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Introduction Surgically assisted rapid maxillary expansion is a widely used surgical procedure for resolving transverse maxillary occlusal changes in patients with bone maturity. However, few studies about the postoperative morphologic alterations in the nasal cavity in its inferior portion and the nasal septum positioning exist. Methods The linear nasal septum measurements of 26 adult patients treated with surgically assisted rapid maxillary expansion from 2009 to 2013 were assessed through a retrospective analysis of cone-beam computed tomographies, in Digital Imaging and Communications in Medicine files, through the Dolphin Imaging program (Dolphin Imaging and Management Solutions, Chatsworth, Calif), aimed to identify significant changes during 3 time periods of the treatment: preoperative, immediately after the palatal expansion device locking (immediate postoperative), and 6-months postoperative (late postoperative). The analyses were performed in the inferior third of the nasal septum, from 4 equidistant points in anteroposterior position and height, using fixed cranial references for lateral measures of displacement. Results No significant difference was found between preoperative, immediate postoperative, and late postoperative measurements in the 4 fixed nasal septum measurements, applying the analysis of variance test with a significance level of 5%. Comparing the surgical times alone, we found no statistically significant difference between the right and left sides applying the Student t test, which also showed symmetry in the nasal septum. Conclusions The measurements of the nasal septum did not change in the different surgical times throughout their inferior extension, and they remained symmetrical throughout patients’ follow-up period.

Este estudo teve como objetivo desenvolver e avaliar um aplicativo para smartphone com uma ferramenta de gerenciamento de conteúdo da web para o estudo da anatomia radiográfica periapical. Atividades de Design Thinking foram realizadas para melhor compreender o problema proposto pelo grupo de pesquisa. Em seguida, foi realizada uma pesquisa exploratória via Google Forms com 44 estudantes de Odontologia, aplicando-se um questionário para auxiliar no desenvolvimento de um aplicativo para ensino de Radiologia. Com o aplicativo na versão inicial, beta, foram aplicados questionários de satisfação e usabilidade com 51 alunos do curso de graduação em Odontologia, para avaliação do App. O coeficiente alfa de Cronbach foi aplicado a esses questionários e valores acima de 0,7 foram obtidos, demonstrando sua confiabilidade. Na avaliação do aplicativo, denominado APPOLO, que significa “App of learning online”, 98,04% dos alunos afirmaram que o conteúdo disponível era certamente importante. A quantidade de imagens foi considerada entre satisfatórias e muito satisfatórias por 94,19% dos participantes e 100% deles julgaram a qualidade das imagens também satisfatória ou muito satisfatória. A maioria dos participantes (94,11%) sentiu-se motivada em complementar seu estudo com esse tipo de metodologia. Quanto a usabilidade do aplicativo, 98,04% classificaram entre fácil e muito fácil o seu manuseio, 100% o acesso aos conteúdos ofertados e 98% o acesso aos textos, seguindo essa mesma métrica. O aplicativo APPOLO demonstrou ser prático, de fácil entendimento, navegação e utilização, e revelou auxiliar no apoio ao ensino dos alunos da disciplina de Radiologia Odontológica.

Radiographic examinations combined with clinical and histological tests play an important role in diagnosing changes in the craniofacial region. Considering that X-radiation is a form of ionizing energy capable of damaging the DNA of individuals, it has been the object of studies since its introduction. The micronucleus test is used to quantify this damage, assessing whether or not chromosomal breakage occurs. Objective: To evaluate, through a systematic review (SR) with meta-analysis, the occurrence of genotoxic effects in the oral epithelium after the exposure of patients to panoramic radiographs. Methods: An SR was performed with the PICOS (Population, Intervention, Comparison, Outcome, and Study design) strategy, aiming to answer the following question: “Can panoramic radiographs induce genotoxic effects on the oral epithelium?” The study was registered in the PROSPERO (International prospective register of systematic reviews) platform. A systematic search was performed in the following electronic databases: PubMed (including MedLine), Scopus, Embase, LILACS, Medline EbscoHost, and Google Scholar. Treatment effects were defined as standardized mean difference (SMD), and 95% confidence intervals (CI) were established. The Joanna Briggs Institute questionnaire for observational studies was applied to assess the risk of bias. The GRADE tool was used to assess the quality of evidence of the SR. Results: A total of 251 potentially relevant studies were selected through the search strategy. After screening titles and abstracts, 11 full-text manuscripts were assessed for eligibility and nine observational studies were included in the meta-analysis. The present study showed an increase in micronuclei after the exposure (SMD = 0.21, 95% CI, 0.03 to 0.28, p = 0.02), with a Tau2index = 0.00, Chi2 = 2.35, and p-value = 0.97. Therefore, the articles selected were considered homogeneous and the I² of 0% indicated low heterogeneity. Conclusion: According to the studies analysed, although the quality of evidence was considered low, panoramic radiographs can cause genotoxic damage in the oral epithelium but with a small effect size.

Aim: To evaluate the radiographic signs of proximity relationship between maxillary molar roots and maxillary sinus in panoramic radiographs, using CBCT as control. Methods: 81 examinations of patients who had panoramic radiographs and CBCT of the maxillary molars and pre molars region were used. Pathological situations were excluded from this study. Panoramic radiographs and CBCT were evaluated randomly and separately by an experienced dental radiology examiner. 1,055 root apices were evaluated individually. When assessing the relationship between maxillary molar and pre molar apices, and maxillary sinus, the examiner rated the images, both in panoramic radiography and CBCT, according to a scale of 0 to 3, where 0–Without relationship or distant; 1-Root apex projection or overlapping; 2-Maxillary sinus circumventing the tooth root; 3-Interruption of the continuity of maxillary sinus floor. Tabulated data were statistically analyzed using Kappa test and interclass correlation coefficient (ICC) respectively, with a significance level of 5%. A second analysis of the sample was performed after 15 days to analyze reproducibility. Results: Kappa test indicated near perfect reproducibility (Kw=0.973). The highest prevalence ratio, when comparing the classification in panoramic radiographs and CBCT, was for type 1 (52,7%). There was no difference between the type 1 signal and the gold standard observed on CBCT (ρ=0.2152). Conclusion: Panoramic radiography can be used to evaluate the relationship between roots of maxillary molars and premolars with the maxillary sinus. For cases where there is overlapping between apices and maxillary sinus, CBCT remains the indicated exam for better evaluation.

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This systematic review (SR) with meta-analysis aimed to evaluate the scientific data related to cytogenetic damage in oral exfoliated cells of patients diagnosed with oral potentially malignant disorders (OPMDs). The SR was conducted according to the PRISMA-P guidelines. The PICOS (Participants, Intervention, Comparison, Outcome, and Study Design) strategy was used to answer the question: "Is micronucleus assay in oral exfoliated cells a suitable biomarker for predicting cancer risk in individuals with OPMDs?" The search strategy was performed in the following electronic databases: PubMed, Medline, Scopus and Web of Science. The comparisons were defined as standardized mean difference (SMD), and 95% confidence intervals (CI). The quality of included studies was assessed using the EPHPP (Effective Public Health Practice Project). The GRADE tool was also utilized to assess the quality of evidence of the SR. A total of 110 potentially relevant studies were selected through the search strategy. After screening titles and abstracts, 20 full-text manuscripts were assessed for eligibility and three observational studies were included in the meta-analysis. After reviewing the 20 studies, 13 were considered weak. The meta-analysis data revealed a statistically significant difference in oral micronucleated cells by patients with OPMDs when compared to control (SMD=1.77, 95% CI, 0.36-3.18, p = 0.01), with a Tau

This clinical note describes a case report where the patient notices that one of the symptoms suffered during COVID-19 infection is a mononeuropathy of the branches of the maxillary nerve, reviewing in the literature the findings of the affinity of the coronavirus to nerve fibers.

O objetivo do trabalho foi comparar a performance de dois softwares com IA em telerradiografia cefalométrica lateral, por meio da avaliação da reprodutibilidade e confiabilidade das medidas lineares e angulares da análise de McNamara. Foram marcadas 30 telerradiografias cefalométricas por meio do método digital pelo examinador no Radiocef (RadioMemory). Posteriormente, a amostra foi marcada por meio da IA dos softwares CEFBOT (RadioMemory) e WebCephTM (AssembleCircle), para avaliação da reprodutibilidade e confiabilidade, em relação ao examinador e os softwares em questão. Para calibrar o examinador e avaliar a confiabilidade das marcações do examinador, CEFBOT, e WebCephTM utilizou o Coeficiente de Correlação Intraclasse (ICC), bem como, o teste ANOVA e pós teste de Tukey avaliou a reprodutibilidade dos softwares, por meio dos pontos cefalométricos que compõem a análise de McNamara. O ICC médio do examinador, CEFBOT e do WebCeph foram 0.960, 0.940 e 0.954, respectivamente, indicando concordância quase perfeita. Ao comparar CEFBOT com examinador, observou-se diferença estatística (p

Aim: This study aimed to investigate whether non-ionizing radiation emitted by smartphones is likely to cause genotoxic effects on oral epithelial cells. Methods: Thirty adults were distributed into two groups according to the mobile phone brand used, namely Samsung (Samsung, Seoul, South Korea) and Apple (Apple, California, USA). The material was collected with gentle swabbing of the right and left buccal mucosa using a cervical brush, then the micronucleus test was performed. Results: The Mann-Whitney test with a 5% significance level did not reveal statistically significant differences in micronuclei frequency between the exposed and non-exposed sides (p=0.251). The different brands do not seem to cause risks of inducing genetic damage because there were no statistically significant differences between them (p=0.47). Conclusion: Therefore, our results suggest no correlations of micronuclei frequency in the exposed buccal cells of mobile phone users at the exposure standard levels observed.

Objective. The aim of the study is to analyze the microbiota of the maxillary sinus of sheep as a viable biome to carry out experimental studies of biomaterials. Materials-Methods. 13 sheep (eight in isolation and five loose created) were used, making 26 maxillary sinuses, where swabs were performed by an extra-oral approach for microbiological analysis. Statistical tests such as Fisher's exact test, Mann Whitney U test, chi-square test, and proportional means were used in the experiment. Results. Only eight maxillary sinuses had positive bacterial growth. The presence of Staphylococcus aureus was statistically significant relative to other microorganisms found. On the other hand, among the animals in isolation and those raised loose, there was no statistically significant difference in the presence of Staphylococcus aureus. Conclusion. Staphylococcus aureus is the predominant bacteria in the maxillary sinus of this experimental model. The difference in environment and feeding did not influence the microbiota of the maxillary sinus. Objetivo. El objetivo del estudio es analizar la microbiota del seno maxilar de las ovejas como bioma viable para realizar estudios experimentales de biomateriales. Materiales-Métodos. Se utilizaron 13 ovejas (ocho aisladas y cinco sueltas creadas), lo que supone 26 senos maxilares, en los que se realizaron hisopos por vía extraoral para su análisis microbiológico. En el experimento se utilizaron pruebas estadísticas como el test exacto de Fisher, el test U de Mann Whitney, el test de chi-cuadrado y las medias proporcionales. Resultados. Sólo ocho senos maxilares presentaron un crecimiento bacteriano positivo. La presencia de Staphylococcus aureus fue estadísticamente significativa en relación con otros microorganismos encontrados. Por otra parte, entre los animales aislados y los criados sueltos, no hubo diferencias estadísticamente significativas en la presencia de Staphylococcus aureus. Conclusión. Staphylococcus aureus es la bacteria predominante en el seno maxilar de este modelo experimental. La diferencia de entorno y alimentación no influyó en la microbiota del seno maxilar. Objetivo. O objetivo do estudo é analisar a microbiota do seio maxilar de ovelhas como um bioma viável para realizar estudos experimentais de biomateriais. Materiais-Métodos. Foram utilizadas 13 ovelhas (oito isoladas e cinco criadas soltas), fazendo 26 seios maxilares, onde foram realizados esfregaços através de uma abordagem extra-oral para análise microbiológica. Foram utilizados os testes estatísticos exato de Fisher, Mann Whitney U, qui-quadrado, e meios proporcionais. Resultados. Apenas oito seios maxilares tiveram um crescimento bacteriano positivo. A presença de Staphylococcus aureus foi estatisticamente significativa em relação a outros microrganismos encontrados. Por outro lado, entre os animais em isolamento e os que foram criados soltos, não houve diferença estatisticamente significativa na presença de Staphylococcus aureus. Conclusão. O Staphylococcus aureus é a bactéria predominante no seio maxilar deste modelo experimental. A diferença no ambiente e na alimentação não influenciou a microbiota do seio maxilar.

The objective of this study was to compare the accuracy of smartphone and tablet displays for the detection of incipient caries on bitewing radiographs. Forty-six digital bitewing radiographs with a total of 1656 unrestored, readable surfaces were evaluated. The included surfaces extended from the distal surface of each canine to the last posterior contact in each arch. The evaluation excluded nonreadable proximal surfaces. The gold standard for the presence or absence of incipient caries was the consensus of 2 expert oral and maxillofacial radiologists with 15 and 30 years of experience. The radiographs were then independently reevaluated by 2 other professionals with a master's degree in dentistry with an emphasis on oral radiology with more than 5 years of experience (observers 1 and 2). Observers 1 and 2 performed the reevaluations using a notebook computer (Pavilion dm1) with a calibrated LCD monitor as well as 2 smartphones (iPhone 6s and Galaxy Gran2 Duos) and 2 tablet computers (iPad and Galaxy Tab). The presence or absence of incipient dental caries was classified according to the following scale: 1, definitely present; 2, probably present; 3, uncertain; 4, probably absent; and 5, definitely absent. Receiver operating characteristic (ROC) curves were used to determine the accuracy of the diagnoses established by operators 1 and 2. The areas under the ROC curves (A

Objective: To assess the reliability of CEFBOT, an artificial intelligence (AI)-based cephalometry software, for cephalometric landmark annotation and linear and angular measurements according to Arnett’s analysis. Methods: Thirty lateral cephalometric radiographs acquired with a Carestream CS 9000 3D unit (Carestream Health Inc., Rochester/NY) were used in this study. The 66 landmarks and the 10 selected linear and angular measurements of Arnett’s analysis were identified on each radiograph by a trained human examiner (control) and by CEFBOT (RadioMemory Ltd., Belo Horizonte, Brazil). For both methods, landmark annotations and measurements were duplicated with an interval of 15 days between measurements and the intraclass correlation coefficient (ICC) was calculated to determine reliability. The numerical values obtained with the two methods were compared by a t-test for independent variables. Results: CEFBOT was able to perform all but one of the 10 measurements. ICC values > 0.94 were found for the remaining eight measurements, while the Frankfurt horizontal plane - true horizontal line (THL) angular measurement showed the lowest reproducibility (human, ICC = 0.876; CEFBOT, ICC = 0.768). Measurements performed by the human examiner and by CEFBOT were not statistically different. Conclusion: Within the limitations of our methodology, we concluded that the AI contained in the CEFBOT software can be considered a promising tool for enhancing the capacities of human radiologists.

The purpose of this article is to assist dental clinicians to identify neurofibromatosis type 1 and its variants. We present a rare case of a 68-year-old man affected since his childhood by the presence of generalized nodules throughout the body, causing aesthetic deformations. Interestingly, the impact in the oral cavity was not significant, presenting nodes only in the gingiva, an unusual area of manifestation. Panoramic radiograph showed a discrete enlargement of the mandibular canal. After 1 year of follow-up, the patient died due to cardiovascular complications caused by the syndrome.

The occurrence of calcifying odontogenic cyst (COC) in the posterior maxillary region is uncommon, with few cases described in literature. We report a case of a 13-year-old female patient presenting a large lesion in the left maxilla (> 7.5 cm). Panoramic radiograph showed a well-delimited radiolucent unilocular lesion extending from the posterior left maxilla to the maxillary sinus. The patient was submitted to decompression followed by conservative surgical removal of the lesion. Histological analysis of the surgical specimen confirmed the diagnosis of COC. After one year, no local recurrence has been observed and the patient remains under follow-up on a regular basis.

Salivary duct carcinoma (SDC) is a rare and aggressive neoplasm arising from salivary glands. SDC occurs most frequently in major salivary glands, with isolated cases arising from the minor salivary glands. The occurrence of clear cells in salivary gland tumors is uncommon and is rarer in SDC cases. We report the case of a 51-year-old male diagnosed with a clear cell variant of SDC in the minor salivary gland, involving the left hard palate. Immunohistochemical analysis revealed positivity for HER2/neu and GATA-3. The patient was submitted to radical surgical excision, neck dissection, and radiotherapy. Unfortunately, he died 14 months after the cancer diagnosis.

The use of mobile phones is based on radiofrequency (RF) waves, and the devices act as transmitters and receivers of non-ionizing energy. The micronucleus test was developed to identify increases in the occurrence of mutations in cells exposed to various agents. This systematic review with meta-analysis adhered to the following protocol: defining the objective, outlining the search method (PICO model), conducting the search, identifying literature, selecting articles, and extracting data. The study aimed to answer the following research question: Does non-ionizing radiation emitted by mobile phones have genotoxic and/or cytotoxic effects on the oral epithelium? The search for evidence published 2009-2019 was conducted in the MEDLINE, PubMed, Scopus, LILACS, Google Scholar, PROSPERO, and Cochrane Library databases. The following inclusion criteria were defined: investigations of effects on the oral mucosa related to RF; investigations of cytotoxic and/or genotoxic effects; investigations involving humans; and investigations using cells exfoliated from the oral epithelium. Investigations related to the parotid gland were excluded. The search strategy found 464 articles; after application of the eligibility criteria, 358 abstracts were analyzed and 351 abstracts excluded. After 7 full texts were reviewed, 1 study was excluded. The 6 included studies were classified as level 5 quality of evidence (observational studies). The meta-analysis included 2 studies that compared the frequency of micronuclei on the side exposed to RF electromagnetic fields (RF-EMFs) to that on the unexposed side. The studies evaluated presented a low degree of evidence, but the meta- analysis indicated that no genotoxic effects are associated with mobile phone use. However, observations of other nuclear abnormalities in some studies suggest the occurrence of cytotoxic effects caused by exposure to the RF-EMFs emitted by mobile phones. More studies are necessary to prove or refute this association.

Resumo Introdução A interface implante-pilar protético e a formação dos seus microgaps são aspectos relevantes na transferência das cargas e na resposta biológica, estando ligadas ao sucesso da reabilitação. Objetivo Avaliar microgaps na interface entre a conexão interna do implante do tipo Cone Morse e a superfície do componente protético por meio da microscopia eletrônica de varredura (MEV). Material e método Foram utilizados 20 implantes dentários de tamanho 3,75 × 11,0mm do tipo Cone Morse com seus respectivos pilares protéticos da Singular® (Singular Implants, RN, Brasil). Os munhões retos foram acoplados aos implantes com torque de 32N/cm2 e o conjunto resultante foi emergido em base de Resina Epóxi ES260, para permitir secção longitudinal da amostra. As amostras foram analisadas e os microgaps mensurados no MEV (JEOL JCM-5700, MA, USA), e posteriormente os dados foram analisados. Resultado A média e o desvio padrão dos maiores microgaps foram observados na parte apical do implante nos lados direito e esquerdo, sendo 1,44±2,68 e 1,16±1,49 μm, respectivamente. Os menores microgaps foram na parte superior do implante nos lados direito e esquerdo, sendo 0,60±0,73 e 0,66±0,67 μm, respectivamente. Contudo, no teste de Kruskal-Wallis, não houve diferença estatisticamente significativa entre as regiões dos implantes, tanto para o lado esquerdo (p=0,692) como para o direito (p=0,865). No teste de Mann-Whitney, não houve diferenças estatisticamente significativas entre os lados para as diferentes regiões dos implantes. Conclusão Mesmo com a presença de microgaps na interface implante-pilar protético, estes apresentam tamanho inferior ao que causaria problemas biológicos e mecânicos. As amostras analisadas quanto à sua compatibilidade de encaixe foram satisfatórias. Abstract Introduction The implant-prosthetic abutment interface and the formation of its microgaps are relevant aspects in load transfer and biological response and are linked to the success of the rehabilitation. Objective To evaluate microgaps at the internal connection interface of the Cone Morse implant and the prosthetic component surface by means of scanning electron microscopy (SEM). Material and method Twenty 3.75 x 11.0 mm Cone Morse dental implants with their respective Singular® prosthetic abutments were used (Singular Implants, RN, Brazil). The straight trunnions were attached to the implants with a 32N/cm2 torque and the ES260 Epoxy Resin-based set emerged to allow longitudinal sectioning of the sample. The samples were analyzed and the microgaps measured in SEM (JEOL JCM-5700, MA, USA), and later the data were analyzed. Result The mean and standard deviation of the largest microgaps were observed in the apical part of the right and left side 1.44±2.68 and 1.16±1.49 μm, respectively. The smallest microgaps were on the upper implant right and left sides 0.60±0.73 and 0.66±0.67 μm, respectively. However, in the Kruskal-Wallis test there was no statistically significant difference between the implant regions, both for the left side (p=0.692) and right side (p=0.865). The Mann-Whitney test, there were no statistically significant differences between the sides for the different regions of the implants. Conclusion Even with the presence of microgaps in the implant-post interface, it presents a smaller size than the one presenting biological and mechanical problems. The samples analyzed for their fitting compatibility were satisfactory.

Introduction Endodontically treated teeth with extensive coronary destruction require posts and cores to enable prosthetic restoration. Despite the increasing use of prefabricated posts, cast metal posts and cores are still widely used. The quality of the latter is important for the longevity of restorative treatment, and failure can occur if the fundamental principles are not followed. Objective To radiographically evaluate the prosthetic principles of 1000 cast metal post-and-core restorations performed in single-rooted teeth and their coherence with the principles used for their confection. Material and method Digital periapical radiographs of 1000 endodontically treated, single-rooted teeth with cast metal posts and cores were selected from the collection of a radiology clinic (Centro de Imagem, Aracaju/SE, Brazil). The images were analyzed using a measurement software (ImageJ, USA) in accordance with the fundamental prosthetic principles: length and diameter of the post, ratio between post and bone crest, contiguity of post to the root canal, gap between post and the remaining root canal filling, amount of remaining root canal filling, and absence of periapical lesion. The data were qualitatively analyzed, classified into ideal and not ideal, and submitted to the chi-square test (α=0.05). Result Only 6.7% of the cast metal posts analyzed were satisfactorily fabricated. Conclusion Many prosthetic criteria are neglected during the manufacturing of cast metal post and cores, resulting in inadequate work that may compromise the longevity of restorative treatments. Resumo Introdução Dentes com ampla destruição coronária e tratados endodonticamente necessitam de retentores intrarradiculares para viabilizar a restauração protética. Apesar do crescente uso de pinos intrarradiculares pré-fabricados, os retentores intrarradiculares metálicos fundidos ainda são muito utilizados. A qualidade desses é importante para a longevidade do tratamento restaurador, pois podem levar ao insucesso quando seus princípios fundamentais não são seguidos. Objetivo Avaliar radiograficamente os princípios protéticos de 1000 retentores intrarradiculares metálicos fundidos em dentes unirradiculares e a coerência dos mesmos com os princípios para sua confecção. Material e método Foram selecionadas radiografias periapicais digitais de 1000 dentes unirradiculares que receberam tratamento endodôntico e retentores intrarradiculares metálicos fundidos, através do acervo de uma clínica radiológica (Centro de Imagem, Aracaju/SE, Brasil). As imagens foram analisadas através de um software de mensuração (ImageJ, EUA) de acordo com os princípios fundamentais protéticos: comprimento e diâmetro do pino, relação do pino com a crista óssea, contiguidade ao canal, espaço entre o remanescente obturador e o pino, quantidade de material obturador e ausência de lesão periapical. Os dados foram tabulados, analisados qualitativamente em ideais e não ideais e submetidos ao teste do Qui-Quadrado (α=0,05). Resultado Apenas 6,7% dos retentores intrarradiculares fundidos analisados foi confeccionado de forma satisfatória. Conclusão Muitos critérios protéticos são negligenciados durante a confecção de retentores intrarradiculares metálicos fundidos, resultando em trabalhos inadequados que podem comprometer a longevidade do tratamento restaurador.

O Blended Learning (B-learning) combina ensino a distância com ensino presencial em sala de aula. A plataforma Moodle é um Sistema de Gestão da Aprendizagem (SGA), que funciona baseado na construção da aprendizagem a partir da interação, e ainda oferece ferramentas que favorecem a integração das atividades presenciais com atividades à distância, mas de fácil usabilidade. O objetivo deste estudo foi avaliar e ampliar os cenários de aprendizagem por meio da criação de um ambiente virtual como material didático de apoio, com intuito de transformá-lo em ferramenta no processo de educação para estudantes, para isso foram selecionados 13 alunos da graduação, que já tinham cursado a disciplina Diagnostico Oral da Universidade Federal de Sergipe (UFS). Ao final do curso, os voluntários foram submetidos a um questionário para avaliar o AVA métodos especializados por imagem - diagnostico oral (AVA-DO), quanto ao material de apoio disponibilizado no ambiente, bem como a acessibilidade e usabilidade no AVA-DO, e por fim, o ganho de conhecimento do aluno após a experiência na educação a distância. A avaliação do ganho de aprendizado do estudante foi feito por meio de questionário a respeito do material ensinado. Todas as questões tiveram mais 80% de acertos. Os resultados expõem também a dificuldade do aluno em manusear o Moodle, encontrando obstáculos na usabilidade e acessibilidade da ferramenta. Conclui-se o emprego do ambiente virtual de aprendizagem favoreceu o processo de aprendizagem dos estudantes de graduação, consistindo em mais um cenário de aprendizagem para a Odontologia.

Background Clinicians often use calcium hydroxide liners during stepwise treatment of advanced caries. In this randomized clinical trial, the authors compared the short-term outcome of stepwise caries removal with and without use of a calcium hydroxide liner in conjunction with provisional resin-modified glass ionomer (RMGI) restorations. Methods The authors included in the trial 98 patients aged 15 to 30 years who had a deep carious lesion in a posterior tooth. The authors measured the dentin thickness radiographically and recorded its color, consistency, and moisture, as well as the bacterial count of the lesions. After partial caries removal, the authors assigned patients randomly to have their caries provisionally restored using RMGI with (control group) or without (test group) a calcium hydroxide liner. The primary outcome measure was tooth vitality after 90 days. Secondary outcomes included changes in dentinal, radiographic, and microbiological characteristics of the lesions. Results The authors found no statistically significant difference between the test and control groups in tooth vitality after 90 days. Irrespective of calcium hydroxide liner use, the authors observed darker, harder, drier, and less contaminated dentin after the provisional restorations, but dentin thickness remained unchanged. Conclusions On the basis of this 3-month clinical trial's results, the use of a calcium hydroxide liner during stepwise caries excavation and provisional restoration did not provide any additional benefit. Practical Implications After 3 months, using a calcium hydroxide liner does not appear to offer any additional benefit when clinicians use RMGI provisional restorations during stepwise caries removal. Longer studies are needed to confirm these results.

The adenomatoid odontogenic tumor (AOT) has a prevalence of 3% to 7% among odontogenic tumors and 3 described variants: Follicular, extrafollicular, and peripheral (or gingival). We reported a case of extrafollicular AOT in a 31-year-old melanoderm woman. An increase in volume was observed in the lower left third of the face associated with bulging of the buccal and lingual cortices in the region of elements 34 to 32. The imaging revealed a well-defined unilocular radiolucent area with sclerotic margin, involving periapices of elements 34, 33, and 32, rupture of the vestibular bone cortex in the region, and mild root resorption of units 33 and 32. Histopathologic examination revealed presence of fibrovascular capsule and epithelial cells forming structures such as ductus and solid patter. The treatment was an excisional biopsy. Follow-up of 7 and 15 days with satisfactory postoperative period was performed. Provision will be made every 6 months.

Introduction: The use of the mobile device is based on radiofrequency waves, a type of electromagnetic wave, formed by a magnetic and electric field. This technology uses radio transmitters and receivers, operating in the microwave range, and therefore, ends up being an emitter and receiver of nonionizing energy. Objective: To evaluate whether the nonionizing radiation emitted by smartphones cause genotoxic and/or cytotoxic effects on the cells present in the oral mucosa, and to compare the different brands. Study design: A total of 30 adults were divided into 2 groups according to 2 mobile phone brands. The material was collected by smearing the jugal mucosa bilaterally with a spatula, and it was evaluated by means of the micronucleus test. This test analyzed the shape, borders, changes within the cytoplasm, and the chromatin structure, color, and texture. Statistical analysis was performed using the Wilcoxon test, with a significance level of 5%. Results: For micronuclei, there was no statistically significant difference between exposed and nonexposed sides (P = .251); however, for the other alterations, there was a statistically significant difference (P = .024). Regarding the comparison between the marks, there was no statistically significant difference (P = .47). Conclusion: The different brands of smartphones do not appear to offer risks of inducing genotoxicity. However, both brands showed cytotoxicity. Funding: CNPq.

OBJECTIVE To assess the temporomandibular joint (TMJ) osseous components morphology and the condyle position in patients with different sagittal skeletal relationships, sex, and age, using cone-beam computed tomography (CBCT). METHODS The CBCT images of 180 asymptomatic patients (60 class I, 60 class II, and 60 class III) were assessed retrospectively. Groups were also divided according to age (

O objetivo deste estudo foi verificar, mediante uma revisão sistemática, se a metodologia ativa do PBL (Problem Basead Learing) é aplicável para o ensino da disciplina de radiologia odontológica. A presente revisão foi realizada seguindo as orientações da PRISMA-P, utilizando a estratégia PICO para a efetivação dos critérios de elegibilidade, buscando responder a seguinte pergunta: “O PBL (Problem Based Learning) é aplicável para a disciplina de radiologia odontológica?”. Para isso, foi feita uma revisão sistemática nas bases de dados PubMed (incluindo MedLine), SciELO, LILACS, Web of Science e IEEE Xplore, sendo realizada também uma pesquisa na literatura cinza nas plataformas eletrônicas OpenThesis e Open Acess Thesis and Dissertations, além da busca manual de referências cruzadas de artigos originais. Ademais, foram utilizados os operadores booleanos AND e OR combinados aos descritores “Aprendizagem Baseada em Problemas, Radiologia, Oontologia e Ensino”, estes selecionados utilizando os Descriptors in Health Science (DeCS) e os Medical Subject Headings (MeSH) para potencializar a estratégia de busca. Dois revisores selecionaram os estudos conforme os critérios de elegibilidade. Em síntese, O PBL mostrou ser uma metodologia de ensino que auxilia na formação de cirurgiões-dentistas capacitados em lidar com situações diárias, baseado em problemas, sendo uma alternativa viável e aplicável para a disciplina de radiologia odontológica. Todavia, em razão das incertezas encontradas nos estudos incluídos, realçadas pelo alto risco de viés, mais pesquisas devem ser desenvolvidas a fim de reduzir as lacunas de conhecimento acerca do melhor método para o processo de ensino-aprendizagem.

Statement of problem Different instruments have been developed to improve crown finish lines after conventional preparation with diamond rotary instruments. However, more evidence on the effectiveness of these instruments is required. Purpose of study The purpose of this in vitro study was to assess the effectiveness of 4 different instruments used for cervical margin finishing in regard to the external line angle (ELA). Material and methods Forty-eight freshly extracted third molar teeth with similar dimensions were conventionally prepared for crowns and randomly allocated into 4 groups (n=12) according to the finishing instrument: hand trimmer (HT), tungsten carbide bur (TCB), ultrasonic instrument (UI), and diamond rotary instrument (DRI) mounted in a contra angle handpiece with reduced speed. Photomicrographs from the margin profiles of each tooth were obtained with scanning electron microscopy (×40) before and after finishing procedures. The images were qualitatively analyzed (scores 1-4) by 9 experienced dental professionals. Average results were assessed with the paired t test and repeated measures ANOVA followed by Tukey HSD test (α=.05). Results HT, TCB, and UI demonstrated no significant differences between unfinished and finished mean ELA scores. DRI was the only group to demonstrate a significantly improved ELA ( P P =.989), all the other groups demonstrated statistically significant different ELA scores. Conclusion DRI mounted in a contra angle handpiece was the only finishing instrument capable of significantly improving the ELA, while TCB and UI produced nonsignificant improvement, and HT was detrimental to the ELA.

The aim of this study was to evaluate the morphological surface and the microtensile bond strength (μTBS) of the immediate dentin sealing (IDS) submitted to four different methods for removing temporary cement. Molar teeth received IDS with adhesive system (Adper Scotchbond Multipurpose, 3 M ESPE). Temporary restorations were made with eugenol-free temporary cement (RelyX Temp NE, 3 M ESPE). After the storage (7 days; 37 °C), the samples were submitted to four methods for removing temporary cement: periodontal curette (PC); sodium bicarbonate sandblasting (SB); aluminum oxide sandblasting (AO); and abrasion with diamond bur (DB). The control group (C) received no treatment. The morphological surface analysis (n = 2) and IDS thickness (n = 3) were analyzed using scanning electron microscopy (SEM). Resin composite blocks (Filtek Z250, 3 M ESPE) were produced and cut into sticks (~1 mm2) for μTBS (n = 9). Fracture patterns were analyzed on stereomicroscope and classified as adhesive, mixed, cohesive-dentin or cohesive-resin. Data were submitted to Shapiro-Wilk test and one-way ANOVA followed by Tukey's post hoc test (α = 0.05). PC and SB groups showed the lowest and the highest μTBS values, respectively (ρ

O trabalho tem como objetivo discutir acerca do carcinoma epidermoide de palato mole, suas principais características clínicas, histológicas e prevalência, critérios fundamentais para auxiliar no diagnóstico e tratamento dessa patologia. O carcinoma epidermoide é o tumor maligno mais comumente encontrado na cavidade oral, acomete principalmente a borda posterior da língua, tendo predileção por indivíduos tabagistas e/ou etilistas crônicos devido maior probabilidade de desenvolver o câncer bucal associado ao fator irritativo crônico. Sua manifestação ocorre em diferentes graus de malignidade tendo como características predominantes anaplasia, destruição do tecido local, crescimento rápido e capacidade de metástase. O diagnóstico do carcinoma epidermoide geralmente é tardio, seja pelo desconhecimento da patologia pelo profissional ou mesmo percepção das alterações na mucosa pelo próprio paciente que evitam buscar atendimento por temer o diagnóstico. Trata-se de uma revisão narrativa, de natureza qualitativa e exploratória, a qual objetiva elencar e evidenciar os critérios diagnósticos para o carcinoma epidermoide de palato mole, pautados em critérios clínicos, histológicos, tratamento e sua etiologia. Foi realizada uma busca ativa nas seguintes bases de dados eletrônicas: PUBMED, Medline, Google Scholar, Diadorim, Portal Periódicos CAPES, utilizando-se de descritores, Descriptors in Health Science (DeCS) e Medical Subject Headings (MeSH). Com o estudo, conclui-se que o conhecimento sobre lesões tumorais é de suma importância por parte dos profissionais da saúde, auxiliando assim em um diagnóstico precoce, tornando-se menos negativo e elevando as taxas de sobrevida do paciente.

The use of the mobile device is based on radiofrequency waves, an electromagnetic wave type. To verify if cellular damage occurs, the micronucleus test was developed, aiming to identify an increase in the frequency of mutations in cells that are exposed to a varied range of agents. Objective: This study aims to answer the following question: "Could the nonionizing radiation emitted by mobile telephone devices cause genotoxic and/or cytotoxic effects in the cells present in the oral mucosa, from microscopic observation by the micronucleus test?" Study Design: Three stages were followed: defining the objective, tracing the search method (PICO), selecting articles, and extracting data. The databases consulted were: MEDLINE, PubMed (AllDatabases, MeSH), Scopus, LILACS, Google academic, PROSPERO, and COCHRANE using the Boolean operators Persons, Smartphone, Mutagenicity Tests, and Mouth, based on MeSH terms. Results: A total of 396 articles were found, 323 abstracts were analyzed, 312 abstracts were excluded, and w6 full texts and 6 studies were included, according to the table of scientific evidence (grade 5). Conclusion: Our study revealed that there is no occurrence of genotoxic effects; nonetheless, there is a suggestion of occurrence of cytotoxic effects caused by exposure to electromagnetic fields of radiofrequency emitted by mobile phones, especially in case of prolonged exposure.

Objective: To develop and evaluate a smartphone application with web application tool, content management, that enables the study of radiographic anatomy. Study Design: Face-to-face meetings and design thinking activities were carried out to better understand the proposed problem by the research group. The application, completed in the beta version, provided satisfaction and usability questionnaires to 51 students of the dentistry course. Results: A total of 50% of students use the Android operating system; 100% of the students feel that applications can aid in the teaching of radiology, 93.20% prefer to study by photos, and 86.40% study with the cell phone connected. Regarding the satisfaction questionnaire, with the APPOLO app (app of learning on line), Cronbach alpha coefficient was applied, obtaining values above 0.7; therefore, the questionnaire is reliable. In addition, 98.04% affirmed that it the content that is made available is certainly important. A total of 64.69% of the students considered the quantity of the images satisfactory. The majority, 68.62%, feel very motivated to complement their study with this type of methodology. As for the usability of the application, 66.66% found its handling very easy. Conclusion: The APPOLO application proved to be practical and easy to understand, navigate, and use; further, it can assist in the teaching support of students of dental radiology.

Objectives: The odontogenic adenomatoid tumor (AOT) has a prevalence of 3% to 7% among odontogenic tumors. There are 3 variants of AOT: follicular, extrafollicular, and peripheral. The present study aims to trace the clinical and epidemiologic profile of extrafollicular AOT, based on a review of case reports. Study Design: Using the adenomatoid and extrafollicular descriptors, a search was performed in the PubMed database. Fifty-one articles were obtained as a result. The following exclusion criteria were adopted: by title, by case report, by the summary, and by the series of cases. At the end, 10 articles were used as sources for the present study. Results: Ten cases were published between 2009 and 2019, with the following most prevalent characteristics: Asian ethnicity (90%), no gender preference, and mandible location (60%). Imaging presentation included well-defined borders (80%); root displacement (50%); presence of cortical perforation (30%); and root resorption (30%). The mean time of the cases was 4 months, with a maximum of 2 years, and no recurrence was observed in any of the cases. Conclusion: Extrafollicular odontogenic adenomatoid tumor is uncommon. It does not present a predominant profile, exhibiting a diversity of clinical manifestations, with slow to fast and locally aggressive growth.

Cleidocranial dysostosis (CCD) is an inherited autosomal dominant syndrome due to the heterozygous mutation of the RUNX2 gene, which is often the same in men and women. The diagnosis is based on clinical and radiographic features, which include images of the skull, thorax, pelvis, and hands. The present study aims to present a case report of CCD in a 29-year-old feoderm woman. During intraoral examination permanent nonerupted teeth, deep palate, prominent mandible, maxillary hypoplasia, and vertical occlusion dimension were observed. Panoramic radiographs and computed tomography scan of the conical bundle showed several nonerupted teeth and multiple supernumerary teeth. Wormian bones and persistent open sutures were observed on the lateral radiograph of the head. The shoulder radiograph shows the absence of right and left clavicles. In view of the complexity of the treatment an interdisciplinary discussion is necessary, taking into account age and economic condition.

Fibrous dysplasia (FD) is a benign fibro-osseous lesion that accounts for 2.5% of bone lesions. Herein, we present an 11-year-old female patient presented to examination with an increase in volume on the right side of the face with indeterminate evolution time. Intraoral clinical examination revealed a hardened region, with no alteration in the mucosa, that suggests a bone etiology lesion. Radiographic examination showed a mixed, circumscribed lesion with a pediculated and poorly delimited aspect in relation to healthy bone tissue, extending from the right coronary process to the lateral region of the ipsilateral jaw. Histopathologically the presence of trabeculae of immature bone tissue dispersed in a cellular fibrous stroma and absence of cellular atypia was observed. The diagnosis was FD. The treatment was the total exeresis of the lesion, performed to avoid relapses and due to aesthetic and functional impairment. The patient has been in follow-up for 9 months without recurrence.

Pain due to administration of local anesthetics is the primary reason for patients' fear and anxiety, and various methods are used to minimize it. This study aimed to measure the degree of pain during administration of anesthesia and determine the latency time and duration of pulpal anesthesia using two anesthetic methods in the maxilla. Materials and Methods: A randomized, single-blind, split-mouth clinical trial was conducted with 41 volunteers who required class I restorations in the maxillary first molars. Local anesthesia was administered with a needleless jet injection system (experimental group) or with a carpule syringe (control) using a 30-gauge short needle. The method of anesthesia and laterality of the maxilla were randomized. A pulp electric tester measured the latency time and duration of anesthesia in the second molar. Visual analogue scale (VAS) was used to measure the degree of pain during the anesthetic method. Data were tabulated and then analyzed by a statistician. The t-test was used to analyze the differences between the groups for basal electrical stimulation. Duration of anesthesia and degree of pain were compared using the Mann-Whitney test. A 5% significance level was considered. Results: There was no statistical difference in the basal electrical stimulation threshold (mA) and degree of pain between the two methods of anesthesia (p>0.05). Latency time was 2 minutes for all subjects. The duration of pulpal anesthesia showed no statistical difference (minutes) between the two methods (p

Aim: The aim of this study is to assess the accuracy of images acquired with cone-beam computed tomography (CBCT) in the identification of three different root alterations. Materials and Methods: Forty human premolars were allocated to four experimental groups (n = 10): sound teeth (control), vertical root fracture (VRF), external root resorption (ERR), and root perforation (RP). After the root alterations had been produced, four teeth were randomly assembled into 10 macerated mandibles and submitted to CBCT. Images were acquired with five voxel sizes (0.125, 0.200, 0.250, 0.300, and 0.400 mm) and assessed by three experienced dental radiologists. Sensitivity, specificity, positive and negative predictive values, and the areas under the receiver operating characteristic curve (accuracy) were calculated. The accuracy of imaging in different voxel sizes was compared with Tukey exact binomial test (α=5%). Results: Accuracy with voxel sizes 0.125, 0.200, and 0.250 mm was significantly higher in the detection of ERRs and VRFs than voxel sizes 0.300 and 0.400 mm. No statistical difference was found in terms of accuracy among any of the studied voxel sizes in the identification of RPs. Conclusions: Voxel size 0.125 mm produced images with the best resolution without increasing radiation levels to the patient when compared to voxel sizes 0.200 and 0.250 mm. Voxel sizes 0.300 and 0.400 mm should be avoided in the identification of root alterations.

Introduction The golden proportion has been used in dentistry in an attempt to improve facial function and, possibly, esthetics by simplifying the diagnosis of facial and dental disharmony. The aim of this study is to analyze pre- and postoperative cephalometric tracings of lateral cephalograms of patients with class II and III deformities submitted to orthognathic surgery, and verify if the 13 dental–skeletal patterns (ratios), as defined by Ricketts, moved closer to or further away from the golden proportion. Materials and methods A total of 110 lateral cephalometric radiographs, 55 obtained preoperatively and 55 postoperatively, were analyzed using Dolphin Imaging software. Results Radiographs analysis demonstrated that ratios 1, 3, 4, 5, 7, 8, 9, 10, and 13 remained statistically different from the golden proportion postoperatively. Ratio 12 was the only one to move closer to the golden number, while the opposite happened with ratio 6, which moved further away after the surgery. Ratios 2 and 11 kept statistically similar to the golden proportion both pre and postoperatively. Conclusion It may be concluded that orthognathic surgery had little effect on the proportions studied, and that the golden proportion was not present in the majority of the ratios analyzed neither before nor after surgery. Clinical significance Determine whether the facial patterns approach the golden ratio after surgical correction. Also determine whether the golden ratio may be a standard to guide the surgical treatment of patients with skeletal patterns of type II and III. How to cite this article Bragatto FP, Chicarelli M, Kasuya AVB, Takeshita WM, Iwaki-Filho L, Iwaki LCV. Golden Proportion Analysis of Dental–Skeletal Patterns of Class II and III Patients Pre and Post Orthodontic-orthognathic Treatment. J Contemp Dent Pract 2016;17(9):728-733.

Schwannomas (also known as neurilemomas) are benign tumors that arise from the Schwann cells of the nerve sheath. While they seldom occur in the oral cavity, the tongue is the most common site. Palatal schwannomas are extremely rare. This article reports a case of a large, slowly developing schwannoma that caused bone erosion in the hard palate of an 18-year-old man. The diagnosis was based on histopathologic and immunohistochemical findings. The tumor was completely excised, and no recurrence was observed at a 1-year follow-up. This case is notable for the large dimensions, long period of evolution, and the uncommon anatomical site of the tumor. A review of the main clinical and histologic characteristics of palatal schwannomas reported in the last 40 years is also provided.

Context: Some radicular changes are challenging for clinicians to diagnose, such as of root perforations, external root resorption (ERR), and vertical root fractures (VRFs). This study aims to facilitate it by comparing the diagnostic accuracy of cone-beam computed tomography (CBCT), orthopantomography, and conventional and digital periapical radiography (DPR) in the diagnosis of such problems. Is it worth doing CBCT despite the radiation dose? Aims: To evaluate and compare the diagnostic accuracy of CBCT, panoramic radiography, and conventional and DPR in the diagnosis of root perforation (RP), ERR, and VRF. Materials and Methods: The sample consisted of 40 extracted human teeth and 10 macerated human mandibles. RPs were performed using diamond burs, ERRs using spherical carbide burs, and RFs using a universal machine EMIC-DL 1000. The images were evaluated by 6 dentomaxillofacial radiologists. Results: Receiver operating characteristic (ROC) revealed that CBCT showed the highest area under the ROC curve (Az) values for RP, ERR, and VRF (0.903, 0.950, and 0.849, respectively). The worst Az values for RP, ERR, and VRF (0.718, 0.494, and 0.611, respectively) were for panoramic radiography. Conclusions: CBCT showed the best results in the diagnosis of ERR and VRF. The diagnosis of ERR was the least accurate, panoramic radiography being not appropriate for its diagnosis. CBCT and conventional periapical radiography obtained similar results for the evaluation of RP. So for, RP indicate the conventional periapical radiography because CBCT has a higher radiation dose.

In this manuscript, we present a rare case report of giant complex odontoma in the maxillary sinus, where the applied therapy included complete excision of the lesion with a conservative approach. Odontomas are also called benign growth abnormalities or hamartomas. They represent a more common type of odontogenic tumor and are related to various disorders such as bad dental placements, expansion, increased volumetric bone, and no eruption of permanent teeth. Usually they have an asymptomatic evolutionary course. The etiologic factors, although obscure, are related to local trauma, infection, and genetic factor. The structural composition of an odontoma consists of mature dental tissues. Odontomas can be differentiated according to their anatomical presentations: Compound odontoma-clusters of several denticles and complex odontoma-well defined tumefaction mass. The diagnosis can be performed by radiographic examination.