Orientador: João Roberto Gonçalves / Resumo: A osteoartrite (OA) é a forma mais comum das artrites. Na articulação temporomandibular (ATM) ela se destaca por causar degeneração da cartilagem de forma progressiva, remodelação do tecido ósseo condilar, quadros agudos e crônicos de dor. Atualmente, o diagnóstico da OA na ATM vem se tornando mais preciso, devido ao desenvolvimento de novas tecnologias, exames por imagem como a tomografia computadorizada de feixe cônico (TCFC) de alta resolução, análises computacionais e inteligência artificial. Dessa forma, esse trabalho teve como principal objetivo avaliar possíveis novos biomarcadores para a OA utilizando marcadores clínicos, por imagem e biomoleculares. Os objetivos secundários foram de comparar diferentes softwares para análises dos marcadores por imagem; avaliar o poder de diagnóstico desses marcadores; e por fim, desenvolver um modelo integrativo utilizando inteligência artificial, dados clínicos, biomoleculares e por imagem para o diagnóstico da OA na ATM. Como metodologia, foram desenvolvidos 3 artigos científicos, apresentados em sequência nessa tese. Nossa amostra foi composta por pacientes com diagnóstico clínico de OA na ATM e pacientes controles, sendo que foram coletados exames de TCFC, sangue, saliva e dados clínicos. Nossos resultados mostraram que o software desenvolvido pelo nosso grupo para análises das imagens é confiável e que os novos marcadores por imagens são capazes de diferenciar pacientes controles e com OA. Também demonstramos que nosso modelo es... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Osteoarthritis (OA) is the most common form of arthritis. In the temporomandibular joint (TMJ) it stands out for causing progressive cartilage degeneration, condylar bone tissue remodeling, acute and chronic pain. Nowadays, the TMJ OA diagnosis is improved by the development of new technologies and imaging exams such as high-resolution cone beam computed tomography (CBCT), advanced computational analysis and artificial intelligence. Thus, this study aimed to evaluate possible new biomarkers for OA using clinical, imaging and biomolecular markers. The secondary objectives were to compare different software for image marker analysis; evaluate the diagnostic power of these markers; and finally, to develop an integrative model using artificial intelligence, clinical, biomolecular and imaging markers for the diagnosis of TMJ OA. As methodology, 3 papers were developed, presented in sequence in this thesis. The sample consisted of patients with clinical diagnosis of TMJ OA and control patients. CBCT, blood, saliva and clinical data were collected. Our results showed that the software developed by our group for image analysis is reliable and that the new imaging markers can differentiate controls and OA patients. We also demonstrate that our integrative statistical model of clinical, biomolecular, imaging markers and artificial intelligence can diagnose the disease with an accuracy of 0.837 ([0.761.0.902]). Finally, our results suggest that different biomarkers and a statistical and... (Complete abstract click electronic access below) / Doutor

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Objective: This study was conducted to examine the changes in the inclination of mandibular incisors and their alveolar bone dimensions between pre- and post- non-extraction orthodontic treatment, measured using cone beam computed tomography (CBCT) images. The study measured the association of the pre- and post- labial and lingual bone measurements with the pre- and post- treatment incisor inclination by comparing the incisor-mandibular plane angle (IMPA). Background: Teeth move through bone by extensive osseous adaptation within the alveolar process. It is a common belief in orthodontics that alveolar bone follows tooth movement. As a tooth moves, bone will remodel around the alveolar socket usually in a 1:1 ratio of bone resorption to bone apposition. However, conflicting evidence in the orthodontic literature questions whether the anterior alveolar bone is able to remodel and follow the direction and quantity of tooth movement. Many studies have shown that the width of the alveolar bone and the lingual and labial cortical plates set limitations on how much anterior tooth movement can be accomplished without negative effects such as periodontal problems, root resorption or fenestrations. Methods: Pre- and post- non-extraction orthodontic treatment CBCT scans of twenty Class I molar patients with mild to moderate crowding were used to observe the buccal and lingual width and incisor inclination of each of the patient's four mandibular incisors. The labial and lingual alveolar bone dimensions were measured pre-treatment and post-treatment at 6 mm apical to the CEJ and at the apex of each tooth. The inclination of the incisors (using IMPA) of both time points was also documented. Results: A Fisher's exact test and a Cramer's V test were performed. The results showed statistical significance between the change in bone of the incisors and the change in their inclination at the buccal 6mm, buccal apex, lingual 6mm and lingual apex. There was also statistical significance found between the change in bone between the buccal apex and lingual apex of the LR1, LR2, LL1, and LL2. Conclusion: Our results showed that the change in bone of the lower incisors is correlated to the change in their inclination. This suggests that incisors were tipped within the confines of the mandibular anterior alveolar process, or the alveolar process bent and remodeled around the incisors in the same direction of tooth movement or a combination of the two.

INTRODUCTION: The diagnosis and treatment of endodontic infections is a multi-step fact gathering process, with the gold standard of periapical lesion diagnosis being histological biopsy. With common diagnoses, such as periapical granulomas and radicular cysts, representing the bulk of biopsies, the possibility of a less invasive method of lesion identification ought to be examined. In recent years Cone Beam Computed Tomography (CBCT) imaging has been proposed as a potential diagnostic tool for periapical diagnosis, but this theory requires further testing and data in order to verify its appropriateness. OBJECTIVE: The aim of this study was to evaluate six criteria used for assessing periapical lesions of teeth seen on CBCT scan from the textbook Oral Radiology White and Pharoah. MATERIAL AND METHODS: Three blinded endodontists observed radiographic features of oral periapical lesions of teeth previously diagnosed as either radicular cysts or periapical granulomas via histological biopsy. All lesions had previously been scanned via CBCT, and endodontic apical surgery was performed allowing for a pathology sample of the lesion. The observers viewed 40 CBCT and 40 corresponding periapical (PA) radiographic images, all randomized, and reported which of the six criteria (Location- apex of tooth, periphery- corticated border, shape- curved or circular, internal structure- radiolucent, effects on surrounding structures- displace or resorb roots, corticated plate perforation- present) were present in the scans. Data was analyzed using a Logistical Regression Fleiss Kappa statistic with a 95% confidence level. RESULTS: CBCT cyst showed no agreement between examiners criteria selected to statistical significance. The most selected criteria by all examiners were shape and internal structure. PA radiographic Cyst showed moderate agreement for ‘Location’ and ‘Periphery’ and substantial agreement on ‘none’ criteria. The most selected criteria by all examiners were internal structure and location. CBCT Granuloma showed moderate agreement for ‘location’ and perfect agreement for ‘none’. The most selected criteria by all examiners were shape, location, and internal structure. PA radiographic Granuloma showed substantial agreement for ‘periphery’ and moderate agreement for internal structure (radiolucency). The most selected criteria by all examiners were location, and occasionally shape and internal structure. Logistic regression of selected criteria shows with each additional criteria present on each lesion the chance of the lesion being a granuloma decreases 24.9% on PA radiographs and 33.9% on CBCT images. CONCLUSION: The current study shows an inter-examiner agreement of moderate to perfect kappa statistic does not align with the most commonly selected criteria among examiners, showing poor examiner agreement among lesions. / 2024-06-21T00:00:00Z

We propose an exact filtered backprojection algorithm for inversion of the cone beam data in the case when the trajectory is composed of a distorted circle and a line segment. The length of the scan is determined by the region of interest , and it is independent of the size of the object. With few geometric restrictions on the curve, we show that we have an exact reconstruction. Numerical experiments demonstrate good image quality.

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Three dimensional imaging in the form of Cone Beam Computed Tomography has become prevalent in the field of orthodontics. Analytical methods of resulting volumetric data sets have not kept pace with the technology capable of producing them. Current 3D analysis techniques are largely adaptations of existing 2D methods, offering no clear diagnostic advantage over traditional imaging techniques in light of increased radiation exposure, and cannot be compared with norms generated from 2D image capture sources. In order to study morphology in 3D, data sets must be generated for longitudinal studies and native 3D analytical methods must also be developed. Existing methods of CBCT volume superimposition are cumbersome, involving complex software pipelines and multiple systems to complete the process. The goal of the current study was to develop a reproducible method of CBCT volume superimposition in the posterior cranial base in a single software package, and construct an easy to follow, step-by-step manual to facilitate future studies in craniofacial morphology. Existing anonymized sequential CBCT volumes of three subjects meeting inclusion criteria were obtained from the Kornberg School of Dentistry Department of Radiology. Volumes for each subject were imported into AMIRA software, resampled to a standardized 0.5 mm voxel size and superimposed with a mutual information algorithm. Posterior cranial base surface data was extracted using a semi-automatic technique. Resulting surface distance data was compiled and visualized through application of color maps. A streamlined image processing protocol was produced and documented in a detailed step-by-step manual. Surface distance analysis of serial segmentations was performed to verify reliability of the process. Surface distance deviations greater than 0.5 mm consistently fell below 0.2 percent of the total surface area. Sequential scan superimpositions of all three subjects exhibited mean surface distances of less than 0.15 mm. Two out of three subjects exhibited deviations of greater than 0.5 mm in less than 1 percent of the total surface area, suggesting consistent sub-voxel accuracy of the protocol. / Oral Biology