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Barros-Costa M, Nascimento EHL, Correia-Dantas IF, Oliveira ML, Freitas DQ. Potential impact of metal crowns at varying distances from a carious lesion on its detection on cone-beam computed tomography scans with several protocols. Imaging Sci Dent 2024; 54:49-56. [PMID: 38571773 PMCID: PMC10985521 DOI: 10.5624/isd.20230202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 04/05/2024] Open
Abstract
Purpose This study evaluated the impact of artifacts generated by metal crowns on the detection of proximal caries lesions in teeth at various distances using cone-beam computed tomography (CBCT). Additionally, the diagnostic impacts of tube current and metal artifact reduction (MAR) were investigated. Materials and Methods Thirty teeth were arranged within 10 phantoms, each containing 1 first premolar, 1 second premolar, and 1 second molar. A sound first molar (for the control group) or a tooth with a metal crown was placed. Of the 60 proximal surfaces evaluated, 15 were sound and 45 exhibited enamel caries. CBCT scans were acquired using an OP300 Maxio unit (Instrumentarium, Tuusula, Finland), while varying the tube current (4, 8, or 12.5 mA) and enabling or disabling MAR. Five observers assessed mesial and distal surfaces using a 5-point scale. Multi-way analysis of variance was employed for data comparison, with P<0.05 indicating statistical significance. Results The area under the curve (AUC) varied from 0.40 to 0.60 (sensitivity: 0.28-0.45, specificity: 0.44-0.80). The diagnostic accuracy was not significantly affected by the presence of a metal crown, milliamperage, or MAR (P>0.05). However, the overall AUC and specificity were significantly lower for surfaces near a crown (P<0.05). Conclusion CBCT-based caries detection was not influenced by the presence of a metal crown, variations in milliamperage, or MAR activation. However, the diagnostic accuracy was low and was further diminished for surfaces near a crown. Consequently, CBCT is not recommended for the detection of incipient caries lesions.
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Affiliation(s)
- Matheus Barros-Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Iago Filipe Correia-Dantas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Matheus L. Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Gaêta-Araujo H, Oliveira-Santos N, de Oliveira Reis L, Nascimento EHL, Oliveira-Santos C. Automatic exposure compensation of digital radiographic technologies does not affect alveolar bone-level measurement. Oral Radiol 2023; 39:53-58. [PMID: 35218461 DOI: 10.1007/s11282-022-00599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/17/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate whether the automatic exposure compensation in the presence of high-density materials can affect the measurement of alveolar bone level. METHODS Thirty regions of seven dry skulls and six mandibles were radiographed with and without a high-density material, using two digital radiographic technologies: photostimulable phosphor plate (PSP, Digora Optime) and sensor (CMOS, Digora Toto), totaling 120 images. The distances from the cement-enamel junction to the alveolar bone crest were measured using cone-beam computed tomography (CBCT) images to represent the reference standard. The same measurements of alveolar bone level and the average of the pixel values of the image were evaluated on the radiographs. Paired t test compared the average pixel values and alveolar bone-level measurements between images with and without high-density material. One-way analysis of variance compared the difference between radiographic and CBCT measurements (α = 0.05). RESULTS The high-density material reduced the pixel values in PSP (p = 0.002) and CMOS (p < 0.001) technologies, demonstrating the AEC functioning in both technologies. There was no difference in bone-level measurements between the images without and with the high-density material for both technologies (p ≥ 0.091), or between the tomographic and radiographic measurements (p ≥ 0.319). CONCLUSION In the presence of high-density material, the automatic exposure compensation reduces the average pixel values of the images (i.e., images get darker), but does not influence the radiographic measurements of alveolar bone level.
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Affiliation(s)
- Hugo Gaêta-Araujo
- Oral Radiology Section, School of Dentistry, Federal University of Alfenas (UNIFAL-MG), Rua Gabriel Monteiro da Silva, 700, Alfenas, MG, 37130-000, Brazil.
| | - Nicolly Oliveira-Santos
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Larissa de Oliveira Reis
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.,Department of Dentistry, Federal University of Juiz de Fora (UFJF-GV), Governador Valadares, MG, Brazil
| | | | - Christiano Oliveira-Santos
- Department of Diagnosis and Oral Health, University of Louisville School of Dentistry, Louisville, KY, USA
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Vitulli I, Fontenele RC, Nascimento EHL, Freitas DQ. Influence of artefacts generated by titanium and zirconium implants in the study of trabecular bone architecture in cone-beam CT images. Dentomaxillofac Radiol 2022; 51:20220066. [PMID: 35466693 PMCID: PMC10043622 DOI: 10.1259/dmfr.20220066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the influence of artefacts generated by titanium and zirconium implants on trabecular bone architecture assessment through cone-beam CT (CBCT). The influence of kilovoltage (kVp) and metal artefact reduction (MAR) in such analysis was also assessed. METHODS CBCT scans were obtained with Picasso Trio with or without a titanium or zirconium implants in a posterior region of a mandible using 70, 80 or 90 kVp, with or without MAR. The other acquisition settings were constant: field of view 8 × 5 cm, voxel size 0.2 mm, 5 mA, 24 s and 720 frames. Two volumes of interest (VOIs) were determined comprising trabecular bone mesial and distal to the implant area. The following morphometric parameters were measured: connectivity density (Conn. Dn.), fractal dimension (FD), bone volume fraction (BV/TV), bone surface density (BS/TV), trabecular thickness (Tb. Th.), and trabecular spacing (Tb. Sp.), and compared by multiway ANOVA (α = 0.05). RESULTS For Conn. Dn. and FD, with MAR, the zirconium group showed values significantly lower than the other groups (p < 0.05). For BV/TV, BS/TV, Tb. Th. and Tb. Sp., the zirconium group showed the highest values, regardless of MAR condition (p < 0.05). MAR increased BS/TV and Tb. Th. values, and decreased FD values for zirconium group. In general, the kVp level did not influence trabecular morphometric parameters. CONCLUSION The assessment of the trabecular bone architecture was mainly influenced by the expression of the artefacts generated by zirconium implants. MAR decreased the FD and increased the BS/TV and Tb.Th. values regardless of the kVp level.
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Affiliation(s)
- Ivana Vitulli
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Maciel ERC, Nascimento EHL, Gaêta-Araujo H, Pontual MLDA, Pontual ADA, Ramos-Perez FMM. Automatic exposure compensation in intraoral digital radiography: effect on the gray values of dental tissues. BMC Med Imaging 2022; 22:4. [PMID: 34983424 PMCID: PMC8728919 DOI: 10.1186/s12880-021-00733-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/28/2021] [Indexed: 01/29/2023] Open
Abstract
Background This study aimed to investigate the effect of automatic exposure compensation (AEC)
of intraoral radiographic systems on the gray values of dental tissues in images acquired with or without high-density material in the exposed region using different exposure times and kilovoltages. The influence of the distance of the high-density material was also investigated. Methods Radiographs from the molar region of two mandibles were obtained using the RVG 6100 and the Express systems, operating at 60 and 70 kV and 0.06, 0.10, and 0.16 s. Subsequently, a titanium implant was inserted in the premolar’s socket and other images were acquired. Using the ImageJ software, two regions of interest were determined on the enamel, coronary dentine, root dentine, and pulp of the first and second molars to obtain their gray values. Results In the RVG 6100, the implant did not affect the gray values (p > 0.05); the increase in kV decreased it in all tissues (p < 0.05), and the exposure time affected only the root dentine and pulp. In the Express, only enamel and coronary dentine values changed (p < 0.05), decreasing with the implant presence and/or with the increase in exposure factors. The distance of the implant did not affect the results (p > 0.05). Conclusions AEC’s performance varies between the radiographic systems. Its effect on the gray values depends not only on the presence or absence of high-density material but also on the kV and exposure time used.
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Affiliation(s)
- Evelyn Rute Carneiro Maciel
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Av. Prof. Artur de Sá, 329-481, Recife, Pernambuco, 52171-011, Brazil
| | - Eduarda Helena Leandro Nascimento
- Division of Oral Radiology, Department of Dentistry, Odontomed Imagem - Medical and Dental Services, Av. Dois Rios, 632, Ibura, Recife, Pernambuco, 51.230-000, Brazil.
| | - Hugo Gaêta-Araujo
- Oral Radiology Area, School of Dentistry, Federal University of Alfenas (UNIFAL-MG), R. Gabriel Monteiro da Silva, 700, Alfenas, Minas Gerais, 37130-001, Brazil
| | - Maria Luiza Dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Av. Prof. Artur de Sá, 329-481, Recife, Pernambuco, 52171-011, Brazil
| | - Andrea Dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Av. Prof. Artur de Sá, 329-481, Recife, Pernambuco, 52171-011, Brazil
| | - Flávia Maria Moraes Ramos-Perez
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Av. Prof. Artur de Sá, 329-481, Recife, Pernambuco, 52171-011, Brazil
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Fontenele RC, Nascimento EHL, Imbelloni-Vasconcelos AC, Martins LAC, Pontual ADA, Ramos-Perez FMM, Freitas DQ. Influence of kilovoltage-peak and the metal artifact reduction tool in cone-beam computed tomography on the detection of bone defects around titanium-zirconia and zirconia implants. Imaging Sci Dent 2022; 52:267-273. [PMID: 36238703 PMCID: PMC9530290 DOI: 10.5624/isd.20220040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/07/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to assess the influence of kilovoltage-peak (kVp) and the metal artifact reduction (MAR) tool on the detection of buccal and lingual peri-implant dehiscence in the presence of titanium-zirconia (Ti-Zr) and zirconia (Zr) implants in cone-beam computed tomography (CBCT) images. Materials and Methods Twenty implant sites were created in the posterior region of human mandibles, including control sites (without dehiscence) and experimental sites (with dehiscence). Individually, a Ti-Zr or Zr implant was placed in each implant site. CBCT scans were performed using a Picasso Trio device, with variation in the kVp setting (70 or 90 kVp) and whether the MAR tool was used. Three oral radiologists scored the detection of dehiscence using a 5-point scale. The area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity were calculated and compared by multi-way analysis of variance (α=0.05). Results The kVp, cortical plate involved (buccal or lingual cortices), and MAR did not influence any diagnostic values (P>0.05). The material of the implant did not influence the ROC curve values (P>0.05). In contrast, the sensitivity and specificity were statistically significantly influenced by the implant material (P<0.05) with Zr implants showing higher sensitivity values and lower specificity values than Ti-Zr implants. Conclusion The detection of peri-implant dehiscence was not influenced by kVp, use of the MAR tool, or the cortical plate. Greater sensitivity and lower specificity were shown for the detection of peri-implant dehiscence in the presence of a Zr implant.
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Affiliation(s)
- Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | | | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Andrea dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, Division of Oral Radiology, Federal University of Pernambuco, Recife, PE, Brazil
| | - Flávia Maria Moraes Ramos-Perez
- Department of Clinical and Preventive Dentistry, Division of Oral Radiology, Federal University of Pernambuco, Recife, PE, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Martins LAC, Nascimento EHL, Gaêta-Araujo H, Oliveira ML, Freitas DQ. Mapping of a multilayer panoramic radiography device. Dentomaxillofac Radiol 2021; 51:20210082. [PMID: 34757830 PMCID: PMC9499199 DOI: 10.1259/dmfr.20210082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To map the shape, location, and thickness of the focal trough of a panoramic radiography device with a multilayer imaging program. METHODS An acrylic plate (148 × 148 × 3 mm) containing 1156 holes distributed in a matrix of 34 × 34 rows was placed in the OP300 Maxio at the levels of the maxilla and mandible. 20 metal spheres (3.5 mm in diameter) were placed on the holes of the plate under 15 different arrangements and panoramic images were acquired for each arrangement at 66 kV, 8 mA, and an exposure time of 16 s. The resulting panoramic radiographs from the five image layers were exported, the horizontal and vertical dimensions of the metal spheres were measured in all images using the Image J software, and the magnification and distortion rates of the spheres were calculated. All metal spheres presenting a magnification rate lower than 30% in both vertical and horizontal dimensions and a distortion rate lower than 10% were considered to map the focal troughs of each of the five image layers. RESULTS All panoramic image layers had a curved shape ranging from 39° to 51° for both dental arches and varied in position and thickness. The anterior region of maxilla was anteriorly displaced when compared to the anterior region of the mandible for all layers. Image layers are thicker at the level of the mandible than those at the level of the maxilla; also, inner layers were thinner and outer layers were thicker. CONCLUSION All image layers in the studied panoramic radiography device had a curved shape and varied in position and thickness. The anterior region of maxilla was anteriorly displaced when compared to that of the mandible for all layers.
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Affiliation(s)
- Luciano Augusto Cano Martins
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | | | - Hugo Gaêta-Araujo
- Oral Radiology Area, School of Dentistry, Federal University of Alfenas (UNIFAL-MG), Alfenas, MG, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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Fontenele RC, Nascimento EHL, Gaêta-Araujo H, Cardelli LODA, Freitas DQ. Which factors related to apical radiolucency may influence its radiographic detection? A study using CBCT as reference standard. Restor Dent Endod 2021; 46:e43. [PMID: 34513649 PMCID: PMC8410997 DOI: 10.5395/rde.2021.46.e43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/06/2021] [Accepted: 02/02/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to evaluate the detection rate of apical radiolucencies in 2-dimensional images using cone-beam computed tomography (CBCT) as the reference standard, and to determine which factors related to the apical radiolucencies and the teeth could influence its detection. Materials and Methods The sample consisted of exams of patients who had panoramic (PAN) and/or periapical (PERI) radiography and CBCT. The exams were assessed by 2 oral radiologists and divided into PAN+CBCT (227 teeth–285 roots) and PERI+CBCT (94 teeth–115 roots). Radiographic images were evaluated for the presence of apical radiolucency, while CBCT images were assessed for presence, size, location, and involvement of the cortical bone (thinning, expansion, and destruction). Diagnostic values were obtained for PERI and PAN. Results PERI and PAN presented high accuracy (0.83 and 0.77, respectively) and specificity (0.89 and 0.91, respectively), but low sensitivity, especially for PAN (0.40 vs. 0.65 of PERI). The size of the apical radiolucency was positively correlated with its detection in PERI and PAN (p < 0.001). For PAN, apical radiolucencies were 3.93 times more frequently detected when related to single-rooted teeth (p = 0.038). The other factors did not influence apical radiolucency detection (p > 0.05). Conclusions PERI presents slightly better accuracy than PAN for the detection of apical radiolucency. The size is the only factor related to radiolucency that influences its detection, for both radiographic exams. For PAN, apical radiolucency is most often detected in single-rooted teeth.
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Affiliation(s)
- Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Hugo Gaêta-Araujo
- Oral Radiology section, School of Dentistry, Federal University of Alfenas, Minas Gerais, Brazil
| | | | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
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Yamasaki MC, Roque-Torres GD, Peroni LV, Nascimento EHL, Salmon B, Oliveira ML, Freitas DQ, Correr-Sobrinho L. Does the administration of meloxicam before head and neck radiotherapy reduce the risk of mandibular osteoradionecrosis? An animal model study. Clin Oral Investig 2021; 25:3739-3745. [PMID: 33387032 DOI: 10.1007/s00784-020-03701-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess whether the administration of meloxicam before head and neck radiotherapy reduces the risk of mandibular osteoradionecrosis in rats. MATERIAL AND METHODS Sixty male Wistar rats were randomly divided into 6 groups (n = 10) according to the meloxicam administration and radiation therapy: control (C), irradiated (I), single dose of meloxicam (M1), single dose of meloxicam and irradiated (M1I), triple dose of meloxicam (M3), triple dose of meloxicam and irradiated (M3I). Meloxicam was administrated (20 mg/kg per dose) 1 h before the radiation therapy (single dose of 20 Gy) and 24 h and 48 h after the radiation therapy for groups with two additional doses. Ten days after the radiation therapy, the three right mandibular molars were extracted from all rats, who were euthanatized after 21 or 35 days (n = 5 per group). The mandibles were assessed by macroscopic evaluation and micro-CT analysis. RESULTS The right hemimandibles of the irradiated groups revealed macroscopic signs of osteoradionecrosis, and those of the non-irradiated groups revealed complete gingival healing. A significant delay in alveolar socket healing in all irradiated groups was observed in the micro-CT assessment regardless meloxicam treatment. CONCLUSION The administration of meloxicam before head and neck radiotherapy does not reduce the risk of mandibular osteoradionecrosis when associated to dental extractions. CLINICAL RELEVANCE Since meloxicam has been shown to be a potential radiation-protective agent, and osteoradionecrosis physiopathology is believed to be related to an inflammatory process, possible interactions are relevant to be investigated.
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Affiliation(s)
- Mayra Cristina Yamasaki
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil.
| | - Gina Delia Roque-Torres
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Leonardo Vieira Peroni
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Benjamin Salmon
- Université de Paris, Orofacial Pathologies, Imaging and Biotherapies UR2496 Lab, F-92120, Montrouge, France.,Dental Medicine Department, AP-HP, Bretonneau hospital, F-75018, Paris, France
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Lourenço Correr-Sobrinho
- Department of Restorative Dentistry, Division of Dental Materials, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Freire BB, Vianna S, Leandro Nascimento EH, Freire M, Chilvarquer I. Guided Endodontic Access in a Calcified Central Incisor: A Conservative Alternative for Endodontic Therapy. Iran Endod J 2021; 16:56-59. [PMID: 36704410 PMCID: PMC9709874 DOI: 10.22037/iej.v16i1.27427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/08/2020] [Accepted: 11/27/2020] [Indexed: 01/29/2023]
Abstract
Guided endodontic access is a promising method to treat teeth with pulp calcification. This report aimed to describe a case of root canal treatment performed through guided endodontic access in a calcified anterior tooth with apical periodontitis. A 23-year-old female with a history of trauma 10 years ago in the anterior maxilla was referred to the dental office. Her chief complaint was discolouration of the left central incisor crown. The tooth was sensitive to percussion and responded negatively to pulp sensitivity tests. The periapical radiography showed pulp calcification and periapical radiolucency. Cone-beam computed tomography (CBCT) was obtained to allow a more detailed view of the pulp canal and the periapical area. An intraoral scan was performed and the standard tessellation language (STL) archive was combined with digital imaging and communications on medicine (DICOM) images from CBCT in the Implant Viewer software. Subsequently, a 3D model was designed and printed to guide the endodontic access in position and appropriate angulation for dental instrumentation. The mold was positioned on the patient's tooth and the root canal treatment was performed. After two years, complete healing of periapical tissues was observed. This method facilitates the drill targeting during access, reducing the risk of deviations and perforations.
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Affiliation(s)
- Bernardo Barbosa Freire
- Department of Oral Diagnosis and Oral Radiology, Division of Oral Radiology, University of São Paulo (USP), São Paulo, Brazil; ,Corresponding author: Bernardo Barbosa Freire, Av. Lineu Prestes, 2227, Zip Code 05508-000, São Paulo, Brazil
| | - Stephane Vianna
- Department of Endodontics, Campos Dental School, University Center Fluminense (UNIFLU), Campos dos Goytacazes, Rio de Janeiro, Brazil;
| | | | - Marcus Freire
- Department Oral Radiology, Oral Radiology Specialized Center (CERO), Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Israel Chilvarquer
- Department of Oral Diagnosis and Oral Radiology, Division of Oral Radiology, University of São Paulo (USP), São Paulo, Brazil;
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Ribas BR, Nascimento EHL, Freitas DQ, Pontual ADA, Pontual MLDA, Perez DEC, Ramos-Perez FMM. Positioning errors of dental implants and their associations with adjacent structures and anatomical variations: A CBCT-based study. Imaging Sci Dent 2020; 50:281-290. [PMID: 33409136 PMCID: PMC7758259 DOI: 10.5624/isd.2020.50.4.281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/26/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose The objective of the present study was to evaluate the prevalence of dental implants positioning errors and their associations with adjacent structures and anatomical variations by means of cone-beam computed tomography (CBCT). Materials and Methods CBCT images of 207 patients (584 dental implants) were evaluated by 2 oral radiologists. The distance between the implant and the adjacent teeth/implants was measured and classified as adequate (≥1.5 mm and ≥3 mm, respectively) or inadequate. The presence of thread exposure, cortical perforation, implant dehiscence, implant penetration into adjacent structures, and anatomical variations was also recorded. The incisor canal diameter and the depth of the concavity of the submandibular fossa were measured in order to evaluate their correlations with the frequency of implant penetration in these structures. Descriptive analyses, the Fisher exact test, and Spearman correlation analysis were performed (α=0.05). Results The overall prevalence of positioning errors was 82.9%. The most common error was the inadequate distance between the implant and the adjacent teeth/implants. The presence of anatomical variations did not significantly influence the overall prevalence of errors (P>0.05). There was a positive correlation between the diameter of the incisor canal and the frequency of implant penetration in this structure (r=0.232, P<0.05). Conclusion There was a high prevalence of dental implant positioning errors, and positioning errors were not associated with the presence of anatomical variations. Professionals should be aware of the space available for implant placement during the preoperative planning stage.
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Affiliation(s)
- Beatriz Ribeiro Ribas
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Andréa Dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Danyel Elias Cruz Perez
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Molez AM, Nascimento EHL, Haiter Neto F, Cirano FR, Pimentel SP, Ribeiro FV, Casati MZ, Corrêa MG. Effect of resveratrol on the progression of experimental periodontitis in an ovariectomized rat model of osteoporosis: Morphometric, immune‐enzymatic, and gene expression analysis. J Periodontal Res 2020; 55:840-849. [DOI: 10.1111/jre.12775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 12/23/2022]
Affiliation(s)
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis Division of Oral Radiology Piracicaba Dental School University of Campinas Piracicaba, São Paulo Brazil
| | - Francisco Haiter Neto
- Department of Oral Diagnosis Division of Oral Radiology Piracicaba Dental School University of Campinas Piracicaba, São Paulo Brazil
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Nascimento EHL, Fontenele RC, Lopes PDA, Santaella GM, Vasconcelos KF, de Freitas DQ, Oenning AC, Groppo FC. Development of a model of soft tissue simulation using ballistic gelatin for CBCT acquisitions related to dentomaxillofacial radiology research. Dentomaxillofac Radiol 2020; 50:20200191. [PMID: 32941781 DOI: 10.1259/dmfr.20200191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To present the ballistic gelatin as a new material capable of simulating the soft tissues in cone-beam CT (CBCT) images. METHODS CBCT images of three piglet heads were acquired with their soft tissues intact (standard group). Subsequently, the piglet heads were fixed in a container using metallic pins and moulded with acrylic resin; the soft tissues were then removed and replaced by ballistic gelatin, with the same thickness of the original soft tissues. The images were evaluated by two oral radiologists, to check the adaptation on bone surfaces, thickness and density, penetration into large bone cavities and cancellous bone, and the presence of air bubbles using a 5-score scale. Additionally, an objective analysis was carried out by one oral radiologist. For each CBCT scan, three axial reconstructions were selected to represent the mandibular, occlusal, and maxillary levels. The mean and standard deviation (SD) of the grey values were calculated in four regions of interest determined on soft tissue areas and compared by two-way ANOVA. RESULTS The ballistic gelatin showed subjective scores ranging from good to excellent for all parameters evaluated. There was no significant difference in the mean and SD values of the grey values between ballistic gelatin and the gold standard groups for all levels (p > 0.05). Higher SD values were observed in the occlusal level for both groups (p < 0.05). CONCLUSIONS Ballistic gelatin has visual and objective similarity with the gold standard. Thus, the ballistic gelatin is a promising material capable of simulating soft tissues in CBCT images.
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Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil.,Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | | | - Priscila de Azeredo Lopes
- Odontoclínica Central da Marinha, Serviço de radiologia e Imaginologia Odontológica, Brazilian Navy, Rio de Janeiro, RJ, Brazil
| | - Gustavo Machado Santaella
- Radiology and Imaging Sciences, Department of Diagnosis and Oral Health, University of Louisville, Lousville, KY, USA
| | - Karla Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Deborah Queiroz de Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, Sao Paulo, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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GalvÃo NS, Nascimento EHL, GaÊta-Araujo H, Freitas DQ, Haiter-Neto F, Oliveira ML. Automatic exposure compensation and subjective image enhancement in the radiographic diagnosis of caries. Braz Oral Res 2020; 34:e082. [PMID: 32785477 DOI: 10.1590/1807-3107bor-2020.vol34.0082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/23/2020] [Indexed: 11/22/2022] Open
Abstract
This study aims to assess the influence of high-density material on the radiographic diagnosis of proximal caries in digital systems with automatic exposure compensation, and to evaluate the effect of subjective adjustment of brightness and contrast to undertake this diagnostic task. Twenty bitewing radiographs of forty posterior human teeth with non-cavitated carious lesions, confirmed by micro-CT, were obtained with two digital systems. A porcelain-fused-to-metal crown attached to a titanium implant was inserted into the exposed area, and all the radiographs were repeated. Five radiologists assessed the radiographs and diagnosed proximal carious lesions. Afterwards, the observers were asked to adjust image brightness and contrast, based on their subjective perception, and to reassess the images. Thirty percent of each experimental group was reassessed to test intraobserver reproducibility, totaling 208 images per observer. Intraobserver and interobserver agreements ranged from fair to substantial. Sensitivity, specificity, predictive values, and area under the ROC curve were calculated and compared for each radiographic system, using ANOVA (α = 0.05). Overall, presence of high-density material and adjustment of brightness and contrast did not significantly influence the radiographic diagnosis of proximal caries (p ≥ 0.05). Regarding Digora Optime, adjustment of brightness and contrast significantly increased (p < 0.05) the diagnostic accuracy of proximal carious lesions in the presence of high-density material. In conclusion, the presence of high-density material in the X-rayed region does not influence radiographic diagnosis of proximal caries. However, when it is present in the X-rayed area, subjective adjustment of brightness and contrast is recommended for use with the Digora Optime digital system.
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Affiliation(s)
- Neiandro Santos GalvÃo
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | | | - Hugo GaÊta-Araujo
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Gaêta-Araujo H, Nascimento EHL, Brasil DM, Madlum DV, Haiter-Neto F, Oliveira-Santos C. Influence of reconstruction parameters of micro-computed tomography on the analysis of bone mineral density. Imaging Sci Dent 2020; 50:153-159. [PMID: 32601590 PMCID: PMC7314611 DOI: 10.5624/isd.2020.50.2.153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/12/2019] [Accepted: 12/30/2019] [Indexed: 12/17/2022] Open
Abstract
Purpose This study was conducted evaluate the influence of reconstruction parameters of micro-computed tomography (micro-CT) images on bone mineral density (BMD) analyses. Materials and Methods The sample consisted of micro-CT images of the maxillae of 5 Wistar rats, acquired using a SkyScan 1174 unit (Bruker, Kontich, Belgium). Each acquisition was reconstructed following the manufacturer's recommendations (standard protocol; SP) for the application of artifact correction tools (beam hardening correction [BHC], 45%; smoothing filter, degree 2; and ring artifact correction [RAC], level 5). Additionally, images were reconstructed with 36 protocols combining different settings of artifact correction tools (P0 to P35). BMD analysis was performed for each reconstructed image. The BMD values obtained for each protocol were compared to those obtained using the SP through repeated-measures analysis of variance with the Dunnett post hoc test (α=0.05). Results The BMD values obtained from all protocols that used a BHC of 45% did not significantly differ from those obtained using the SP (P>0.05). The other protocols all yielded significantly different BMD values from the SP (P<0.05). The smoothing and RAC tools did not affect BMD values. Conclusion BMD values measured on micro-CT images were influenced by the BHC level. Higher levels of BHC induced higher values of BMD.
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Affiliation(s)
- Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Danieli Moura Brasil
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Daniela Verardi Madlum
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health, Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Gaêta-Araujo H, Nascimento EHL, Fontenele RC, Mancini AXM, Freitas DQ, Oliveira-Santos C. Magnitude of beam-hardening artifacts produced by gutta-percha and metal posts on cone-beam computed tomography with varying tube current. Imaging Sci Dent 2020; 50:1-7. [PMID: 32206614 PMCID: PMC7078413 DOI: 10.5624/isd.2020.50.1.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/26/2019] [Accepted: 10/10/2019] [Indexed: 02/01/2023] Open
Abstract
Purpose This study was performed to evaluate the magnitude of artifacts produced by gutta-percha and metal posts on cone-beam computed tomography (CBCT) scans obtained with different tube currents and with or without metal artifact reduction (MAR). Materials and Methods A tooth was inserted in a dry human mandible socket, and CBCT scans were acquired after root canal instrumentation, root canal filling, and metal post placement with various tube currents with and without MAR activation. The artifact magnitude was assessed by the standard deviation (SD) of gray values and the contrast-to-noise ratio (CNR) at the various distances from the tooth. Data were compared using multi-way analysis of variance. Results At all distances, a current of 4 mA was associated with a higher SD and a lower CNR than 8 mA or 10 mA (P<0.05). For the metal posts without MAR, the artifact magnitude as assessed by SD was greatest at 1.5 cm or less (P<0.05). When MAR was applied, SD values for distances 1.5 cm or closer to the tooth were reduced (P<0.05). MAR usage did not influence the magnitude of artifacts in the control and gutta-percha groups (P>0.05). Conclusion Increasing the tube current from 4 mA to 8 mA may reduce the magnitude of artifacts from metal posts. The magnitude of artifacts arising from metal posts was significantly higher at distances of 1.5 cm or less than at greater distances. MAR usage improved image quality near the metal post, but had no significant influence farther than 1.5 cm from the tooth.
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Affiliation(s)
- Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Arthur Xavier Maseti Mancini
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
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Vasconcelos TV, Leandro Nascimento EH, Bechara BB, Freitas DQ, Noujeim M. Influence of Cone Beam Computed Tomography Settings on Implant Artifact Production: Zirconia and Titanium. Int J Oral Maxillofac Implants 2019; 34:1114-1120. [PMID: 31528863 DOI: 10.11607/jomi.7129] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This in vitro study assessed the artifact production related to titanium and zirconia implants in cone beam computed tomography (CBCT) and compared the effect of different protocol settings on image quality for both materials. MATERIALS AND METHODS A titanium implant and a zirconia implant were placed in a dry mandible. CBCT scans were obtained separately for each implant using the ProMax 3D (Planmeca) unit; 20 protocols were tested with varying kilovoltage (70 to 90 kVp) and resolution (high and low), and with and without a metal artifact reduction tool. Standard deviation and contrast-noise ratio were calculated in regions of interest adjacent and distant to the implant. RESULTS The zirconia produced more artifacts and its images were more affected by the different protocols than titanium. High kVps and an activated metal artifact reduction tool decreased the standard deviation values related to both implants. Activation of the metal artifact reduction tool also increased contrast-noise ratio values for both implants, whereas increasing kVp improved them only on titanium images. The standard deviation and contrast-noise ratio were not affected by resolution. CONCLUSION The zirconia implant generated more image artifacts than the titanium implant. Increasing kVp and the metal artifact reduction tool are efficient in decreasing the CBCT artifacts for both implants, whereas resolution does not affect their production.
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Gaêta-Araujo H, Fontenele RC, Nascimento EHL, Nascimento MDCC, Freitas DQ, de Oliveira-Santos C. Association between the Root Canal Configuration, Endodontic Treatment Technical Errors, and Periapical Hypodensities in Molar Teeth: A Cone-beam Computed Tomographic Study. J Endod 2019; 45:1465-1471. [DOI: 10.1016/j.joen.2019.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/28/2019] [Accepted: 08/11/2019] [Indexed: 01/26/2023]
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Nascimento EHL, Gaêta-Araujo H, Brasil DM, Madlum DV, Freitas DQ, Haiter-Neto F, Oliveira-Santos C. Impact of micro-computed tomography reconstruction protocols on bone microarchitecture analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:411-417. [DOI: 10.1016/j.oooo.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/03/2019] [Accepted: 05/13/2019] [Indexed: 11/28/2022]
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Lima CAS, Nascimento EHL, Gaêta-Araujo H, Oliveira-Santos C, Freitas DQ, Haiter-Neto F, Oliveira ML. Is the digital radiographic detection of approximal caries lesions influenced by viewing conditions? Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:165-170. [PMID: 31474575 DOI: 10.1016/j.oooo.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/04/2019] [Accepted: 08/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this study was to assess the influence of different viewing conditions (combinations of computer display, horizontal viewing angle, and ambient lighting) on the detection of approximal caries lesions on digital radiographic images. STUDY DESIGN Forty posterior teeth were mounted in a plaster block and radiographed by using a CMOS sensor-based system. Three oral radiologists assessed the radiographic images under different conditions of computer display (iMac 5K 27", Barco MDRC-2124, and Dell P2314H), horizontal viewing angles (90 degrees, 67.5 degrees, and 45 degrees), and ambient lighting (low, medium, and high) and were asked to detect the presence of approximal caries lesions, which were confirmed by means of micro-computed tomography (micro-CT), using a 5-point scale. The area under the receiver operating characteristic curve, sensitivity, and specificity were calculated and compared by analysis of variance testing (α = 0.05). Intra- and interobserver agreements were assessed with the Kappa test. RESULTS Computer display, horizontal viewing angle, and ambient lighting did not significantly influence the diagnosis of approximal caries lesions. In general, moderate values of accuracy, low sensitivity, and high specificity were found for all viewing conditions. CONCLUSIONS The viewing conditions assessed in this study did not influence the detection of approximal caries lesions on digital radiographic images. Dental practitioners are encouraged to find their most comfortable viewing condition for this diagnostic task.
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Affiliation(s)
- Carlos Augusto Souza Lima
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
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Yamasaki MC, Roque-Torres GD, Peroni LV, Nascimento EHL, Salmon B, Oliveira ML, Freitas DQ, Correr-Sobrinho L. A modified protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. Clin Oral Investig 2019; 24:1561-1567. [PMID: 31401733 DOI: 10.1007/s00784-019-03054-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/05/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To propose a modified protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. MATERIAL AND METHODS A total of 45 male Wistar rats were used in this study. Firstly, 25 rats were divided into 5 groups (n = 5) according to the radiation dose protocol: without irradiation and irradiated with 15 Gy, 20 Gy, 25 Gy, or 30 Gy using a linear accelerator. Secondly, 15 other rats were divided into 3 groups (n = 5) according to the time of extraction of the three right mandibular molars: 7, 10, or 14 days after irradiation of 20 Gy. Lastly, dental extractions were performed in 5 other rats without irradiation (C-E10) for comparison with those of the group of dental extractions 10 days after irradiation (I-E10). RESULTS The irradiated animals survived throughout the study period only at single doses of 15 Gy and 20 Gy. The suitable time for dental extractions after irradiation to induce mandibular osteoradionecrosis was defined as 10 days. Macroscopic evaluation of the right hemimandibles showed presence of osteoradionecrosis in I-E10 group and complete gingival healing in C-E10 group. CONCLUSION A single radiation dose of 20 Gy focused on head and neck region combined with the extraction of the three mandibular molars 10 days after irradiation constitutes a feasible protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. CLINICAL RELEVANCE Establishing a solid and widely available protocol of mandibular osteoradionecrosis induction is essential in the search for methods to prevent this complex disease.
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Affiliation(s)
- Mayra Cristina Yamasaki
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil.
| | - Gina Delia Roque-Torres
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Leonardo Vieira Peroni
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Benjamin Salmon
- Orofacial Pathologies, Imaging and Biotherapies Laboratory, Paris Descartes University, Sorbonne Paris Cité, 2496, Montrouge, EA, France.,Dental Medicine Department, Bretonneau Hospital HUPNVS, AP-HP, Paris, France
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Lourenço Correr-Sobrinho
- Department of Restorative Dentistry, Division of Dental Materials, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Freire BB, Nascimento EHL, Vasconcelos KDF, Freitas DQ, Haiter-Neto F. Radiologic assessment of mandibular third molars: an ex vivo comparative study of panoramic radiography, extraoral bitewing radiography, and cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:166-175. [DOI: 10.1016/j.oooo.2018.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/01/2018] [Accepted: 11/10/2018] [Indexed: 11/28/2022]
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Nascimento EHL, Fontenele RC, Santaella GM, Freitas DQ. Difference in the artefacts production and the performance of the metal artefact reduction (MAR) tool between the buccal and lingual cortical plates adjacent to zirconium dental implant. Dentomaxillofac Radiol 2019; 48:20190058. [PMID: 31276425 DOI: 10.1259/dmfr.20190058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To quantify the artefacts production and the performance of the metal artefact reduction (MAR) tool, enabled before or after the acquisition, in cortical plates (buccal and lingual) and other regions adjacent to zirconium implants. METHODS Cone beam CT scans were acquired using the OP300 Maxio unit before (control group) and after (implant group) the insertion of a zirconium implant into the posterior region of a dry mandible. Three conditions of MAR tool were tested: "without MAR", with "MAR activated after acquisition", and with "MAR activated before acquisition". The standard deviation (SD), contrast-to-noise ratio (CNR) and voxel values were calculated in the buccal and lingual cortical plates, medullary bone and water region, close to the implant. The structural bone analysis was performed in the medullary bone close to the implant. RESULTS Overall, in control and implant groups, the lingual cortical had higher SD, lower CNR and lower voxel values than the buccal cortical, regardless of the MAR condition (p < 0.05). Implant caused higher SD values and lower voxel values in adjacent regions "without MAR" (p < 0.05). MAR activation decreased SD and changed voxel values when the implant was present, regardless of MAR activation mode (p < 0.05). The activation of MAR increased the trabecular thickness values for the implant group (p < 0.05). CONCLUSION The expression of artefacts adjacent to zirconium implants is greater in the lingual than in the buccal cortical. The greater the expression of artefacts in this region, the greater the effectiveness of the MAR tool in homogenizing the grey values, regardless of the time of its activation.
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Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Gustavo Machado Santaella
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
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Nascimento EHL, Nascimento MCC, Gaêta-Araujo H, Fontenele RC, Freitas DQ. Root canal configuration and its relation with endodontic technical errors in premolar teeth: a CBCT analysis. Int Endod J 2019; 52:1410-1416. [PMID: 31111507 DOI: 10.1111/iej.13158] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/17/2019] [Indexed: 01/26/2023]
Abstract
AIM To evaluate the association between endodontic technical errors and the root canal configuration (RCC) of human premolars, as well as their relationship with periapical lesions through cone-beam computed tomography (CBCT) images. METHODOLOGY The sample consisted of CBCT scans belonging to 136 patients, totalling 152 root filled premolars (185 roots). CBCT images were evaluated by two oral radiologists. RCC was recorded according to Vertucci's classification, and the endodontic treatment quality was judged on the presence and type of technical endodontic errors (underfilling, overfilling, nonhomogeneous filling, nonfilled canal, fractured instruments, root deviation and absence of coronal restoration). In addition, the presence of periapical lesions associated with each RCC was recorded. Data were expressed by frequencies and percentages, and intraobserver agreement was calculated using the Kappa test. RESULTS The most common RCC was type I (71%), followed by type IV (15%), type II (8%), type V (3%), type VI (1%) and type III (1%). Types VII and VIII were not observed in the sample. Underfilling was the most frequent endodontic technical error for most RCCs, except for types IV, V and 'other', whose most frequent error was a nonfilled canal. The presence of technical errors was greater with an increase in the proportion of the periapical lesions. The intraobserver agreement was excellent. CONCLUSIONS There was an increase in the prevalence of endodontic technical errors and in the presence of periapical lesions as the anatomical complexity of the root canals increased. Underfilled and nonfilled canal were the most frequent endodontic technical errors.
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Affiliation(s)
- E H L Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
| | - M C C Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba.,Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - H Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
| | - R C Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
| | - D Q Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba
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Nascimento EHL, Abrahão Elias MR, Vasconcelos VHF, Haiter-Neto F, Mendonça EF, Sousa TO. Ex Vivo Detection of Apical Delta in Premolars: A Comparative Study Using Periapical Radiography, Cone-beam Computed Tomography, and Micro-computed Tomography. J Endod 2019; 45:549-553. [PMID: 30954279 DOI: 10.1016/j.joen.2019.02.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Imaging methods are essential for the correct identification of root canal anatomy, which is a key factor for successful endodontic therapy. This study aimed to evaluate the performance of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in identifying the apical delta (AD) using micro-computed tomographic imaging as the gold standard. METHODS PR and CBCT images of 110 human premolars (120 root canals) were obtained using the VistaScan digital intraoral system (Durr Dental, Beitigheim-Bissinger, Germany) and the 3D Accuitomo CBCT unit (J Morita, Kyoto, Japan), respectively. Two oral radiologists assessed the PR and CBCT images for the presence of ADs using a 5-point scale. Additionally, in the CBCT images, the number of apical foramina was also evaluated. The gold standard was established by means of micro-computed tomographic imaging. The diagnostic values related to PR and CBCT imaging were compared using the McNemar test. The detection of the number of foramina was compared using the paired t test (α ≤ 0.05). RESULTS ADs were present in 40 root canals (33.3%). Both PR and CBCT images differed significantly from the gold standard (P < .05) in the detection of ADs. CBCT imaging showed higher values than PR for all diagnostic tests (P < .05). Despite the moderate accuracy of PR (0.62) and CBCT imaging (0.73), these methods presented very low sensitivity values (0.07 and 0.35 for PR and CBCT, respectively). CBCT imaging had a tendency of underestimating the number of foramina (P < .05). CONCLUSIONS CBCT imaging showed better performance than PR in the detection of ADs; both imaging modalities underestimate its presence when compared with the gold standard. In general, the number of apical foramina cannot be reliably assessed using CBCT imaging.
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Affiliation(s)
| | - Marcela Ramos Abrahão Elias
- Department of Stomatology (Oral Diagnosis), Faculty of Dentistry, Federal University of Goias, Goiânia, Goiás, Brazil
| | | | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Sáo Paulo, Brazil
| | - Elismauro Francisco Mendonça
- Department of Stomatology (Oral Diagnosis), Faculty of Dentistry, Federal University of Goias, Goiânia, Goiás, Brazil
| | - Thiago Oliveira Sousa
- Department of Stomatology (Oral Diagnosis), Faculty of Dentistry, Federal University of Goias, Goiânia, Goiás, Brazil.
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Freitas DQ, Nascimento EHL, Vasconcelos TV, Noujeim M. Diagnosis of external root resorption in teeth close and distant to zirconium implants: influence of acquisition parameters and artefacts produced during cone beam computed tomography. Int Endod J 2019; 52:866-873. [PMID: 30585641 DOI: 10.1111/iej.13065] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/15/2018] [Indexed: 12/16/2022]
Abstract
AIM To assess the influence of artefacts, the metal artefact reduction (MAR) tool and kilovoltage (kVp) on the diagnosis of simulated external root resorption (ERR) in teeth close and distant to zirconium implants in cone beam computed tomography (CBCT) images. METHODOLOGY Cavities (0.62 mm in diameter and 0.19 mm deep) were created in the apical thirds of 12 roots on the buccal, lingual, distal or mesial surface; ten roots served as controls. The roots were randomly positioned in the first and second right and left premolar sockets of a dry human mandible, and a zirconium implant was placed in the socket of the first right molar. A ProMax 3D unit varying kVp (70, 80, or 90 kVp) and with the MAR tool activated or not was used to obtain CBCT scans. Five examiners evaluated all images to determine the area under the receiver operating characteristic (ROC) curve, sensitivity and specificity. RESULTS The ROC values and sensitivity were not affected by MAR or artefacts regardless of the distance to the implant (P > 0.05), whilst increasing kVp from 70 to 90 led to a significant increase in these values (P = 0.0202 and 0.0199, respectively). Specificity was not affected by the factors studied (P > 0.05). CONCLUSIONS Amongst the factors studied, only kVp influenced the diagnosis of simulated external root resorption in CBCT images. Increasing kVp from 70 to 90 improved the accuracy in diagnosing the simulated lesions.
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Affiliation(s)
- D Q Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - E H L Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - T V Vasconcelos
- Division of Oral Radiology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - M Noujeim
- Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Galvão NS, Nascimento EHL, Lima CAS, Freitas DQ, Haiter-Neto F, Oliveira ML. Can a high-density dental material affect the automatic exposure compensation of digital radiographic images? Dentomaxillofac Radiol 2019; 48:20180331. [PMID: 30540916 DOI: 10.1259/dmfr.20180331] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES: To investigate the influence of high-density dental material on the automatic exposure compensation of digital radiographic imaging systems. METHODS: Two radiographic phantoms were custom made to reproduce radiographic densities of the dental tissues: enamel, dentin and pulp chamber. The phantoms were X-rayed using the Digora Toto, Digora Optime and VistaScan systems for 0.063, 0.1 and 0.16 s. Radiographic acquisitions were repeated in the presence of a high-density material equivalent to a titanium implant, in the small and large sizes. Mean grey values of the dental tissue-equivalent regions were obtained with the Image J software, averaged and compared between the absence and presence of the high-density material using ANOVA for multiple comparisons and Tukey's test (α = 0.05). RESULTS: The presence of a high-density material significantly (p ≤ 0.05) decreased grey values of the dental tissue-equivalent images in the Digora Toto and VistaScan, regardless of the exposure time. For the Digora Optime, the high-density material decreased the pulp-equivalent grey values at all exposure times, the dentin-equivalent grey values significantly increased at exposure time of the 0.1 and 0.16 s, and the enamel-equivalent grey values significantly increased at the exposure time of 0.16 s (p ≤ 0.05). In general, the size of the high-density material did not affect the grey values significantly (p ≤ 0.05). CONCLUSIONS: In general, the presence of a high-density dental material in digital radiographic systems influences the AEC by adjusting dental tissue-equivalent grey values.
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Affiliation(s)
- Neiandro Santos Galvão
- 1 Department of Oral Diagnosis, Division of Oral Radiology,, Piracicaba Dental School, University of Campinas (UNICAMP) , Sao Paulo , Brazil
| | - Eduarda Helena Leandro Nascimento
- 1 Department of Oral Diagnosis, Division of Oral Radiology,, Piracicaba Dental School, University of Campinas (UNICAMP) , Sao Paulo , Brazil
| | - Carlos Augusto Souza Lima
- 1 Department of Oral Diagnosis, Division of Oral Radiology,, Piracicaba Dental School, University of Campinas (UNICAMP) , Sao Paulo , Brazil
| | - Deborah Queiroz Freitas
- 1 Department of Oral Diagnosis, Division of Oral Radiology,, Piracicaba Dental School, University of Campinas (UNICAMP) , Sao Paulo , Brazil
| | - Francisco Haiter-Neto
- 1 Department of Oral Diagnosis, Division of Oral Radiology,, Piracicaba Dental School, University of Campinas (UNICAMP) , Sao Paulo , Brazil
| | - Matheus Lima Oliveira
- 1 Department of Oral Diagnosis, Division of Oral Radiology,, Piracicaba Dental School, University of Campinas (UNICAMP) , Sao Paulo , Brazil
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Nascimento EHL, Freitas DQ. Letters From Our Readers. Angle Orthod 2019; 89:163. [DOI: 10.2319/0003-3219-89.1.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
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Nascimento EHL, Oliveira ML, Freitas DQ. Incidental findings of implant complications on postimplantation CBCTs: A cross-sectional study-Methodological issues. Clin Implant Dent Relat Res 2018; 21:11-12. [PMID: 30556356 DOI: 10.1111/cid.12690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/25/2018] [Accepted: 10/02/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil
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Nascimento EHL, Costa Oenning AC, Freire BB, Gaêta-Araujo H, Haiter-Neto F, Freitas DQ. Comparison of panoramic radiography and cone beam CT in the assessment of juxta-apical radiolucency—an answer to Letter to Editor. Dentomaxillofac Radiol 2018; 47:20180246. [DOI: 10.1259/dmfr.20180246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Anne Caroline Costa Oenning
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Bernardo Barbosa Freire
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
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Cavalcanti PHP, Nascimento EHL, Pontual MLDA, Pontual ADA, Marcelos PGCLD, Perez DEDC, Ramos-Perez FMDM. Cemento-Osseous Dysplasias: Imaging Features Based on Cone Beam Computed Tomography Scans. Braz Dent J 2018; 29:99-104. [PMID: 29267533 DOI: 10.1590/0103-6440201801621] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/01/2017] [Indexed: 12/18/2022] Open
Abstract
Imaging exams have important role in diagnosis of cemento-osseous dysplasia (COD). Cone beam computed tomography (CBCT) stands out for allowing three-dimensional image evaluation. This study aimed to assess the prevalence of cases diagnosed as COD on CBCT scans, as well identify the main imaging features related to these lesions. An analysis was performed in a database containing 22,400 radiological reports, in which all cases showing some type of COD were initially selected. These CBCT exams were reevaluated to confirm the radiographic diagnosis and determine the prevalence and distribution of the types of COD with regard to gender, age and preferred location, while describing its most common imaging aspects. Data were presented using descriptive analyses. There were 82 cases diagnosed as COD in the CBCT images (prevalence of 0.4%). The distribution of patients was 11 (13.4%) male and 71 (86.6%) female, with a mean age of 49.8 years (age-range 17-85 years). There were 47 (57.3%) cases of periapical COD, 23 (28%) of focal COD and 12 (14.6%) of florid COD. The mandible was more affected than the maxilla. In most cases, the lesions were mixed or hyperdense. All COD had well-defined limits and there were no cases of tooth displacement. In conclusion, periapical COD was the most common type and the most affected bone was the mandible. Imaging evaluation is critical for diagnosis and dentists should bear in mind all possible radiographic presentations of COD in order to prevent misleading diagnoses and consequently, inadequate treatments.
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Affiliation(s)
| | | | | | - Andréa Dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | | | - Danyel Elias da Cruz Perez
- Department of Clinical and Preventive Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
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Nascimento HAR, Andrade MEA, Frazão MAG, Nascimento EHL, Ramos-Perez FMM, Freitas DQ. Dosimetry in CBCT with Different Protocols: Emphasis on Small FOVs Including Exams for TMJ. Braz Dent J 2018; 28:511-516. [PMID: 29160405 DOI: 10.1590/0103-6440201701525] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/22/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5x5, 6x8 and 8x15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV.
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Affiliation(s)
- Helena Aguiar Ribeiro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
| | | | | | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
| | - Flavia Maria Moraes Ramos-Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade de Campinas, Piracicaba, SP, Brazil
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Freitas DQ, Fontenele RC, Nascimento EHL, Vasconcelos TV, Noujeim M. Influence of acquisition parameters on the magnitude of cone beam computed tomography artifacts. Dentomaxillofac Radiol 2018; 47:20180151. [PMID: 29916722 DOI: 10.1259/dmfr.20180151] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
AIM To evaluate the influence of kilovoltage (kVp) and metal artifact reduction tool (MAR) on the magnitude of cone beam CT (CBCT) artifacts. METHODS A titanium and zirconia implants were inserted alternately in a posterior region of a mandible. CBCT exams were acquired with ProMax 3D (Planmeca Oy, Helsinki, Finland) and Picasso Trio machines (Vatech, Hwaseong, South Korea) using 70 kVp, 80 kVp and 90 kVp with and without MAR activation. The other exposure factors remained fixed at 5mA, field of view 80 × 50 mm and voxel 0.20 mm. The scans were performed before and after the insertion of the implants. Regions of interest were determined in different distances from the artifact production area (15, 25 and 35 mm) in an axial image, in which standard deviation (SD) of grayscale values was measured and contrast-to-noise ratio (CNR) was calculated. Analysis of variance was used to compare the data. RESULTS Overall, in cases where the artifact was pronounced, MAR was efficient in reducing SD values. MAR also improved the CNR of ProMax images, but did not affect the Picasso images. Additionally, the higher was the kVp, the lower was the SD value and the higher was the CNR in both machines. CONCLUSION In both machines, increasing kVp and MAR are effective in decreasing the CBCT artifacts in all their magnitude when they are pronounced. Therefore, the professionals should choose one of those options or even both considering the purpose of the CBCT imaging and radiation dose for the patient.
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Affiliation(s)
- Deborah Queiroz Freitas
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Limeira , Brazil
| | - Rocharles Cavalcante Fontenele
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Limeira , Brazil
| | | | | | - Marcel Noujeim
- 3 Department of Comprehensive Dentistry, Division of Oral and Maxillofacial Radiology, University of Texas Health Science Center at San Antonio , San Antonio, TX , United States
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Nascimento EHL, Gaêta-Araujo H, Andrade MFS, Freitas DQ. Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis. Clin Oral Investig 2018; 22:2495-2503. [PMID: 29354883 DOI: 10.1007/s00784-018-2344-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 01/15/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aims of this study are to identify the most frequent technical errors in endodontically treated teeth and to determine which root canals were most often associated with those errors, as well as to relate endodontic technical errors and the presence of coronal restorations with periapical status by means of cone-beam computed tomography images. METHODS Six hundred eighteen endodontically treated teeth (1146 root canals) were evaluated for the quality of their endodontic treatment and for the presence of coronal restorations and periapical lesions. Each root canal was classified according to dental groups, and the endodontic technical errors were recorded. Chi-square's test and descriptive analyses were performed. RESULTS Six hundred eighty root canals (59.3%) had periapical lesions. Maxillary molars and anterior teeth showed higher prevalence of periapical lesions (p < 0.05). Endodontic treatment quality and coronal restoration were associated with periapical status (p < 0.05). Underfilling was the most frequent technical error in all root canals, except for the second mesiobuccal root canal of maxillary molars and the distobuccal root canal of mandibular molars, which were non-filled in 78.4 and 30% of the cases, respectively. CONCLUSIONS There is a high prevalence of apical radiolucencies, which increased in the presence of poor coronal restorations, endodontic technical errors, and when both conditions were concomitant. Underfilling was the most frequent technical error, followed by non-homogeneous and non-filled canals. CLINICAL RELEVANCE Evaluation of endodontic treatment quality that considers every single root canal aims on warning dental practitioners of the prevalence of technical errors that could be avoided with careful treatment planning and execution.
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Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, Sao Paulo, 13414-903, Brazil.
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, Sao Paulo, 13414-903, Brazil
| | - Maria Fernanda Silva Andrade
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, Sao Paulo, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, Sao Paulo, 13414-903, Brazil
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Vasconcelos KDF, Rovaris K, Nascimento EHL, Oliveira ML, Távora DDM, Bóscolo FN. Diagnostic accuracy of phosphor plate systems and conventional radiography in the detection of simulated internal root resorption. Acta Odontol Scand 2017; 75:573-576. [PMID: 28754080 DOI: 10.1080/00016357.2017.1359331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the performance of conventional radiography and photostimulable phosphor (PSP) plate in the detection of simulated internal root resorption (IRR) lesions in early stages. MATERIALS AND METHODS Twenty single-rooted teeth were X-rayed before and after having a simulated IRR early lesion. Three imaging systems were used: Kodak InSight dental film and two PSPs digital systems, Digora Optime and VistaScan. The digital images were displayed on a 20.1″ LCD monitor using the native software of each system, and the conventional radiographs were evaluated on a masked light box. Two radiologists were asked to indicate the presence or absence of IRR and, after two weeks, all images were re-evaluated. Cohen's kappa coefficient was calculated to assess intra- and interobserver agreement. The three imaging systems were compared using the Kruskal-Wallis test. RESULTS For interexaminer agreement, overall kappa values were 0.70, 0.65 and 0.70 for conventional film, Digora Optima and VistaScan, respectively. Both the conventional and digital radiography presented low sensitivity, specificity, accuracy, positive and negative predictive values with no significant difference between imaging systems (p = .0725). CONCLUSIONS The performance of conventional and PSP was similar in the detection of simulated IRR lesions in early stages with low accuracy.
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Affiliation(s)
- Karla de Faria Vasconcelos
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Karla Rovaris
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Débora de Melo Távora
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Frab Norberto Bóscolo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Nascimento EHL, Oenning ACC, Freire BB, Gaêta-Araujo H, Haiter-Neto F, Freitas DQ. Comparison of panoramic radiography and cone beam CT in the assessment of juxta-apical radiolucency. Dentomaxillofac Radiol 2017; 47:20170198. [PMID: 28871830 DOI: 10.1259/dmfr.20170198] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare the performance of panoramic radiography (PAN) and cone beam CT (CBCT) in the detection of juxta-apical radiolucency (JAR), as well as to investigate, in CBCT images, if there are factors associated with the detection of JAR on PAN. METHODS Two oral radiologists assessed the presence of JAR in PAN and CBCT images of 175 individuals (308 mandibular third molars). The cortical plates involvement and the JAR size and location were assessed on CBCT to evaluate if these factors were related to JAR detection on PAN. McNemar's test and multiple logistic regression were performed. RESULTS PAN and CBCT differed significantly in the detection of JAR (p = 0.001). On PAN, JAR was identified on 24% of the patients while on CBCT its detection increased to 32.6%. JAR was detected only on CBCT and only on PAN in 26 and 7 cases, respectively. Distal/mesial surfaces of dental roots were where JAR was mostly located (84.5%), cortical thinning was found in 59.2% of cases and the mean (SD) of JAR size was 5.03 (±1.8) mm. However, these factors were not associated with JAR detection on PAN (p > 0.05). On the other hand, the location of the cortical involvement (if buccal or lingual) was associated with JAR detection on PAN, which was more detectable when the thinning was on buccal cortical. CONCLUSIONS Juxta-apical radiolucency is more often detected on CBCT than on PAN. JAR detection on PAN was improved when it was related to the buccal cortical plate of the mandible.
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Affiliation(s)
- Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Anne Caroline Costa Oenning
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Bernardo Barbosa Freire
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Hugo Gaêta-Araujo
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
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Sousa TO, Haiter-Neto F, Nascimento EHL, Peroni LV, Freitas DQ, Hassan B. Diagnostic Accuracy of Periapical Radiography and Cone-beam Computed Tomography in Identifying Root Canal Configuration of Human Premolars. J Endod 2017; 43:1176-1179. [PMID: 28527842 DOI: 10.1016/j.joen.2017.02.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/19/2017] [Accepted: 02/26/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The aim of this study was to assess the diagnostic accuracy of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in the detection of the root canal configuration (RCC) of human premolars. METHODS PR and CBCT imaging of 114 extracted human premolars were evaluated by 2 oral radiologists. RCC was recorded according to Vertucci's classification. Micro-computed tomographic imaging served as the gold standard to determine RCC. Accuracy, sensitivity, specificity, and predictive values were calculated. The Friedman test compared both PR and CBCT imaging with the gold standard. RESULTS CBCT imaging showed higher values for all diagnostic tests compared with PR. Accuracy was 0.55 and 0.89 for PR and CBCT imaging, respectively. There was no difference between CBCT imaging and the gold standard, whereas PR differed from both CBCT and micro-computed tomographic imaging (P < .0001). CBCT imaging was more accurate than PR for evaluating different types of RCC individually. Canal configuration types III, VII, and "other" were poorly identified on CBCT imaging with a detection accuracy of 50%, 0%, and 43%, respectively. With PR, all canal configurations except type I were poorly visible. CONCLUSIONS PR presented low performance in the detection of RCC in premolars, whereas CBCT imaging showed no difference compared with the gold standard. Canals with complex configurations were less identifiable using both imaging methods, especially PR.
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Affiliation(s)
- Thiago Oliveira Sousa
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil.
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Leonardo Vieira Peroni
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, São Paulo, Brazil
| | - Bassam Hassan
- Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam, Universiteit van Amsterdam and Vrije Universiteit, The Netherlands
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Nascimento EHL, Oenning ACC, Rocha Nadaes M, Ambrosano GMB, Haiter-Neto F, Freitas DQ. Juxta-apical radiolucency: relation to the mandibular canal and cortical plates based on cone beam CT imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:401-407. [DOI: 10.1016/j.oooo.2016.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/07/2016] [Accepted: 12/03/2016] [Indexed: 11/24/2022]
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