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Abstract Background The purpose of this study was to objectively assess dimensional alteration (blooming artefact) on dental implant using 13 cone-beam computed tomography (CBCT) devices adjusted to device-specific scanning protocols and to assess whether subjective adjustment of brightness and contrast (B&C) could alter its visualization. Methods An anthropomorphic phantom containing a dental implant was scanned in 13 CBCT devices adjusted to three scanning protocols: medium-FOV standard resolution, small-FOV standard resolution, and small-FOV high resolution. The diameter of the implant was measured at five levels, averaged, and compared with those from a reference standard industrial CT image. B&C adjustments were performed and measurements were repeated. The intraclass correlation coefficient assessed the reliability of the measurements and general linear mixed models were applied for multiples comparisons at a 95% confidence interval. Results Implant diameter obtained from small-FOV high-resolution protocols in most CBCT devices was not significantly different when compared to that from the reference (p > 0.05). For standard protocols, significant dimensional alteration of the implant ranging from 23 to 34% (0.67 to 1.02 mm) was observed in 9 CBCT devices for small-FOV scanning (p < 0.05), and in 8 CBCT devices for medium-FOV scanning, implant dimensional alteration ranged significantly from 21 to 35% (0.62 to 1.04 mm). After B&C adjustments, dimensional alteration was reduced for several of the CBCT devices tested (p < 0.05). Conclusions The visualization of the implant dimensional alteration differed between CBCT devices and scanning protocols with an increase in diameter ranging from 0.27 to 1.04 mm. For most CBCT devices, B&C adjustments allowed to reduce visualization of implant blooming.

Abstract The aim of this study was to evaluate the foraminal enlargement and its influence on microcrack formation and apical transportation in root canals with apical curvature. Eighteen maxillary lateral incisors with apical curvature were selected by using micro-CT images. Root canals were randomly divided in two groups (n = 9) according to root canal preparation using two working lengths: 1 mm short of the apical foramen (control group) and 1 mm beyond the apical foramen (foraminal enlargement). For both groups Reciproc Blue R40 was used for root canal instrumentation. Specimens were scanned by nano-CT (UniTOM HR) before and after root canal preparation. Percentage, length, and width of microcracks, and apical transportation were assessed. Kappa, chi‐square and McNemar tests were used for qualitative analyses while paired and unpaired t-test were used for quantitative analyses (α = 0.05). For both groups, rather similar and low percentages of microcracks were observed before root canal preparation (P > 0.05). The foraminal enlargement promoted new microcracks, not observed in the control group. An increase in microcrack length was observed when the foraminal enlargement was performed (P

Abstract The aim of this study was to evaluate CBCT exposure protocols and CBCT devices in terms of image quality for the detection of cracks and fine endodontic structures using 3 conditions of metallic artifacts. An anthropomorphic phantom containing teeth with cracks, isthmus, narrow canal, and apical delta was scanned using ten CBCT devices. A reference industrial CT image was used to detect and measure all structures. Three conditions were created: (1) metal-free, (2) ‘endo’ and (3) ‘implant’ with metallic objects placed next to the teeth of interest. For each condition, three protocols were selected: medium field of view (FOV) standard resolution, small FOV standard and high resolution. The results showed that only small FOV high-resolution metal-free images from two devices (A and H) were appropriate to visualize cracks. For fine structure identification, the best result was observed for small FOV high resolution. However, the visualization significantly worsened in the presence of metallic artefacts. The ability of CBCT images for visualizing cracks is restricted to certain CBCT devices. Once metallic artefacts are present, crack detection becomes unlikely. Overall, small FOV high-resolution protocols may allow detection of fine endodontic structures as long as there are no high-dense objects in the region of interest.

Background and purposeIn comparison to conventional medical imaging diagnostic modalities, the aim of this overview article is to analyze the accuracy of the application of Artificial Intelligence (AI) techniques in the identification and diagnosis of malignant tumors in adult patients.Data sourcesThe acronym PIRDs was used and a comprehensive literature search was conducted on PubMed, Cochrane, Scopus, Web of Science, LILACS, Embase, Scielo, EBSCOhost, and grey literature through Proquest, Google Scholar, and JSTOR for systematic reviews of AI as a diagnostic model and/or detection tool for any cancer type in adult patients, compared to the traditional diagnostic radiographic imaging model. There were no limits on publishing status, publication time, or language. For study selection and risk of bias evaluation, pairs of reviewers worked separately.ResultsIn total, 382 records were retrieved in the databases, 364 after removing duplicates, 32 satisfied the full-text reading criterion, and 09 papers were considered for qualitative synthesis. Although there was heterogeneity in terms of methodological aspects, patient differences, and techniques used, the studies found that several AI approaches are promising in terms of specificity, sensitivity, and diagnostic accuracy in the detection and diagnosis of malignant tumors. When compared to other machine learning algorithms, the Super Vector Machine method performed better in cancer detection and diagnosis. Computer-assisted detection (CAD) has shown promising in terms of aiding cancer detection, when compared to the traditional method of diagnosis.ConclusionsThe detection and diagnosis of malignant tumors with the help of AI seems to be feasible and accurate with the use of different technologies, such as CAD systems, deep and machine learning algorithms and radiomic analysis when compared with the traditional model, although these technologies are not capable of to replace the professional radiologist in the analysis of medical images. Although there are limitations regarding the generalization for all types of cancer, these AI tools might aid professionals, serving as an auxiliary and teaching tool, especially for less trained professionals. Therefore, further longitudinal studies with a longer follow-up duration are required for a better understanding of the clinical application of these artificial intelligence systems.Trial registrationSystematic review registration. Prospero registration number: CRD42022307403.

Este artigo apresenta ferramentas para lidar com o diagnóstico tardio do câncer bucal no Brasil, com base na Estratégia de Saúde da Família (ESF). A ESF é uma política pública de saúde. Ela representa uma ruptura com a organização disciplinar tradicional, muito fragmentada e dirigida ao aspecto biológico do processo saúde-doença, fornecendo um caminho para médicos, dentistas, enfermeiros e outros profissionais da saúde para estabelecer ligações entre o conhecimento específico em cada área. Nesse contexto, o presente artigo apresenta os seguintes instrumentos para lidar com o atraso no diagnóstico de câncer bucal: a educação continuada para a equipe de saúde bucal; a identificação de pacientes de risco, o acesso invertido e a garantia do exame obrigatório para pacientes com idade acima de 50 anos, fumantes e ou etilistas. Investir em educação continuada pode ser a chave para reduzir as barreiras associadas ao diagnóstico precoce do câncer bucal.

El artículo está estructurado en dos estudios exploratorios sobre el ejercicio de diagnóstico clínico de las lesiones orales. Los datos fueron obtenidos a través de cuestionarios administrados durante las actividades de educación continua. Alrededor de 300 dentistas que trabajan en atención primaria respondieran. Para la mayoría (79,5%), hay tiempo, infraestructura y voluntad de un diagnóstico precoz. Por otro lado, los profesionales han expresado dificultades para realizar el exámen clínico centrado en el cáncer, debido a que necesitan más informaciones sobre la enfermedad. Los resultados proporcionan la base para la interpretación de auto-reporte del cirujano dentista, a nivel individual, así como la base para, a partir de la revisión de la literatura, de la actualidad para la interpretación individual de los marcos conceptuales en el comportamiento de la salud (la teoría del comportamiento planificado) desde el punto de vista individual, y la interpretación de la sociología de las profesiones y las teorías de la planificación y programación para la promoción y vigilancia de la salud, en la perspectiva colectiva.

The aim of this study was to compare clinical staging and magnetic resonance imaging (MRI) staging for oral cancer, and to assess inter-observer agreement between oral and medical radiologists. A total of 10 patients diagnosed with oral cancer were assessed before treatment. A head and neck surgeon performed clinical TNM staging. Two medical radiologists and two oral radiologists performed a new staging assessment by interpreting MRI scans, without prior knowledge of the clinical staging. They evaluated the extent of the primary tumor (T), metastasis to regional lymph nodes (N) and grouping by stages. The data were analyzed using the Kappa Index. There was significant agreement (p < 0.05) between the clinical and MRI staging assessments made by one oral radiologist for N stage, and between those made by one medical radiologist for the T and N stages and for the grouping by stages. In the MRI assessment, there was significant agreement among all four observers for both T stage and grouping by stages. For the N stage, there was no significant agreement between one oral radiologist and one medical radiologist or between both medical radiologists. There was significant agreement among the remaining radiologists. There was no agreement between the clinical and MRI staging. These results indicate the importance of using MRI for the diagnosis of oral cancer. Training initiatives and calibration of medical and oral radiologists should be promoted to provide an improved multidisciplinary approach to oral cancer.

A osteoporose é considerada um problema de saúde pública pela Organização Mundial de Saúde (OMS). A identificação de indivíduos com baixa densidade mineral óssea e alto risco para fratura associada à osteoporose e o estabelecimento de estratégias específicas de prevenção de fraturas são o alicerce de qualquer programa preventivo de osteoporose. O passo seguinte a esse reconhecimento seria o encaminhamento destes indivíduos para realização de densitometria óssea, exame considerado padrão-ouro para o diagnóstico da doença. No entanto, o custo e a falta de acesso da população ao exame são fatores que dificultam a utilização da densitometria como método de rastreamento populacional para a osteoporose. A radiografia panorâmica é importante na rotina de pacientes idosos, particularmente antes da colocação de próteses totais e implantes em edêntulos. Existem medidas qualitativas e quantitativas realizadas nas radiografias panorâmicas, denominadas índices radiomorfométricos, que podem ser capazes de identificar mulheres na pós-menopausa com indicação de realização de densitometria óssea. O objetivo principal deste artigo é discutir a importância da radiografia panorâmica como ferramenta auxiliar no diagnóstico da osteoporose e de baixa densidade mineral óssea.Osteoporosis is considered as a public health problem by World Health Organization. The identification of subjects at risk of fractures and with low bone mineral density is the basis of any preventive osteoporosis program. Then, high risk individuals should be referred for dual X-ray absorptiometry (DXA). DXA is considered the gold standard of bone mineral density assessment. Nevertheless, bone densitometry has a limited availability for routine use in population screening. Panoramic radiography is conducted routinely in elderly populations, especially for edentulous patients before treating with complete denture or implants. Some panoramic radiographic measurements, also known as panoramic radiomorphometric indices, may identify postmenopausal women that should perform bone densitometry. The main purpose of this paper is to discuss the importance of panoramic radiography as an auxiliary tool in the diagnosis of osteoporosis and low bone mineral density.

Objectives. This paper offers a critical review of published information on the imaging strategies used for diagnosing bisphosphonate-associated osteonecrosis of the jaw (BRONJ) in patients taking intravenous bisphosphonates, pointing at the different methodologies and results of existing literature. Methods. Electronic literature search was performed in order to identify as many quantitative studies that discussed the imaging findings of BRONJ up to February 2014. Initially, the search for articles was based on the following four types of imaging modalities for evaluating BRONJ: computed tomography, plain film radiographs, magnetic resonance imaging, and nuclear bone scanning. Results. Eleven out of the 79 initially selected articles met the inclusion criteria. Most of the selected articles were cross-sectional studies. Regarding the selected studies, 54.5% have used plain films radiographs and 54.5% were based on computed tomography findings. All of the selected studies showed a small number of patients and none of the selected studies have tested the accuracy of the imaging examination for evaluating BRONJ. Conclusions. This critical review showed a scarcity of quantitative studies that analyzed the typical imaging findings related to BRONJ. Further studies are necessary in order to analyze the role of different imaging techniques in the assessment of BRONJ.

Objective Analyze the influence of sarcopenia in bone health of elderly men. Subjects and methods This cross-sectional study evaluated 198 men aged over 60 years. Body composition was measured by dual energy X-ray absorptiometry. The BMD was measured at the femoral neck, total hip, lumbar spine and 33% radius. The diagnosis of abnormal BMD was defined for men who presented densitometric diagnosis of osteopenia or osteoporosis defined by T-score of femoral neck, total hip and lumbar spine. The pre-sarcopenia and sarcopenia were defined according to the European Working Group on Sarcopenia in Older People. Results The group diagnosed with normal BMD, compared to the group of abnormal BMD, have significantly higher body weight, body mass index, grip strength, lean mass, fat mass, and relative appendicular skeletal muscle mass (RASM). However, after multiple linear regression analysis, we found that only the RASM, lean mass, and handgrip strength in the dominant hand influenced the variability of the BMD after adjustment for age and weight. Regression analyzes showed a positive association between greater appendicular lean mass and a smaller number of elderly patients with abnormal BMD diagnostic. The regression analyzes showed that elderly men diagnosed with pre-sarcopenia and sarcopenia had more abnormal BMD than non-sarcopenic elderly men. Conclusion We concluded that pre-sarcopenia and sarcopenia were associated with abnormal BMD. The lean mass, compared to fat mass, has a greater positive influence on the BMD of elderly men. This result suggests the importance of the increase in lean mass for the bone health of elderly men. Arch Endocrinol Metab. 2015;59(1):59-65