RESUMO
AIMS: Studies have shown that inappropriate therapeutic strategies may be adopted if crown and root changes are misdiagnosed, potentially leading to undesirable consequences. Therefore, the aim of this study was to evaluate a digital learning object, developed to improve skills in diagnosing radiographic dental changes. MATERIALS AND METHODS: The object was developed using the Visual Basic Application (VBA) software and evaluated by 62 undergraduate students (male: 24 and female: 38) taking an imaging diagnosis course. Participants were divided in two groups: test group, which used the object and control group, which attended conventional classes. After 3 weeks, students answered a 10-question test and took a practice test to diagnose 20 changes in periapical radiographs. RESULTS: The results show that test group performed better that control group in both tests, with statistically significant difference (P = 0.004 and 0.003, respectively). In overall, female students were better than male students. Specific aspects of object usability were assessed using a structured questionnaire based on the System Usability Scale (SUS), with a score of 90.5 and 81.6 by male and female students, respectively. CONCLUSIONS: The results obtained in this study suggest that students who used the DLO performed better than those who used conventional methods. This suggests that the DLO may be a useful teaching tool for dentistry undergraduates, on distance learning courses and as a complementary tool in face-to-face teaching.
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Instrução por Computador/métodos , Educação em Odontologia/métodos , Radiografia Dentária , Avaliação Educacional , Feminino , Humanos , Masculino , Radiologia/educação , SoftwareRESUMO
AIM: To examine the influence of the field of view (FOV) and voxel size on the measurement of the volume of simulated internal root resorption (IRR) lesions through cone-beam computed tomography (CBCT). METHODOLOGY: Eleven single-rooted teeth with IRR simulated by acid demineralization were studied. CBCT images were acquired using large FOV (voxel sizes of 0.200, 0.250 and 0.300 mm) and limited FOV (voxel sizes of 0.076, 0.100 and 0.200 mm). The IRR volumes were calculated using the Dolphin(®) software. Volumetric measurements were validated using IRR silicone putty casts. The analysis of variance (anova) for randomized block design complemented with the Tukey's test was employed. RESULTS: IRR volumes obtained using voxel sizes of 0.200 and 0.250 mm were similar (P > 0.05). However, both these values were significantly different from that obtained using the 0.300-mm voxel (P < 0.05). There was no significant difference between IRR volumes measured through voxel sizes of 0.076 and 0.100 mm (P > 0.05), but both differed significantly from that obtained through the 0.200-mm voxel (P < 0.05). There was no significant difference between the volumetric measurements of the 0.200-mm voxel images of the restricted and large FOV protocols. The mean volumes of the silicone casts were smaller than those calculated using a 0.200-mm voxel, but were similar to those obtained using voxel sizes of 0.076 and 0.300 mm. CONCLUSIONS: Despite the FOV protocol, voxel size can influence measurement of simulated IRR volumes. The importance of standardization of CBCT image acquisition protocols is emphasized, especially during follow-up of an IRR lesion, to prevent misinterpretation of its extent, which can create a bias in clinical decisions.
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Tomografia Computadorizada de Feixe Cônico , Reabsorção da Raiz/diagnóstico por imagem , Humanos , Técnicas In Vitro , Interpretação de Imagem Radiográfica Assistida por Computador , SoftwareRESUMO
AIM: To compare detection of the second mesiobuccal (MB2) canal in maxillary molar teeth using cone-beam computed tomography (CBCT) with different voxel sizes against conventional radiographic examination when the MB1 was unprepared, prepared and filled. METHODOLOGY: Radiographic examination and 0.2-, 0.25- and 0.3-mm CBCT (n = 89) were performed in 3 stages: S1, no first mesiobuccal (MB1) canal preparation or filling; S2, after MB1 preparation and filling; and S3, after MB1 root canal filling removal and canal repreparation. Images were analysed using the i-Cat software. After RE and CBCT acquisition in S3, all the samples were clarified to directly visualize the presence of the MB2 canal. All images were analysed by a blinded, previously calibrated examiner. Accuracy, specificity and sensitivity were compared using analysis of variance (P < 0.05 level of significance). RESULTS: MB2 root canals were detected in 67% of the samples. Overall, radiographic examination was associated with lower mean accuracy values for detecting MB2 than CBCT regardless of the MB1 condition. The MB1 root canal condition did not influence MB2 detection in 0.2-mm voxel images. The presence of root fillings in the MB1 canals reduced the detection of MB2 canals, especially in the 0.3- and 0.25-mm voxel-size images (P < 0.05). CONCLUSION: CBCT was associated with higher mean values of specificity and sensibility than radiographic examination for the detection of MB2 canals. When endodontic retreatment is necessary removal of the root filling prior to the CBCT examination eliminates artefacts, thereby permitting the use of the 0.3-mm voxel protocol that has good diagnostic performance and lower radiation dose.
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Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Cavidade Pulpar/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Materiais Restauradores do Canal Radicular/química , Artefatos , Humanos , Intensificação de Imagem Radiográfica , Preparo de Canal Radicular/métodos , Sensibilidade e Especificidade , Software , Ápice Dentário/diagnóstico por imagemRESUMO
AIM: This was to evaluate the CEJ-ABC distance in sound and unsound deciduous teeth, according to subject's age and the presence of caries. STUDY DESIGN: cross-sectional study. The study sample comprised 334 radiographs, the teeth were divided in two groups, according to the interproximal surface characteristics. The distal surface of the mandibular first deciduous molar and/or the mesial surface of the second mandibular deciduous molar were analysed. RESULTS: The average for the CEJ-ABC distance in the distal surface of the mandibular first molar was different between sound and carious teeth. The same behaviour was observed in the mesial surface of the mandibular second molar. Both the presence of lesion on the interproximal surface and the subject age exherted influence over the mean CEJ- ABC distance. No interaction between these factors was statistically observed. STATISTICS: data were analyzed with SPSS. Two- way ANOVA was used to assess the distance of CEJ-ABC considering the interproximal surface status and age. CONCLUSION: Although the observation that both the interproximal surface status and the age had influence on the CEJ- ABC distance values, in the present study the interaction between these variables was not a determinant for the increase CEJ- ABC distances.
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Processo Alveolar/diagnóstico por imagem , Cárie Dentária/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Dente Decíduo/diagnóstico por imagem , Fatores Etários , Perda do Osso Alveolar/diagnóstico por imagem , Criança , Pré-Escolar , Estudos Transversais , Esmalte Dentário/diagnóstico por imagem , Dentina/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Radiografia Interproximal , Radiografia Dentária Digital , Colo do Dente/diagnóstico por imagemRESUMO
OBJECTIVES: The aim of this study was to compare cephalometric measurements obtained from conventional cephalograms with total and half-skull synthesized cone beam CT (CBCT) cephalograms. METHODS: Cephalometric analyses of 30 clinically symmetric patients were conducted by a calibrated examiner on conventional and CBCT-synthesized cephalograms (total, right and left). Reproducibility was investigated using the intraclass correlation coefficient (ICC). The Bland-Altman analysis was used to assess the agreement of the measurements from each factor obtained by conventional, total, right and left CBCT-synthesized cephalograms. RESULTS: The ICC was above 0.9 for most of the 40 cephalometric factors analysed, revealing similar levels of reproducibility. When the measurements obtained from conventional and CBCT-synthesized cephalograms were compared, the Bland-Altman analysis showed a strong agreement between them. CONCLUSIONS: Half-skull CBCT-synthesized cephalograms offer the same diagnostic performance and equivalent reproducibility in terms of cephalometric analysis as observed in conventional and total CBCT-synthesized cephalograms.
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Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico , Adolescente , Feminino , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: The validity of any measurement obtained through a cephalogram largely depends on the reproducibility of the cephalometric landmarks. The purpose of this study is to evaluate the influence of a programme of professional calibration (PPC) on the variability of landmark identification comparing conventional radiographs and cone beam CT (CBCT)-synthesized cephalograms. METHODS: 5 graduate students in oral radiology identified 20 cephalometric landmarks from cephalograms generated from conventional radiographs (RADs), Ray-Sum CBCT-synthesized cephalograms (CBTs) and half-skull CBT (HSTs) from 10 patients. After a period of reinforcement on instruction and calibration with inter- and intraexaminer assessment of reproducibility (intraclass coefficient correlation scores > 0.75) for RADs, CBTs and HSTs obtained from 5 different patients, observers were asked to repeat the analysis of the first 10 patients under the same circumstances. Values in millimetres represented each landmark in a table of Cartesian co-ordinates (x- and y-axes). RESULTS: ANOVA showed significant reduction in variability levels after the PPC, and there were no differences among the methods of image acquisition. Repeated measures ANOVA indicated that the PPC accounted for reduction in variability levels in 14 of 20 landmarks. CONCLUSIONS: The results suggest that a PPC has more influence than the type of image acquisition on variability of landmark identification based on two-dimensional cephalometric analysis. Cephalograms obtained from RAD or CBCT can be considered equivalent for clinical and experimental applications.
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Cefalometria/métodos , Cefalometria/normas , Tomografia Computadorizada de Feixe Cônico , Radiologia/educação , Análise de Variância , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: The aim was to determine the intra- and interexaminer reproducibility in the interpretation of MRI of the temporomandibular joint among independent observers, with respect to six specific articular characteristics, and to discover which of these had greater and lesser agreement. METHODS: 30 magnetic resonance examinations of temporomandibular joints of adults were independently interpreted by 9 experienced and trained observers at 2 different times. Observers were divided into three groups according to their specialties: surgeon dentists specialized in temporomandibular dysfunction and orofacial pain, surgeon dentists specialized in radiology and medical doctors specialized in radiology. The reproducibility analysis was carried out using Cohen's kappa coefficient. RESULTS: The interexaminer reproducibility ranged from slight to fair. The intraexaminer reproducibility ranged from slight to no agreement. In the interexaminer evaluation, anterior disc displacement without reduction presented greater agreement, whereas change in condylar head shape showed the poorest agreement. In the intraexaminer evaluation, anterior disc displacement without reduction presented slight agreement, whereas, for the other characteristics, no agreement was observed. CONCLUSION: Examiners do not demonstrate reproducibility in the interpretation of MRI of temporomandibular joints. Therefore, more efforts are necessary with respect to understanding the changes that may be detected in these images in terms of diagnosis and appropriate treatment approaches.
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Imageamento por Ressonância Magnética/métodos , Transtornos da Articulação Temporomandibular/diagnóstico , Adulto , Competência Clínica , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: The aim of this study was to evaluate the diagnostic ability of CT to detect simulated external root resorption defects. METHODS: External root resorption defects of different sizes and in different locations were simulated in 59 human mandibular incisors. Cavities simulating root resorption defects of 0.6 mm, 1.2 mm, or 1.8 mm in diameter and 0.3 mm, 0.6 mm, or 0.9 mm in depth (small, medium and large defects) were drilled in the cervical, middle and apical thirds of buccal surfaces. Axial CT was used to obtain cross-sectional images of the teeth, and 177 root thirds were assessed by a blinded observer. RESULTS: Of the 131 cavities, 117 were detected (89%). 32 of the 44 (72.72%) cavities located in the apical third were identified. A statistically significant difference (P<0.01) was found between the sizes of defects examined in the apical third. CONCLUSIONS: The evaluation of CT diagnostic ability revealed high sensitivity and excellent specificity. However, small cavities located in the apical third were more difficult to detect than all other cavities.