Interstitial and intracavitary brachytherapy plays an essential role in management of several malignancies. However, the achievable accuracy of brachytherapy treatment for prostate and cervical cancer is limited due to the lack of intraoperative planning and adaptive replanning. A major problem in implementing TRUS-based intraoperative planning is an inability of TRUS to accurately localize individual seed poses (positions and orientations) relative to the prostate volume during or after the implantation. For the locally advanced cervical cancer patient, manual drawing of the source positions on orthogonal films can not localize the full 3D intracavitary brachytherapy (ICB) applicator geometry. A new iterative forward projection matching (IFPM) algorithm can explicitly localize each individual seed/applicator by iteratively matching computed projections of the post-implant patient with the measured projections. This thesis describes adaptation and implementation of a novel IFPM algorithm that addresses hitherto unsolved problems in localization of brachytherapy seeds and applicators. The prototype implementation of 3-parameter point-seed IFPM algorithm was experimentally validated using a set of a few cone-beam CT (CBCT) projections of both the phantom and post-implant patient’s datasets. Geometric uncertainty due to gantry angle inaccuracy was incorporated. After this, IFPM algorithm was extended to 5-parameter elongated line-seed model which automatically reconstructs individual seed orientation as well as position. The accuracy of this algorithm was tested using both the synthetic-measured projections of clinically-realistic Model-6711 125I seed arrangements and measured projections of an in-house precision-machined prostate implant phantom that allows the orientations and locations of up to 100 seeds to be set to known values. The seed reconstruction error for simulation was less than 0.6 mm/3o. For the physical phantom experiments, IFPM absolute accuracy for position, polar angle, and azimuthal angel were (0.78 ± 0.57) mm, (5.8 ± 4.8)o, and (6.8 ± 4.0)o, respectively. It avoids the need to match corresponding seeds in each projection and accommodates incomplete data, overlapping seed clusters, and highly-migrated seeds. IFPM was further generalized from 5-parameter to 6-parameter model which was needed to reconstruct 3D pose of arbitrary-shape applicators. The voxelized 3D model of the applicator was obtained from external complex combinatorial geometric modeling. It is then integrated into the forward projection matching method for computing the 2D projections of the 3D ICB applicators, iteratively. The applicator reconstruction error for simulation was about 0.5 mm/2o. The residual 2D registration error (positional difference) between computed and actual measured applicator images was less than 1 mm for the intrauterine tandem and about 1.5 mm for the bilateral colpostats in each detector plane. By localizing the applicator’s internal structure and the sources, the effect of intra and inter-applicator attenuation can be included in the resultant dose distribution and CBCT metal streaking artifact mitigation. The localization accuracy of better than 1 mm and 6o has the potential to support more accurate Monte Carlo-based or 2D TG-43 dose calculations in clinical practice. It is hoped the clinical implementation of IFPM approach to localize elongated line-seed/applicator for intraoperative brachytherapy planning may have a positive impact on the treatment of prostate and cervical cancers.

BACKGROUND: The aim was to compare the thickness of the palatal masticatory mucosa as determined on a cone-beam computerized (CBCT) scan versus thickness determined via bone-sounding. METHODS: A total of twenty patients requiring palatal surgery participated. Thickness of the palatal tissue was measured at various points radiographically and clinically. The two techniques were compared to determine the agreement of the two measurement modalities. RESULTS: Analysis of variance determined that there was no significant difference between the two methods. A small bias of the radiographic measurement being larger was found to be statistically significant (0.09 ± 0.69mm; p <0.0001). Moreover, the tissue thickness was shown to increase as the distance from the gingival margin increased and the tissue over the molars was thinner than the tissue over the premolars. CONCLUSIONS: CBCT can be used to accurately determine the soft tissue thickness of the palatal masticatory mucosa with minimal bias.

Pre-surgical planning for endodontic microsurgery is facilitated by the use of cone beam computed tomography (CBCT). The purpose of this study was to determine whether limited field CBCT accurately predicts buccal cortical plate perforations due to endodontic lesions. Thirty-five roots that underwent microsurgical root end resection were included in this study. Prior to the surgery, 90 voxel CBCTs were taken with a Carestream 9300. The scans were analyzed by an endodontic resident and oral radiologist to determine the presence of a perforation in the buccal plate. These findings were compared to the clinical appearance of the bone. There was a significant relationship between a judgment of perforation made on the basis of CBCT and actual perforation as observed clinically. The CBCT prediction was accurate 83% of the time. A predicted perforation was validated in 88% of the instances and a predicted non-perforation was validated in 75% of the instances.

Accounting for respiration motion during imaging helps improve targeting precision in radiation therapy. Respiratory motion can be a major source of error in determining the position of thoracic and upper abdominal tumor targets during radiotherapy. Thus, extracting respiratory motion is a key task in radiation therapy planning. Respiration-correlated or four-dimensional CT (4DCT) imaging techniques have been recently integrated into imaging systems for verifying tumor position during treatment and managing respiration-induced tissue motion. The quality of the 4D reconstructed volumes is highly affected by the respiratory signal extracted and the phase sorting method used. This thesis is divided into two parts. In the first part, two image-based respiratory signal extraction methods are proposed and evaluated. Those methods are able to extract the respiratory signals from CBCT images without using external sources, implanted markers or even dependence on any structure in the images such as the diaphragm. The first method, called Local Intensity Feature Tracking (LIFT), extracts the respiratory signal depending on feature points extracted and tracked through the sequence of projections. The second method, called Intensity Flow Dimensionality Reduction (IFDR), detects the respiration signal by computing the optical flow motion of every pixel in each pair of adjacent projections. Then, the motion variance in the optical flow dataset is extracted using linear and non-linear dimensionality reduction techniques to represent a respiratory signal. Experiments conducted on clinical datasets showed that the respiratory signal was successfully extracted using both proposed methods and it correlates well with standard respiratory signals such as diaphragm position and the internal markers’ signal. In the second part of this thesis, 4D-CBCT reconstruction based on different phase sorting techniques is studied. The quality of the 4D reconstructed images is evaluated and compared for different phase sorting methods such as internal markers, external markers and image-based methods (LIFT and IFDR). Also, a method for generating additional projections to be used in 4D-CBCT reconstruction is proposed to reduce the artifacts that result when reconstructing from an insufficient number of projections. Experimental results showed that the feasibility of the proposed method in recovering the edges and reducing the streak artifacts.

Artefatos ocorrem principalmente, próximos de estruturas de alta densidade como o metal, sendo que essa alteração pode interferir na interpretação das imagens e no diagnóstico. O intuito do presente estudo é avaliar o nível ósseo ao redor de dentes e implantes por meio de dois programas diferentes e a qualidade da imagem na presença de artefatos metálicos. Foram avaliadas imagens de arquivo obtidas através do TCFC Gendex(TM) GXCB500 (Gendex Dental Systems, Des Plaines, IL, USA). Os software utilizados foram o Xelis Dental (InfinnitHealthcare, South Korea) e o OsiriX MD (Pixmeo, Geneva, Switzerland) em cortes tomográficos transaxiais de 2 mm. Foram avaliadas 145 imagens de TCFC, sendo incluídos no estudo 35 exames (as idades variaram de 35 a 83 anos), representando um total de 30 Dentes e 30 Implantes, sendo que houve uma distribuição harmônica entre os grupos em relação ao gênero e idade. Três avaliadores treinados realizaram as observações das imagens separadamente em dois períodos distintos e a qualidade da imagem foi classificada em severa, forte, moderada e mínima. Na avaliação da qualidade de imagem os implantes apresentaram uma prevalência maior de artefatos severo e forte. No entanto, as avaliações dos implantes apresentaram uma maior consistência intra-observador, demonstrando, portanto, uma maior dificuldade na classificação dos dentes. Além disso, na avaliação conjunta de dentes e implantes a consistência global dos observadores aumentou. O software OsiriX apresentou desempenho superior nas medidas lineares dos dentes e implantes na avaliação intra-examinador. Embora nenhuma das correlações intraclasse avaliadas tenha sido excelente, a grande maioria foi satisfatória, com valores entre 0,4 e 0,7. Podemos concluir que a presença de artefatos metálicos limita a qualidade da imagem do nível ósseo ao redor dos dentes e implantes, assim como o programa OsiriX apresentou resultados nitidamente superiores na avaliação das medidas lineares. / Artifacts occur mainly near high-density structures, such as metal, this alteration may affect images interpretation and diagnosis. The aim of this study is to evaluate the bone level around teeth and implants through two different software and image quality in presence of metal artefacts. Archival images obtained were evaluated by CBCT Gendex(TM)GXCB500 (Gendex Dental Systems, Des Plaines, IL, USA). The software used was Xelis Dental (InfinnitHealthcare, South Korea) and OsiriX MD (Pixmeo, Geneva, Switzerland) in transaxial tomographic slices of 2 mm. We evaluated 145 CBCT images and included in the study 35 exams (ages ranged from 35 to 83 years-old), representing a total of 30 teeth and 30 implants, there was a harmonic distribution between groups in relation gender and age. Three trained examiners made observations of images separately in two distinct periods and the image quality evaluation was classified in severe, strong, moderate and minimal. Evaluation of implants image quality presented a higher prevalence of severe and strong artifacts. However, implants evaluation presented a higher intra-observer consistency, therefore teeth assessment presents a greater difficulty. In addition, joint assessment of teeth and implants increased global consistency of observers. OsiriX software outperformed intra-examiner linear measurements of teeth and implants. Although none of the intraclass correlations evaluated has been excellent, vast majority was satisfactory, with values between 0.4 and 0.7. We conclude that presence of metal artifacts limits the image quality of bone level around teeth and implants as well as software OsiriX presented significantly better results in the evaluation of linear measurements.

A deformidade dentofacial de Classe III está associada a importantes alterações funcionais, psicológicas e estéticas. O objetivo neste trabalho foi avaliar a morfologia craniofacial de indivíduos adultos, com deformidades dentofaciais de Classe III comparando-os com um grupo de indivíduos com faces equilibradas com finalidade de diagnóstico e prognóstico ortodôntico e cirúrgico. Foram avaliados 50 indivíduos, os quais foram submetidos ao exame de tomografia computadorizada de feixe cônico (i- Cat®/ Cone beam 3-D Dental Imaging System, Imaging Sciences International, Hatfield, USA) com o propósito de avaliação e diagnóstico. A amostra foi dividida em dois grupos, sendo 25 indivíduos com equilíbrio das relações faciais e oclusão dentária excelente e 25 com maloclusão Classe III sendo que estes fazem parte da clínica de preparo ortodôntico para Cirurgia Ortognática da Faculdade de Odontologia da FOUSP. Após a obtenção dos arquivos digitais foram realizadas as reconstruções das imagens em três dimensões nos softwares Dolphin 3D® (Dolphin Imaging and Management Solutions, Chatsworth, CA EUA) e Maxilim® (Medicim- Medical Image Computing, Mechelen-Bélgica). Seqüencialmente foram demarcados pontos de referência anatômica e a seguir foram mensuradas grandezas lineares angulares e proporcionais que foram representadas, após avaliação estatística, por média e desvio padrão. Para determinação do erro do método foram calculadas as correlações intraclasses para avaliação da concordância e a fórmula de Dahlberg. Para comparação entre os grupos foi aplicada a Análise de Variância (ANOVA) com dois fatores, destinada a representar a oclusão e gênero. No caso de ocorrência de interação estatisticamente significativa foram realizadas comparações múltiplas de Tukey para verificar em qual dos gêneros dentro de cada grupo ocorreu diferença. O nível de significância adotado foi o de 5%. Com relação ao erro do método foi observada alta reprodutibilidade na avaliação intraoperador nos softwares Dolphin 3D® e Maxilim®. Na comparação cefalométrica 3D entre os grupos avaliados, foram observadas diferenças significativas (p<0,05), sendo que o grupo com deformidades dentofaciais Classe III demonstrou variações para o relacionamento entre altura e largura facial, associada ao aumento da porção inferior da face; rotação horária da mandíbula relacionada à maior inclinação do corpo e do ramo mandibular e pelo predomínio da altura facial anterior em relação à posterior; diminuição do comprimento e do ângulo da base craniana; compensação na altura alveolar da maxila; predominância da dimensão mandibular na configuração ânteroposterior do esqueleto facial e tendências compensatórias verticais que reduziram ao nível alveolar, os desequilíbrios esqueléticos estruturais. / Class III dentofacial deformity is associated with important functional, psychologic and aesthetics changes. The objective of this study was to evaluate the craniofacial morphology of adults, with Class III dentofacial deformity comparing them with a group of subjects with harmonious faces for diagnosis and prognosis in orthodontic and surgical cases. This study evaluated 50 subjects that were submitted to the cone beam computed tomography (i-Cat®/ Cone beam 3-D Dental Imaging System, Imaging Sciences International, Hatfield, USA) with the purpose of diagnosis. The sample was divided in two groups, one with 25 subjects with harmonious faces and excellent occlusion and another with 25 subjects with Class III malocclusion, that are in treatment in the orthodontic clinic for orthognathic surgery in the Faculty of Dentistry of University of São Paulo. After the digital archives were obtained, the 3D reconstruction of images were performed with the softwares Dolphin 3D® (Dolphin Imaging and Management Solutions, Chatsworth, CA EUA) and Maxilim® (Medicim- Medical Image Computing, Mechelen-Bélgica). After demarcation of the reference points, linear, angular and proportional measurements were made and represented in statistical analysis, by mean and standard deviation. To determine the error of method, intraclass correlations were calculated, and Dahlbergs formula was used. To compare both groups the Variance Analyses was applied (ANOVA) with two factors, representing occlusion and gender. When statistical significant differences were observed, Tukeys multiple comparison was performed to evaluate in which gender the variance happened. The level of significance adopted was 5%. The error of method showed high reproducibility for intra-operator evaluation in Dolphin 3D® and Maxilim® softwares. Cephalometric 3D evaluation of the groups, showed significant differences (p<0,05), and the group with Class III dentofacial deformity showed changes in the relationship of height and width, associated with an augmented height of the lower face; clock-wise rotation of the mandible related to an increase of the inclination of the mandible body and ramus and a greater anterior facial height in relation to the posterior facial height; decrease in the size and angulation of the cranial base; compensation in height of dentoalveolar maxilla; predominant mandibular size in anterior-posterior configuration of the facial skull and vertical dentoalveolar compensations that reduced to alveolar level the structural skeletal unbalance.

A maioria das calcificações em tecidos moles na região de cabeça e pescoço são achados radiográficos incidentais. Com o crescente uso da Tomografia Computadorizada de Feixe Cônico na Odontologia (TCFC) há um aumento do número desses achados, visto que o exame permite a visualização das estruturas em três dimensões. Esse estudo estabeleceu uma metodologia para identificar algumas dessas calcificações. Um observador calibrado analisou 100 exames de TCFC e as respectivas panorâmicas, quanto à presença de Ossificação do Complexo Estilo-Hióideo (OCEH), tonsilólitos e ateromas. Adicionalmente os processos estilóides foram mensurados. As correlações para as radiografias panorâmicas foram estatisticamente significante entre idade e comprimento do processo estilóide. As correlações para os exames de TCFC foram estatisticamente significantes entre idade e tonsilólitos, idade e o comprimento do processo estilóide e idade e ateromas. Houve diferença estatística significante (Wilcoxon p<0,05) entre os exames de TCFC e panorâmicas quanto à presença de tonsilólitos, presença de OCEH e para as mensurações dos processos estilóides. Foi detectada maior quantidade de calcificações em tecidos moles nos exames de TCFC. A identificação das calcificações em tecidos moles é importante no diagnóstico diferencial de muitas patologias incluindo os flebólitos. Portanto o profissional deve ficar atento a correta interpretação dessas estruturas, buscando evitar erros e omissões, para que possa oferecer ao paciente opção correta de tratamento se for necessário. / The most common soft tissue calcifications in head and neck region are incidental findings in radiographic images. The use of Cone Beam Computed Tomography in Dentistry, has increased these incidental findings mainly, because CBCT allows a third dimension view. The goal of this study was to differentiate the styloid chain ossification (SHCO), tonsilloliths and calcified atheromas. Based on a specific methodology, one calibrated observer analysed 100 panoramic and CBCT exams from the same patients regarding these alterations. Afterwards, the styloid process was measured at the same exams. The correlations tests for the panoramic exams were statistically significant between age and styloid process length. The correlations tests for CBCT exams were statistically significant between age and tonsilloliths, age and styloid process length and age and calcified atheromas. There was a difference statistically significant (Wilcoxon p<0.05) between CBCT and panoramic exams regarding: presence of tonsillolith, presence of SHCO and styloid process length. It was detected more quantity of soft tissues calcifications in CBCT exams. The identification of soft tissues calcifications is important for the differential diagnoses of many pathologies including phlebolits. Therefore the professional should be able to do a correct image interpretation in some cases in order to avoid mistakes and offer the patient a treatment if is necessary.

Objetivo: Avaliar a precisão e a acurácia de medidas lineares da mandíbula por meio da Tomografia Computadorizada de Feixe Cônico (TCFC), alterando o valor do voxel. Material e Métodos: Dez mandíbulas foram submetidas à TCFC seguindo dois protocolos de voxel, 0,2 e 0,4 mm, do aparelho i-CAT Classic. Dez medidas lineares foram realizadas 2 vezes, por 2 examinadores independentes, previamente calibrados, nos cortes multiplanares e nas reformatações 3D no programa Dolphin®. As medidas físicas foram realizadas com um paquímetro digital diretamente nas mandíbulas. Análise de variância para medidas repetidas (ANOVA), coeficiente de correlação intraclasse e o teste de Bland-Altman foram utilizados para avaliar a precisão e a acurácia (p<0,05). Resultados: Excelente precisão intra e boa precisão interexaminadores foi encontrada para todas as variáveis, com exceção da largura interforame mentual entre os dois examinadores nas reformatação 3D. As mensurações realizadas nos cortes multiplanares apresentaram maior acurácia que as mensurações nas reformatações 3D, em relação às medidas físicas. Conclusão: As imagens nos cortes multiplanares em TCFC nos dois protocolos de voxel podem ser utilizadas com precisão e acurácia para a obtenção de medidas lineares quando comparadas com às medidas físicas. Maior cautela deve ser tomada para as reformatações 3D, pois as mensurações neste formato foram precisas, mas não acuradas para todas as variáveis. Um protocolo com menor exposição aos raios X, sem comprometer o diagnóstico, torna-se viável, pois o aumento na resolução das imagens não aumenta a precisão e acurácia na mensuração das medidas lineares avaliadas. / Objective: The purpose of this study was to determine the accuracy and reliability of mandibular linear measurements obtained from 3-dimensional cone-beam computed tomography (CBCT) scans of dry human mandibles using different voxel sizes. Methods: Ten dry human mandibles were scanned at voxel sizes of 0.2 and 0.4 mm. Craniometric anatomical landmarks were identified on the multiplanar reconstructed and on volume rendering images that were generated by the software Dolphin®, independently, by two operators twice. Subsequently, physical measurements were made using a digital caliper. Analysis of variance for repeated measures (ANOVA), Intraclass correlation (ICC) and BlandAltman were used for evaluating accuracy and reliability(p<0.05). Results: Excellent intrarater and good interobserver reliability values were found for linear measurements from CBCT images, with only one exception, interforame width, between observers in volume rendering images. Measurements performed on multiplanar reconstructed images were more accurate than the measurements in volume rendering compared to the gold standard. Conclusion: Linear measurements on multiplanar images of 0.2 and 0.4-voxel are reliable and accurate when compared with direct caliper measurements. Caution should be taken in the volume rendering measurements, because the measurements were reliable, but not accurate for all variables. A protocol with less exposure, without compromising the diagnosis becomes feasible, because an increased voxel resolution did not result in greater accuracy of the measurements and potentially provides increased patient radiation exposure.

O objetivo neste estudo foi avaliar a reprodutibilidade quantitativa dos modelos tridimensionais gerados por meio de imagens de tomografia volumétrica de feixe cônico, obtidos por dois tomógrafos volumétricos NEWTOM 9000 DVT (i- (Quantitative Radiology, Verona, Itália) e i-CAT (Imaging Sciencies Int. Hatfield, Pensilvânia. Estados Unidos da América), submetidos à inspeção de engenharia reversa. Uma mandíbula macerada foi digitalizada por meio do SCANNER 3D VIVID 910, com precisão de 0,01 mm, associado à fotometria digital, sendo utilizado o software GEOMAGIC STUDIO, e assim obteve-se um modelo considerado padrão ouro. Posteriormente realizamos o exame de tomografia volumétrica de feixe cônico, na mesma mandíbula nos dois tomógrafos volumétricos, obtendo-se assim os modelos virtuais tridimensionais. Por meio de um alinhamento das geometrias do padrão ouro com os modelos virtuais resultantes da tomografia do aparelho NEWTOM 9000 DVT e do i-CAT, foram observadas as possíveis discrepâncias. Concluímos que estas alterações encontradas após a análise quantitativa das diversas regiões foram menores nas imagens adquiridas pelo tomógrafo volumétrico de feixe cônico modelo i-CAT, e portanto possibilitam a geração de modelos de prototipagem rápida de melhor qualidade. / The purpose of this study was to evaluate the quantitative reproductability of the 3d models created using CT images. The images used were obtained from two different cone beam tomographs: NEWTOM 9000 DVT (Quantitative Radiology, Verona, Italy) and i-CAT ( Imaging Sciences Int., Hatfield, EUA) and then inspected through reverse engineering processing software. A dry mandible was digitalized using a 3D Scanner VIVID 910 and the GEOMAGIC STUDIO software to obtain a 0,01mm precision model considered to be our gold standard. Two distinct 3D virtual models were then created after submitting the same dry mandible to a cone beam exam on both tomographs (NEWTOM and i-Cat). Possible discrepancies between the 3D models and the gold standard were analyzed through and alignment of their geometries. After evaluating the discrepancies at the different sites of the models, we concluded that the virtual model obtained using the i-Cat tomograph images was more accurate and therefore of greater quality.

O uso crescente da Tomografia Computadorizada de Feixe Cônico (TCFC) na área odontológica tem permitido o aumento dos achados incidentais em exames que são realizados por outros fins. Dentre essas uma, das mais comuns e com impacto na vida dos pacientes é o ateroma calcificado das artérias carótidas (ACAC), e no seu diagnóstico diferencial existem as ossificações das cartilagens da laringe. Para correta identificação dessas calcificações são necessários conhecimentos acerca da localização anatômica, distribuição e sua morfologia, sendo que a TCFC fornece uma localização tridimensional (3D) acurada. Entretanto existem diferentes softwares de pós-processamento de imagens disponíveis no mercado, e não há na literatura estudos sobre a capacidade desses softwares para a visualização dessas estruturas. Esse estudo tem o objetivo de identificar essas calcificações supracitadas, nos softwares de visualização de TCFC, i-Cat Vision® e Invivo5®, nas reconstruções multiplanares e 3D em dois grupos diferentes, sendo um grupo de exames de indivíduos com fissuras labiopalatinas (HRAC) (50 exames de TCFC) e outro sem fissuras labiopalatinas (FOB) (100 exames de TCFC). Foram avaliados 150 exames (112 do gênero feminino e 38 do gênero masculino) de TCFC por dois observadores devidamente treinados e calibrados. Para o grupo sem fissuras labiopalatinas foi encontrada diferença estatística significante entre a idade e a quantidade de calcificações encontradas. Considerando todas as calcificações, foram encontrados 104 indivíduos com alguma calcificação, representando 69,33% da amostra, sendo que o grupo HRAC apresentou 88% e o grupo FOB 59%. Foi possível demonstrar diferença estatística significante ao se comparar a quantidade de calcificações entre os grupos avaliados. Foi assumido nesse trabalho que as reconstruções separadamente do programa Invivo5® seria a padrão- ouro, nesse momento o programa i-Cat Vision® foi considerado mais específico do que sensível. Foram identificados muito falsos positivos no programa i-Cat Vision® e menores resultados para falso-negativos. Esse trabalho não tem o propósito de identificar os ACAC nos exames de TCFC, mas incentivar e demonstrar que é possível visualizar tais calcificações e diferenciá-las umas das outra, lembrando-se da responsabilidade do dentista em prevenir um problema futuro ao paciente que pode levar a quadros de morbidade e mortalidade. / The widespread use of CBCT in Dentistry leads to an increasing of incidental findings regarding exams for different purposes. The most common incidental finding that impacts the patients quality of life is the carotid artery calcifications as well as the ossification of laryngeal cartilage which is the most common differential diagnosis for aterosclerosis. To identify this calcifications/ossification correctly it is necessary to know about its anatomic localization, distribution and morphology once that CBCT images may evidence an accurate 3D location. Therefore many different manipulations imaging software for CBCT technology is available and there is no research in the literature about the capacity of this software to visualize these calcification/ossification structures. This study aimed to identify these calcifications/ossification, in two different visualization softwares: i-Cat Vision® and Invivo5®, both in Multiplanar Reconstruction (MPR) and 3D reconstruction, in two different groups, where one was constituted of cleft lip and palate (50 CBCT exams) patients and the other by patients without cleft lip and palate (100 CBCT exams). Two calibrated and trained observers evaluated 150 CBCT exams (112 were female and 38 male). There was significantly statistical difference when comparing age and calcifications quantity for no cleft lip and palate group. When considering all calcifications in both groups, 104 patients in 150 (total number) showed some calcification/ossification, representing 69,33%. The percentage of calcification/ossification in the cleft lip and palate group were 88% whereas the other one evidenced 59%. And due to this difference, there was significantly statistical difference between these groups. Besides, the Invivo5® software was considered the gold-standard (multiplanar reconstruction and 3D reconstruction) to identify the structures previously mentioned; then i-Cat Vision® software showed more specificity than sensitivity comparing the results with the Invivo5®. Many false positives were identified in i-Cat Vision® and only some false negatives, showing again the characteristics of these softwares. This work was not intended to identify carotid artery calcifications in CBCT exams, but in fact the real purpose was to demonstrate that it is possible to identify calcifications/ossifications and differentiate one of another. It is always important to remember about the dentistry knowledge and responsibility to prevent patient coming disease that may lead to morbidity and mortality situations.