Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-07-04T10:50:47Z No. of bitstreams: 1 andreiafialhorodrigues.pdf: 1214952 bytes, checksum: 9f8b3461dead1f5e477600658f658442 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-08T14:15:16Z (GMT) No. of bitstreams: 1 andreiafialhorodrigues.pdf: 1214952 bytes, checksum: 9f8b3461dead1f5e477600658f658442 (MD5) / Made available in DSpace on 2017-08-08T14:15:16Z (GMT). No. of bitstreams: 1 andreiafialhorodrigues.pdf: 1214952 bytes, checksum: 9f8b3461dead1f5e477600658f658442 (MD5) Previous issue date: 2013-10-29 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / As imagens de tomografia computadorizada de feixe cônico (TCFC) têm sido utilizadas para a avaliação da qualidade óssea, entretanto algumas variáveis inerentes ao exame parecem influenciar os valores de densidade obtidos, sendo que a influência do volume do campo de visão (FOV) ainda não foi completamente explicada. O objetivo deste estudo foi determinar os efeitos do volume do FOV no valor da densidade em TCFC e tomografia computadorizada multislice (TCMS). Um objeto teste composto por três cilindros de acrílico contendo água destilada, gesso e óleo de motor foi construído e inserido em um cilindro de acrílico completamente preenchido com água destilada. O objeto teste foi escaneado com uma TCFC e com uma TCMS, utilizando três tamanhos de FOV: 8x8cm, 16x8cm e 16x13cm. A densidade de cada material foi avaliada em 40 regiões de interesse posicionadas nos cortes axiais. Nos exames de TCFC, houve diferença significativa entre os valores de densidade dos diferentes FOVs para os três materiais. Já nos exames de TCMS houve diferença significativa somente para o óleo. Os valores de densidade mostraram significante correlação entre os exames de TCFC e TCMS para o gesso em todos os FOVs. A água não apresentou correlação significante entre os exames de TCFC e TCMS com os FOVs utilizados. O óleo não apresentou correlação no FOV 8 x 8mm e apresentou uma baixa correlação nos FOVs 16 x 8mm e 16 x 13mm. Os valores de densidade determinados em imagens de TCFC sofreram interferência significativa pela variação do tamanho do FOV. Os valores de densidade obtidos em exames de TCMS apresentaram diferença estatisticamente significante somente para o óleo. / Computed tomography cone beam (CBCT) scans have been used to evaluate the quality of bone. The values of density seem to be influenced by some CBCT inherent variables. However, some variables inherent to CBCT seem to influence the values of density and the influence of FOV volume has not been completely elucidated. The aim of this study was to determine the effects of FOV size on density values in large-volume CBCT and MSCT images. A phantom made up of 3 cylinders containing distilled water, plaster and motor oil was constructed and inserted into an acrylic cylinder filled with distilled water. The phantom was scanned with a CBCT and MSCT device using 3 FOV sizes. Density of each material was evaluated in 40 regions of interest. In CBCT exams there was significant difference between the density values of different FOVs for the 3 materials. In the MSCT there was significant difference only for the oil. A significant correlation between CBCT and MSCT exams for the plaster in all of the FOVs was obtained. The water did not show significant correlation between CBCT and MSCT exams with the FOVs under study. The oil was not correlated in 8 x 8mm FOV and a low correlation of the FOVs 16 x 8mm and 16 x 13mm. The density values determined in CBCT images showed significant interference by varying the size of the FOV. The density values obtained in MSCT examinations showed a statistically significant difference only for oil.

Orientador: Guilherme Monteiro Tosoni / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T18:16:43Z (GMT). No. of bitstreams: 1 Macedo_PaulodeTarsoSilvade_M.pdf: 1116393 bytes, checksum: 75612f26705c22bfdd039c815abb1367 (MD5) Previous issue date: 2014 / Resumo: O objetivo neste estudo foi avaliar a influência de diferentes protocolos de aquisição da imagem de Tomografia Computadorizada de Feixe Cônico (TCFC) na visualização das estruturas periodontais e na mensuração do nível ósseo alveolar. Inicialmente, foi realizada uma avaliação subjetiva sobre a qualidade de visualização das estruturas periodontais (cortical alveolar, espaço do ligamento periodontal e trabeculado ósseo) em imagens de TCFC, obtidas de crânios macerados com seis diferentes protocolos de aquisição, combinando-se tamanhos de voxel (0,20, 0,30 e 0,40mm) e graus de rotação (180 e 360º). As imagens foram avaliadas por três examinadores que atribuíram escores sobre a qualidade de visualização. Em seguida, realizou-se uma avaliação quantitativa, na qual o nível ósseo de 64 sítios apresentando perda óssea foi medido nas imagens de TCFC e nos crânios macerados. Após 30 dias, a amostra foi reexaminada. Para a avaliação qualitativa, o índice Kappa ponderado foi utilizado para avaliar as concordâncias intra- e interexaminador. As médias dos escores para cada uma das três estruturas periodontais, com cada protocolo de aquisição, foram comparadas utilizando-se a Análise de Variância (ANOVA) e Teste de Tukey. Para os dados quantitativos, o coeficiente de correlação intra-classe (ICC) foi aplicado para verificar as concordâncias intra- e interexaminador. A comparação entre as médias de erro dos diferentes protocolos também foi feita por meio da Análise de Variância (ANOVA) e teste de Tukey. O nível de significância adotado foi de 5%. De modo geral, o protocolo com menor tamanho de voxel e rotação completa do tubo apresentou escore significativamente melhor para a visualização das estruturas periodontais (p<0,0001). As concordâncias intra- e interexaminador também se mostraram fortes na avaliação quantitativa, com valores médios de ICC superiores a 0,90. As médias de erro dos protocolos que utilizaram voxel de 0,40 mm foram significativamente maiores que as dos outros protocolos (p<0,0001). Os protocolos que utilizam tamanhos de voxel de 0,20 e 0,30 mm, independente dos graus de rotação total (360º) ou parcial (180º), apresentaram a mesma acurácia na mensuração do nível ósseo alveolar. O grau de rotação não influenciou o resultado das mensurações do nível ósseo (p>0,05). Concluímos que, em relação à qualidade subjetiva da imagem, a combinação do menor tamanho de voxel (0,20 mm) com o grau de rotação total (360º) proporciona uma visualização significativamente melhor das estruturas periodontais. Do ponto de vista quantitativo, com relação à mensuração do nível ósseo alveolar, os tamanhos de voxel de 0,20 e 0,30 mm, independente dos graus de rotação total (360º) ou parcial (180º), apresentam a mesma acurácia / Abstract: The aim of this study was to assess the efficacy of cone-beam CT image acquisition protocols in the visualization of periodontal structures and periodontal bone height determination. First, subjective quality assessment of lamina dura delineation, trabecular bone and periodontal ligament space was performed using an ordinal scale ranging from 0 to 3 on CBCT scans obtained of dry skulls, with six different acquisition protocols, varying the voxel size (0.20, 0.30 and 0.40 mm) and degree of rotation (180 and 360º). In addition, a total of 64 sites, in the dry skulls, showing bone loss, were measured with a digital caliper (gold standard) and in the CBCT scans obtained with each protocol (quantitative analysis). The images were evaluated by 3 examiners. After 30 days, the total sample was re-evaluated. For subjective rating, weighted Kappa coefficients were calculated for intra- and inter-rater agreement. The mean scores of each structure in each of the protocols were compared by means of ANOVA one-way. Tukey¿s post hoc test was used to determine significant differences within protocols. For quantitative data, the intraclass correlation coefficients (ICC) was used to evaluate intra- and inter-examiner agreement; one-way ANOVA tested differences in mean errors for each acquisition protocol and Tukey¿s post hoc test was used to determine significant differences within protocols. The images acquired with lower voxel size and complete tube rotation (360º) were significantly superior in the visualization of lamina dura, trabecular bone and periodontal ligament space. ICC showed high intra- and inter-examiner agreement for all observations. There were significant differences (p<.0001) between the mean error (gold standard deviation) of periodontal bone level measurements of the 0.40 mm protocols, when compared with protocols using voxel sizes of 0.20 and 0.30 mm. The mean error of protocol that used 0.40 mm voxel size and half rotation (180º) was 0.57 mm, therefore, clinically significantly. Rotation arch did not influence the measurements of periodontal bone level. In conclusion, protocols that use 0.20 or 0.30 mm of voxel size, independently of the rotation arch, has the same accuracy in the measurement of periodontal bone height. The combination of smaller voxel (0.20 mm) with the complete tube rotation (360º) showed higher efficacy in the visibility of periodontal structures / Mestrado / Radiologia Odontologica / Mestre em Radiologia Odontológica

Orientador: Solange Maria de Almeida Bóscolo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T18:23:38Z (GMT). No. of bitstreams: 1 Marchini_MonikellydoCarmoNascimento_D.pdf: 1392987 bytes, checksum: e5d4a72a80998af2c16e333f3dee6408 (MD5) Previous issue date: 2014 / Resumo: A tomografia computadorizada de feixe cônico (TCFC) tem sido uma ferramenta de auxílio no diagnóstico, com várias aplicações clínicas. Devido ao aumento das diversas possibilidades de aquisição da imagem, há uma grande necessidade de um constante ajuste da imagem para cada proposta de diagnóstico. A avaliação da cortical óssea é importante para os casos de planejamento de implante imediato e para os casos em que há a necessidade de movimentação ortodôntica extensa. Entretanto, alguns fatores de qualidade de imagem devem ser considerados para uma acurada visualização da cortical óssea. Assim, com o presente estudo avaliou a influência do grau de rotação do aparelho, 3600 e 1800, bem como a influência de diferentes posições do crânio na avaliação da espessura da cortical óssea em imagens de TCFC. Para tanto, foram utilizados 11 crânios de humanos nos quais foram selecionados 59 dentes da maxila e mandíbula para avaliação de suas corticais ósseas. As imagens foram adquiridas no aparelho de TCFC Accuitomo 170, com voxel de 0,16mm, em quatro diferentes aspectos com relação à rotação do aparelho e posição do crânio respectivamente (protocolo 1: 3600/00; protocolo 2: 1800/00; protocolo 3: 1800/900; protocolo 4: 1800/1800). Para a avaliação das imagens, a cortical óssea foi classificada em três grupos de acordo com a condição ou espessura (cortical ausente, cortical fina e cortical espessa). No total 472 imagens bidimensionais (2D), referentes a cortes sagitais, foram avaliadas por três radiologistas previamente calibrados. Para concordância intra e interobservador foi utilizado o teste kappa e para avaliação das espessuras das corticais ósseas em relação ao real e entre os diferentes tipos de imagem foi utilizado o teste de Wilcoxon Signed Ranks. O teste de Kappa ponderado foi utilizado para comparar as diferentes condições da espessura óssea nos quatro protocolos de imagem. O nível de significância estabelecido foi de 95% (?=0,05). Os resultados obtidos mostraram que a concordância intraobservador variou de quase perfeita (k=0,87) a moderada (k=0,50) e a concordância interobservador variou de substancial (k=0,79) a moderada (k=0,56). De acordo com os resultados obtidos, observou-se que apenas para o protocolo 1 na região da cortical lingual, não houve diferença estatística entre as imagens e o padrão-ouro. Quando avaliando a cortical lingual, os maiores valores de concordância foram observados no protocolo 3, quando esta era ausente (k=0,80) e fina (k=0,47), já para cortical lingual espessa, o mais concordante foi o protocolo 2 (k=0,60). Avaliando-se somente a cortical vestibular, quando esta era ausente, o protocolo 3 exibiu o maior valor de concordância (k=0,61), enquanto que o protocolo 4 foi o mais concordante para cortical vestibular fina (k=0,38) e o protocolo 2 para a cortical vestibular espessa (k=0,40). Concluiu-se que o diagnóstico da espessura da cortical óssea não apresenta concordância perfeita com as imagens de TCFC, exceto para a região da cortical lingual no protocolo 1. Houve uma maior dificuldade de diagnóstico para a cortical vestibular em relação a lingual. Além disso, quando a espessura é mais fina, mais difícil é o diagnóstico / Abstract: The cone beam computed tomography (CBCT) has been a complement tool in diagnosis of many clinical applications. Due to the increase of the various possibilities of imaging, there is a great need for an image adjustment for each proposal to be diagnosed. The evaluation of cortical bone is important for implants pos-extraction placement and in cases requiring extensive orthodontic movement. However, some factors of image quality should be considered for accurate visualization of cortical bone. Thus, this study aimed to evaluate the influence of the arc rotation (3600 and 1800), and the influence of different positions of the skull to assess the thickness of buccal and lingual cortical bone in CBCT images. For this, 59 teeth of 11 human skulls in both arcs were selected. Images were made on Accuitomo 170 CBCT. The voxel size used was 0.16 mm. Four different aspects of image regarding the rotation of the device and position of the skull were made respectively (protocol 1: 3600/00; protocol 2: 1800/00; protocol 3: 1800/900; protocol 4: 1800/1800). For evaluation of the images, the cortical bone was classified into three groups according to the condition or the thickness (absent cortical, thin cortical, and thick cortical). A total of 472 two-dimensional images (2D) in sagittal sections were evaluated by three radiologists previously calibrated. For intra- and interobserver agreement kappa test was used. Wilcoxon Signed Ranks test was used to assess the cortical bone thickness compared to the gold standard and among different protocols. Ponderate Kappa test was used to compare conditions of cortical bone among protocols. The significance level was set at 95% (?=0.05). The results showed that the intraobserver agreement ranged from almost perfect (k=0.87) to moderate (k=0.50) and interobserver agreement ranged from substantial (k=0.79) to moderate (k=0.56). According to the results obtained, the protocol 1 showed that no statistical difference between the images and the gold standard was found only in lingual cortical bone region. When evaluating lingual cortical, higher reliability values was found with protocol 3 for absent (k=0.80) and thin (k=0.47), while for thick cortical in lingual side, the more consistent was the protocol 2 (k=0.60). Evaluating only buccal cortical side, the protocol 3 obtained the best agreement value for absent, (k=0.61), while the protocol 4 was better for thin cortical in buccal side (k=0.38), and protocol 2 for thick cortical in buccal side (k=0.40). It was concluded that the diagnosis of cortical bone thickness do not show agreement with CBCT images, except for lingual cortical bone in the protocol 1. There was more difficult diagnosis in buccal cortical compared to lingual cortical side. In addition, when the thickness is thinner more difficult the diagnosis is / Doutorado / Radiologia Odontologica / Doutora em Radiologia Odontológica

Magister Scientiae - MSc / Nowadays, the availability of radiographic modalities from conventional radiography to more advanced approaches such as medical computed tomography as well as cone beam computed tomography have been useful in providing insights of relevant anatomy prior to surgical procedures. The increased popularity of cone beam computed tomography has prompted interest in the utility of this approach for diagnostic application in dentistry, including the assessment of the proximity of impacted mandibular third molars to the inferior alveolar canal. It is important to understand the reliability of conventional panoramic radiograph in the assessment of this criterion since it is more commonly used as first line radiographic approach due to its availability and lower radiation dose. This study is aimed to investigate the reliability of conventional panoramic radiograph in the evaluation of the proximity of impacted mandibular third molar root tip to the inferior alveolar canal by correlating the results with cone beam computed tomography. A retrospective study of forty nine patients who underwent panoramic radiography as well as cone beam computed tomography for examination of impacted mandibular third molars was conducted. Two observers were participated in all image evaluation. In this study, both observers recorded statistically significant differences in the measurement of the apices of vertically impacted third molars and the inferior alveolar canal from panoramic radiographs and cone beam computed tomography images. The low reliability of panoramic radiograph to assess the vertical proximity between these two anatomical structures suggests the importance of additional assessment with cone beam computed tomography in cases where panoramic radiograph shows superimposition of the third molar root on the roof of the canal, presence of root below the roof of the canal and presence of bone height of less than one millimetre separating the third molar from the inferior alveolar canal.

Cone-beam computed tomography (CBCT) has become increasingly popular in dentistry. It is usually associated with radiation doses that are lower than those seen with conventional computed tomography (CT) but greater than those seen with dental radiography. Because exposure to ionising radiation is associated with risks, the radiation protection principles of justification and optimisation should be applied. These are especially important in children and young people due to their greater risk of developing stochastic effects. Justification requires a balancing of the radiation risk with the potential benefits and the latter is dependent on diagnostic efficacy. There has been a proliferation of articles published on dental CBCT and there is a need to review this systematically so that diagnostic efficacy can be judged. In terms of optimisation, radiation dose reduction can be achieved in various ways, but the use of barrier materials to protect younger patients in CBCT has not been adequately tested. Reduction in exposure parameters in CBCT will lower doses but at the expense of a loss of image quality. While some efforts have been made to relate radiation exposure and image quality in CBCT, there is a need to develop low-dose CBCT protocols specifically for children and young people. The first aim of this thesis was to survey current uses of CBCT in children and young people in three United Kingdom dental hospitals. The second aim was to determine the efficacy of thyroid shielding in a child phantom testing several different designs, materials and thickness of thyroid shields. The third aim was to evaluate the evidence on diagnostic efficacy of dental CBCT for root fractures in permanent, non-endodontically treated, anterior teeth by conducting a systematic review. The fourth aim was to evaluate objective and subjective image quality in a laboratory study to determine a low-dose CBCT protocol which maintains adequate diagnostic image quality for a clinical indication in children. Finally, the aim was to evaluate this low-dose protocol in terms of image quality in real clinical situations. A high adherence to the European guidelines No 172 on radiation protection in dental CBCT was found amongst the surveyed hospitals. Thyroid shielding was found to be effective in dose reduction when performing a large field of view CBCT scan in a child phantom, but design influenced efficacy. The systematic review showed that research articles investigating CBCT diagnostic accuracy for vertical and horizontal root fractures had deficiencies in methodology, while only one study was identified addressing higher levels of diagnostic efficacy. A low-dose imaging protocol was identified in a laboratory study, which has been shown to be an effective tool in dose reduction providing an adequate diagnostic image quality and reducing radiation doses considerably for clinical indications in the anterior maxilla in children and young people.

No description available.

The RTT80 cone beam x-ray computed tomography system, developed by Rapiscan Systems Ltd, uses switched x-ray sources and fixed offset detector rings to remove the time consuming mechanical rotations of earlier imaging systems. This system produces three-dimensional images in real time. A Geant4 Monte Carlo simulation has been developed to investigate scattered radiation in the uncollimated detector machine, showing high levels of scatter behind highly attenuating objects. A new scatter correction method is proposed which estimates scatter to each detector, in each projection, from 1cm³ voxels of the computerised object. The scatter distributions from different materials are pre-determined using a Geant4 Monte Carlo simulation. The intensity of scatter from each voxel is based on measured data. The method is applied to two simulated test objects, a water box simulated with a monoenergetic input spectrum and a test suitcase simulated with a polyenergetic spectrum. The test suitcase is broken down into separate components to analyse the method further. The results show that the method performs well for low attenuating objects, but the results are sensitive to the intensity values. However, the method provides a good basis for a scatter correction method.

Changes occur to the mandible with dental loss and senescence. However, the influence that these changes have on sex and ancestry estimations remains unclear. The purpose of this study was to investigate the influence of dental loss and senescence on changes in mandibular morphology. The outcome has implications for both forensic anthropology and restorative dentistry. The study sample consisted of 717 mandibles consisting of both male and female South Africans of African (SAA) and European ancestry (SAE). To minimise the effects of variation in dentition amongst sex-ancestry groups, the sample included individuals with a spectrum of tooth loss patterns, namely efficient and inefficient occlusions as well as no occlusions. Dentition was considered efficient when the remaining teeth in occlusion were evenly distributed between the sides. Linear measurements as well as geometric morphometric shape analyses were performed. Shape analyses of the complete mandible were performed on models from digitised landmarks by using a MicroScribe G2. Detailed shape analyses of the ramus and chin area as well as measurements of the cortical thickness at specific sites were executed on images generated by cone beam computed tomography (CBCT). A comprehensive assessment of changes in shape, size and cortical thickness of the mandible with age and dental loss were made. Shape and size differences of the mandible were evaluated for discriminant abilities between sex and ancestry groups. Although most dimensions decreased with tooth loss, the greatest impact was noted in the loss of alveolar bone. The mandibular angle increased minimally in size when a few teeth were lost, but recovered to some extent with further tooth loss. The cortical thicknesses at the mental foramen lingually as well as in the midline in females, were relatively spared with tooth loss. Male individuals of SAA were often the most resilient to tooth loss. In general external linear dimensions were maintained with age despite tooth loss. Conversely, measurements of cortical bone thickness decreased slightly, but could have been influenced by dental loss. The shape of the chin and gonial area was more affected by aging in SAE. The sex and ancestry discriminant ability of the linear dimensions when considered collectively approximated 90%, in general improving further when tooth loss was taken into account. All linear measurements were smaller in females and in general tooth loss accentuated sex differences. SAA exhibited greater dimensions, apart from maximum ramus height, bigonial breadth and cortical thickness at the gonion. The mental tubercles were more prominent than the pogonion in SAE (square chin) and vice versa in individuals of SAA (pointed chin). The gonial area in individuals of African ancestry was broad and more convex and the gonial eversion more prominent with a more upright ramus. Discriminant qualities of the gonial shape for sex in individuals of African ancestry reached 90% within dentition groups. Ramus flexure and chin shape were not found to be useful in sex estimation. In conclusion, this research elucidated the effects of tooth loss and senescence on the morphology of the mandible for the forensic anthropological setting. / Thesis (PhD)--University of Pretoria, 2015. / tm2015 / Anatomy / PhD / Unrestricted

Orientador: José Ricardo de Albergaria Barbosa / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T08:11:33Z (GMT). No. of bitstreams: 1 CoutoFilho_CarlosEduardoGomesdo_D.pdf: 781269 bytes, checksum: ece61cf44630f51a36c78d2c819a23e9 (MD5) Previous issue date: 2014 / Resumo: A reabilitação bucal com implantes dentários revolucionou a odontologia. No entanto, conhecimentos anatômicos como também técnicos são essenciais para a realização de um adequado tratamento. Desta forma, a reabilitação através da instalação de implantes dentários na região interforaminal (forames mentuais) tornou-se comum em reabilitações totais mandibulares. Em consequência disto, um grande número de transtornos sensoriais tem sido descritos e relacionados a alças anteriores do nervo mentual. A divisão do canal mandibular em nervo mentual, responsável pela inervação de tecidos moles (mucosa vestibular, fundo de sulco vestibular, mucosa labial do lábio inferior, pele do mento e lábio inferior), e feixe incisivo, que pode localizar-se no canal incisivo e é responsável pela inervação da região ântero-inferior (dentes e tecidos periodontais) deve ser considerada no planejamento de intervenções nesta região. A injúria a alça do nervo mentual do canal mandibular e ao feixe incisivo poderá trazer transtornos como perda de sensibilidade, edema, hematoma e falha na osseointegração. Apesar de ser considerada uma área segura para cirurgias ela é muito negligenciada no planejamento de tais procedimentos. A associação do conhecimento anatômico, tanto clínico quanto de imagens, torna o procedimento mais previsível devido às variações anatômicas, fazendo-se necessários exames de imagens, essenciais no controle de acidentes relacionados aos procedimentos de implantes intraforaminais. Como um dos exames de imagem mais utilizado em implantes dentais, a radiografia panorâmica apresenta precisão diagnóstica questionável. Portanto, verificamos a precisão da radiografia panorâmica quando comparada com a tomografia computadorizada cone-beam no diagnóstico da alça anterior do nervo mentual. Palavras chave: radiografia.panorâmica, tomografia computadorizada de feixe cônico, alça anterior do nervo mentual. / Abstract: Oral rehabilitation with dental implants has revolutionized dentistry. However, both anatomical and technical knowledge are essential to provide an appropriate treatment. Thus, the rehabilitation by installing dental implants at interforaminal region (mental foramina) has become common in total mandibular rehabilitation. Consequently, a large number of sensory disorders has been described and related to the anterior loop of mental nerve. The division of the mandibular canal into mental nerve, responsible for innervation of soft tissues (buccal mucosa, bottom of buccal sulcus, labial mucosa of the lower lip, skin of the chin and lower lip), and incisive branch, which may be located in the incisive canal and is responsible for the innervation of the lower anterior region (teeth and periodontal tissues) should be considered during the planning of interventions in this region. Injury to the loop of the mental nerve of the mandibular canal and to the incisive branch will likely bring disorders such as loss of sensitivity, swelling, hematoma and failure of osseointegration. Although considered a safe area for surgery, it is very neglected in the planning of such procedures. The association of anatomical knowledge, both clinical and of images, makes the procedure more predictable due to anatomical variations, making the imaging examinations necessary, which are essential in the control of accidents related to intraforaminal implant procedures. As one of the most widely used imaging examinations in dental implants, panoramic radiograph presents questionable diagnostic accuracy. Therefore, we verified the accuracy of panoramic radiograph in comparison with cone-beam computed tomography in the diagnosis of the anterior loop of the mental nerve. Keywords: panoramic radiography, cone-beam computed tomography, anterior loop length, mental nerve. / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

Orientador: Adriana de Jesus Soares / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-26T12:44:09Z (GMT). No. of bitstreams: 1 Lima_ThiagoFariasRocha_D.pdf: 1878040 bytes, checksum: 8fd5f1baf140fcbb28173a988c006681 (MD5) Previous issue date: 2015 / Resumo: O presente trabalho teve como objetivos: avaliar a acurácia da Tomografia Computadorizada de Feixe Cônico e de radiografias periapicais digitais no diagnóstico de reabsorções radiculares em dentes traumatizados e verificar a influência da presença do material obturador na detecção dessas lesões (capítulo 1); relatar dois casos clínicos de reabsorções radiculares cujo diagnóstico foi realizado por meio da Tomografia Computadorizada de Feixe Cônico (capítulo 2). No capítulo 1, a amostra desta pesquisa foi constituída por radiografias e tomografias de pacientes com reabsorções radiculares e histórico de trauma dental, coletadas do banco de dados de uma clínica radiológica. Vinte oito dentes com reabsorções inflamatórias externas (14 com tratamento endodôntico e 14 sem tratamento endodôntico), 8 dentes com reabsorções inflamatórias internas e 4 dentes com reabsorção por substituição foram incluídos. Vinte casos sem reabsorção foram selecionados para o grupo controle. A análise das imagens foi realizada por 2 endodontistas e 2 radiologistas, previamente calibrados. Os resultados revelaram que a sensibilidade, especificidade e acurácia da Tomografia Computadorizada de Feixe Cônico foi superior às radiografias periapicais para o diagnóstico de reabsorções inflamatórias externas e internas (p<0.05 / Teste t). Para reabsorção por substituição, não houve diferença entre os métodos avaliados (p>0.05 / Teste t). Nos dentes tratados endodonticamente, a tomografia também apresentou resultados estatisticamente superiores para o diagnóstico das reabsorções inflamatórias externas (p=0.0138 / Teste t). No capítulo 2, dois casos clínicos de reabsorções radiculares (1 de reabsorção cervical externa e 1 de reabsorção inflamatória interna) foram descritos. A abordagem terapêutica adotada durante o diagnóstico e tratamento foi minuciosamente detalhada. O tratamento da reabsorção cervical externa foi multidisciplinar e envolveu a endodontia e periodontia. No caso com reabsorção interna, apenas o tratamento endodôntico foi necessário. Após o período de proservação, ambos os casos apresentaram-se sem sintomatologia e o sucesso clínico foi verificado. Concluiu-se que a Tomografia Computadorizada de Feixe Cônico foi superior às radiografias periapicais em relação ao diagnóstico de reabsorções inflamatórias (capítulo 1) e apresenta-se como um importante recurso de diagnóstico auxiliar para a detecção, localização e planejamento do tratamento clínico das reabsorções radiculares (capítulo 2) / Abstract: The aims of this study were: to evaluate the accuracy of cone beam computed tomography (CBCT) and digital periapical radiography in diagnosing root resorption following dental trauma and to verify the influence of filling material in detecting these lesions. (Chapter 1); describe two cases reports of root resorptions diagnosed by CBCT (Chapter 2). In chapter 1, periapical radiographs and CBCT images of patients with root resorption and a history of dental trauma from the database of a private radiology clinic were retrospectively reviewed. The sample comprised 28 teeth with external inflammatory resorption (14 with and 14 without endodontic treatment), 8 teeth with internal inflammatory resorption, 4 teeth with replacement resorption and 20 normal teeth as the control group. Images were analyzed by two radiologists and two endodontists who were previously calibrated. The results showed that the sensitivity, specificity and accuracy of CBCT in diagnosing internal and external inflammatory resorption was significantly higher than for radiography (p < 0.05 / t test). For replacement resorption, no statistical difference was noted (p > 0.05 / t test). In endodontically treated teeth, CBCT was also statistically superior in diagnosing external inflammatory resorption (p = 0.0138 / t test). In chapter 2, two cases reports of root resorptions (cervical external resorption and internal inflammatory resorption) were described. The therapeutic approach adopted for the diagnosis and treatment was detailed. Treatment of cervical external resorption involved endodontics and periodontics.In casewith inflammatory internal resorption, only endodontic treatment wasnecessary. After the observation period, both cases were presented without symptoms and clinical success was confirmed. Based on these findings, it was concluded that CBCT was superior to periapical radiography in diagnosing inflammatory root resorption following dental trauma, with or without endodontic treatment (Chapter 1) and presents itself as an important resource of as an auxiliary diagnosis for the detection, location and planning of the clinical treatment of root resorption (Chapter 2) / Doutorado / Endodontia / Doutor em Clínica Odontológica