Orientador: Frab Norberto Bóscolo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T04:09:35Z (GMT). No. of bitstreams: 1 Ramirez-Sotelo_LauraRicardina_D.pdf: 1681017 bytes, checksum: 948bf57afd3cf56354df233fedc8eafe (MD5) Previous issue date: 2015 / Resumo: Métodos têm sido propostos para analisar a articulação temporomandibular, com o intuito de avaliar as estruturas nesta região, principalmente em indivíduos com padrões esqueléticos diferentes, pois o tratamento ortodôntico realizado, neste grupo de indivíduos, pode trazer consequências diretas na morfologia e função articular. Neste estudo, comparou-se as regiões medial central e lateral da ATM de indivíduos com padrão esquelético I, II e III, pelas medidas relação da cabeça da mandíbula com a fossa mandibular, inclinação da vertente posterior da eminência articular e altura da eminência articular. Foram avaliadas as imagens de tomografia computadorizada de feixe cônico de 95 indivíduos com padrões esqueléticos I (N=36), II (N=31) e III (N=28). Três examinadores independentes avaliaram as imagens da articulação temporomandibular, na região lateral central e medial, em dois momentos diferentes. Houve correlação inter e intraexaminador de satisfatória a excelente para todas as medidas avaliadas em cada região da articulação e nos três tipos de padrão esquelético. Não houve diferenças estatísticas significativas na relação entre a cabeça da mandíbula com a fossa mandibular, nem na inclinação da vertente posterior e altura da eminência articular entre os padrões esqueléticos estudados em nenhuma das regiões. As medidas apresentaram diferença estatística significativa entre a região central, lateral e medial em cada tipo de padrão esquelético I, II e III, exceto a medida da inclinação da vertente posterior da eminência articular para indivíduos de padrão esquelético I no lado direito (p?0,05). Houve diferença estatística entre ambos os lados para as medidas da inclinação da eminência na região central do grupo de padrão esquelético I e para a medida do espaço articular anterior em todas as regiões e todos os padrões esqueléticos (p?0,05). Concluiu-se que não há influência do padrão esquelético I, II, III na relação da cabeça da mandíbula com a fossa mandibular, inclinação da vertente posterior e altura da eminência articular nas regiões estudadas em nenhuma das regiões estudadas. E a avaliação desses mesmos parâmetros ósseos em indivíduos com padrões esqueléticos I, II e III devem ser realizados em diferentes regiões, já que o corte central nem sempre representa a relação óssea da articulação em toda a sua extensão / Abstract: Methods have been proposed to analyze the temporomandibular joint, in order to evaluate the structures of this region particularly in individuals with different skeletal patterns, since the orthodontic treatment performed in this group of people can bring direct effect on the morphology and joint function. This study evaluated the relationship between the mandibular condylar process - mandibular fosse, the slope of the posterior slope and the height of the articular eminence in medial regions, central and lateral temporomandibular joint of individuals with skeletal patterns I, II and III. Were evaluated computed tomography cone beam of 95 patients with skeletal patterns I (N = 36), II (n = 31) and third (N = 28). Three independent observers evaluated the images of the temporomandibular joint, the lateral, central and medial region, at two different times. There was correlation, inter and intra-rater, from satisfactory to excellent for all measures evaluated in each region of the joint in the three types of skeletal pattern evaluated. There were not statistically significant differences in the relation between the mandibular condylar process and the mandibular fosse or the slope of the posterior slope and the height of the articular eminence in any of the regions between the studied skeletal patterns. The measures showed statistically significant differences between the central, lateral and medial in each type of skeletal pattern I, II and III, except the measure of the slope of the posterior slope of the articular eminence in skeletal pattern I on the right side (p?0,05). There was statistical difference between measures, of both sides, of the slope of the eminence in central skeletal pattern of group I, and for the measure of the previous joint space in all regions and all skeletal patterns (p = 0.05). It was concluded that there is no influence of the skeletal pattern I, II, III in respect of the mandibular condylar process with the mandibular fosse, posterior slope of the slope and height of the articular eminence in the regions studied in any of the studied regions. And the evaluation of the same bone parameters in subjects with skeletal patterns I, II and III should be conducted in different regions, as the central court is not always the bone of the joint relationship in all its extension / Doutorado / Radiologia Odontologica / Doutora em Radiologia Odontológica

Orientador: Solange Maria de Almeida Boscolo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T15:58:05Z (GMT). No. of bitstreams: 1 Verner_FrancielleSilvestre_D.pdf: 3297356 bytes, checksum: 3989155d7f53d24a1147b56f4abedc69 (MD5) Previous issue date: 2015 / Resumo: As características dentárias podem influenciar diretamente na determinação da morfologia da eminência articular (EA). Entretanto, até o presente momento, os estudos se restringiram a correlacionar a morfologia da EA com perdas dentárias e má-oclusões. Neste contexto, torna-se importante a realização de estudos que estabeleçam uma possível correlação entre a morfologia dos arcos dentais e da EA em pacientes que não apresentem alterações oclusais ou ausências dentárias. O objetivo no presente estudo foi avaliar a correlação entre a morfologia do arco dental e da EA por meio de tomografia computadorizada de feixe cônico (TCFC). Foram utilizadas imagens de 60 pacientes, sem ausências dentárias ou alterações oclusais, e que apresentassem Classe I de Angle. As imagens foram avaliadas por três especialistas em Radiologia Odontológica, instruídos a realizar mensurações da altura (EAh) e inclinação da EA (ângulos 'alfa' e 'beta'), nas regiões centrais, laterais e médias, e inclinação da parede lateral da fossa mandibular (ângulo 'sigma'). Foram avaliadas as medidas da largura, profundidade e perímetro dos arcos dentários superior e inferior. Posteriormente, os arcos foram classificados quanto às formas cônica, quadrangular e ovoide. Após 30 dias 10% da amostra foi reavaliada, para cálculo do índice de correlação intraclasse (ICC). Foram obtidas as médias e desvio-padrão das mensurações realizadas na EA e nos arcos dentais, em cada uma das formas encontradas, que foram comparadas por meio da análise de variância (ANOVA) um fator e teste de 'Tukey'. Para verificar a correlação entre os arcos e a EA foi calculado o coeficiente de Correlação de Pearson. A influência das medidas dos arcos nas medidas da EA foi determinada por meio de regressão linear. O nível de significância foi de 5%. O ICC variou de satisfatório a excelente. Para a EA, o ângulo 'beta' na forma ovoide foi diferente no corte central do lado direito e em todos os cortes do lado esquerdo. O ângulo 'alfa', também na forma ovoide, diferiu no corte central direito e lateral esquerdo. E o ângulo 'sigma' no corte central esquerdo entre as formas quadrangular e ovoide. Na forma cônica observaram-se o maior número de correlações, seguida das formas ovoide e quadrangular. A altura da EA foi a característica mais correlacionada às medidas dos arcos. Os perímetros dos arcos superiores e inferiores influenciaram a altura da EA no lado esquerdo. No arco inferior, IC influenciou 'alfa' e 'beta' dos lados direito e esquerdo, IL influenciou 'alfa' do lado direito, 2PM influenciou 'alfa' do lado esquerdo e 'beta' dos lados direito e esquerdo, e 1M influenciou 'alfa' do lado direito. No arco superior, IC influenciou a altura da EA do lado esquerdo. Pode-se concluir que houve correlação entre as diferentes características dos arcos dentais com a morfologia da eminência articular. A forma cônica apresentou maior número de correlações e, portanto, modificações nas características dos arcos cônicos podem representar maior potencial em gerar alterações morfológicas na eminência articular / Abstract: The dental features can directly influence in determining the morphology of the articular eminence (EA). However, to date, the studies have been restricted to correlate EA morphology with dental losses and malocclusions. In this context, it is important to conduct studies to establish a possible correlation between the dental arches and EA morphology in patients with no occlusal alterations or missing teeth. The aim in this study was to evaluate the correlation between dental arch and articular eminence (AE) morphology by cone beam computed tomography (CBCT). Three dental radiologists analyzed images from 60 patients without dental absences neither occlusal alterations, and classified as Class I of Angle. The images were evaluated by three oral radiologists, and the height (AEh), the slope of AE ('alpha' e 'beta' angles), at central, lateral and medial positions, and lateral inclination ('sigma' angle) of mandibular fossae were measured. The measures of width, depth and perimeter of maxillary and mandibular arches were evaluated. Then, the arches were subjectively classified according to tapered, squared and ovoid shapes. After 30 days, 10% of the sample was reevaluated. Mean and standard deviation of the measures in AE and dental arches were obtained in each shape, and compared by ANOVA (one way) and "Tukey" test. To verify the correlation between arches and AE, the Pearson Correlation coefficient was calculated. The influence of arches' measures on AE's measures was determined by linear regression. The level of significance was 5%. For dental arches, the measures of depth and perimeter of square arches were different from the other shapes, in both arches. The measures CI and 2PM were different on upper and lower arches, respectively, between the tapered and square shapes. For the AE, the 'beta' angle on the ovoid shape was different on central slice on the right side and on all slices on the left side. The 'alpha' angle, also on the ovoid shape, differed on central right slice and lateral left. And the 'sigma' angle on central left slice between square and ovoid shapes. In general, the measures in men were higher than in women, but only the 'beta' angle on medial right slice, the measures C, 2PM, 1M and perimeter from upper arch, and 1PM and PM from lower arch, showed significant differences. On the tapered shape, there was the highest number of correlations, followed by ovoid and square shapes. The height of AE was the most correlated feature to the measures of the arches. The perimeter of the upper and lower arches influenced on the height of the AE on the left side. On lower arch, CI influenced 'alpha' and 'beta' on both sides, IL influenced 'alpha' on the right side, 2PM influenced 'alfa' on the left side and 'beta' on both sides, and 1M influenced 'beta' on the right side. On the upper arch, CI influenced the height of the AE on the left side. It can be concluded that there was correlation between the different features of the dental arches with the AE morphology. The tapered shape showed a higher number of correlations and, therefore, changing in the features of the tapered arches may represent greater potential in generating morphological changes in the AE / Doutorado / Radiologia Odontologica / Doutora em Radiologia Odontológica

Orientador: Deborah Queiroz de Freitas França / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-28T02:05:09Z (GMT). No. of bitstreams: 1 Queiroz_PolyaneMazucatto_M.pdf: 2757992 bytes, checksum: 06e73a8b08ccb2c9d71f5790996c28cb (MD5) Previous issue date: 2015 / Resumo: Materiais de alta densidade física e alto número atômico quando presentes no objeto escaneado podem resultar em artefato nas imagens tomográficas. O artefato compromete a qualidade da imagem tomográfica, podendo inviabilizar o uso dessa modalidade de diagnóstico. Com este trabalho, teve-se dois objetivos: avaliar a ação da ferramenta de redução de artefato metálico (RAM) nas imagens tomográficas de phantoms com diferentes materiais utilizados na Odontologia (amálgama de prata, guta-percha e liga metálica) e avaliar a influência de diferentes tamanhos de campo de visão (field of view - FOV) e de voxel sobre a ação da ferramenta. Foram confeccionados três phantoms de resina acrílica com amostras dos materiais estudados em seu interior. Os phantoms foram escaneados no tomógrafo do aparelho Picasso Trio® (Vathec, Hwaseong, Coréia do Sul) com diferentes FOVs (120x85 mm, 80x80 mm, 80x50 mm e 50x50 mm) e voxels (0,3 mm e 0,2 mm). Todos os escaneamentos foram realizados duas vezes com cada parâmetro, uma sem ativação e uma com ativação da ferramenta de RAM. As imagens foram avaliadas no programa OnDemand3D (CyberMed, Seul, Coréia do Sul). Foram obtidos valores de média e desvio-padrão do histograma das áreas ao redor das amostras e das áreas-controle e foi calculada a relação contraste-ruído (RCR). Os dados foram submetidos à análise. Observou-se influência positiva da ferramenta nos valores do desvio-padrão das áreas ao redor das amostras dos materiais amálgama de prata e liga metálica. Não houve influência da utilização da ferramenta sobre os valores das médias e valores de RCR. Na presença da ferramenta de RAM, o FOV e o voxel não influenciaram os valores de desvio-padrão das áreas ao redor das amostras. Foi possível concluir que a ferramenta mostrou-se eficaz na redução do artefato gerado pelo amálgama de prata e pela liga metálica; e a ação da ferramenta não é influenciada por diferentes FOVs e voxels, de forma que esses parâmetros podem ser selecionados de acordo com o objetivo do exame, sem haver alterações quando a ferramenta é utilizada / Abstract: High density and high atomic number materials are scanned results in artefact in tomographic image. The artefact compromises the quality of tomographic image, which may make the image useless for the diagnosis. The aim of this study were: to assess the action of metal artefact reduction (MAR) algorithm on tomographic images of phantoms with different materials used in Dentistry (dental amalgam, gutta-percha and dental alloy); to assess the influence of different sizes of field of view (FOV) and voxel on the action of the MAR algorithm. Three phantoms were made of acrylic resin with the dentals materials in their interior. The phantoms were scanned on Picasso Trio® machine (Vathec, Hwaseong, South Korea) with different FOVs (120x85 mm, 80x80 mm, 80x50 mm and 50x50 mm) and voxels (0.3 mm and 0.2 mm). All scans were performed twice with each parameter, without and with activation of the MAR algorithm. The images were evaluated on the OnDemand3D software (CyberMed, Seoul, South Korea). The mean and variation (standard deviation - SD) of greyscale values of the histogram of the areas around samples and control areas were obtained. The contrast-to-noise ratio (CNR) was calculated. Data were statistically analyze. There was positive influence of the algorithm on the SD of the areas around the samples of dental amalgam and dental alloy. There was no influence of the algorithm on the mean of greyscale values and CNR. The FOV and voxel did not influence the SD of the areas around the samples when the MAR algorithm was active. In conclusion, the MAR algorithm showed positive effect in reducing the artefact caused by dental amalgam and dental alloy; its action was not influenced by different FOVs and voxels, so those parameters can be selected according to the examination purpose, as there are no changes in the algorithm use / Mestrado / Radiologia Odontologica / Mestra em Radiologia Odontológica

Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: In order to successfully treat an infected root canal system (RCS), it is required to locate all root canals and have an access path to the apex of each canal. This can be challenging in teeth with pulp canal obliteration (PCO), often leading to increased chair time and increased risk of iatrogenic errors. Guided endodontic access (GEA) combines information from a cone-beam computed tomography (CBCT) scan with an intra-oral scan to create a stent. GEA stents with or without fixation pins have been shown to be successful in accurately negotiating a RCS with PCO. Objective: Compare the degree of deviation and difference in 3D offset at the base to apical tip of the drill from the designed access path when a GEA stent with and without pin fixation is used to access tooth #8 with PCO. Materials and Methods: A 3-D printed maxillary model of an anonymous patient had a GEA stent designed using coDiagnonstiX software. The stent extended from tooth #3 to tooth #14 with the guide sleeve over tooth #8. Tooth #8 with no calcification, calcification to the cervical third, and calcification to the middle third of the RCS were designed in the coDiagnostiX software. Tooth #8 will be accessed using a 1.3 mm drill that fits a 1.3 mm sleeve used for both access and pin fixation. 15 of the 30 GEA samples will utilized pin fixation, while the other 15 samples did not utilize pin fixation. Following GEA in all 30 samples a CBCT was taken of each sample. Each post-operative CBCT was aligned with the pre-operative CBCT in the coDiagnostiX software. The coDiagnostiX software was able to calculate the degree of deviation and difference in 3D offset between the base and apical tip of the drill during GEA. Paired t-tests were used to test each group for significant differences in 3D offset between base and tip. Two-way ANOVA was used to evaluate the effects of pin fixation and calcification on the degree of deviation and the deviation of 3D offset of the entry point and tip. Results: There was a significant interaction between use of pin fixation and calcification level on the degree of deviation of GEA. GEA with pin fixation had a significantly larger degree of deviation than GEA without pin fixation with calcification extending to the middle third of the RCS. GEA with and without pin fixation did not have a significant difference when calcification extended to the cervical third of the RCS or no calcification was present. There was a significant interaction between use of pin fixation and calcification level on 3D offset difference. GEA with pin fixation had a significantly larger 3D offset difference than GEA with no pin fixation for calcification in the middle third of the RCS. For GEA with and without pin fixation there was no significant difference when calcification extended to the cervical third of the RCS or no calcification was present. Conclusion: The use of pin fixation did not result in a decrease of degree of deviation or difference in 3D offset during GEA access. It can be concluded that the use of pin fixation is not necessary for GEA of teeth with PCO when a full dentition is present to provide stability and retention of the stent. / 2022-06-21

Magister Scientiae Dentium - MSc(Dent) / Previously, many studies have used cone beam computed tomography (CBCT) to detect and confirm the exact location of the MB2 canal in maxillary molars. It is now considered the gold standard, as it allows clinicians to visualize complex anatomical structures and to perform endodontic treatment safely. However, in the context of this study, the prevalence and location of the MB2 in maxillary first and second permanent molars among the Libyan population is limited. The aim of this in vivo study is to describe the prevalence and location of the MB2 in the mesiobuccal root of first and second maxillary molars and to describe a methodology to enable its geometric location in the Libyan population using CBCT imaging.

Evaluar la dimensión antero- posterior (A-P)/medio-lateral (M–L), y la morfología del cóndilo mandibular en pacientes de 18 a 65 años con patrón esquelético Clase I en tomografías computarizadas Cone Beam. Material y Métodos: 71 tomografías fueron evaluadas mediante el software RealScan 2.0. La dimensión fue determinada por los puntos A (más anterior en el plano sagital), P (más posterior en el plano sagital), M (más interno en el plano coronal), L (más externo en plano coronal). Se evaluó la morfología del cóndilo en dos planos coronal y sagital, clasificándose en: redonda, aplanada, convexa y mixta. La dimensión del cóndilo fue analizada por estadística descriptiva y la morfología mediante distribución de frecuencias. Para el análisis bivariado, se aplicó la prueba de t de Student. Resultado: Se obtuvieron las medidas del diámetro A-P del cóndilo derecho (CD) (8,72mm ± 1,25mm) y el izquierdo (CI) (8,50mm ± 1,50mm), el diámetro M-L del CD (19,24mm ± 2,03mm) y el CI (18,97mm ± 1,87mm). Hubo diferencias significativas en la dimensión M-L del CI del sexo masculino en comparación al femenino (p=0.002). La morfología más prevalente del CD (35,21) y CI (23,94) en plano coronal fue de tipo redonda. Conclusión: La dimensión A-P del cóndilo derecho e izquierdo es similar en ambos sexos; sin embargo, existen diferencias en la dimensión M-L del cóndilo izquierdo del sexo masculino. La morfología del cóndilo derecho e izquierdo más prevalente fue la redonda en plano sagital a excepción del plano coronal. / To evaluate the anterior-posterior (A-P)/medial-lateral (M-L) dimension, and morphology of the mandibular condyle in patients aged 18 to 65 years with Class I skeletal pattern on Cone Beam Computed Tomography scans (CBCTs). Materials and Methods: Seventy one CBCTs were evaluated using RealScan 2.0 software. The dimension was determined by points A (most anterior in the sagittal plane), P (most posterior in the sagittal plane), M (most interior in the coronal plane), L (most exterior in the coronal plane). The morphology of the condyle was evaluated in two coronal and sagittal planes, being classified as: round, flat, convex or mixed. The size of the condyle was analyzed by descriptive statistics and the morphology by frequency distribution. For the bivariate analysis, the Student’s t-test was applied. Results: Measurements were obtained for the A-P diameter of the right condyle (RC) (8.72mm ± 1.25mm) and the left condylar (LC) (8.50mm ± 1.50mm), the M-L diameter of the RC (19.24mm ± 2.03mm) and the LC (18.97mm ± 1.87mm). There were significant differences in the male M-L dimension of the LC compared to the female (p=0.002). The most prevalent morphology of RC (35.21) and IQ (23.94) in the coronal plane was round.. Conclusion: The A-P dimension of the right and left condyle is similar in both genders; however, there are differences in the M-L dimension of the left male condyle. The most prevalent morphology of the right and left condyle was round in the sagittal plane with the exception of the coronal plane. / Revisión por pares

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

No description available.