RESUMEN
AIM: To evaluate the impact of acquisition protocols and artifact reduction filters in cone beam computed tomography on diagnosing vertical root fractures in endodontically treated teeth with and without intraradicular posts. MATERIALS AND METHODS: We analyzed 480 tomographic images acquired from two J. Morita scanners (0.125- and 0.08-mm voxel sizes protocols), with application of a blooming artifact reduction filter. Three evaluators assessed these images for root fractures using a 5-point Likert scale. Diagnostic accuracy between filters and protocols was determined using generalized linear models with binomial distribution for the outcome, considering protocol, filter, and dental status. Sensitivity, specificity, positive predictive value, and negative predictive value were also estimated for the filters and protocols. RESULTS: The 0.08-mm voxel size protocol demonstrated a significantly higher percentage of accurate diagnosis compared to the 0.125-mm protocol (p = .001). No statistically significant differences (p ≥ .087) were observed for filter application, interaction between protocol and filter, or dental status. Accuracy, sensitivity, and specificity values were respectively: .93, .87, 1.00 (protocol 1); .99, .99, .99 (protocol 2); .98, .96, .99 (no filter); .95, .90, 1.00 (with filter). CONCLUSION: The new findings found for the two J Morita scanners used in our study were that images acquired using the voxel size of 0.08 mm showed an improvement in the diagnosis of root fractures and the filters in these devices have no relevance significant for the diagnosis.
RESUMEN
Mastery of interpretation of radiographic images is a contributing factor in correct diagnosis of conditions affecting the dentoalveolar apparatus. It is therefore essential that students' perfect these skills while studying for their degrees. Once they embark upon their professional careers outside of the university setting, it is expected that the theoretical knowledge and clinical experience accumulated during the course of their studies will have led to improved diagnostic performance. Objective: The objective of this study was to evaluate diagnoses made using intraoral radiographs by undergraduate students at a School of Dentistry in the South of Brazil, before and after their introduction to clinical practice. Materials and methods: Diagnoses made during the second (T0) and fourth (T1) years of the undergraduate course in dentistry using interproximal and periapical radiographs were analyzed. Descriptive statistics were calculated and the McNemar test was used to compare answers at T0 and T1. Results: Fifteen students answered questionnaires at both T0 and T1. The overall percentage of correct answers was 70.5% at T0 and 61.6% at T1, with a significant difference (p = 0.024). Discussion: This study highlights the need for educational strategies that improve diagnostic competence during undergraduate clinical activities, since radiographic examinations are essential in all areas of dentistry. Conclusions: Therefore, it was concluded that the rate of correct diagnosis of dentoalveolar disorders by intraoral radiography decreased significantly after the initial years of clinical training. (AU)
Introdução: O domínio da interpretação radiográfica contribui para o correto diagnóstico de alterações do complexo dento-alveolar, e seu aprimoramento durante o período da graduação é essencial. No momento em que se inicia a carreira profissional fora da faculdade, é esperado que o conhecimento teórico adquirido, associado à experiência clínica durante a graduação, melhore a performance diagnóstica do dentista. Objetivo: Esse estudo objetivou avaliar diagnósticos feitos a partir de exames radiográficos intrabucais, realizados por alunos de graduação de uma faculdade de odontologia do sul do Brasil, antes e após a sua introdução na prática clínica. Materiais e métodos: Para tal, diagnósticos de radiografias interproximais e periapicais, feitos durantes o Segundo ano (T0) e Quarto ano (T1) do curso de graduação, foram avaliados. Uma análise descritiva foi expressa e o teste de McNemar foi realizado para comparar as respostas em T0 e T1. Resultados: Quinze alunos completaram os dois questionários. De uma forma geral, a porcentagem de respostas corretas em T0 foi de 70.5%, e em T1 foi de 61.6%, com uma diferença significativa entre elas (p = 0.024). Discussão: Este estudo salienta a necessidade de estratégias educacionais que melhorem a competência diagnóstica durante as atividades clínicas da graduação, uma vez que exames radiográficos são essenciais em todas as áreas da odontologia. Conclusão: Neste estudo, o correto diagnóstico de alterações dentoalveolares a partir de radiografias intraorais apresentou um redução significativa após os primeiros anos de prática clínica. (AU)