<p>Based on the compressed sensing theorem, we present the integrated software and hardware platform for developing a total-variation based image restoration algorithm by applying prior image information and free-form deformation fields for image guided therapy. The core algorithm we developed solves the image restoration problem for handling missing structures in one image set with prior information, and it enhances the quality of the image and the anatomical information of the volume of the on-board computed tomographic (CT) with limited-angle projections. Through the use of the algorithm, prior anatomical CT scans were used to provide additional information to help reduce radiation doses associated with the improved quality of the image volume produced by on-board Cone-Beam CT, thus reducing the total radiation doses that patients receive and removing distortion artifacts in 3D Digital Tomosynthesis (DTS) and 4D-DTS. The proposed restoration algorithm enables the enhanced resolution of temporal image and provides more anatomical information than conventional reconstructed images.</p><p>The performance of the algorithm was determined and evaluated by two built-in parameters in the algorithm, i.e., B-spline resolution and the regularization factor. These parameters can be adjusted to meet different requirements in different imaging applications. Adjustments also can determine the flexibility and accuracy during the restoration of images. Preliminary results have been generated to evaluate the image similarity and deformation effect for phantoms and real patient's case using shifting deformation window. We incorporated a graphics processing unit (GPU) and visualization interface into the calculation platform, as the acceleration tools for medical image processing and analysis. By combining the imaging algorithm with a GPU implementation, we can make the restoration calculation within a reasonable time to enable real-time on-board visualization, and the platform potentially can be applied to solve complicated, clinical-imaging algorithms.</p> / Dissertation

X-ray scatter in cone-beam computed tomography (CBCT) is known to reduce image quality by introducing image artifacts, reducing contrast, and limiting computed tomography (CT) number accuracy. The extent of the effect of x-ray scatter on CBCT image quality is determined by the shape and magnitude of the scatter distribution in the projections. A method to allay the effects of scatter is imperative to enable application of CBCT to solve a wider domain of clinical problems. The work contained herein proposes such a method. A characterization of the scatter distribution through the use of a validated Monte Carlo (MC) model is carried out. The effects of imaging parameters and compensators on the scatter distribution are investigated. The spectral frequency components of the scatter distribution in CBCT projection sets are analyzed using Fourier analysis and found to reside predominately in the low frequency domain. The exact frequency extents of the scatter distribution are explored for different imaging configurations and patient geometries. Based on the Fourier analysis it is hypothesized the scatter distribution can be represented by a finite sum of sine and cosine functions. The fitting of MC scatter distribution estimates enables the reduction of the MC computation time by diminishing the number of photon tracks required by over three orders of magnitude. The fitting method is incorporated into a novel scatter correction method using an algorithm that simultaneously combines multiple MC scatter simulations. Running concurrent MC simulations while simultaneously fitting the results allows for the physical accuracy and flexibility of MC methods to be maintained while enhancing the overall efficiency. CBCT projection set scatter estimates, using the algorithm, are computed on the order of 1-2 minutes instead of hours or days. Resulting scatter corrected reconstructions show a reduction in artifacts and improvement in tissue contrast and voxel value accuracy.

X-ray scatter in cone-beam computed tomography (CBCT) is known to reduce image quality by introducing image artifacts, reducing contrast, and limiting computed tomography (CT) number accuracy. The extent of the effect of x-ray scatter on CBCT image quality is determined by the shape and magnitude of the scatter distribution in the projections. A method to allay the effects of scatter is imperative to enable application of CBCT to solve a wider domain of clinical problems. The work contained herein proposes such a method. A characterization of the scatter distribution through the use of a validated Monte Carlo (MC) model is carried out. The effects of imaging parameters and compensators on the scatter distribution are investigated. The spectral frequency components of the scatter distribution in CBCT projection sets are analyzed using Fourier analysis and found to reside predominately in the low frequency domain. The exact frequency extents of the scatter distribution are explored for different imaging configurations and patient geometries. Based on the Fourier analysis it is hypothesized the scatter distribution can be represented by a finite sum of sine and cosine functions. The fitting of MC scatter distribution estimates enables the reduction of the MC computation time by diminishing the number of photon tracks required by over three orders of magnitude. The fitting method is incorporated into a novel scatter correction method using an algorithm that simultaneously combines multiple MC scatter simulations. Running concurrent MC simulations while simultaneously fitting the results allows for the physical accuracy and flexibility of MC methods to be maintained while enhancing the overall efficiency. CBCT projection set scatter estimates, using the algorithm, are computed on the order of 1-2 minutes instead of hours or days. Resulting scatter corrected reconstructions show a reduction in artifacts and improvement in tissue contrast and voxel value accuracy.

Introdução: O arco dentário superior de pacientes com mordida cruzada posterior normalmente apresenta-se atrésico e a expansão rápida da maxila é indicada para esses casos durante a dentadura mista promovendo abertura da sutura palatina mediana e incrementos transversais na região posterior do arco dentário. Objetivo: O objetivo deste trabalho consistiu em avaliar os efeitos da expansão rápida da maxila, utilizando o disjuntor com cobertura em acrílico, por meio do acompanhamento clínico e radiográfico. Material e Método: A amostra do estudo foi composta por 21 pacientes com mordida cruzada posterior, uni ou bilaterais e atresia do arco dentário superior. O procedimento de expansão rápida da maxila foi realizado na dentadura mista tardia, por meio do aparelho de expansão com cobertura oclusal em acrílico. Foram realizados exames de feixe cônico antes da instalação do aparelho e 06 meses após a instalação do disjuntor McNamara, na ocasião da remoção do aparelho. Nas imagens de tomografia computadorizada, as mensurações foram realizadas por meio do software On Demand 3D (Versão 1.0, Cybermed Inc., Seul, Coreia do Sul). Nas imagens de tomografia computadorizada foram analisadas a espessura das tábuas ósseas vestibular e lingual, o nível da crista óssea vestibular dos primeiros molares permanentes, a largura do palato duro, a distância transversa entre os primeiros molares superiores. Os parâmetros clínicos foram obtidos mensalmente até o final do tratamento: o índice de placa dental visível (IPV), índice sangramento gengival (ISG), profundidade de sondagem (PS), nível clínico de inserção (NIC) e índice de sangramento à sondagem (SS). As medidas pré e pós-tratamento foram submetidas ao teste t pareado (p<0,05). Resultados: Não foram observadas diferenças estatisticamente significantes entre o tempo inicial e final para as variáveis IPV, ISG, ISS, PS E NIC, porém houve um aumento significativo para PS e NIC durante os períodos de 30, 60 e 150 dias. Os resultados das medidas realizadas por meio da TCFC não mostraram diferenças estatisticamente significantes entre os tempos para a altura da crista óssea vestibular. A espessura da tábua óssea vestibular diminuiu nos molares permanentes e deciduos, sendo essa diminuição significativa apenas nos molares permanentes (p<0,05), enquanto que no lado palatino aumentou significativamente (p<0,001) em todos os dentes analisados. Não houve redução da crista óssea vestibular. À distância bi-molar mostrou um aumento significativo (p<0,001) tanto na região cervical quanto na região apical. O mesmo aumento significativo (p<0,001) foi verificado para a largura do palato. Conclusão: Os resultados dos parâmetros clínicos e das medidas realizadas por meio da tomografia computadorizada permitiu constatar o efeito ortopédico do disjuntor com acrílico na oclusal dos dentes na expansão rápida da maxila. As alterações observadas não sugerem danos significativos aos dentes e nas estruturas periodontais avaliadas. / Introduction: The upper dental arch of patients with posterior crossbite is usually atresic and rapid maxillary expansion is indicated for these cases during the mixed dentition, promoting the opening of the medial palatine suture and transverse increments in the posterior region of the dental arch. Objective: The purpose of this study was to evaluate the effects of rapid maxillary expansion using the acrylic cover breaker, through clinical and radiographic monitoring. Material and Method: The study sample consisted of 21 patients with posterior crossbite, uni or bilateral and upper dental arch atresia. The rapid maxillary expansion procedure was performed in the late mixed dentition using the expansion apparatus with acrylic occlusal cover. Cone beam tests were performed prior to appliance installation and 06 months after the McNamara circuit breaker was installed at the time of removal. Computed tomography images were measured using On Demand 3D software (Version 1.0, Cybermed Inc., Seoul, South Korea). Computed tomography images were analyzed for the thickness of the buccal and lingual bone plates, the level of the buccal bone crest of the first permanent molars, the width of the hard palate, the transverse distance between the first maxillary first molars. Clinical parameters were obtained monthly until the end of the treatment: visible dental plaque index (IPV), gingival bleeding index (ISG), probing depth (PS), clinical insertion level (NIC) and bleeding probing index SS). Pre- and posttreatment measurements were submitted to paired t-test (p <0.05). Results: There were no statistically significant differences between the initial and final time for IPV, ISG, ISS, PS and NIC, but there was a significant increase for PS and CIN during the 30, 60 and 150 day periods. The results of the measurements made through the CBCT did not show statistically significant differences between the times for the height of the buccal bone crest. The thickness of the buccal bone plate decreased in the permanent and deciduous molars, which was only significant in the permanent molars (p <0.05), whereas on the palatine side it increased significantly (p <0.001) in all teeth analyzed. There was no reduction of the buccal bone crest. At the bi-molar distance showed a significant increase (p <0.001) in both the cervical region and the apical region. The same significant increase (p <0.001) was found for the width of the palate. Conclusion: The results of the clinical parameters and the measurements made by means of the computerized tomography allowed to verify the orthopedic effect of the acrylic breaker in the occlusal of the teeth in the rapid expansion of the maxilla. The observed changes do not suggest significant damage to the teeth and to the periodontal structures evaluated.

O objetivo desta tese foi avaliar a interferência da presença de materiais metálicos na imagem radiográfica e tomográfica por meio da análise da adaptação marginal de restaurações e coroas metálicas. Esta investigação resultou em 3 artigos: uma revisão sistemática da literatura para identificar o estado da arte com relação ao uso dos métodos radiográficos; um estudo in vitro comparando o desempenho do filme radiográfico convencional e dos sistemas digitais VistaScan Dürr Dental, Digora Classic Soredex e Express Instrumentarium – com e sem o emprego de filtros para o pós processamento da imagem; e um estudo in vitro avaliando o processamento das imagens da TCFC – utilizando diferentes espessuras de reconstrução. Na revisão sistemática foram incluídos 14 estudos, sendo classificados de baixa ou moderada qualidade, de acordo com os critérios QUADAS de classificação. Na investigação radiográfica (artigo 2), os maiores valores de sensibilidade (0,67 0,83), especificidade (0,81 0,92) e acurácia (0,73 0,86) foram obtidos com radiografias convencionais e imagens digitais originais. Na avaliação tomográfica (artigo 3), os valores da aucROC variaram de 0,60 a 0,72, sendo que o limite inferior do intervalo de confiança mostrou-se abaixo ou muito próximo da linha de referencia. Frente aos resultados, conclui-se que imagens radiográficas originais (convencionais ou digitais) devem ser preferidas para a avaliação de dentes com restaurações metálicas. Quanto à TCFC, mesmo quando se aumenta a espessura de reconstrução da imagem e diminui-se o artefato, ainda assim não há melhora na acurácia do diagnóstico. / The aim of this thesis was to evaluate the interference of the presence of metallic materials on radiographic and tomographic image by assessing misfits tooth and restoration in metal-restored teeth. This investigation resulted in three articles: a systematic review of the literature to identify the state of the art on the use of radiographic methods; an in vitro study comparing the performance of conventional film and digital phosphor plate systems Vistascan Dürr Dental, Digora Classic Soredex and Instrumentarium Express – exported as original images and with the use of post processing filters; and an in vitro study evaluating the post-processing of CBCT images – using diverse reconstruction thicknesses. The systematic review retrived 14 studies, classified as low- / moderate quality based on QUADAS criteria. For radiographic evaluation (article II), higher sensitivity (0.67 0.83), specificity (0.81 0.92) and accuracy (0.73 0.86) values were obtained with conventional and digital original images. For tomographic evaluation (article III), mean aucROC ranged from 0.60 to 0.72, and the analysis of the 95% CI showed the lower bound of the curve bellow or very close to the reference line. Based on the results, it is concluded that original images (conventional or digital) should be preferred for the assessment of teeth with metal restorations. Considering CBCT images, even thought increased reconstruction thickness decreased perceived artifact, it did not improve diagnosis accuracy.

Orientador: João Roberto Gonçalves / Resumo: O exame de tomografia computadorizada de feixe cônico (TCFC) tem sido utilizado amplamente na área clínica e científica médico/odontológica. Diversos softwares de diferentes fabricantes fornecem opções para processamento das imagens, segmentações e análises quantitativas tridimensionais. Um ponto que ainda gera controvérsias nessa área é a confiabilidade dos dados analisados computacionalmente devido às limitações dos algoritmos utilizados, complexidade da estrutura a ser avaliada, magnitude da mensuração, resolução espacial e variações nas metodologias de análises. Muitas dessas limitações são devidas as análises serem realizadas de formas não padronizadas e dependentes do operador. Deste modo, o objetivo geral do presente estudo foi desenvolver e validar um novo aplicativo para mensuração automática de deslocamentos ósseos a partir de TCFC de um crânio humano macerado. Para testar a confiabilidade do método, criamos um protótipo onde foram realizados deslocamentos físicos no crânio seguidos por exames de TCFC e realizamos os mesmos deslocamentos de forma virtual. As mensurações foram obtidas com base nos registros em maxila e na base do crânio por meio do nosso aplicativo e pelo 3D-Slicer, respectivamente. Além disso, realizamos uma análise visual após segmentação semiautomática por meio do ITK-SNAP para detecção do menor defeito ósseo em fragmento de osso bovino. Nossos resultados mostraram que as ferramentas testadas foram... (Resumo completo, clicar acesso eletrônico abaixo) / Cone beam computerized tomography (CBCT) has been widely used in the clinical, scientific, medical and dental field. Various software from different manufacturers offer options for image processing, segmentation and quantitative analysis. One point that still generates controversy in this area is the reliability of the computer-analyzed data, because of the algorithms limitations, complexity of the structure to be assessed, magnitude of the measurement, spatial resolution and spatial variations in the records. Many of these limitations are caused by analyzes that are conducted in a non-standard form and highly dependent on the operator. Thus, the general objective of this study was to develop and validate a new application for automatic measurement of bone displacement from CBCTs of a macerated human skull. To evaluate our method's reliability, we created a prototype where physical movements were performed in a human skull followed by CBCT examinations and performed the same movements virtually. Measurements were obtained from the records in jaw and skull base using our application and the 3D Slicer software, respectively. We also performed a visual analysis after the semi-automatic segmentation using the ITK-SNAP for detection of the lower bone defect in bovine bone fragment. Our results showed that we have succeeded in implementing our application of automatic analysis for three-dimensional measurements in the craniofacial area. The tools used in this study could detect physical displacements smaller than the spatial resolution of the image, and the results were comparable to the 3D Slicer software. For virtual displacements, precise results were obtained, and the movements were limited by the image resolution. Furthermore, we observed that the detection and visualization of bone defects in the bovine cortex...(Complete abstract electronic access below) / Mestre

Orientador: Dirceu Barnabé Raveli / Banca: Gladys Cristina Dominguez Rodriguez / Banca: Ary dos Santos-Pinto / Resumo: As mudanças nos padrões de respiração nasal afetam profundamente o crescimento craniofacial. Avanços tecnológicos, como a tomografia computadorizada de feixe cônico (TCFC), têm sido utilizados com o propósito de se observar tridimensionalmente, o crânio, a face e o espaço aéreo faríngeo, sendo possível a avaliação das mudanças do espaço aéreo induzidas pelos aparelhos ortopédicos propulsores mandibular. O intuito deste estudo é apresentar um método de avaliação das vias aéreas de fácil reprodutibilidade, e avaliar, mediante a TCFC, os efeitos do aparelho de Herbst bandado no espaço aéreo orofaríngeo (EAOF), nasofaríngeo (EANF) e faríngeo superior (EAFS), em indivíduos com má oclusão classe II divisão 1ª. A amostra foi composta por imagens digitais de 15 indivíduos (idade média inicial de 15,7 anos ± 1.7, após surto de crescimento pubertário) com má oclusão classe II divisão 1ª, tratados com aparelho Herbst bandado (8 meses). Os exames tomográficos foram realizados antes (T1) e após (T2) o tratamento. A fase inicial foi realizada com a orientação do nos planos; axial, coronal e sagital. Foram mensurados: comprimento no software Dolphin 3D ®: comprimento, maior área no corte coronal, maior área no corte sagital, área mínima da secção transversal e volume, de EANF, EAOR e EAFS (orofaringe e nasofaringe). Dois avaliadores previamente calibrados mensuraram duas vezes apenas um tempo das tomografias, para observar a reprodutibilidade (inter-examinador) e replicabilidade (intra-examinador). Sendo confirmada a reprodutibilidade do método, foi avaliado o efeito do aparelho Herbst, analisando os períodos pré (T1) e pós (T2) tratamento ortopédico. A análise estatística dos dados foi realizada em duas etapas. Primeira etapa, a confiabilidade das medidas apresentaram boa replicabilidade (intra-examinador)... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Changes in nasal breathing patterns profoundly affects the craniofacial growth. Technological advances, such as cone beam computed tomography (CBCT), have been used in order to observe three-dimensionally: the skull, face and pharyngeal airway space, with possible assessment of airspace changes induced by orthopedic activators. The purposes of this study are to present a method for assessing airway that is easily reproducted, and evaluate through the CBCT the effects of banded Herbst appliance in the oropharyngeal airspace (EAOF), nasopharyngeal (EANF) and upper pharynx (EAFS) in individuals with malocclusion class II division 1. The sample consisted of digital images of 15 individuals (initial age of 15.7 years ± 1.7, after pubertal growth spurt) with malocclusion class II division 1, treated with banded Herbst appliance (8 months). CBCT scans were performed before (T1) and after (T2) treatment. The initial phase was conducted with the guidance of planes: axial, coronal and sagittal. The following were measured: the largest area in the coronal and sagittal, minimum cross-sectional area and volume of EANF, and EAOR EAFS (oropharynx and nasopharynx) by length in Dolphin 3D® software. Two calibrated evaluator mesured twice time of CBCT to observe the reproducibility (inter-examiner) and repeatability (intra-examiner). Once the reproductability of the method was coinfirmed, the effect of the Herbst applicance was evaluated before (T1) and after (T2) the orthodontic treatment. The statistical analysis was performed in two steps. First step, the reliability of the measurements showed good repeatability (intra-examiner) (ICC ≥ 0.984) and good reproducibility (inter-examiner) (ICC ≥ 0.911) for all measures except the minimum area of cross section of all regions, which showed variability. Second step, once confirmed the reliability of the measuremens, Student t test was appleid, significance... (Complete abstract click electronic access below) / Mestre

Submitted by RICARDO MANOEL TÂNGARI DE ARAÚJO E MEIRA null (tangarimeira@gmail.com) on 2016-06-07T21:20:56Z No. of bitstreams: 1 Dissertação.pdf: 1713062 bytes, checksum: dea4b5a0cb16097137546acd6f9efe5e (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-06-08T18:32:21Z (GMT) No. of bitstreams: 1 meira_rmta_me_arafo.pdf: 1713062 bytes, checksum: dea4b5a0cb16097137546acd6f9efe5e (MD5) / Made available in DSpace on 2016-06-08T18:32:21Z (GMT). No. of bitstreams: 1 meira_rmta_me_arafo.pdf: 1713062 bytes, checksum: dea4b5a0cb16097137546acd6f9efe5e (MD5) Previous issue date: 2016-04-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo deste trabalho foi avaliar a influência da miliamperagem (mA) sobre a qualidade do diagnóstico das fraturas radiculares por meio de TCFC. Foram selecionados 58 dentes anteriores e posteriores extraídos de humanos, sendo que todos tiveram os condutos radiculares preparados e, metade destes, foram obturados. Os dentes foram distribuídos em dois grupos (n=29): controle (GC) e fraturado (GF). Fraturas radiculares nos dentes anteriores e posteriores foram induzidas em uma máquina universal de ensaios mecânicos e, posteriormente, os dentes foram inseridos em um crânio macerado adulto de humano composto por maxila e mandíbula. Em seguida, o volume de imagem de cada dente foi adquirido no aparelho de TCFC (Scanora 3Dx), utilizando-se cinco diferentes protocolos de miliamperagem (4; 5; 6,3; 8 e 10 mA). As imagens foram aleatorizadas e avaliadas por dois especialistas em Radiologia Odontológica e Imaginologia, que as classificaram quanto a presença ou ausência de fraturas, seguindo uma escala de confiança de cinco pontos. A concordância intra e interexaminador foi estimada por meio da estatística Kappa com ponderação linear. O desempenho do diagnóstico foi determinado pela área sob a curva ROC (AUROC) por ponto e por intervalo de 95% de confiança (IC95%), sendo adotado nível de significância de 5%. As reprodutibilidades intra e interexaminador indicaram concordâncias substancial e moderada, respectivamente. Observou-se que todos os protocolos de mA tiveram capacidade de diagnóstico (p<0,0001). A AUROC foi significativamente maior com os protocolos de 8 e 10 mA (p≤0,0389) e, consequentemente, promoveram uma melhor eficácia de diagnóstico. Pôde-se concluir que a miliamperagem exerce uma influência significativa sobre a qualidade do diagnóstico das fraturas radiculares em imagens de TCFC. A sua redução é possível e deve ser realizada com cautela, a fim de que não haja prejuízo para a eficácia de diagnóstico dessa condição. / The aim of this study was to assess the influence of mA on diagnostic quality of RF in CBCT imaging. Fifty-eight (58) anterior and posterior human teeth were selected, in which all had their root canals prepared and half of them were endodontically filled. The teeth were divided into two groups (n=29): control (CG) and fractured (FG). A universal testing machine induced RF(s) on anterior and posterior teeth. Prior to the image acquisition, these teeth were inserted in the upper and lower empty alveolar sockets of an adult dried skull (phantom). Then, the imaging volume of each tooth was acquired in the Scanora 3DX machine, using five different protocols of mA(s): 4; 5; 6.3; 8 and 10. Two oral radiologists, independently and blind to the identification of the samples, interpreted the randomized images. On suspicion of the presence/absence of root fractures, they were interpreted using a five points confidence scale. The intra and interexaminer agreement was estimated by the Kappa statistic with linear weighting. The diagnostic performance was determined by the area under the ROC curve (AUROC) by point and by 95% confidence interval (95% CI), being adopted the significance level of 5%. The intra and interexaminer reproducibility indicated calibration substantial and moderate, respectively. It was observed that all protocols of mA have diagnostic capability (p <0.0001). The AUROC was significantly higher with the protocols 8 and 10 mA (p≤0,0389) and, consequently, they had better diagnostic efficacy. It was concluded that the mA has a significant influence on the quality of diagnosis of root fractures in CBCT images. The reduction is possible and should be performed with caution, so that there is no damage to the efficacy of diagnosis of this condition.

Orientador: Guilherme Monteiro Tosoni / Banca: Andréa Gonçalves / Banca: Matheus Lima de Oliveira / Resumo: O objetivo deste trabalho foi avaliar a influência da miliamperagem (mA) sobre a qualidade do diagnóstico das fraturas radiculares por meio de TCFC. Foram selecionados 58 dentes anteriores e posteriores extraídos de humanos, sendo que todos tiveram os condutos radiculares preparados e, metade destes, foram obturados. Os dentes foram distribuídos em dois grupos (n=29): controle (GC) e fraturado (GF). Fraturas radiculares nos dentes anteriores e posteriores foram induzidas em uma máquina universal de ensaios mecânicos e, posteriormente, os dentes foram inseridos em um crânio macerado adulto de humano composto por maxila e mandíbula. Em seguida, o volume de imagem de cada dente foi adquirido no aparelho de TCFC (Scanora 3Dx), utilizando-se cinco diferentes protocolos de miliamperagem (4; 5; 6,3; 8 e 10 mA). As imagens foram aleatorizadas e avaliadas por dois especialistas em Radiologia Odontológica e Imaginologia, que as classificaram quanto a presença ou ausência de fraturas, seguindo uma escala de confiança de cinco pontos. A concordância intra e interexaminador foi estimada por meio da estatística Kappa com ponderação linear. O desempenho do diagnóstico foi determinado pela área sob a curva ROC (AUROC) por ponto e por intervalo de 95% de confiança (IC95%), sendo adotado nível de significância de 5%. As reprodutibilidades intra e interexaminador indicaram concordâncias substancial e moderada, respectivamente. Observou-se que todos os protocolos de mA tiveram capacidade de diag... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The aim of this study was to assess the influence of mA on diagnostic quality of RF in CBCT imaging. Fifty-eight (58) anterior and posterior human teeth were selected, in which all had their root canals prepared and half of them were endodontically filled. The teeth were divided into two groups (n=29): control (CG) and fractured (FG). A universal testing machine induced RF(s) on anterior and posterior teeth. Prior to the image acquisition, these teeth were inserted in the upper and lower empty alveolar sockets of an adult dried skull (phantom). Then, the imaging volume of each tooth was acquired in the Scanora 3DX machine, using five different protocols of mA(s): 4; 5; 6.3; 8 and 10. Two oral radiologists, independently and blind to the identification of the samples, interpreted the randomized images. On suspicion of the presence/absence of root fractures, they were interpreted using a five points confidence scale. The intra and interexaminer agreement was estimated by the Kappa statistic with linear weighting. The diagnostic performance was determined by the area under the ROC curve (AUROC) by point and by 95% confidence interval (95% CI), being adopted the significance level of 5%. The intra and interexaminer reproducibility indicated calibration substantial and moderate, respectively. It was observed that all protocols of mA have diagnostic capability (p <0.0001). The AUROC was significantly higher with the protocols 8 and 10 mA (p≤0,0389) and, consequently, they had bette... (Complete abstract click electronic access below) / Mestre

The objective of this study was to evaluate the ability to identify occlusal prematurity, by cutting the paraxial CT cone beam, comparing the opinion of these images, provided by professionals in different specialities, with clinical examination obtained from strips of carbon paper. Sixteen young asymptomatic patients underwent an initial clinical examination and then were made appliance desprogramming individual (Lucia JIG). Through manipulation and marking interocclusal jaw with carbon film (Accufilm) identified clinically premature contact Centric Relation (CR) of each patient. Later these devices were set in the position of centric contact and used during the CT scans so that they could obtain tomographic images in the position of centric relation. After processing the images, these were analyzed for thirty professionals from different areas and compared the results obtained by the analysis of imaging and analysis of clinical markers. The data were statistically analyzed by analysis of variance ANOVA and Scott-Knott. From the evaluation of the ability to identify occlusal prematurity through cuts of paraxial CT cone beam, we can conclude that there was no statistically significant difference between the views of professionals with clinical examination carried out with carbon paper. Comparing the opinions expressed by professionals in the areas of occlusion, Radiology and General Clinicians, notes that there was no statistically significant differences. Regarding the time of his profession, the group with less time since graduation had the lowest rate of agreement among the analysis of imaging and clinical analysis with carbon paper. / O objetivo deste estudo foi avaliar a capacidade de identificação de prematuridades oclusais, por meio de cortes paraxiais de tomografias computadorizadas de feixe cônico, confrontando o parecer destas imagens, estabelecido por profissionais de diferentes áreas odontológicas, com a análise clínica obtida por meio de marcações com papel carbono. Dezesseis pacientes jovens assintomáticos foram submetidos a um exame clínico inicial e em seguida foram confeccionados dispositivos desprogramadores individuais ( JIG de Lucia ). Mediante manipulação mandibular e marcação interoclusal com papel carbono (Accufilm) identificou-se clinicamente o contato prematuro em Relação Cêntrica (RC) de cada paciente. Posteriormente estes dispositivos foram ajustados na posição de contato cêntrico e utilizados durante os exames tomográficos para que se pudessem obter imagens tomográficas na posição de Relação Cêntrica. Após o processamento das imagens, estas foram analisadas por trinta profissionais das áreas de Oclusão, Radiologia e Clínico Geral (n=10 para cada área) e compararam-se os resultados obtidos pela análise das imagens tomográficas e pela análise clínica por marcações. Os dados obtidos foram analisados estatisticamente pela Análise de Variância ANOVA e pósteste de Scott-Knott (p <0,05). A partir da avaliação da capacidade de identificação de prematuridades oclusais por meio de cortes paraxiais de tomografias computadorizadas de feixe cônico, pode-se concluir que não houve diferenças estatisticamente significantes entre os pareceres dos profissionais com a análise clínica realizada com papel carbono. Ao comparar os pareceres emitidos pelos profissionais das áreas de Oclusão, Radiologia e Clínica Geral, constata-se que não houve diferenças estatisticamente significantes. Em relação ao tempo de exercício profissional, o grupo com menor tempo de formado apresentou o menor índice de concordância entre os pareceres da análise das imagens tomográficas e a análise clínica com papel carbono. / Mestre em Odontologia