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.

The objective of this work is to develop an on-line planning and delivery technique for palliative radiotherapy of spinal metastases using a linear accelerator capable of cone-beam CT (CBCT) imaging. This technique integrates all preparation and delivery steps into a single session equivalent to an initial treatment session. The key technical challenges pertaining to the development and implementation of this novel treatment technique are related to CBCT image performance, efficient system integration, development of on-line planning tools and design of novel quality assurance (QA) phantoms and processes. Hardware and software image corrections were first implemented to make CBCT images suitable for target definition and planning. These corrections reduced CBCT non-uniformity and improved CBCT-number accuracy. The on-line treatment technique workflow and the integration of all the subsystems involved in the process were assessed on a customized spine phantom constructed for the study. The challenges related to the routine QA of the highly integrated on-line treatment technique were addressed with the construction and validation of an integral test phantom. This phantom, which contains point detectors (diodes) allows for real-time QA of the entire image guidance, planning and treatment process in terms of dose delivery accuracy. The integral test phantom was also effective for the QA of high-dose, high-precision spinal radiosurgery. Simulation of the on-line treatment technique on patient data showed that the planning step was the one of the most time consuming tasks due predominantly to manual target definition. A semi-automatic method for detection and identification of vertebrae on CBCT images was developed and validated to streamline vertebra segmentation and improve the on-line treatment efficiency. With a single patient setup at the treatment unit, patient motion during the on-line process represents the main source of geometric uncertainty for dose delivery. Spine intra-fraction motion was assessed on CBCT for a group of 49 patients treated with a palliative intent. The use of surface marker tracking as a surrogate for spine motion was also evaluated. Finally, the complete on-line planning and delivery technique was implemented in a research ethics board (REB) approved clinical study at the Princess Margaret Hospital and 7 patients have been successfully treated at the time of this report with this novel treatment approach.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 95-101).

To investigate the relationship between maturation of the spheno-occipital synchondrosis (SOS) with cervical vertebrae (CVM), dental development of the canine (DI), chronologic age and intra-rater / inter-rater reliability using retrospective cone-beam computed tomography, seventy-seven subjects were randomly selected into six groups based on age and sex. Spearman correlation coefficients and tabulations between stages of maturation indices were evaluated. SOS maturation was significantly correlated with CVM and age (r > 0.8). A weaker significant correlation coefficient was found between SOS and DI (r > 0.6). All males with fused SOS were in CVM stage 4 or later, while all females were in at least CVM stage 3. No subjects with open SOS were in the post-pubertal growth spurt age group and no subjects with closed SOS were in the pre-pubertal growth spurt age group. SOS maturation showed substantial and significant inter-rater and intra-rater reliability (kappa > 0.7). / February 2015

Submitted by ARIANE DE SOUZA OLIVEIRA null (ariane.oliveira.2@hotmail.com) on 2016-05-17T00:24:12Z No. of bitstreams: 1 Dissertação.pdf: 1165162 bytes, checksum: 802092cd564571fefbc1c2524f006e37 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-05-18T13:10:09Z (GMT) No. of bitstreams: 1 oliveira_as_me_arafo.pdf: 1165162 bytes, checksum: 802092cd564571fefbc1c2524f006e37 (MD5) / Made available in DSpace on 2016-05-18T13:10:09Z (GMT). No. of bitstreams: 1 oliveira_as_me_arafo.pdf: 1165162 bytes, checksum: 802092cd564571fefbc1c2524f006e37 (MD5) Previous issue date: 2016-03-24 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O objetivo desta pesquisa foi avaliar as alterações volumétricas da cavidade nasal de pacientes diagnosticados com deficiência transversa de maxila submetidos à expansão rápida de maxila assistida cirurgicamente. Foram avaliadas tomografias computadorizadas de feixe cônico de 28 pacientes adultos (17 mulheres e 11 homens), em três períodos distintos, a saber: período pré-operatório imediato (T1), pós-operatório ao final da expansão (T2) e 6 meses após do término da expansão (T3), no qual as imagens, em formato DICOM, foram importadas e reconstruídas por meio do software On Demand 3D, que permitiu a reconstrução multiplanar da região de interesse de maneira padronizada. Para cada imagem do corte gerado, dois examinadores treinados delimitaram manualmente o espaço aéreo nasal, utilizando o software ImageJ. Com base no principio de Cavalieri, a soma de todas as áreas medidas em cada paciente/período foi utilizada para gerar o volume da estrutura avaliada, em milímetros cúbicos. Os dados obtidos foram verificados pelo teste ANOVA e teste de Tukey, com nível de significância de 5%. Concluiu-se que as expansões maxilares cirurgicamente assistida em adultos não promoveram alterações de volume da cavidade nasal. / The objective of this study was to evaluate the volumetric changes of the nasal cavity in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion. Cone beam tomographic images of 28 adult patients (17 women and 11 men) were evaluated. They were obtained after three different time periods: immediate preoperative period (T1), postoperative after completion of expansion (T2) and 6 months after expansion (T3). The DICOM images were imported and reconstructed through the On Demand 3D software, which allowed standardized multiplanar reconstruction of the interest region. For each image two examiners manually delimited the nasal air space, using the Image J software. Based on the Cavalieri principle, the summation of all measured areas in each patient/period was used to calculate of the volume in cubic millimeters. The data were analysed by the ANOVA and Tukey tests at 5% significance level. It was concluded that surgically assisted maxillary expansion in adults did not promote volume changes of the nasal cavity. / FAPESP: 2014/10239-3

Made available in DSpace on 2015-05-14T12:56:01Z (GMT). No. of bitstreams: 1 ArquivoTotal.pdf: 1110219 bytes, checksum: 8abd8a2ef0a4c21202b26d2491cd7a34 (MD5) Previous issue date: 2013-02-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research that aimed to evaluate endodontic treatments performed by undergraduate dental UFPB and factors for failure by clinical examination, radiographic and symptomatic cases in CBCT. Were selected 120 patients through analysis of 557 medical records are on file in the Department of Endodontics that were seen between the years 2007 to 2011. The patients' ages ranged from 15 to 78 years, 31 were male and 89 were female. The diagnosis chronic apical periodontitis was 50% of cases, followed by chronic periapical abscess (15.0%). With respect to dental group the most frequent were upper central incisors (28.3%) and pre-molars (24.2%). As for the number of sessions required to treat 59.2% of the cases was conducted in three sessions. The time of follow up ranged from 1 ½ years to 4 ½ years. Regarding the clinical management 73.3% the patients had no signs or symptoms, but the rest of the sample signs and symptoms were: 11.7% pain only by percussion and 3.3% pain by percussion with mobility. The presence of blackened crown was recorded in 37.5% of cases. The majority of patients had appropriate endodontic treatment (72.5%), keeper intracanal absent (88.3%) and adequate coronal restoration (74.2%). Most radiographic images in the index PAI showed normal appearance bringing a success index (PAI 1 + PAI 2) 70%. In index Strindberg most (62.5%) of the treatments were considered successful, with 30.0% uncertain healing and 7.5% failure. The percentage with endodontic treatment and adequate coronal restoration and success in Strindberg and PAI index was highest among those who had no signs and symptoms, with a significant association. The percentage of cases with endodontic treatment and adequate coronal restoration was higher among cases successfully than among uncured, with significant association. The success rate by Strindberg and PAIwas higher among cases with vital pulp than pulp necrosis. A significant association between the index PAI and the index CTCTPAI, but the measures tomography and radiography, the mean and median were higher in CT than on radiographs, significant difference betweenthe two methods.Concludes that the clinical and radiographic examinations are important in the process of preservation endodontic, but the CBCT is more suitable for this type of diagnosis, due to higher sensitivity and specificity in evidence of endodontic failure. / Esta pesquisa teve como objetivo avaliar tratamentos endodônticos realizados por alunos de graduação de Odontologia da UFPB e os fatores relacionados ao insucesso, através de exame clínico, radiográfico e CBCT em casos sintomáticos. Foram selecionados 120 pacientes através da análise de 557 fichas de atendimento existentes no arquivo da Disciplina de Endodontia que foram atendidos entre os anos de 2007 a 2011. A idade dos pacientes variou de 15 a 78 anos, 31 eram do sexo masculino e 89 do feminino. A hipótese diagnóstica de Periodontite apical crônica correspondeu a 50% dos casos, seguido de Abcesso periapical crônico (15,0%). Com relação ao grupo dental os mais freqüentes foram: Incisivos centrais superiores (28,3%) e Prémolares superiores (24,2%). Quanto ao número de sessões requeridas para o tratamento 59,2% dos casos foi realizada em três sessões. O tempo de proservação variou entre 1 ano e meio a 4 anos e meio. Em relação ao controle clínico 73,3% dos pacientes não apresentaram sinais e sintomas, porém no restante da amostra os sinais e sintomas mais freqüentes foram: 11,7% dor somente por percussão e 3,3% dor por percussão e mobilidade. A presença de coroa escurecida foi registrada em 37,5% dos casos. A maioria dos pacientes apresentava tratamento endodôntico adequado (72,5%), retentor intracanal ausente (88,3%) e restauração coronária adequada (74,2%). A maioria das imagens radiográficas no índice PAI apresentava aspecto normal trazendo um índice de sucesso (PAI 1+PAI 2) de 70%. No índice de Strindberg a maioria (62,5%) dos tratamentos foi considerada sucesso, 30,0% com cura incerta e 7,5% de insucesso. O percentual com tratamento endodôntico e restauração coronária adequada e sucesso no índice Strindberg e PAI foi mais elevado entre os que não apresentavam sinais e sintomas, havendo associação significativa. O percentual de casos com tratamento endodôntico e restauração coronária adequada foi maior entre os casos com sucesso do que entre os não curados, havendo associação significativa. O percentual de sucesso pelo Strindberg e PAI foi mais elevado entre os casos com polpa vital do que com necrose pulpar. Houve associação significativa entre o índice CBCTPAI e o índice PAI, porém nas medidas da tomografia e radiografia, a média e a mediana foram mais elevadas na tomografia do que na radiografia, havendo diferença significativa entre os dois métodos. Conclue-se que os exames clínicos e radiográficos são importantes no processo de proservação endodôntica, porém a CBCT é mais indicada para este tipo de diagnóstico, devido a maior sensibilidade e especificidade na evidência do insucesso endodôntico. Esta pesquisa teve como objetivo avaliar tratamentos endodônticosrealizados por alunos de graduação de Odontologia da UFPB e osfatores relacionados ao insucesso, através de exame clínico,radiográfico e CBCT em casos sintomáticos. Foram selecionados 120pacientes através da análise de 557 fichas de atendimento existentesno arquivo da Disciplina de Endodontia que foram atendidos entre osanos de 2007 a 2011. A idade dos pacientes variou de 15 a 78 anos, 31eram do sexo masculino e 89 do feminino. A hipótese diagnóstica dePeriodontite apical crônica correspondeu a 50% dos casos, seguido deAbcesso periapical crônico (15,0%). Com relação ao grupo dental osmais freqüentes foram: Incisivos centrais superiores (28,3%) e Prémolaressuperiores (24,2%). Quanto ao número de sessões requeridaspara o tratamento 59,2% dos casos foi realizada em três sessões. Otempo de proservação variou entre 1 ano e meio a 4 anos e meio. Emrelação ao controle clínico 73,3% dos pacientes não apresentaramsinais e sintomas, porém no restante da amostra os sinais e sintomasmais freqüentes foram: 11,7% dor somente por percussão e 3,3% dorpor percussão e mobilidade. A presença de coroa escurecida foiregistrada em 37,5% dos casos. A maioria dos pacientes apresentavatratamento endodôntico adequado (72,5%), retentor intracanal ausente(88,3%) e restauração coronária adequada (74,2%). A maioria dasimagens radiográficas no índice PAI apresentava aspecto normaltrazendo um índice de sucesso (PAI 1+PAI 2) de 70%. No índice deStrindberg a maioria (62,5%) dos tratamentos foi considerada sucesso,30,0% com cura incerta e 7,5% de insucesso. O percentual comtratamento endodôntico e restauração coronária adequada e sucessono índice Strindberg e PAI foi mais elevado entre os que nãoapresentavam sinais e sintomas, havendo associação significativa. Opercentual de casos com tratamento endodôntico e restauraçãocoronária adequada foi maior entre os casos com sucesso do que entreos não curados, havendo associação significativa. O percentual desucesso pelo Strindberg e PAI foi mais elevado entre os casos compolpa vital do que com necrose pulpar. Houve associação significativaentre o índice CBCTPAI e o índice PAI, porém nas medidas datomografia e radiografia, a média e a mediana foram mais elevadas natomografia do que na radiografia, havendo diferença significativa entreos dois métodos. Conclue-se que os exames clínicos e radiográficossão importantes no processo de proservação endodôntica, porém aCBCT é mais indicada para este tipo de diagnóstico, devido a maiorsensibilidade e especificidade na evidência do insucesso endodôntico.

This thesis aims at deciphering the respective roles of autogenic processes and allogenic forcing in the post-orogenic evolution of a coupled mountain catchment/foreland megafan system, with a focus on the Lannemezan megafan and its mountainous catchment in the northern Pyrenees (France). AFT data are consistent with previously published thermochronological data, showing (i) the main exhumation phase of the Axial Zone (AZ; ~50-30 Ma) with lateral variations in the exhumation rates, (ii) a later unroofing of the North-Pyrenean Zone (NPZ; since ~20 Ma), and (iii) a late (~20-15 Ma) exhumation phase only recorded in the western part of the range (west of the Neste River). The megafan was thus built at a late stage of the orogeny and its source catchment lays on the boundary between two tectonic domains. Petrographic data shows that the source area encompasses the NPZ and AZ but modern river sands yield more granitic material than the megafan sediments. This discrepancy suggest that (i) the foreland deposits are locally sourced, but this is not consistent with the definition of a megafan, (ii) the crystalline massifs may have been insufficiently unroofed, but this is inconsistent with the presence of granitic material in Eocene deposits of the south foreland, (iii) the main drainage divide migrated to the south around that period, but this seems inconsistent with the exhumation history of the range as inferred from thermochronological data. Comparison of my estimation of the sedimentary budget and AFT-derived exhumation rates suggests that the current watershed of the Neste is more than sufficient to provide the material for the building of the Lannemezan megafan. This implies that (i) the catchment boundaries have not necessarily changed since the Miocene and (ii) a significant portion of the sediments bypassed the megafan. I dated the abandonment of Quaternary surfaces using cosmogenic nuclides (10Be, 26Al). The abandonment of the megafan (~300 ka) and of the alluvial terraces (~100ka, ~20ka and ~1ka) suggests that incision episodes are triggered by cold-to-warm climatic shifts. The terrace slopes increase with time: I propose that the region was subjected to northward tilting by flexural isostatic rebound as a response to erosional unloading of the range during the Quaternary. From the morphometric analysis (χ-proxy, steepness index, concavity, long river profiles) I show (i) drainage reorganization near the megafan apex and (ii) no influence on the drainage network from active tectonic structures or base-level variations. The abandonment and of the Lannemezan megafan is thus linked to the capture of the Neste by the Garonne and its episodic incision is linked to Quaternary climatic cycles. Numerical modelling adequately reproduce the building of a large megafan in 15 Ma by progradation of the deposits carried by a central river that becomes dominant in the sediment routing. I suggest that, in the northern Pyrenean foreland, the Atlantic Ocean to the west and large, efficient rivers create the conditions needed for a river to be singled out and build a megafan. Negligible subsidence at during the Miocene may have encouraged progradation. I suggest that, in the northern Pyrenees, the main driving force for long-term entrenchment of the megafan is linked to autogenic processes but these are modulated by short-term climatic changes (and possibly isostatic movements). Numerical modelling also evidenced the strong coupling between the mountainous catchment and the basin and the characteristic response times (on the order of 10 ka). / Le but de cette thèse est de comprendre ce qui contrôle l’évolution géomorphologique post-orogénique d’un ensemble composé d’un bassin versant montagneux et de son piedmont à partir de l’exemple du méga-cône alluvial de Lannemezan et son bassin versant au flanc nord des Pyrénées. Les données de thermochronologie in-situ et détritiques confirment les phases d’exhumations : (1) une phase d’exhumation majeure (~50-30 Ma), enregistrée dans toute la ZA bien qu’avec des vitesses différentes à l’est (Ariège) qu’à l’ouest, (2) une excavation plus tardive de la ZNP (à partir de ~20 Ma), et (3) une phase tardive d’exhumation (vers 15-20 Ma) enregistrée seulement à l’ouest. Le méga-cône se forme donc à une période post-orogénique où la tectonique cesse de jouer un rôle dominant, mais le bassin versant d’alimentation du cône se situe à une position charnière entre deux zones qui s’exhume différemment. Les données de pétrographie des sédiments indiquent une zone source qui inclut la ZNP et la ZA. La proportion de matériel cristallin dans les sédiments Oligo-Miocène est plus faible que celle des sédiments des rivières actuellesce qui pourrait suggérer que (1) les massifs cristallins n’étaient pas suffisamment exhumés mais cela semble incohérent avec les études précédentes, (2) que la ligne de partage des eaux a migré vers le sud, mais ce n’est pas cohérent avec l’histoire d’exhumation de la chaîne. J’ai comparé le volume érodé dans le bassin pour produire le méga-cône et le flux sédimentaire estimé à partir des taux d’exhumation : il semble que le bassin versant actuel de la Neste est plus que suffisant pour produire les sédiments du cône, ce qui suggère que (1) la taille du bassin versant n’a pas nécessairement changé et (2) une partie des sédiments a été directement exportée vers le bassin marin. Les résultats des datations par nucléides cosmogéniques (10Be et 26Al) suggèrent que le cône est abandonné vers ~300 ka et les terrasses alluviales qui bordent les rivières du piémont (~100ka, ~20ka et ~1ka) pourraient suggérer un contrôle climatique sur l’incision (cycles glaciaires/interglaciaires). Pour expliquer la pente des terrasses je propose l’hypothèse d’un basculement de la région en lien avec un rebond isostatique au Quaternaire. L’analyse morphométrique du réseau de drainage montre (i) une réorganisation par capture dans la partie sud du cône et (ii) qu’il n’y a pas de structure tectonique active ou de variation du niveau marin. J’ai utilisé un modèle numérique pour comprendre les conditions de formation et d’incision d’un méga-cône et comparé les résultats avec les observations faites sur le cône de Lannemezan et son bassin versant. Les résultats suggèrent que le temps de construction d’un tel cône est de l’ordre de 15 Ma, par progradation des dépôts d’une rivière centrale qui domine les apports du piémont. La comparaison avec le cas de Lannemezan suggère que (1) l’Océan Atlantique à l’ouest et les grandes rivières, au transport efficace créent un environnement propice à la formation du méga-cône; (2) la subsidence négligeable du piémont pourrait avoir favorisé la construction du méga-cône; (3) les processus autogéniques sont suffisants pour produire au long terme une incision permanente du cône par sa rivière d’alimentation. Les forçages externes (tectoniques, climat) ne font que moduler l’incision autogénique. La réponse du paysage à un forçage climatique cyclique montre un temps caractéristique de l’ordre de 10 ka. Finalement, la modélisation a permis de mettre en évidence les interactions entre le piémont et la chaîne.

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.

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Introdução: A terapia a laser de baixa intensidade (LLLT) é uma importante ferramenta na biomodulação tecidual quando do processo cicatricial de uma ferida ou dano cirúrgicos. A sua aplicação favorece o reparo ósseo na região de implantes dentários. Objetivos: Avaliar as alterações no processo de reparo ósseo perimplantar em alvéolo do incisivo inferior de coelho após exodontia seguido da instalação imediata de um implante osseointegrável, irradiado ou não com laser de baixa intensidade (AsGaAl) em diferentes parâmetros através da análise da densidade de imagem perimplantar por tomografia computadorizada de feixe cônico (TCFC) e histomorfométrica da interação entre osso e implante. Verificar a aplicabilidade da TCFC no controle pós-operatório de implantes dentários através de correlação com a microscopia óptica. Metodologia: A amostra foi composta por vinte e quatro fragmentos de mandíbulas dissecadas de coelhos contendo um implante dentário colocado após a exodontia. A distribuição das amostras foi realizada de forma que cada grupo conteve seis mandíbulas, sendo um grupo controle (C) e três grupos experimentais (EI, EII, EIII) seguindo o padrão de aplicação da laserterapia, nos animais in vivo durante 13 dias. O grupo controle recebeu aplicação de laser placebo. O grupo EI recebeu dose de 70J/cm2, o EII-35J/cm2 e o EIII-140J/cm2. Aos 45 dias do experimento todos os animais foram mortos tendo suas mandíbulas dissecadas e submetidas à TCFC para análise da densidade de imagem perimplantar através de dois métodos de avaliação (linear e área retangular). Após, as amostras foram incluídas em resina e preparadas para análise através de microscopia óptica. Na análise histomorfométrica foi mensurada a extensão linear de contato entre osso e implante (ELCOI), a área óssea por espira (AOE), a área óssea retangular (AOR) e a área de fibras colágenas (FC) das três espiras médias do implante. Resultados: Os resultados foram analisados através da análise de variância (ANOVA) complementada pelo teste de comparações múltiplas de Tukey ao nível de significância de 5%. Observou-se um aumento da ELCOI e da FC para o grupo EIII em comparação com os demais grupos. A avaliação linear por TCFC demonstrou médias de nível de cinza mais elevadas para o grupo EIII em comparação com os demais grupos e que os grupos EI e EII apresentaram valores maiores que o grupo C. A avaliação da área retangular por TCFC e avaliações histomorfométricas de área óssea retangular (AOR) e por espira (AOE) não apresentaram diferenças significativas entre os grupos. Não foi possível detectar correlação entre as análises dos resultados obtidos por histomorfometria e TCFC através do coeficiente de correlação de Pearson ao nível de significância de 5%. Conclusão: A LLLT biomodula positivamente o reparo ósseo perimplantar na dose de 140J/cm2. A densidade de imagem perimplantar avaliada pelos dois métodos propostos obtidos por TCFC não demonstrou correlação significativa com os resultados da histomorfometria, sendo discutível sua aplicação no controle pós-operatório de implantes dentários. / Introduction: The use of low level laser therapy (LLLT) is an important tool in tissue biomodulation during the healing process of a wound or surgical damage. The application promotes bone repair in the area of dental implants. Objectives: To evaluate the changes in the peri-implant bone healing in mandibular incisor alveoli of rabbits after extraction followed by immediate installation of an osseointegrated implant, irradiated or not with low intensity laser (GaAlAs) on different parameters by analyzing the image density perimplantar with cone beam computed tomography (CBCT) and histomorphometry of the interaction between bone and implant. Verify the applicability of CBCT in postoperative follow up of dental implants through correlation with optical microscopy. Methodology: The sample was composed of twenty-four fragments of dissected rabbits jaws containing a dental implant placed after the extraction. The distribution of samples was performed so that each group contained six jaws A sample was divided in one control group (C) and three experimental groups (EI, EII, EIII) in which the standard laser therapy was applied in live animals for 13 days. The control group received placebo laser application. The EI group received a dose 70J/cm2, EII-35J/cm2 and EIII-140J/cm2. At 45 days of the experiment all animals were killed and their mandibles were dissected and submitted for analysis to the CBCT image density perimplantar through two evaluation methods (linear and rectangular area). After the samples were embedded in resin and prepared for analysis by optical microscopy. In histomorphometry was measured the bone-implant contact (BIC), bone area within the implant threads (BAS), bone area rectangular (BAR) and the area of collagen fibers (CF) of three median spirals of the implant. Results: The results were analyzed by analysis of variance (ANOVA) complemented by the multiple comparison test of Tukey at a significance level of 5%. It was observed an increase in BIC and CF for the group EIII compared to the other groups. The CBCT linear evaluation demonstrated gray level averages higher for the group EIII compared to the other groups and that the groups EI and EII were higher than group C. The evaluation of the rectangular area by CBCT and ratings histomorphometric bone area rectangular (BAR) and within the implant threads (BAT) showed no significant differences between groups. There were no significant relation between the analyzes of the results obtained by histomorphometry and CBCT through the Pearson correlation coefficient at a significance level of 5%. Conclusion: LLLT modulates positively bone repair in the peri-implant with dose 140J/cm2. The image density perimplantar evaluated by the two proposed methods obtained by CBCT demonstrated no significant correlation with the results of histomorphometry, being moot its application in controlling postoperative dental implants.