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This study analyzed the impact of CBCT on the level of confidence in diagnostic and treatment thinking in mandibular lower molar (M3M) clinical management. Thirty cases for which panoramic radiographs and CBTC images were available were selected and classified according to radiologic signs indicating the proximity of the M3M to the mandibular canal (interruption of the radiopaque borders of the canal of the mandibular canal wall, darkening of the roots, and diversion or narrowing of the canal, n = 10 for each classification). Twelve oral and maxillofacial surgeons (OMS) contributed to this study by answering two questionnaires. The first questionnaire contained a clinical description of the case and a panoramic radiograph. After 30 days, a second questionnaire with the same clinical illustrations and tomographic multiplanar reconstruction images was administered. Both questionnaires asked specialists to rate diagnostic confidence, the surgical complexity, chosen treatment, and surgical confidence. In approximately 40% of answers, CBCT images had a positive impact on ratings of diagnostic confidence and treatment thinking confidence, and in 24.4%, they increased the surgical complexity score. There was no change in the treatment plan following the use of CBCT, but the CBCT examination was a determining factor for diagnosis and treatment planning in 72.8% of the answers CBCT improved the confidence level in diagnostic and treatment thinking of the M3M management while also increasing the perceived level of surgical complexity. The findings of this study support the need to consider using CBCT in diagnosis and treatment planning for M3Ms with radiographic signs such as darkening of the roots, interruption of the radiopaque borders of the mandibular canal, or deviation of the mandibular canal and narrowing of the roots.

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Purpose: The purpose of this study was to compare volume measurements obtained using 2 image software packages on Digital Imaging and Communications in Medicine (DICOM) images acquired from 1 multidetector computed tomography and 5 cone-beam computed tomography devices, using different protocols for physical volume measurements. Materials and Methods: Four pieces of bovine leg were prepared. Marrow was removed from 3 pieces, leaving cortical bone exposed. The resulting space of 1 piece was filled with water, another was filled with propylene glycol, and the third was left unfilled. The marrow in the fourth sample was left fully intact. Volume measurements were obtained after importing DICOM images into the Dolphin Imaging 11.95 and ITK-SNAP software programs. Data were analyzed using 3-way analysis of variance with a generalized linear model to determine the effects of voxel size, software, and content on percentage mean volume differences between tomographic protocols. A significance level of 0.05 was used. Results: The intraclass correlation coefficients for intraobserver and interobserver reliability were, respectively, 0.915 and 0.764 for the Dolphin software and 0.894 and 0.766 for the ITK-SNAP software. Three sources of statistically significant variation were identified: the interaction between software and content (P=0.001), the main effect of content (P=0.014), and the main effect of software (P=0.001). Voxel size was not associated with statistically significant differences in volume measurements. Conclusion: Both content and software influenced the accuracy of volume measurements, especially when the content had gray values similar to those of the adjacent tissues.

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Abstract This study analyzed the impact of CBCT on the level of confidence in diagnostic and treatment thinking in mandibular lower molar (M3M) clinical management. Thirty cases for which panoramic radiographs and CBTC images were available were selected and classified according to radiologic signs indicating the proximity of the M3M to the mandibular canal (interruption of the radiopaque borders of the canal of the mandibular canal wall, darkening of the roots, and diversion or narrowing of the canal, n = 10 for each classification). Twelve oral and maxillofacial surgeons (OMS) contributed to this study by answering two questionnaires. The first questionnaire contained a clinical description of the case and a panoramic radiograph. After 30 days, a second questionnaire with the same clinical illustrations and tomographic multiplanar reconstruction images was administered. Both questionnaires asked specialists to rate diagnostic confidence, the surgical complexity, chosen treatment, and surgical confidence. In approximately 40% of answers, CBCT images had a positive impact on ratings of diagnostic confidence and treatment thinking confidence, and in 24.4%, they increased the surgical complexity score. There was no change in the treatment plan following the use of CBCT, but the CBCT examination was a determining factor for diagnosis and treatment planning in 72.8% of the answers CBCT improved the confidence level in diagnostic and treatment thinking of the M3M management while also increasing the perceived level of surgical complexity. The findings of this study support the need to consider using CBCT in diagnosis and treatment planning for M3Ms with radiographic signs such as darkening of the roots, interruption of the radiopaque borders of the mandibular canal, or deviation of the mandibular canal and narrowing of the roots.

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This study comparedtwo teaching pedagogies to addressmedical emergencies in dental officevisitsandevaluateddental school students' knowledge about medical emergencies.This randomized controlled trial involved54senior undergraduate dental students at theFederal University of Santa Mariadivided in two groups:students who received instruction via face-to-face traditional expository class;andstudents whoreceived the same instruction via distant learning format.The students were randomly allocated to the groupsby the randomiser.orgwebsite. Data were obtained by comparing the scores students received from answering to a semi-structured questionnaire containing inquiries on ethical and legal implications, and diagnosis and management of medicalemergencies in a dental officebefore and after the instruction. Before the instruction, 96%of studentsfrom the two groupslackedknowledge about the ethical and legal implications related to the dentist obligation to deal with medical emergencies. After the instruction, both groups increasedtheir knowledge similarly as there was no significant difference in the comparison between learning about medical emergencies through lectures and thorough an e-learning format.Both teaching methods presented satisfactory results, which makes the e-learning method an option as a didactic strategy (AU).

Esteestudocomparouduaspedagogiasdeensinoparalidarcomemergênciasmédicasemconsultasodontológicaseavaliouoconhecimentodealunosdocursoodontologiasobreemergênciasmédicas.Esteensaioclínicorandomizadoenvolveu54alunosdoúltimoanodocursodeodontologiadaUniversidadeFederaldeSantaMaria,divididosemdoisgrupos:alunosquereceberaminstruçãopormeiodeaulaexpositivatradicionalpresencial;ealunosquereceberamamesmainstruçãopormeiodoformatodeensinoadistância.Osalunosforamalocadosaleatoriamenteaosgrupospelositerandomiser.org.Osdadosforamobtidospormeiodacomparaçãodaspontuaçõesrecebidaspelosalunosaoresponderaumquestionáriosemiestruturadocontendoindagaçõessobreimplicaçõeséticaselegais,ediagnósticoemanejodeemergênciasmédicasemconsultórioodontológicoanteseapósainstrução.Antesdainstrução,96%dosalunosdosdoisgruposdesconheciamasimplicaçõeséticaselegaisrelacionadasàobrigaçãododentistaemlidarcomemergênciasmédicas.Apósainstrução,os dois grupos aumentaram seus conhecimentos de forma semelhante,poisnãohouvediferençasignificativanacomparaçãoentreoaprendizadosobreemergênciasmédicaspormeiodepalestrasepormeiodoformatoe-learning.Ambososmétodosdeensinoapresentaramresultadossatisfatórios,o que torna o método e-learning uma opção como estratégia didática (AU).

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