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1.
BMC Oral Health ; 24(1): 772, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38987714

RESUMO

Integrating artificial intelligence (AI) into medical and dental applications can be challenging due to clinicians' distrust of computer predictions and the potential risks associated with erroneous outputs. We introduce the idea of using AI to trigger second opinions in cases where there is a disagreement between the clinician and the algorithm. By keeping the AI prediction hidden throughout the diagnostic process, we minimize the risks associated with distrust and erroneous predictions, relying solely on human predictions. The experiment involved 3 experienced dentists, 25 dental students, and 290 patients treated for advanced caries across 6 centers. We developed an AI model to predict pulp status following advanced caries treatment. Clinicians were asked to perform the same prediction without the assistance of the AI model. The second opinion framework was tested in a 1000-trial simulation. The average F1-score of the clinicians increased significantly from 0.586 to 0.645.


Assuntos
Inteligência Artificial , Cárie Dentária , Humanos , Cárie Dentária/terapia , Encaminhamento e Consulta , Planejamento de Assistência ao Paciente , Algoritmos
2.
BMJ Open ; 14(7): e082083, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977367

RESUMO

OBJECTIVES: Provision of personalised care planning is a national priority for people with dementia. Research suggests a lack of quality and consistency of care plans and reviews. The PriDem model of care was developed to deliver feasible and acceptable primary care-based postdiagnostic dementia care. We aimed to increase the adoption of personalised care planning for people with dementia, exploring implementation facilitators and barriers. DESIGN: Mixed-method feasibility and implementation study. SETTING: Seven general practices from four primary care networks (PCNs) in the Northeast and Southeast of England. PARTICIPANTS: A medical records audit collected data on 179 community-dwelling people with dementia preintervention, and 215 during the intervention year. The qualitative study recruited 26 health and social care professionals, 14 people with dementia and 16 carers linked to participating practices. INTERVENTION: Clinical dementia leads (CDL) delivered a 12-month, systems-level intervention in participating PCNs, to develop care systems, build staff capacity and capability, and deliver tailored care and support to people with dementia and their carers. PRIMARY AND SECONDARY OUTCOME MEASURES: Adoption of personalised care planning was assessed through a preintervention and postintervention audit of medical records. Implementation barriers and facilitators were explored through semistructured qualitative interviews and non-participant observation, analysed using codebook thematic analysis informed by Normalisation Process Theory. RESULTS: The proportion of personalised care plans increased from 37.4% (95% CI 30.3% to 44.5%) preintervention to 64.7% (95% CI 58.3% to 71.0%) in the intervention year. Qualitative findings suggest that the flexible nature of the PriDem intervention enabled staff to overcome contextual barriers through harnessing the skills of the wider multidisciplinary team, delivering increasingly holistic care to patients. CONCLUSIONS: Meaningful personalised care planning can be achieved through a team-based approach. Although improved guidelines for care planning are required, commissioners should consider the benefits of a CDL-led approach. TRIAL REGISTRATION NUMBER: ISRCTN11677384.


Assuntos
Demência , Estudos de Viabilidade , Planejamento de Assistência ao Paciente , Atenção Primária à Saúde , Pesquisa Qualitativa , Humanos , Demência/terapia , Atenção Primária à Saúde/organização & administração , Inglaterra , Masculino , Feminino , Planejamento de Assistência ao Paciente/organização & administração , Idoso , Cuidadores , Medicina de Precisão/métodos , Idoso de 80 Anos ou mais , Acessibilidade aos Serviços de Saúde/organização & administração , Pessoa de Meia-Idade
3.
Pediatrics ; 154(1)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38899390

RESUMO

OBJECTIVES: A seizure action plan (SAP) is a powerful tool that provides actionable information for caregivers during seizures. Guidelines have expressed the need for individualized SAPs. Our quality improvement team aimed to increase implementation of an SAP within a pediatric tertiary center, initially among epilepsy providers and expanded to all neurology providers. METHODS: Process changes were implemented using Plan-Do-Study-Act cycles and data were evaluated monthly using control charts. The team focused on tracking patients who received SAPs and identified opportunities for improvement, including reminders within the electronic medical record, and standardizing clinic processes. A secondary analysis was performed to trend emergency department (ED) use among our patient population. RESULTS: The SAP utilization rate among epilepsy providers increased from a baseline of 39% to 78% by December 2019 and reached the goal of 85% by June 2020, with a further increase to 92% by February 2022 and maintained. The SAP utilization rate among general neurology providers increased from 43% in 2018 to 85% by July 2020, and further increased to 93% by February 2022 and maintained. ED visits of established patients with epilepsy decreased from a baseline of 10.2 per 1000 to 7.5 per 1000. CONCLUSIONS: Quality improvement methodologies increased the utilization of a standardized SAP within neurology outpatient care centers. The SAP is a simplified tool that allows patients and providers to navigate a complex health care system. The utility of an SAP may potentially extend to minimizing unnecessary ED visits.


Assuntos
Serviço Hospitalar de Emergência , Melhoria de Qualidade , Convulsões , Humanos , Convulsões/terapia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Criança , Epilepsia/terapia , Assistência Ambulatorial , Centros de Atenção Terciária , Planejamento de Assistência ao Paciente
5.
Curr Oncol ; 31(6): 3278-3290, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38920732

RESUMO

Primary care providers (PCPs) have been given the responsibility of managing the follow-up care of low-risk cancer survivors after they are discharged from the oncology center. Survivorship Care Plans (SCPs) were developed to facilitate this transition, but research indicates inconsistencies in how they are implemented. A detailed examination of enablers and barriers that influence their use by PCPs is needed to understand how to improve SCPs and ultimately facilitate cancer survivors' transition to primary care. An interview guide was developed based on the second version of the Theoretical Domains Framework (TDF-2). PCPs participated in semi-structured interviews. Qualitative content analysis was used to develop a codebook to code text into each of the 14 TDF-2 domains. Thematic analysis was also used to generate themes and subthemes. Thirteen PCPs completed the interview and identified the following barriers to SCP use: unfamiliarity with the side effects of cancer treatment (Knowledge), lack of clarity on the roles of different healthcare professionals (Social Professional Role and Identity), follow-up tasks being outside of scope of practice (Social Professional Role and Identity), increased workload, lack of options for psychosocial support for survivors, managing different electronic medical records systems, logistical issues with liaising with oncology (Environmental Context and Resources), and patient factors (Social Influences). PCPs value the information provided in SCPs and found the follow-up guidance provided to be most helpful. However, SCP use could be improved through streamlining methods of communication and collaboration between oncology centres and community-based primary care settings.


Assuntos
Sobreviventes de Câncer , Atenção Primária à Saúde , Sobrevivência , Humanos , Sobreviventes de Câncer/psicologia , Planejamento de Assistência ao Paciente , Ciência da Implementação , Feminino , Neoplasias/terapia , Neoplasias/psicologia , Pessoal de Saúde/psicologia , Masculino
8.
Breast Cancer Res Treat ; 206(3): 483-493, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38856885

RESUMO

PURPOSE: Opportunities exist for patients with metastatic breast cancer (MBC) to engage in shared decision-making (SDM). Presenting patient-reported data, including patient treatment preferences, to oncologists before or during a treatment plan decision may improve patient engagement in treatment decisions. METHODS: This randomized controlled trial evaluated the standard-of-care treatment planning process vs. a novel treatment planning process focused on SDM, which included oncologist review of patient-reported treatment preferences, prior to or during treatment decisions among women with MBC. The primary outcome was patient perception of shared decision-making. Secondary outcomes included patient activation, treatment satisfaction, physician perception of treatment decision-making, and use of treatment plans. RESULTS: Among the 109 evaluable patients from December 2018 to June 2022, 28% were Black and 12% lived in a highly disadvantaged neighborhood. Although not reaching statistical significance, patients in the intervention arm perceived SDM more often than patients in the control arm (63% vs. 59%; Cramer's V = 0.05; OR 1.19; 95% CI 0.55-2.57). Among patients in the intervention arm, 31% were at the highest level of patient activation compared to 19% of those in the control arm (V = 0.18). In 82% of decisions, the oncologist agreed that the patient-reported data helped them engage in SDM. In 45% of decision, they reported changing management due to patient-reported data. CONCLUSIONS: Oncologist engagement in the treatment planning process, with oncologist review of patient-reported data, is a promising approach to improve patient participation in treatment decisions which should be tested in larger studies. TRIAL REGISTRATION: NCT03806738.


Assuntos
Neoplasias da Mama , Tomada de Decisão Compartilhada , Participação do Paciente , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Pessoa de Meia-Idade , Idoso , Relações Médico-Paciente , Preferência do Paciente , Adulto , Planejamento de Assistência ao Paciente
9.
Int J Comput Assist Radiol Surg ; 19(7): 1439-1447, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38869779

RESUMO

PURPOSE: Accurate estimation of reference bony shape models is fundamental for orthognathic surgical planning. Existing methods to derive this model are of two types: one determines the reference model by estimating the deformation field to correct the patient's deformed jaw, often introducing distortions in the predicted reference model; The other derives the reference model using a linear combination of their landmarks/vertices but overlooks the intricate nonlinear relationship between the subjects, compromising the model's precision and quality. METHODS: We have created a self-supervised learning framework to estimate the reference model. The core of this framework is a deep query network, which estimates the similarity scores between the patient's midface and those of the normal subjects in a high-dimensional space. Subsequently, it aggregates high-dimensional features of these subjects and projects these features back to 3D structures, ultimately achieving a patient-specific reference model. RESULTS: Our approach was trained using a dataset of 51 normal subjects and tested on 30 patient subjects to estimate their reference models. Performance assessment against the actual post-operative bone revealed a mean Chamfer distance error of 2.25 mm and an average surface distance error of 2.30 mm across the patient subjects. CONCLUSION: Our proposed method emphasizes the correlation between the patients and the normal subjects in a high-dimensional space, facilitating the generation of the patient-specific reference model. Both qualitative and quantitative results demonstrate its superiority over current state-of-the-art methods in reference model estimation.


Assuntos
Procedimentos Cirúrgicos Ortognáticos , Humanos , Procedimentos Cirúrgicos Ortognáticos/métodos , Imageamento Tridimensional/métodos , Feminino , Masculino , Pontos de Referência Anatômicos , Planejamento de Assistência ao Paciente , Adulto
10.
Soins ; 69(886): 8-12, 2024 Jun.
Artigo em Francês | MEDLINE | ID: mdl-38880599

RESUMO

OMAGE comprehension interviews (CIs) use a card game as a vehicle for active listening. CIs performed by training professionals revealed new information for 92% of patients. CIs seem to be an effective method for building patient-centered management plans, can be used by a wide range of health professionals and as prerequisites for medication reconciliation and patient education.


Assuntos
Assistência Centrada no Paciente , Humanos , Planejamento de Assistência ao Paciente/organização & administração , Entrevistas como Assunto , Compreensão , Educação de Pacientes como Assunto/métodos
11.
Compend Contin Educ Dent ; 45(5): 256-260, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38900465

RESUMO

Obtaining an accurate assessment of the causes of severe dental destruction is crucial when planning a clinical workflow for full-mouth rehabilitation cases. Some cases that initially appear extremely challenging may be surprisingly straightforward, especially if the patient presents with an acceptable functional occlusion. In the seemingly highly complex case presented, only a Lucia jig was required to obtain a reliable restorative reference point for the full-mouth rehabilitation. Increasing the vertical dimension of occlusion allowed for predictable restoration of function and esthetics. The treatment was completed in phases for patient comfort, and the final outcome provided the patient with regained confidence in his smile and comfort when eating.


Assuntos
Planejamento de Assistência ao Paciente , Humanos , Masculino , Estética Dentária , Reabilitação Bucal/métodos , Pessoa de Meia-Idade
12.
Sci Rep ; 14(1): 13888, 2024 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-38880802

RESUMO

Recent studies have shown that dental implants have high long-term survival rates, indicating their effectiveness compared to other treatments. However, there is still a concern regarding treatment failure. Deep learning methods, specifically U-Net models, have been effectively applied to analyze medical and dental images. This study aims to utilize U-Net models to segment bone in regions where teeth are missing in cone-beam computerized tomography (CBCT) scans and predict the positions of implants. The proposed models were applied to a CBCT dataset of Taibah University Dental Hospital (TUDH) patients between 2018 and 2023. They were evaluated using different performance metrics and validated by a domain expert. The experimental results demonstrated outstanding performance in terms of dice, precision, and recall for bone segmentation (0.93, 0.94, and 0.93, respectively) with a low volume error (0.01). The proposed models offer promising automated dental implant planning for dental implantologists.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Aprendizado Profundo , Implantes Dentários , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Imageamento Tridimensional/métodos , Implantação Dentária/métodos , Planejamento de Assistência ao Paciente , Perda de Dente/diagnóstico por imagem
13.
Compend Contin Educ Dent ; 45(6): 288-293; quiz 294, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38900444

RESUMO

A comprehensive understanding of the factors that influence treatment outcomes is crucial in endodontic diagnosis and treatment planning. Having knowledge that takes into account dental and patient-related conditions when choosing procedures can help clinicians maximize the prognosis of natural teeth and reduce postoperative complications. That being said, the landscape of outcome studies in endodontics is continually evolving, presenting a challenge for many clinicians trying to stay current with the latest literature. This article reviews factors that influence the outcomes of the following endodontic therapies: primary root canal treatment, nonsurgical retreatment, and surgical retreatment. An emphasis is placed on the importance of considering preoperative and treatment-related factors as prognostic indicators before developing a treatment plan, with the ultimate goal of enhancing tooth durability and ensuring patient satisfaction.


Assuntos
Planejamento de Assistência ao Paciente , Tratamento do Canal Radicular , Humanos , Tratamento do Canal Radicular/métodos , Retratamento , Endodontia/métodos , Resultado do Tratamento , Odontologia Baseada em Evidências
14.
J Dent ; 147: 105146, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38914182

RESUMO

OBJECTIVES: To assess quality, clinical acceptance, time-efficiency, and consistency of a novel artificial intelligence (AI)-driven tool for automated presurgical implant planning for single tooth replacement, compared to a human intelligence (HI)-based approach. MATERIALS AND METHODS: To validate a novel AI-driven implant placement tool, a dataset of 10 time-matching cone beam computed tomography (CBCT) scans and intra-oral scans (IOS) previously acquired for single mandibular molar/premolar implant placement was included. An AI pre-trained model for implant planning was compared to human expert-based planning, followed by the export, evaluation and comparison of two generic implants-AI-generated and human-generated-for each case. The quality of both approaches was assessed by 12 calibrated dentists through blinded observations using a visual analogue scale (VAS), while clinical acceptance was evaluated through an AI versus HI battle (Turing test). Subsequently, time efficiency and consistency were evaluated and compared between both planning methods. RESULTS: Overall, 360 observations were gathered, with 240 dedicated to VAS, of which 95 % (AI) and 96 % (HI) required no major, clinically relevant corrections. In the AI versus HI Turing test (120 observations), 4 cases had matching judgments for AI and HI, with AI favoured in 3 and HI in 3. Additionally, AI completed planning more than twice as fast as HI, taking only 198 ± 33 s compared to 435 ± 92 s (p < 0.05). Furthermore, AI demonstrated higher consistency with zero-degree median surface deviation (MSD) compared to HI (MSD=0.3 ± 0.17 mm). CONCLUSION: AI demonstrated expert-quality and clinically acceptable single-implant planning, proving to be more time-efficient and consistent than the HI-based approach. CLINICAL SIGNIFICANCE: Presurgical implant planning often requires multidisciplinary collaboration between highly experienced specialists, which can be complex, cumbersome and time-consuming. However, AI-driven implant planning has the potential to allow clinically acceptable planning, significantly more time-efficient and consistent than the human expert.


Assuntos
Inteligência Artificial , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea , Planejamento de Assistência ao Paciente , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Implantação Dentária Endóssea/métodos , Cirurgia Assistida por Computador/métodos , Mandíbula/diagnóstico por imagem , Implantes Dentários para Um Único Dente , Interface Usuário-Computador , Dente Molar/diagnóstico por imagem
15.
Br Dent J ; 236(11): 872-875, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38877247

RESUMO

The Dental Practicality Index (DPI) has been designed to describe, on a clinical level, the 'practicality' of restoring a tooth versus referring to secondary care or extraction.The systematic approach of DPI has been shown to improve decision-making and confidence in treatment planning when used by young dentists. In addition, there is good evidence demonstrating that it provides an accurate estimation of the outcome of treatment. The DPI enhances clinician-patient communication and ultimately the consent process.


Assuntos
Planejamento de Assistência ao Paciente , Humanos , Extração Dentária , Relações Dentista-Paciente
16.
Br Dent J ; 236(11): 911-915, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38877263

RESUMO

This paper researches the history of treatment planning for extraction of the first permanent molars and the early influence of American orthodontists on dental practice in the UK. It also discusses the development of clinical guidelines for the enforced extraction of first permanent molars to the present day.


Assuntos
Dente Molar , Extração Dentária , Humanos , Reino Unido , Extração Dentária/história , Dente Molar/cirurgia , História do Século XX , Planejamento de Assistência ao Paciente , História do Século XIX , História do Século XXI , Estados Unidos
17.
J Nurs Care Qual ; 39(3): 206-211, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38701406

RESUMO

BACKGROUND: With the rapidly advancing technological landscape of health care, evaluating the potential use of artificial intelligence (AI) models to prepare nursing care plans is of great importance. PURPOSE: The purpose of this study was to evaluate the quality of nursing care plans created by AI for the management of postpartum hemorrhage (PPH). METHODS: This cross-sectional exploratory study involved creating a scenario for an imaginary patient with PPH. Information was put into 3 AI platforms (GPT-4, LaMDA, Med-PaLM) on consecutive days without prior conversation. Care plans were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale. RESULTS: Med-PaLM exhibited superior quality in developing the care plan compared with LaMDA ( Z = 4.354; P = .000) and GPT-4 ( Z = 3.126; P = .029). CONCLUSIONS: Our findings suggest that despite the strong performance of Med-PaLM, AI, in its current state, is unsuitable for use with real patients.


Assuntos
Inteligência Artificial , Planejamento de Assistência ao Paciente , Hemorragia Pós-Parto , Humanos , Estudos Transversais , Feminino , Hemorragia Pós-Parto/enfermagem , Qualidade da Assistência à Saúde/normas , Adulto , Gravidez
18.
Eur J Orthod ; 46(3)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38700388

RESUMO

BACKGROUND: Magnetic resonance imaging (MRI) is a non-ionizing imaging technique. Using MRI in dentistry may potentially lower the general radiation dose of the examined population, provided MRI can replace various radiation-based images. Furthermore, novel MRI imaging modalities for three-dimensional and two-dimensional cephalometrics have recently been developed for orthodontic diagnosis. OBJECTIVES: This systematic review aimed to determine the diagnostic accuracy and reliability of MRI in orthodontic diagnosis and treatment planning. SEARCH METHODS: An electronic search was conducted on 20 November 2022 in the following databases: PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane. The search was updated on 30 August 2023. Furthermore, a grey literature search was performed in Google Scholar and Open-Grey. SELECTION CRITERIA: This review included descriptive, observational, cohort studies, cross-sectional, case-control studies, and randomized/non-randomized trials related to the research question. The study excluded studies related to patients with syndromes, chronic diseases, craniofacial anomalies, or bone diseases. DATA COLLECTION AND ANALYSIS: The included studies were quality assessed using the "Joanna Brigg's Critical Appraisal Tool for diagnostic test accuracy". The GRADE approach for non-randomized studies was used for strength-of-evidence analysis. RESULTS: Eight of the 10 included studies compared MRI with either cone beam computed tomography or lateral cephalogram and found a high intra- and inter-rater agreement for landmark identification. The risk of bias was high in four studies, moderate in three, and low in three studies. Homogeneity was lacking among the included studies in terms of MRI imaging parameters and sample characteristics. This should be taken into consideration by future studies where uniformity with respect to these parameters may be considered. CONCLUSIONS: Despite dissimilarity and heterogeneity in the sample population and other methodological aspects, all the included studies concluded that MRI enjoyed considerable intra- and inter-examiner reliability and was comparable to current diagnostic standards in orthodontics. Furthermore, the studies agreed on the innovative potential of MRI in radiation-free diagnosis and treatment planning in orthodontics in the future. REGISTRATION: CRD number: CRD420223XXXXX.


Assuntos
Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Reprodutibilidade dos Testes , Planejamento de Assistência ao Paciente , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Cefalometria/métodos , Ortodontia/métodos
19.
BMC Prim Care ; 25(1): 187, 2024 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-38796442

RESUMO

BACKGROUND: Community Paramedicine (CP) is an emerging model of care addressing health problems through non-emergency services. Little evidence exists examining the integration of an app for improved patient, CP, and family physician (FP) communication. This study investigated FP perspectives on the impact of the Community Paramedicine at Clinic (CP@clinic) program on providing patient care and the feasibility and value of a novel "My Care Plan App" (myCP app). METHODS: This retrospective mixed-methods study included an online survey and phone interviews to elucidate FPs ' perspectives on the CP@clinic program and the myCP app, respectively, between January 2021 and May 2021. FPs with patients in the CP@clinic program were recruited to participate. Survey responses were summarized using descriptive statistics, and audio recordings from the interviews thematically analyzed. RESULTS: Thirty-eight FPs completed the survey and 10 FPs completed the phone interviews. 60.5% and 52.6% of FPs reported that the CP@clinic program improved their ability to further screen and diagnose patients for hypertension, respectively (in addition to their regular screening practices). The themes that emerged in the phone interviews were grouped into three topics: app benefits, drawbacks, and integration within practice. Overall, FPs described the myCP app as user-friendly and useful to improve interprofessional communication with CPs. CONCLUSIONS: CP@clinic helped family physicians to screen and monitor chronic disease. The myCP app can impact health service delivery by closing the gap between primary, community, and emergency care through an eHealth information-sharing platform.


Assuntos
Aplicativos Móveis , Humanos , Masculino , Estudos Retrospectivos , Feminino , Idoso , Atitude do Pessoal de Saúde , Pessoa de Meia-Idade , Serviços de Saúde Comunitária/organização & administração , Médicos de Família/psicologia , Planejamento de Assistência ao Paciente/organização & administração , Adulto , Paramedicina
20.
BMC Oral Health ; 24(1): 616, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802759

RESUMO

OBJECTIVES: The aim of our study is to compare the relationship between hand-wrist and cervical vertebra maturation stages with chronological age and to investigate the effect of malocclusion type on the relationship between these methods. MATERIALS AND METHODS: Hand-wrist and cephalometric radiographs of 1000 patients (526 females, 474 males) with a mean age of 13.41 ± 1.83 were analyzed. The methods of Bacetti et al. were used for the cervical vertebra maturation stage, and Björk, Grave and Brown's methods were used for the hand-wrist maturation stage. One-way ANOVA test was applied to compare skeletal classes between them. Tukey post hoc test was used to determine the differences. The relationship between the malocclusion type, cervical vertebra and hand-wrist maturation stages was evaluated with the Spearman correlation test. RESULTS: Spearman's correlation coefficient was 0.831, 0.831 and 0.760 in Class I, II and III females, respectively. In males, it was calculated as 0.844, 0.889 and 0.906, respectively. When sex and malocclusion were not differentiated, the correlation was found to be 0.887. All were statistically significant (P < 0.001). The highest correlation was observed in class III males, while the lowest was found in class III females. CONCLUSION: Cervical vertebrae can be used safely to assess pubertal spurt without hand-wrist radiography. Diagnosing growth and development stages from cephalometric images is important in reducing additional workload and preventing radiation risk.


Assuntos
Determinação da Idade pelo Esqueleto , Cefalometria , Vértebras Cervicais , Má Oclusão , Humanos , Masculino , Feminino , Vértebras Cervicais/diagnóstico por imagem , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Criança , Má Oclusão/diagnóstico por imagem , Má Oclusão Classe I de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/diagnóstico por imagem , Fatores Sexuais , Má Oclusão Classe II de Angle/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Ossos da Mão/diagnóstico por imagem , Ossos da Mão/crescimento & desenvolvimento , Fatores Etários
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