Background: Cognitive processing in diagnostic oral radiology requires a solid foundation in the basic sciences as well as knowledge of the radiologic changes associated with disease. Although it is generally assumed that in dentistry, students must acquire both knowledge sets, little is known about the role or impact of the basic sciences on clinical reasoning because the two have traditionally been taught separately in the curriculum. Objectives: This dissertation investigates the role of basic sciences in oral radiology and its effects on diagnostic accuracy. The studies were designed to satisfy the following research aims: 1) to examine and compare the effects of integration and segregation of the basic and clinical sciences on diagnostic accuracy; 2) to examine the effects of basic science instructional methodology and diagnostic strategy on diagnostic outcomes; 3) to explore the potential interactions between instructional methodologies used to teach disease categorization and diagnostic strategies; and 4) to examine the effects of testing the basic sciences on diagnostic accuracy in an integrated instructional methodology. Methods: We conducted three quantitative studies, all of which involved a learning phase and an immediate testing phase that assessed diagnostic performance and memory. In each of the studies, learning strategies, and or testing frequency were varied. We also included performance assessment of diagnostic ability and memory, one week after the initial learning phase. Results: Our results show that students who learned basic sciences explanations had higher diagnostic accuracy when using a holistic System 1 type diagnostic strategy than those who did not. We also demonstrated that basic science knowledge was the most effective when directly integrated with the clinical sciences, and this result is further enhanced with testing. Conclusions: We conclude that integrated basic science learning provides a coherent framework that has the potential to significantly improve the diagnostic accuracy of training dentists.

Background: Cognitive processing in diagnostic oral radiology requires a solid foundation in the basic sciences as well as knowledge of the radiologic changes associated with disease. Although it is generally assumed that in dentistry, students must acquire both knowledge sets, little is known about the role or impact of the basic sciences on clinical reasoning because the two have traditionally been taught separately in the curriculum. Objectives: This dissertation investigates the role of basic sciences in oral radiology and its effects on diagnostic accuracy. The studies were designed to satisfy the following research aims: 1) to examine and compare the effects of integration and segregation of the basic and clinical sciences on diagnostic accuracy; 2) to examine the effects of basic science instructional methodology and diagnostic strategy on diagnostic outcomes; 3) to explore the potential interactions between instructional methodologies used to teach disease categorization and diagnostic strategies; and 4) to examine the effects of testing the basic sciences on diagnostic accuracy in an integrated instructional methodology. Methods: We conducted three quantitative studies, all of which involved a learning phase and an immediate testing phase that assessed diagnostic performance and memory. In each of the studies, learning strategies, and or testing frequency were varied. We also included performance assessment of diagnostic ability and memory, one week after the initial learning phase. Results: Our results show that students who learned basic sciences explanations had higher diagnostic accuracy when using a holistic System 1 type diagnostic strategy than those who did not. We also demonstrated that basic science knowledge was the most effective when directly integrated with the clinical sciences, and this result is further enhanced with testing. Conclusions: We conclude that integrated basic science learning provides a coherent framework that has the potential to significantly improve the diagnostic accuracy of training dentists.

Bakgrund: Radiologi används inom tandvårdsyrket för diagnostik. Det är strikt reglerat via lagar och förordningar så att patienter inte i onödan utsätts för joniserande strålning, vilket innebär att en tandläkare måste ha tillräcklig kunskap om dess användning. Detta inkluderar kunskap om när och var den radiologiska metoden kan användas och vilken bildteknik som är mest pålitlig. Dessutom är det viktigt att kunna tolka röntgenbilder och därigenom kunna identifiera eventuell patologi i de undersökta områdena. Syftet: Jämföra teman som ingår i olika kursmål inom odontologisk radiologi vid tandläkarutbildningar vid universitet i Europa. Metod: Kursmål i odontologisk radiologi begärdes från olika tandläkarutbildningar via e-post. Webblänkar från universitet analyserades. En påminnelse skickades ut för att förbättra svarsfrekvensen. Svaren analyserades på ett beskrivande sätt.  Resultat: Studien identifierade 123 tandläkaruniversitet. 23 universitet skickade sina kursmål. 17 av dessa ingick i studien. En skillnad identifierades med avseende på hur kursmålen skrevs. Dessutom fanns skillnader i antalet uttryckta kursmål för specifika radiologiska avbildningsmetoder. Konklusion: Kursmål för studenter inom odontologisk radiologi skiljer sig avseende struktur och innehåll mellan studerade utbildningar. Många universitet saknar delar av teman inom ämnet. Mer ingående forskning inom området är angeläget för att säkerställa en likvärdig utbildning inom odontologisk radiologi för tandläkarstudenter i Europa. / Background: Radiology is used in the dental profession for diagnostics. It is strictly regulated so patients won´t be exposed to unnecessarily ionizing radiation, meaning that a dentist must have adequate knowledge. This include knowledge about when and where the radiographic method can be used, and which imaging technique is the most reliable. Furthermore, being able to interpret the radiographs is essential and thereby able to identify any pathology in the investigated areas.  Aim: Compare the themes that are included in various course objectives in the field of oral radiology at dental universities in Europe. Method: Course objectives in oral radiology were requested from different dental universities by email and weblinks, they were later analysed. One remainder were sent to improve the response rate. The answers were analysed in a descripted way.   Results: The study identified 123 dental universities. 23 universities sent their course objectives. 17 of these where included in the study. A difference was identified as to how course objectives were written. In addition, there was a disparate difference in the number of expressions of the course objectives in according to specific type of radiographic imaging methods.  Conclusion: Course objectives in oral radiology for students at dental universities in Europe differ in terms of structure and content. Many universities have no specific part of themes within the subject.

El objetivo del estudio fue determinar el nivel de conocimiento y actitudes sobre normas de bioseguridad en radiología oral en estudiantes de una universidad, Chiclayo, 2023. El estudio fue descriptivo, prospectivo y transversal. La población del estudio fue de 101estudiantes, con 36 varones y 65 mujeres. Se incluyeron estudiantes matriculados en el semestre 2023-I, en la escuela de odontología, de ambos sexos, mayores de 18 años, que aceptaron participar en el estudio, se excluyeron a aquellos que no contestaron en forma correcta o completa el cuestionario. El cuestionario utilizado contiene dos dimensiones como son conocimiento y actitud sobre normas de bioseguridad en radiología oral, cada una con 10 preguntas y cuenta con adecuadas características de validez y confiabilidad. En el estudio se obtuvo que el 66.3% de los estudiantes alcanzaron un nivel medio de conocimiento y en actitud se reportó un 83.2% desfavorable. Asimismo, se encontró significancia estadística al asociar conocimiento y actitud sobre normas de bioseguridad en radiología en los estudiantes (p=0.002). Los datos fueron analizados con estadística descriptiva y con la prueba Chi Cuadrado. Se concluyó que existe relación entre conocimiento y actitud sobre normas de bioseguridad en radiología oral en estudiantes de odontología, por otro lado, el nivel de conocimiento fue medio y en actitud fue desfavorable. / The objective of the study was to determine the level of knowledge and attitudes about biosafety standards in oral radiology in students at a university, Chiclayo, 2023. The study was descriptive, prospective and cross-sectional. The study population was 101 students, with 36 men and 65 women. Students enrolled in the 2023-I semester, in the dental school, of both sexes, over 18 years of age, who agreed to participate in the study, were included. Those who did not answer the questionnaire correctly or completely were excluded. The questionnaire used contains two dimensions such as knowledge and attitude regarding biosafety standards in oral radiology, each with 10 questions and has adequate validity and reliability characteristics. In the study, it was found that 66.3% of the students reached a medium level of knowledge and 83.2% reported an unfavorable attitude. Likewise, statistical significance was found when associating knowledge and attitude about biosafety standards in radiology in students (p=0.002). The data were analyzed with descriptive statistics and the Chi Square test. It was concluded that there is a relationship between knowledge and attitude regarding biosafety standards in oral radiology in dental students; on the other hand, the level of knowledge was medium and the attitude was unfavorable.

A unicidade da cavidade sinusal frontal é um importante fator para a identidade humana. O uso de registros de imagens dessa cavidade para a identificação forense é amplamente difundido, sendo uma metodologia secundária segundo a INTERPOL. Recentes avanços nas tecnologias de imagem permitiram o registro de imagens tridimensionais dessa cavidade. Nosso objetivo foi validar a metodologia proposta por Beaini et al. (2015), padronizando critérios para a obtenção de imagens tridimensionais da cavidade sinusal frontal com tomografia computadorizada de feixe cônico e avaliando a capacidade desses dados para a identificação humana. Para tanto, utilizamos um banco de imagens tomográficas de 200 pacientes randomizados e analisados por três observadores. As imagens foram exportadas em formato DICOM e submetidas a dois processos de segmentação distintos e sobreposição tridimensional. Realizou-se a metodologia descrita para estabelecer a identificação entre pacientes randomizados. Os resultados mostraram que há uma diferença significativa entre os processos de segmentação, sendo mais indicada a técnica de segmentação manual. A metodologia proposta por Beaini et al. (2015) foi validada e um total de 166 pacientes foram identificados. O volume da cavidade sinusal possui um elevado potencial de identificação com uma probabilidade aproximada de 85% para determinar o gênero dos indivíduos. / The uniqueness of the frontal sinus cavity is an important factor for establishing human identity. The usage of imaging records of this cavity for human identity is a secondary methodology according to the INTERPOL protocols. Recent advances in imaging technologies have enabled the three-dimensional imaging records of this cavity. Our goal was to validate the methodology proposed by Beaini et al. (2015), by developing standardized criteria for the use of cone beam computed tomography three-dimensional images of the front sinus and evaluating the ability of these data for human identification. The aim of this study was to investigate a total of 200 imaging records from randomized patients that were analyzed by three observers. Images were exported in DICOM format and underwent two distinct segmentation processes and a three-dimensional overlap. The Beaini et al. (2015) technique was applied to establish identification of the randomized patients. My results showed a significant difference between both segmentation processes, with manual segmentation showing the best results. Beaini et al. (2015) technique was validated and a total of 166 patients were identified. The volume of the sinus cavity has a high identification probability with a rough probability of 85% to determine the sex of individuals.

Objetivos: Desenvolver um programa de computador sobre anatomia em radiografias panorâmicas; analisar a opinião de peritos a respeito do software como método de ensino-aprendizado; analisar a aceitação do método proposto, pelos alunos do 2 0 , 3 0 e 4 0 anos de graduação da Faculdade de Odontologia da Universidade Federal de Goiás. Métodos: O software elaborado resultou em um programa tutorial multimídia interativo, estruturado em módulos, compostos dos seguintes temas: formação da imagem na técnica panorâmica, seqüência para interpretação radiográfica, anatomia radiográfica em panorâmicas, jogos e avaliação. Após a conclusão do programa, aplicou-se um questionário a 56 entrevistados (10 professores Doutores em Radiologia, denominados peritos, e 46 alunos de graduação) com a finalidade de avaliar o software como método de ensino-aprendizado. Resultados: As respostas foram analisadas por meio de análise estatística descritiva e verificou-se que: 100% dos avaliadores não fariam qualquer modificação no layout, navegação e conteúdo do módulo de anatomia radiográfica, objetivo central do software; 98% dos alunos e 60% dos peritos aprovaram as imagens desse mesmo módulo. 100% dos entrevistados gostariam de ter mais acesso a softwares educacionais e afirmaram que o programa apresentou-se explicativo e de fácil entendimento. 100% dos peritos declararam que o programa atingiu todos os objetivos propostos e se constitui de um método de ensino-aprendizado válido. Conclusão: O programa foi amplamente aceito pela população 13 pesquisada, tornado sua aplicação factível e pertinente como método de ensino-aprendizado / Objectives: To develop a software about panoramic radiography; to analyze professors opinions about the software as a teacher and learning method; to analyze graduation students - 2 0 , 3 0 and 4 0 levels / Dentistry Scholl of Goiás / Brazil - acceptation of the method. Methods: The software was developed, resulting in a multimedia tutorial containing pages about panoramic technique, interpretation sequences, panoramic radiographic anatomy, games and tests. After the completing said program, a questionnaire was applied to ten professors PhDs in Radiology, denominated experts, and 46 dental graduating students, with the purpose to analyze their opinions about the program as a teaching and learning method. Results: The answers was analyzed descriptively, and it could be observed that, 100% of experts wouldn’t make any alteration on the layout, navigation and texts in the most important part of the program, that is panoramic radiography anatomy; 98% of the students and 60% of the experts approved the images of the refereed modulus. 100% of the interviewed would like to have more educational software, and declared that the program was clear and easily understanding. 100% of the experts affirmed that the program reached all objectives proposed and can be considered as a valid teaching and learning method Conclusion: The program interested and was great accepted by the interviewed population, becoming completely feasible and pertinent the application of the said instrument as a teaching and learning method

Objetivos: Desenvolver um programa de computador sobre anatomia em radiografias panorâmicas; analisar a opinião de peritos a respeito do software como método de ensino-aprendizado; analisar a aceitação do método proposto, pelos alunos do 2 0 , 3 0 e 4 0 anos de graduação da Faculdade de Odontologia da Universidade Federal de Goiás. Métodos: O software elaborado resultou em um programa tutorial multimídia interativo, estruturado em módulos, compostos dos seguintes temas: formação da imagem na técnica panorâmica, seqüência para interpretação radiográfica, anatomia radiográfica em panorâmicas, jogos e avaliação. Após a conclusão do programa, aplicou-se um questionário a 56 entrevistados (10 professores Doutores em Radiologia, denominados peritos, e 46 alunos de graduação) com a finalidade de avaliar o software como método de ensino-aprendizado. Resultados: As respostas foram analisadas por meio de análise estatística descritiva e verificou-se que: 100% dos avaliadores não fariam qualquer modificação no layout, navegação e conteúdo do módulo de anatomia radiográfica, objetivo central do software; 98% dos alunos e 60% dos peritos aprovaram as imagens desse mesmo módulo. 100% dos entrevistados gostariam de ter mais acesso a softwares educacionais e afirmaram que o programa apresentou-se explicativo e de fácil entendimento. 100% dos peritos declararam que o programa atingiu todos os objetivos propostos e se constitui de um método de ensino-aprendizado válido. Conclusão: O programa foi amplamente aceito pela população 13 pesquisada, tornado sua aplicação factível e pertinente como método de ensino-aprendizado / Objectives: To develop a software about panoramic radiography; to analyze professors opinions about the software as a teacher and learning method; to analyze graduation students - 2 0 , 3 0 and 4 0 levels / Dentistry Scholl of Goiás / Brazil - acceptation of the method. Methods: The software was developed, resulting in a multimedia tutorial containing pages about panoramic technique, interpretation sequences, panoramic radiographic anatomy, games and tests. After the completing said program, a questionnaire was applied to ten professors PhDs in Radiology, denominated experts, and 46 dental graduating students, with the purpose to analyze their opinions about the program as a teaching and learning method. Results: The answers was analyzed descriptively, and it could be observed that, 100% of experts wouldn’t make any alteration on the layout, navigation and texts in the most important part of the program, that is panoramic radiography anatomy; 98% of the students and 60% of the experts approved the images of the refereed modulus. 100% of the interviewed would like to have more educational software, and declared that the program was clear and easily understanding. 100% of the experts affirmed that the program reached all objectives proposed and can be considered as a valid teaching and learning method Conclusion: The program interested and was great accepted by the interviewed population, becoming completely feasible and pertinent the application of the said instrument as a teaching and learning method

A unicidade da cavidade sinusal frontal é um importante fator para a identidade humana. O uso de registros de imagens dessa cavidade para a identificação forense é amplamente difundido, sendo uma metodologia secundária segundo a INTERPOL. Recentes avanços nas tecnologias de imagem permitiram o registro de imagens tridimensionais dessa cavidade. Nosso objetivo foi validar a metodologia proposta por Beaini et al. (2015), padronizando critérios para a obtenção de imagens tridimensionais da cavidade sinusal frontal com tomografia computadorizada de feixe cônico e avaliando a capacidade desses dados para a identificação humana. Para tanto, utilizamos um banco de imagens tomográficas de 200 pacientes randomizados e analisados por três observadores. As imagens foram exportadas em formato DICOM e submetidas a dois processos de segmentação distintos e sobreposição tridimensional. Realizou-se a metodologia descrita para estabelecer a identificação entre pacientes randomizados. Os resultados mostraram que há uma diferença significativa entre os processos de segmentação, sendo mais indicada a técnica de segmentação manual. A metodologia proposta por Beaini et al. (2015) foi validada e um total de 166 pacientes foram identificados. O volume da cavidade sinusal possui um elevado potencial de identificação com uma probabilidade aproximada de 85% para determinar o gênero dos indivíduos. / The uniqueness of the frontal sinus cavity is an important factor for establishing human identity. The usage of imaging records of this cavity for human identity is a secondary methodology according to the INTERPOL protocols. Recent advances in imaging technologies have enabled the three-dimensional imaging records of this cavity. Our goal was to validate the methodology proposed by Beaini et al. (2015), by developing standardized criteria for the use of cone beam computed tomography three-dimensional images of the front sinus and evaluating the ability of these data for human identification. The aim of this study was to investigate a total of 200 imaging records from randomized patients that were analyzed by three observers. Images were exported in DICOM format and underwent two distinct segmentation processes and a three-dimensional overlap. The Beaini et al. (2015) technique was applied to establish identification of the randomized patients. My results showed a significant difference between both segmentation processes, with manual segmentation showing the best results. Beaini et al. (2015) technique was validated and a total of 166 patients were identified. The volume of the sinus cavity has a high identification probability with a rough probability of 85% to determine the sex of individuals.

Foram poucos os estudos realizados para avaliar a capacidade da cavidade dos seios frontais para a diferenciação sexual. No entanto, a predição do sexo dos indivíduos é o passo mais importante para o desenvolvimento de um perfil biológico confiável durante a análise de restos esqueléticos. O advento da tomografia computadorizada por feixe cônico trouxe uma série de vantagens à clínica odontológica, e a quantidade de pacientes que realizam exames tomográficos para fins de diagnóstico tem aumentado cada vez mais permitindo com que estes dados sejam úteis para propósitos de identificação forense. Neste estudo, o objetivo foi propor uma nova metodologia para avaliar a capacidade de imagens em 3D da cavidade sinusal frontal, provenientes de tomografia computadorizada por feixe cônico, em determinar dimorfismo sexual entre os indivíduos. A amostra da pesquisa foi composta por 130 exames (65 do sexo masculino e 65 do sexo feminino) que foram segmentados e reconstruídos tridimensionalmente. O volume 3D foi exportado em formato Tiff nas normas frontal, lateral e basal. E as seguintes variáveis foram mensuradas em um segundo programa: área, perímetro, retângulo delimitador, elipse delimitadora, circularidade, razão de aspecto, arredondamento do objeto, solidez e diâmetro de Feret. O estudo foi capaz de demonstrar a existência de dimorfismo sexual com uma acurácia do modelo final de regressão logística igual a 80,0%. A norma basal foi a que garantiu maior poder de explicação na equação final. A metodologia foi validada e os resultados mostraram alto grau de confiabilidade. / There were few studies to assess the ability of the cavity of the frontal sinuses for sexual differentiation. However, the prediction of the sex of the individuals is the most important step in the development of a reliable biological profile during analysis of skeletal remains. The advent of cone beam computed tomography brought a number of advantages to the dental clinic, and the number of patients undergoing CT scans for diagnostic purposes has increased increasingly allowing that these data are useful for forensic identification purposes. The study aimed to propose a new methodology to assess the 3D images capacity of the frontal sinus cavity, from computed tomography cone beam, to attribute sexual dimorphism between individuals. The survey sample consisted of 130 exams (65 male and 65 female) who were reconstructed three-dimensionally. The 3D volume was exported in Tiff format in the frontal, side and basal views. In addition, the following variables were measured in a second program: area, perimeter, bounding rectangle, ellipse fit, circularity, aspect ratio, roundness, solidity and Feret\'s diameter. The study was able to demonstrate the existence of sexual dimorphism with an accuracy of the final logistic regression model equal to 80.0%. The basal view assured greater explanatory power in the final equation. The methodology has been validated and the results showed a high degree of reliability.

Foram poucos os estudos realizados para avaliar a capacidade da cavidade dos seios frontais para a diferenciação sexual. No entanto, a predição do sexo dos indivíduos é o passo mais importante para o desenvolvimento de um perfil biológico confiável durante a análise de restos esqueléticos. O advento da tomografia computadorizada por feixe cônico trouxe uma série de vantagens à clínica odontológica, e a quantidade de pacientes que realizam exames tomográficos para fins de diagnóstico tem aumentado cada vez mais permitindo com que estes dados sejam úteis para propósitos de identificação forense. Neste estudo, o objetivo foi propor uma nova metodologia para avaliar a capacidade de imagens em 3D da cavidade sinusal frontal, provenientes de tomografia computadorizada por feixe cônico, em determinar dimorfismo sexual entre os indivíduos. A amostra da pesquisa foi composta por 130 exames (65 do sexo masculino e 65 do sexo feminino) que foram segmentados e reconstruídos tridimensionalmente. O volume 3D foi exportado em formato Tiff nas normas frontal, lateral e basal. E as seguintes variáveis foram mensuradas em um segundo programa: área, perímetro, retângulo delimitador, elipse delimitadora, circularidade, razão de aspecto, arredondamento do objeto, solidez e diâmetro de Feret. O estudo foi capaz de demonstrar a existência de dimorfismo sexual com uma acurácia do modelo final de regressão logística igual a 80,0%. A norma basal foi a que garantiu maior poder de explicação na equação final. A metodologia foi validada e os resultados mostraram alto grau de confiabilidade. / There were few studies to assess the ability of the cavity of the frontal sinuses for sexual differentiation. However, the prediction of the sex of the individuals is the most important step in the development of a reliable biological profile during analysis of skeletal remains. The advent of cone beam computed tomography brought a number of advantages to the dental clinic, and the number of patients undergoing CT scans for diagnostic purposes has increased increasingly allowing that these data are useful for forensic identification purposes. The study aimed to propose a new methodology to assess the 3D images capacity of the frontal sinus cavity, from computed tomography cone beam, to attribute sexual dimorphism between individuals. The survey sample consisted of 130 exams (65 male and 65 female) who were reconstructed three-dimensionally. The 3D volume was exported in Tiff format in the frontal, side and basal views. In addition, the following variables were measured in a second program: area, perimeter, bounding rectangle, ellipse fit, circularity, aspect ratio, roundness, solidity and Feret\'s diameter. The study was able to demonstrate the existence of sexual dimorphism with an accuracy of the final logistic regression model equal to 80.0%. The basal view assured greater explanatory power in the final equation. The methodology has been validated and the results showed a high degree of reliability.