searched PubMed, ScienceDirect, Scopus, and Latin American and Caribbean Health Sciences Literature and collected cross-sectional studies published in English before 2021. A risk of bias assessment was completed based on Joanna Briggs Institute's critical appraisal tools. The data are presented descriptively and were analyzed using Microsoft Office Excel 365. HIGHLIGHT: Of the 104 eligible articles, 94 examined the sexual dimorphism of the mandible, while 25 attempted to estimate age. Ancestry and stature were the least explored biological characteristics (five and one articles, respectively). A metric analysis was the most common approach (n = 80), followed by morphological analysis and combined morphologic and metric techniques (n = 18 and n = 6, respectively). The results showed no statistically significant correlation between an individual's mandible and stature. Orthopantomogram radiography continues to be the most common radiographic technique for assessing the mandible. CONCLUSION: The mandible is reliable when used for sex estimation; however, caution should be exercised in relying solely on it for morphological assessments. This review provides guidance on estimating age, sex, and ancestry directly from mandibular specimens or radiographs.

Psiconeurodontologia, (bio)decodificação dental e os mil e um nomes para o charlatanismo odontológico no século XXI: uma revisão de escopo / Psychoneurodontology, dental (bio)decoding and a thousand terms for odontological charlatanism in the 21st century: a scoping review

Junto às tecnologias que surgem para aprimorar a Odontologia mundial, emergem temáticas que progressivamente prosperam no obscuro e na incerteza. Tais "áreas odontológicas" se caracterizam por uma roupagem prolixa e de alto apelo público (como por meio de inferências sobre o emocional e os mistérios do corpo humano). Em tempos de disseminação da psiconeurodontologia e (bio)decodificação dental, assim como da incerteza acerca de sua confiabilidade, faz-se imperativa a busca pela fundamentação científica que sustenta esta temática. Para isto, foi realizada uma revisão de escopo seguindo as recomendações do PRISMA-ScR e JBI. Uma ampla busca foi realizada em cinco bases de dados e em parte da literatura cinza. Não houve restrição quanto ao ano de publicação e nem quanto ao idioma. Os dados foram coletados e expostos na forma narrativa/descritiva. De maneira complementar, utilizou-se a ferramenta JBI para avaliação da qualidade metodológica. A busca resultou em 4.785 registros iniciais, dos quais somente dois foram classificados como elegíveis. Ambos os estudos foram detectados a partir da literatura cinzenta e consistiam em trabalhos peruanos de conclusão de curso em nível de graduação (Bacharelado) em Odontologia. Os trabalhos aferiam a ocorrência de lesão de cárie em quadrantes de dentes permanentes e decíduos e correlacionavam com um questionário psicoemocional. Os dois trabalhos concluíram em prol da aplicação da psiconeurodontologia e da (bio)decodificação dental como ferramentas adicionais ao armamentário diagnóstico do Cirurgião-dentista. Detectou-se alto risco de viés, em especial acerca das limitações metodológicas dos estudos elegíveis. Tendo em vista os métodos e resultados observados nos estudos elegíveis, pode-se concluir que não há fundamentação científica na psiconeurodontologia ou na (bio)decodificação dental, muito menos validade e confiabilidade para a sua aplicação na prática clínica odontológica atual

Along with the technologies that emerged to improve Dentistry worldwide, there are themes that progressively dive into darkness and uncertainty. Such "dental areas" are characterized by a verbose approach and strong public appeal (such as through inferences about the emotions and mysteries of the human body). In times of dissemination of psychoneurodontology and dental (bio)decoding, as well as uncertainty about their reliability, the search for alleged scientific foundations that support this theme is imperative. To this end, a scoping review was carried out following the recommendations of PRISMA-ScR and JBI. A broad search was carried out in five databases and part of the gray literature. There was no restriction on the year of publication or language. Data were collected and presented in narrative/descriptive form. Complementarily, the JBI tool was used to assess methodological quality. The search resulted in 4.785 initial records, of which only two were classified as eligible. Both studies were detected from the gray literature and consisted of Peruvian studies at Bachelor's degree in Dentistry. The studies measured the occurrence of caries lesions in quadrants of permanent and deciduous teeth and correlated them with a psychoemotional questionnaire. The two studies concluded in favor of the application of psychoneurodontology and dental (bio)decoding as additional tools to the dental surgeon's diagnostic armamentarium. A high risk of bias was detected, especially regarding the methodological limitations of the eligible studies. Considering the methods and results observed in the eligible studies, it can be concluded that there is no scientific basis in psychoneurodontology or dental (bio)decoding, as well as lack of validity and reliability for its application in current clinical dental practice

Age estimation of Russian individuals by teeth using the London Atlas / Análise da estimativa de idade em indivíduos russos utilizando a metodologia London Atlas

Knowing an individual's age is necessary for several situations, both in the living and the deceased. The London Atlas uses dental development and eruption to estimate age. Testing the method in different populations is necessary to assess its performance. This study aimed to assess the performance of the London Atlas method in a Russian sample using panoramic radiographs. A sample of 703 panoramic radiographs of Russian individuals (n = 405 females, 57.61% and n = 298 males, 42.39%) with ages between 8 and 23 years were analyzed. The results showed overestimation in individuals from 8 to 14 years and underestimation from 15 to 23 years. The mean difference between estimated and chronological ages did not exceed 0.7 years among individuals with ages below 19 years. The difference increased to over three years in individuals from 20 to 23 years. Statistically significant differences were found between females and males between 17 and 18 years (p<0.05). The London Atlas is suitable for Russian children and adolescents aged between 8 and 19 years; however, it showed unsatisfactory results for application in individuals over 20 years (AU).

Conhecer a idade de um indivíduo, vivo ou morto, é essencial em diversas situações. O método London Atlas utiliza desenvolvimento e erupção dentais para estimar a idade. Testar o método em diferentes populações é importante para avaliar sua performance. Esse estudo objetivou analisar o desempenho do London Atlas em uma amostra de origem russa, utilizando radiografias panorâmicas. Uma amostra de 703 indivíduos russos (n = 405 mulheres, 57,61% e n = 298 homens, 42,39%), com idades entre 8 e 23 anos foram analisadas. Resultados obtidos mostram uma superestimação em indivíduos de 8 a 14 anos e subestimação nos grupos de 15 a 23 anos. A diferença média entre idades estimadas e reais não excederam o valor de 0,7 anos nos indivíduos com idade abaixo de 19 anos. Essa diferença aumentou em até três anos em indivíduos de 20 a 23 anos. Diferenças estatisticamente significantes foram encontradas entre homens e mulheres com 17 e 18 anos (p<0,05). O London Atlas é adequado para crianças e adolescentes de origem russa, com idades de 8 a 19 anos. No entanto, observou-se resultados insatisfatórios para sua aplicação em indivíduos acima de 20 anos (AU).

Volumetric assessment of canines using post-mortem computed tomography (PMCT) for sexual dimorphism in a Malaysian population.

Background: Recent research has explored volumetric assessment in three-dimensional (3D) imaging procedures for sexual dimorphism. The 3D techniques have enabled a more realistic, accurate, and non-invasive visualization of sex-related anatomical parameters, such as the size and shape of human teeth. Aim: To perform sexual dimorphism based on dental tissue volumes of permanent left maxillary and mandibular canines in a Malaysian population. Methods: A cross-sectional study was carried out on 220 post-mortem computed tomography (PMCT) scans of Malaysian subjects (114 males and 106 females) aged between 18 and 40 years old. The permanent left maxillary and mandibular canines were analysed based on the volume of their (I) enamel cap, (II) coronal dentine, and (III) root, as well as the combination between the three dental tissue volumes (DTV). 3D Slicer version 4.10.2 computer software was used to perform a semi-automated segmentation of the anatomic regions of interest of each tooth. Results: The DTV of the permanent left maxillary and mandibular canines showed sexual dimorphism as the males presented larger DTV than females (p < 0.05). After binary logistic regression, the DTV revealed an overall sex classification rate of 60 to 74.1%. The DTV of the permanent left mandibular canine had more discriminant power to correctly classify males and females compared to the left maxillary canine. Conclusions: The volumetric assessment of the dental tissues of the permanent left maxillary and mandibular canines could discriminate sex in the Malaysian population. Given the limited classification rate, this approach could act solely as a supplementary tool to existing sex estimation methods.

Pulp volume quantification methods in cone-beam computed tomography for age estimation: A critical review and meta-analysis.

The secondary dentin deposition that occurs after the tooth formation process results in a decrease in pulp cavity volume in adolescents and adults. The purpose of this critical review was to correlate pulpal and/or dental volume on cone-beam computed tomography (CBCT) with chronological age approximation. A subobjective was to investigate which methodology and CBCT technical parameters would be most appropriate to evaluate this correlation. This critical review followed the PRISMA guidelines, and it was conducted by a search through PubMed, Embase, SciELO, Scopus, Web of Science, Cochrane Library databases, as well as gray literature. Primary studies that used pulp volume, or pulp chamber to tooth volume ratio measured using CBCT were included. Seven hundred and eight indexed and 31 non-indexed records were identified. A qualitative analysis was performed including 25 selected studies with a total of 5100 individuals, age ranging from 8 to 87 years without sex predilection. The most used method was pulp volume/tooth volume. CBCT voxel size ranged between 0.09 and 0.5. Manual segmentation associated with threshold algorithms was used in most of the studies. Correlation between the pulp volume/tooth volume ratio was moderate: -0.66 for the upper central incisors, -0.59 for upper canines and -0.56 for lower canines. High heterogeneity was observed among the studies. It is concluded that pulp volume should be used with caution in age estimation. Evidence supports the preferable use of upper incisors with pulp volume/tooth volume ratio for age estimation. There is not enough evidence that voxel size interferes in age estimation by pulp volume.

The radiographic diversity of dental patterns for human identification - Systematic review and meta-analysis.

This study aimed to revisit the scientific literature related to the diversity of dental patterns observed in radiographs. The rationale was to find evidence to support dental human identifications. A systematic review was performed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Strategic search was accomplished in five electronic data sources (SciELO, Medline/Pubmed, Scopus, Open Grey and OATD) were searched. The study model of choice was observational analytical cross-sectional. The search resulted 4.337 entries. The sequential screening based on title, abstract and full-text reading led to 9 eligible studies (n = 5.700 panoramic radiographs) published between 2004 and 2021. Studies from Asian countries were predominant (e.g., South Korea, China, and India). All the studies showed low risk of bias (measured according to the Johanna Briggs Institute's critical appraisal tool for observational cross-sectional studies). Morphological, therapeutic, and pathological identifiers were charted from radiographs to create dental patterns across studies. Six studies (n = 2.553 individuals) had similar methodology and outcome metrics and were included in the quantitative analysis. A meta-analysis was performed and revealed a pooled diversity of the human dental pattern of 0.979 combining maxillary and mandibular teeth. The additional subgroup analysis with maxillary and mandibular teeth have a diversity rate of 0.897 and 0.924, respectively. The existing literature shows that human dental patterns are highly distinctive, especially if morphological, therapeutic and pathological dental features are combined. The diversity of dental identifiers found in the maxillary, mandibular and combined arches is hereby corroborated by this meta-analyzed systematic review. These outcomes support applications for evidence-based human identification.

Radiographic dental age estimation applying and comparing Demirjian's seven (1973) and four (1976) teeth methods.

To apply Demirjian's seven (1973, D7) and four (1976, D4) teeth methods in a sample of Brazilian children and compare their performances for age estimation. Panoramic radiographs of 1200 children (600 females and 600 males) were collected from Southeast Brazil. The children were equally distributed (n = 60 females and 60 males) between age intervals of 1 year between 6 and 15.9 (mean age = 10.9; standard deviation [SD]: 2.9) years. D7 and D4 dental age estimation methods were applied by two observers and were compared based on their error rates (error = estimated age-chronological age). Both methods overestimated the chronological age (p < 0.0001). D7 led to overestimations of 0.71 (p < 0.0001) in females and 0.83 (p < 0.0001) in males, while the overestimations with D4 were 0.14 (p = 0.0067) and 0.73 (p < 0.0001) for females and males, respectively. The mean age estimated by D7 was 11.7 (SD: 3.1) years, while for D4, it was 11.3 (SD: 3.3) years. Intra- and interobserver agreement was ≥ 0.98. D4 optimized the performance of radiographic dental age estimation compared to D7. Improvements were reflected in the total sample and separately for female and male children from Southeast Brazil.

Domestic Violence against Women Detected and Managed in Dental Practice: a Systematic Review.

This study aimed to investigate the knowledge of dental care professionals to identify and manage clinical situations that indicate violence against women. PRISMA guidelines were followed and a systematic review protocol was registered in PROSPERO. The systematic search was designed based on the PICo strategy. Six databases were used as primary research sources (PubMed, Scopus, LILACS, SciELO, Web of Science, and Embase). Three databases (OpenGrey, OpenThesis, and OATD) were used to detect the "grey literature". Observational studies (cross-sectional, cohort, or case-control) were included, and there were no restrictions of year or language of publication. Two authors selected and extracted the data from the eligible studies. The risk of bias was assessed with the JBI Critical Appraisal Checklist. The search resulted in 10,115 studies. Eleven met the eligibility criteria and were included in the qualitative synthesis. The studies were published from 1994 to 2018. All studies presented low risk of bias. Among the dental care professionals, only 1-7.1% of the dentists included injury search and examination of their patients for signs of violence. Less than 47% of the professionals had knowledge to identify violence injuries. When it comes to knowledge to identify signs of domestic violence, positive answers were below 24%. Considering all the variables assessed in this study, dental care professionals presented deficiencies regarding the knowledge and management of situations of domestic violence against women. Educational strategies are necessary to prepare dental care professional to identify and report suspicious cases.

3D segmentation of dental crown for volumetric age estimation with CBCT imaging.

In adult dental age estimation, segmentation of dental volumetric information from different tooth parts using cone-beam computed tomography (CBCT) has proven beneficial in improving the regression model reliability. This segmentation method can be expanded in the crown part since the volumetric information in the crown is affected by attrition in the enamel and secondary dentine in the dentine and pulp chamber. CBCT scans from 99 patients aged between 20 and 60 were collected retrospectively. A total of 80 eligible teeth for each tooth type were used in this study. The enamel to dentine volume ratio (EDVR), pulp to dentine volume ratio (PDVR) and sex were used as independent variables to predict chronological age (CA). The EDVR was not affected by PDVR. The highest R2 was calculated from the maxillary canine (R2 = 0.6). The current approach in crown segmentation has proven to improve model performance in anterior maxillary teeth.

Application of the London Atlas Software App 2nd edition for the radiographic assessment of dental development.

Background: Assessing the dental development of children and adolescents is an important part of treatment planning. The radiographic visualization of dental developmental stages prior to age estimation is currently feasible by means of digital software apps. Testing the existing software tools is necessary to safeguard application in practice. This study applied the London Atlas Software App 2nd edition™ for dental age estimation in Brazilian children. Material and Methods: The software was applied to 1.104 digital panoramic radiographs of females (n = 509) and males (n = 595) with ages between 6 and 15.99 years (mean = 10.88 ± 2.84 years). The sample included at least 100 individuals similarly distributed based on sex within 10 age categories of one year each (6├ 15.99) years. Metrics of errors were quantified between the estimated (EA) and chronological (CA) ages. Results: The mean absolute errors among females and males were 0.56 and 0.60 years, respectively (overall = 0.58 years for the combined sample). The lower error values were observed in the age interval of 6 ├ 9.99 years. Error values above one year were detected in older age intervals (10 ├ 15.99 years). Statistically significant differences in dental development were not observed between females and males (p> 0.05). Conclusions: The London Atlas Software App 2nd edition led to specific error rates that can be acceptable for case-specific clinical applications. In the forensic field, caution is advised if the application is planned in the transition between late childhood and early adolescence - when third molars play a major role among the scarce developing teeth. Key words:Brazil, children, dental age estimation, forensic dentistry, radiology.

Assessment of cone beam computed tomography for determining position and prognosis of interradicular mini-implants.

OBJECTIVE: To investigate the influence of dynamic visualization of cone beam computed tomography (CBCT) scans on orthodontist's assessment of positioning status and prognosis of interradicular mini-implants (MI). METHODS: Three MI positions were virtually simulated in thirty CBCT volumes: (1) MI 1 mm from the lamina dura (LD), (2) MI touching the LD and (3) MI overlapping the LD. Each position was exposed to orthodontists (n = 35) as panoramic reconstruction, sagittal reconstruction and a sequence of axial slices. Each orthodontist evaluated the MI position (relationship with the LD) and scored the prognosis using a four-point scale (the higher the score, the better the prognosis). Kappa, Friedman and Nemenyi statistics were used. RESULTS: Statistically significant associations were detected between the prognosis scores and the type of image visualized (p<0.05). The dynamic visualization of the CBCT volume (axial slices) was associated with higher scores for prognosis and more reliable evaluation of MI positioning. Inconsistent outcomes were more frequently associated with panoramic and sagittal reconstructions. CONCLUSION: The dynamic visualization of axial slices allowed orthodontists to perform better assessment of MI position and considerably affected prognosis judgment.

Students' perspective of the teaching-learning process of oral radiology before and during the COVID-19 pandemic.

The SARS-Cov-2 (COVID-19) pandemic changed the educational structure of dentistry courses and highlighted the importance of online tools. Understanding students' perception regarding these changes is essential to establishing future teaching-learning strategies to accommodate students' needs in higher education. The aim of this study was to assess students' perceptions of the Oral Radiology teachinglearning process before and during the COVID-19 pandemic. The sample consisted of students (n = 111) of the 2nd, 4th and 6th semesters of the dentistry course, who answered a questionnaire with 21 items: A) Students' demographic data (5 questions); B) Students' teaching-learning experiences during the pre-pandemic period (8 questions); and C) Students' teaching-learning experiences during the post-pandemic period (8 questions). Stuart-Maxwell tests revealed statistically significant differences between students' opinions before and during the pandemic when they were asked about the structure of the Oral Radiology module (p = 0.008); their previous experience with e-learning and teaching (p < 0.001); their thoughts about the importance of e-learning in Oral Radiology (p < 0.05); and the time they spent online for academic purposes (p < 0.05). Students seem to prefer on-campus activities (before COVID-19), but the pandemic increased their awareness of the importance of e-learning, the time they spent on online studies, and their knowledge of online educational tools.

A pandemia de SARS-Cov-2 (COVID-19) mudou a estrutura educacional dos cursos de odontologia e destacou a importância das ferramentas online. Compreender a percepção dos alunos sobre as mudanças vivenciadas é essencial para estabelecer futuras estratégias de ensino-aprendizagem e acomodar as necessidades dos alunos no ensino superior. Este estudo teve como objetivo avaliar a percepção dos alunos sobre o processo de ensino-aprendizagem de Radiologia Odontológica antes e durante a pandemia de COVID-19. A amostra foi composta por alunos (n = 111) do 2º, 4º e 6º semestres do curso de odontologia que responderam a um questionário com 21 itens: A) Dados demográficos dos alunos (5 questões); B) Experiências de ensino-aprendizagem dos alunos no período pré-pandemia (8 questões); e C) Experiências de ensino-aprendizagem dos alunos no período pós-pandemia (8 questões). Os testes de Stuart-Maxwell revelaram diferenças estatisticamente significativas entre as opiniões dos alunos antes e durante as pandemias quando questionados sobre a estrutura do módulo de Radiologia Odontológica (p = 0,008); sua experiência anterior com ensino a distância (p < 0,001); seus pensamentos relacionados à importância da Radiologia Odontológica via e-learning (p < 0,05); e o tempo gasto online para fins acadêmicos (p < 0,05). Os alunos parecem preferir atividades no campus (antes do COVID-19), mas as pandemias aumentaram sua conscientização sobre a importância do e-learning, seu tempo dedicado aos estudos online e sua familiarização com ferramentas educacionais online.