>Magister Scientiae - MSc / Different pathology associated with impacted wisdom teeth in the oral cavity showed that it is prevalent and may lead to varied dental complications. This study adopted a descriptive cross-sectional retrospective analytical design in order to examine hard tissue features associated with the presence of impacted third molars in a random sample of 2998 digital panoramic radiographs (DPRs) of patients' records in Tygerberg Oral Health Centre, Faculty of Dentistry, University of Western Cape. The specific objectives of the study were to categorize the type of impactions in the DPRs of patients and to determine the prevalence of distal cervical caries (DCC) in second molars, any radiolucent (RL) /radiopaque (RO) lesions or external root resorption (ERR) complications associated with impacted wisdom teeth. Results of the pantomographs and clinical records of patients indicated that the most prevalent type of impaction (TOI) is Mesioangular (MA) Impaction (65%) followed by Horizontal (H) Impaction (17%), Vertical (V) Impaction (15%), Transverse (TVS) Impaction (2 %) and Distoangular (DA) Impaction (1.2 %), respectively. The least prevalent type was Inverted (INV) Impaction with a frequency count of 0.5%. The results further indicated varied dental complications resulting from impaction, ranging from ERR with a frequency of 3% of which 66.70% was associated with MA type of impaction, followed by H with a frequency of 26.7%. The association of Gender and RL/ RO lesions was significant (p-value=0.04) while association between DCC and types of impaction was also significant (p-value =0.0017). The study concluded that the high prevalence of MA among all populations and genders over the years may be related to the anatomical normal inclination of the third molars to the mesial surface. The low prevalence of DA observed in the study sample on the other hand might be attributable to gender and demographic factors. Lastly, this study has only one radiopaque lesion and the high prevalence of RL lesions in males and in the older age group suggests that these complications take a while to develop. Future research is needed to raise more awareness and encourage patients to seek treatment of symptomatic and asymptomatic third molars before complications arise.

Die Zielsetzung dieser Studie war es, für digitale Panoramaschichtaufnahmen die Relation der subjektiven Bildqualität zur Exposition zu bestimmen. An Hand von Humanpräparataufnahmen konnten bei Standardwerten sowie experimentellen Variationen der Expositionsdaten weiterhin Effekte der intentionellen Unterexposition sowie der Strahlenaufhärtung auf die subjektive Bildqualität quantifiziert werden. Die Herstellung der Aufnahmen erfolgte auf einem Sirona Orthophos DS. Dabei wurden 37 Aufnahmen mit Expositionswerten von 60 kV/9 mA - 84 kV/13 mA aus dem Herstellerprogramm erzeugt und mit Hilfe einer modifizierten Steuerungssoftware zusätzliche PSA mit experimentellen Einstellungen von 60 kV/3 mA - 90 kV/11 mA hergestellt. Für die Beurteilung und Auswertung der subjektiven Bildqualität wurde eine individuelle Software (Eldoredo V2.2) entwickelt. 39 Zahnärzte und 5 MTRA beurteilten die Aufnahmen damit an einem Monitor unter standardisierten Bedingungen. Ein iterativer Beurteilungsprozess erlaubte, eine Serie von 1369 (37 x 37) PSA-Abbildungspaaren darzustellen. Für jedes Paar entschieden die Untersucher an Hand definierter Kriterien, ob eine PSA hinsichtlich der subjektiv beurteilten Bildqualität vorzuziehen oder Äquivalenz gegeben sei. Nach statistischer Aufarbeitung der Einzelentscheidungen ließ sich damit für jede Expositionsstufe ein Index der Bildqualität berechnen. Bei Expositionswerten in einem Bereich von 60 kV/9 mA - 69 kV/15 mA der Herstellersoftware und 60 kV/5 - 15 mA sowie 70 kV/5 - 15mA der experimentellen Software fanden sich dabei keine signifikanten Verteilungsunterschiede der Bildqualität. Eine intentionelle Unterexposition bei digitalen PSA-Geräten, etwa bei Kindern oder häufigen Wiederholungsaufnahmen, kann nach den vorliegenden Ergebnissen vertreten werden, ohne dass es dabei zu einer signifikanten Verschlechterung der Bildqualität kommt. Damit ist im Gegensatz dazu bei einer Strahlenaufhärtung in dem untersuchten digitalen System stets zu rechnen. Insgesamt zeigen die Ergebnisse, dass auch digitale PSA-Systeme beachtliche Reserven hinsichtlich der Dosisminimierung aufweisen können. / The aim of this study was to describe the relation of the subjective image quality of digital panoramic radiographs in relation to exposure. In addition, variations of exposure were compared to standard settings, thus evaluating the effects of intentional underexposure on the achievable image quality. A Sirona Orthophos DS unit was used to produce 37 digital panoramic images of a human skull. Exposure values ranged from 60 kV/9 mA to 84 kV/13 mA in the conventional and 60 kV/3 mA to 90 kV/11 mA in the experimental setting. Assessment and evaluation of the subjective image quality were performed with an HTML-based protocol. 39 dentists and 5 radiographic assistants had to assign their preference of an image or equality in 1,369 (37x37) image pairs. The decisions were computed to a quality index for each exposure setting. Statistical analysis demonstrated no significant differences of image quality between 60 kV/9 mA - 69 kV/15 mA in the conventional and 60 kV/5 to15 mA as well as 70 kV/5 to 15 mA in the experimental setting. Following these results, a considerable dose reduction by the means of intentional underexposure can be achieved without any loss of image quality. By reducing the absorbed doses, an increase of kV values up to 80 kV and more is also correlated with dose reduction. However, those images showed high significant loss of quality. In summary, the results demonstrate an equivalent image quality of digital panoramic images over a very wide range of exposure values. The feasible dose reduction might be of interest not only in individuals (minors, repeated images), but also in defining general principles of panoramic imaging.

Made available in DSpace on 2015-05-14T12:56:09Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1065398 bytes, checksum: 8472a5b9890ab8a05d3ed62360e845d7 (MD5) Previous issue date: 2010-08-13 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The frequency of cardiovascular diseases has increased worldwide, and today they are regarded the major cause of mortality and morbidity. Atherosclerosis affects the arteries, with fat deposition in their walls and later calcium salts deposition that may form a calcified atheroma. This study aimed to evaluate the occurrence of calcification in the carotid artery by conventional and digital panoramic radiography in patients aged 40 or older. The study used 728 panoramic radiographs, 600 obtained in direct digital equipment and 128 in film conventional unit. The occurrence of carotid calcification was 7%, and was identified in 51 cases. Patients with calcification in the carotid artery were aged between 43-90 years old, while in women the peak incidence was in the 5th decade of life. In men, the fifth, sixth and eighth decade were the most affected, with no predominance of age. Carotid calcifications were present unilaterally in 30 cases and bilateral in 21 cases. Pearson Chi-square test showed no statistically significant difference in the occurrence of calcification in the carotid artery in male and female, although the percentage was slightly higher among men. Differences in occurrence in conventional and digital panoramic radiographs also showed no statistical difference. The results of this study suggest that panoramic radiography, digital and conventional can be used as an auxiliary method in the identification of carotid calcification. / A frequência de doenças cardiovasculares aumentou mundialmente, sendo consideradas na atualidade como uma das principais causas de mortalidade e morbidade. A aterosclerose acomete as artérias, caracterizando-se pelo acúmulo de gordura na parede das mesmas, a qual sofre a deposição subsequente de sais de cálcio, formando o ateroma calcificado. O presente trabalho teve como objetivo identificar a presença de calcificação na artéria carótida através da radiografia panorâmica digital e convencional de pacientes com 40 anos ou mais de idade. A amostra foi constituída de 728 radiografias panorâmicas, sendo 600 delas obtidas em equipamento digital e 128 em aparelho convencional. A ocorrência de calcificação carotídea foi de 7%, sendo identificada em 51 casos. Os pacientes com calcificação na artéria carótida pertenciam à faixa etária de 43 a 90 anos de idade, sendo que nas mulheres o pico de ocorrência foi na 5ª década de vida. Nos homens, a quinta, a sexta e a oitava década foram as mais acometidas, sem predomínio de faixa etária. As calcificações carotídeas estavam presentes unilateralmente em 30 casos e bilateralmente em 21 casos. Ao aplicar o teste Qui-quadrado de Pearson, não se observou diferença estatisticamente significante na ocorrência de calcificação na artéria carótida quando se considerou o gênero masculino e feminino, apesar do valor percentual ter sido discretamente maior nos homens. O mesmo foi evidenciado quando se avaliou a diferença da ocorrência da calcificação carotídea na radiografia panorâmica digital e na convencional. Os resultados deste estudo sugerem que a radiografia panorâmica obtida tanto pelo método digital quanto pelo convencional pode contribuir na identificação de calcificação carotídea.

O estudo epidemiológico transversal randomizado objetivou avaliar condições de saúde bucal nos competidores dos XV Jogos Pan-Americanos (JPA) e III Jogos Parapan-Americanos (JPPA), 2007. Foram enviados convites para 5.662 atletas (JPA) e 1.300 (JPPA). Radiografias panorâmicas digitais (RPD) foram utilizadas para o exame de triagem nos 2 eventos, e nos JPPA, os atletas também foram submetidos à avaliação do sangramento gengival interdental (SI) através de uma versão modificada do Índice de Sangramento Interdental de Eastman (EIBI). Foram obtidas RPDs de 410 atletas dos JPA, média de idade 24,38 (dp5,35), 55% homens; e de 118 dos atletas dos JPPA, média de idade de 32,3 (dp9,53), 77,97% homens. 121 competidores (JPPA) foram avaliados para SI: 78,51% homens, média de idade 32,6(dp9,6), e foram separados em grupos (G), conforme sua deficiência física: GI c/ deficiência visual (DV), com 2 subgrupos: GI-a: DV tardia e GI-c-: DV congênita/precoce; GII- deficiência de membro superior; com 1 subgrupo: GII-t: deficiência/ausência bilateral; GIII- deficiência de membro inferior (grupo controle). As RPDs foram examinadas por 1 examinador com o Kodak Dental Imaging(v6.7). A frequência e a distribuição do SI foram calculadas, e os grupos foram comparados. Resultados da triagem com RPDs, representados por número de observações(média por atleta) JPA//número de observações(média por atleta JPPA: Dentes erupcionados/ hígidos: 9097(22,19)//2451(20,77); Ausentes: 803(1,96 //405(3,43); Não erupcionados ou impactados: 330(0,80)//52(0,44); Parcialmente erupcionados e/ou hígidos: 109(0,27)//20(0,17); Cárie extensa: 261(0,64)//62(0,53); Cárie extensa e lesão periapical: 96(0,23)//50(0,42); Tratamento endodôntico e lesão periapical: 24(0,06)//13(0,11); Restaurados: 2298(5,60)//670(5,68); Imagens radiolúcidas patológicas circunscritas: 23(0,06)//0; Raízes-residuais: 27(0,07)//22(0,19); Implantes:6(0,01)//5(0,04); Dentes anteriores fraturados: 13 (0,03)//3(0,03); Molares bandados: 26(0,06)//11(0,09); Dentes anômalos: 7(0,02)//12(0,10). Resultados para SI: G-I>G-III (p=0.0002);GI-c>GI-a (p=0,042). Homens exibiram > freqüência de SI (3,6%+1,7) que mulheres (0,8%+0,5), p<0,01. Conclusões: Os dados das 2 populações de atletas mostraram que há uma grande variação na saúde bucal entre os indivíduos avaliados. Diversas condições com potencial de influenciar o desempenho esportivo dos atletas foram detectadas através de radiografias panorâmicas digitais, sugerindo que um programa de saúde bucal deve ser incluído como parte da preparação destes indivíduos.A avaliação da frequência e distribuição de sangramento gengival interdental em uma população de atletas que competiu nos III Jogos Parapan-Americanos, revelou que o tipo de deficiência ou limitação física dos competidores é um fator que influencia na saúde gengival desses indivíduos. O planejamento de um programa de saúde bucal para esta população deve ser adaptado às diferentes limitações de cada atleta. / This randomized cross-sectional epidemiological study aimed to assess oral health status of athletes competing at the XV-Pan-American-Games (PAG) and III-Parapan-American-Games (PPAG), 2007). Invitations were sent to 5,662 athletes (PAG), and 1,300 (PPAG). Digital panoramic radiographs (DPRs) were used for screening recruited contestants in both events, and a modified version of Eastman Interdental Bleeding Index (EIBI), for screening interdental gingival bleeding (IB) among athletes at PPAG. DPR were taken from 410 athletes (PAG), mean age 24.38(sd5.35), 55% males; and from 118 contestants (PPAG), mean age 32.3(sd9.53), 77.97% males. At PPAG, 121 contestants were also screened for IB: 78.51% males, mean age 32.6(sd9.6) and were separated in groups according to their physical impairment: GI visually impaired (VI), with 2 subgroups: GI-a- w/ late acquired VI, and GI-c- w/ either congenital or early acquired VI; GII- w/ impaired upper limb; with 1 subgroup: GII-t- with bilateral impairment or absent limbs; GIII, with lower limb impairment (control group). DPR were examined, by a single examiner, with Kodak Dental Imaging Software(v6.7). Groups were compared for frequency and distribution of IB. Results for DPR screenings are presented as: number of observations (average per athlete)for PAG//number of observations (average per athlete) for PPAG.Totally erupted/sound teeth: 9097 (22.19)// 2451(20.77); Absent: 803(1.96)//405(3.43); Nonerupted/ Impacted: 330(0.80)//52(0.44); Partly erupted/sound: 109(0.27)//20 (0.17); Extensive carious lesion: 261(0.64)//62 (0.53); Extensive carious lesion+periapical lesion: 96(0.23)//50 (0.42); Endodontic Treatment+PeriapicalLesion: 24(0.06)//13 (0.11); Restored: 2298 (5.60)//670(5.68); Circunscribed pathological radiolucencies: 23(0.06)//0; Residual roots: 27(0.07)//22 (0.19); Dental Implants: 6(0.01)//5(0.04); Fractures: 13(0.03)//3(0.03); Molars with orthodontic band: 26 (0.06)//11(0.09); Anomalous teeth: 7(0.02)//12(0.1). Results for IB showed statistically significant differences as: GI>GIII (p=0.0002); GI-c>GI-a (p=0.042). Males showed higher frequency of IB (3.6%+1.7) than females (0.8%+0,5), p<0.01. In conclusion: Data of the 2 populations of athletes showed that there is a great variance on the oral health among the evaluated individuals. Several conditions that might have a potencial influence on the performance of the athletes were detected with the aid of digital panoramic radiographs, and this suggests that an oral health program should be included as part of the preparation of those individuals. The evaluation of the frequency and distribution of interdental gingival bleeding in a population of athletes that participated in the III Parapan-American Games, revealed that the kind of physical impairment is a factor that influences the gingival health of these individuals. The planning of an oral health program for this population should be adapted to the different limitations of each athlete.

O estudo epidemiológico transversal randomizado objetivou avaliar condições de saúde bucal nos competidores dos XV Jogos Pan-Americanos (JPA) e III Jogos Parapan-Americanos (JPPA), 2007. Foram enviados convites para 5.662 atletas (JPA) e 1.300 (JPPA). Radiografias panorâmicas digitais (RPD) foram utilizadas para o exame de triagem nos 2 eventos, e nos JPPA, os atletas também foram submetidos à avaliação do sangramento gengival interdental (SI) através de uma versão modificada do Índice de Sangramento Interdental de Eastman (EIBI). Foram obtidas RPDs de 410 atletas dos JPA, média de idade 24,38 (dp5,35), 55% homens; e de 118 dos atletas dos JPPA, média de idade de 32,3 (dp9,53), 77,97% homens. 121 competidores (JPPA) foram avaliados para SI: 78,51% homens, média de idade 32,6(dp9,6), e foram separados em grupos (G), conforme sua deficiência física: GI c/ deficiência visual (DV), com 2 subgrupos: GI-a: DV tardia e GI-c-: DV congênita/precoce; GII- deficiência de membro superior; com 1 subgrupo: GII-t: deficiência/ausência bilateral; GIII- deficiência de membro inferior (grupo controle). As RPDs foram examinadas por 1 examinador com o Kodak Dental Imaging(v6.7). A frequência e a distribuição do SI foram calculadas, e os grupos foram comparados. Resultados da triagem com RPDs, representados por número de observações(média por atleta) JPA//número de observações(média por atleta JPPA: Dentes erupcionados/ hígidos: 9097(22,19)//2451(20,77); Ausentes: 803(1,96 //405(3,43); Não erupcionados ou impactados: 330(0,80)//52(0,44); Parcialmente erupcionados e/ou hígidos: 109(0,27)//20(0,17); Cárie extensa: 261(0,64)//62(0,53); Cárie extensa e lesão periapical: 96(0,23)//50(0,42); Tratamento endodôntico e lesão periapical: 24(0,06)//13(0,11); Restaurados: 2298(5,60)//670(5,68); Imagens radiolúcidas patológicas circunscritas: 23(0,06)//0; Raízes-residuais: 27(0,07)//22(0,19); Implantes:6(0,01)//5(0,04); Dentes anteriores fraturados: 13 (0,03)//3(0,03); Molares bandados: 26(0,06)//11(0,09); Dentes anômalos: 7(0,02)//12(0,10). Resultados para SI: G-I>G-III (p=0.0002);GI-c>GI-a (p=0,042). Homens exibiram > freqüência de SI (3,6%+1,7) que mulheres (0,8%+0,5), p<0,01. Conclusões: Os dados das 2 populações de atletas mostraram que há uma grande variação na saúde bucal entre os indivíduos avaliados. Diversas condições com potencial de influenciar o desempenho esportivo dos atletas foram detectadas através de radiografias panorâmicas digitais, sugerindo que um programa de saúde bucal deve ser incluído como parte da preparação destes indivíduos.A avaliação da frequência e distribuição de sangramento gengival interdental em uma população de atletas que competiu nos III Jogos Parapan-Americanos, revelou que o tipo de deficiência ou limitação física dos competidores é um fator que influencia na saúde gengival desses indivíduos. O planejamento de um programa de saúde bucal para esta população deve ser adaptado às diferentes limitações de cada atleta. / This randomized cross-sectional epidemiological study aimed to assess oral health status of athletes competing at the XV-Pan-American-Games (PAG) and III-Parapan-American-Games (PPAG), 2007). Invitations were sent to 5,662 athletes (PAG), and 1,300 (PPAG). Digital panoramic radiographs (DPRs) were used for screening recruited contestants in both events, and a modified version of Eastman Interdental Bleeding Index (EIBI), for screening interdental gingival bleeding (IB) among athletes at PPAG. DPR were taken from 410 athletes (PAG), mean age 24.38(sd5.35), 55% males; and from 118 contestants (PPAG), mean age 32.3(sd9.53), 77.97% males. At PPAG, 121 contestants were also screened for IB: 78.51% males, mean age 32.6(sd9.6) and were separated in groups according to their physical impairment: GI visually impaired (VI), with 2 subgroups: GI-a- w/ late acquired VI, and GI-c- w/ either congenital or early acquired VI; GII- w/ impaired upper limb; with 1 subgroup: GII-t- with bilateral impairment or absent limbs; GIII, with lower limb impairment (control group). DPR were examined, by a single examiner, with Kodak Dental Imaging Software(v6.7). Groups were compared for frequency and distribution of IB. Results for DPR screenings are presented as: number of observations (average per athlete)for PAG//number of observations (average per athlete) for PPAG.Totally erupted/sound teeth: 9097 (22.19)// 2451(20.77); Absent: 803(1.96)//405(3.43); Nonerupted/ Impacted: 330(0.80)//52(0.44); Partly erupted/sound: 109(0.27)//20 (0.17); Extensive carious lesion: 261(0.64)//62 (0.53); Extensive carious lesion+periapical lesion: 96(0.23)//50 (0.42); Endodontic Treatment+PeriapicalLesion: 24(0.06)//13 (0.11); Restored: 2298 (5.60)//670(5.68); Circunscribed pathological radiolucencies: 23(0.06)//0; Residual roots: 27(0.07)//22 (0.19); Dental Implants: 6(0.01)//5(0.04); Fractures: 13(0.03)//3(0.03); Molars with orthodontic band: 26 (0.06)//11(0.09); Anomalous teeth: 7(0.02)//12(0.1). Results for IB showed statistically significant differences as: GI>GIII (p=0.0002); GI-c>GI-a (p=0.042). Males showed higher frequency of IB (3.6%+1.7) than females (0.8%+0,5), p<0.01. In conclusion: Data of the 2 populations of athletes showed that there is a great variance on the oral health among the evaluated individuals. Several conditions that might have a potencial influence on the performance of the athletes were detected with the aid of digital panoramic radiographs, and this suggests that an oral health program should be included as part of the preparation of those individuals. The evaluation of the frequency and distribution of interdental gingival bleeding in a population of athletes that participated in the III Parapan-American Games, revealed that the kind of physical impairment is a factor that influences the gingival health of these individuals. The planning of an oral health program for this population should be adapted to the different limitations of each athlete.