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INTRODUCTION: 3D printing is experiencing significant growth in the teaching and learning process. This study aims to present a 3D printed skull model for preclinical intraoral radiographic practice. MATERIALS AND METHODS: Two 3D printed mannequins were created. One mannequin used an STL file of a skull that was edited using two 3D modelling software (Meshmixer and Netfabb). The second mannequin was designed directly from a patient's segmented CBCT data and then converted into an STL file. Both mannequins were printed using fused deposition modelling (FDM) technology and polylactic acid (PLA) filament; teeth for the second mannequin were also printed using digital light processing (DLP). The printed skull bones were attached, the mandible was articulated to the articular fossa of the temporal bone, and the teeth were inserted into the alveoli. Intraoral radiographs of both mannequins were taken using a digital sensor (RVG 5100, Carestream). RESULTS: Both 3D printed mannequins showed satisfactory radiographic appearance, allowing geometric representation of each intraoral radiographic projection, regardless of STL file origin. Anatomical structures, such as the periodontal ligament space, zygomatic process of the maxilla and intermaxillary suture, were represented. The material cost of the first and second printed prototype was $34.00 and $39.00, respectively. CONCLUSIONS: The use of 3D printed models is presented as an alternative to artificial commercial phantoms for the preclinical training of intraoral radiographic techniques through the combined benefits of superior radiographic projection quality, the possibility of model manipulation and an affordable price.

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OBJECTIVE: To evaluate the association between headache, myofascial temporomandibular disorder (TMD), and awake bruxism (AB). BACKGROUND: Bruxism seems to act as a risk factor for TMD and its associated comorbidities, such as headaches. METHODS: In total, 406 medical records of individuals who sought care at a university dental clinic were screened. The Research Diagnostic Criteria for Temporomandibular Disorders was used to assess and diagnose TMD, as well as to obtain self-reports of AB and headache. RESULTS: The sample consisted of 307 medical records. About 72.5% (221/305) of the sample reported having headaches, and 67.4% (180/267) and 68.4% (210/307) were diagnosed with AB and TMD, respectively. Individuals who reported having AB (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.09-4.7) and who were diagnosed with myofascial TMD (OR, 2.53; 95% CI, 1.15-5.5) were more likely to have had headaches in the past 6 months when compared with patients without myofascial TMD and bruxism. Also, individuals who self-reported headache were 2.27 times (95% CI, 1.09-4.7) more likely to have AB and 2.45 times (95% CI, 1.13-5.34) more likely to have myofascial pain than individuals without headaches. CONCLUSIONS: Individuals with myofascial TMD, headaches, or AB were more likely to have at least one of the other conditions.

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BACKGROUND: Pain is a complex sensory experience and can be influenced by psychosocial factors, such as romantic relationships. OBJECTIVE: To evaluate the association between marital status and temporomandibular disorder-related chronic pain. METHODS: Patients diagnosed with temporomandibular disorder (TMD) through Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were assessed for chronic pain and marital and socioeconomic status, according to Axis II. Multinomial logistic regression models assessed the association between chronic pain and the predictive variables. RESULTS: Three hundred and ten patients were included in the sample, the majority being female (74.5%), single (52.3%), and diagnosed with chronic pain (85.1%). The adjusted analysis showed about a 5-time greater chance of chronic pain occurrence with high disability in individuals who were married or in a common-law marriage (OR 5.99; 95% CI 1.45-24.73). Also, women were 7.62 times more likely to develop chronic pain with high disability (OR 7.62; 95% CI 2.03-28.52). CONCLUSION: Marital status showed an impact on chronic pain, with married individuals and those in a common-law marriage being the most affected by high disability chronic pain.

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Objetivo: avaliar caninos inclusos em tomografias computadorizadas multidetectores (TCMD) realizadas no Hospital Universitário de Santa Maria. Materiais e mé¬todo: foi realizado um estudo observacional transversal com imagens de um banco de dados de TCMD de baixa dose de radiação, solicitadas por indicações clínicas odontológicas. Os exames em formato digital imaging and communications in medicine foram avaliados por um examinador treinado, no software Weasis Medical Viewer. A avaliação dos exames compreendeu a observação das seguintes características: impactação do canino (uni ou bilateral), localização do canino (maxila ou mandíbula), localização da coroa do canino (vesti¬bular ou lingual/palatal), eixo de erupção, espessura do folículo pericoronário, presença de lesões associadas, presença de reabsorção nos dentes adjacentes e presença de agenesias dentárias ou de supranumerários. Os resultados foram avaliados de maneira descritiva, por meio de prevalência dos achados. Resultados: foram encontrados 21 caninos inclusos em 837 tomografias avaliadas (1,9%). Foi observado um predomínio de indivíduos do sexo feminino (71,4%), e a retenção do canino foi mais frequente na maxila (71,4%) e com impactação unilateral (61,9%). Quatro caninos apre¬sentaram folículo pericoronário, com espessura maior que 2 mm; 19% dos exames apresentaram reabsorção radicular externa em algum incisivo lateral. Apenas um canino apresentava lesão associada, sugerindo esclero-se óssea. Além dos caninos inclusos, foi possível avaliar alterações relacionadas às demais regiões e estruturas dentomaxilofaciais. Conclusão: apesar da amostra limitada de imagens, o presente estudo demonstrou a aplicabilidade clínica da TCMD com protocolo de baixa dose de radiação, para a avaliação dos caninos inclusos e características relacionadas a esses dentes, bem como de dentes e regiões adjacentes. (AU)

Objective: to evaluate impacted canines by tomographic exams performed at the University Hospital of Santa Maria. Materials and method: a cross-sectional observational study was performed with selected images from a database of low dose computed tomography (CT) scans requested by several dental indications. The DICOM files were evaluated by a trained examiner, using Weasis Medical Viewer software. The evaluation of each exam included the following characteristics: canine impaction (uni or bilateral), location of the canine (maxilla or mandible), location of the canine crown (buccal or lingual / palatal), shaft of canine eruption, thickness of the pericoronal follicle, presence of associated lesions, presence of external root resorption in adjacent teeth and presence of dental agenesis or supernumerary tooth. The results were evaluated in a descriptive way, through prevalence of the findings. Results: a total of 21 impacted canines were found in 837 CT scans evaluated (1,9%). A predominance of female patients was observed (71,4%); canine impaction was more frequent in the maxilla (71,4%), and unilateral (61,9%). In 19% of the exams, external root resorption occurred in some lateral incisor. Four dental elements presented pericoronal follicles thicker than 2 mm. In the evaluated sample, only one canine presented an associated lesion, suggesting bone sclerosis. Beyond the canine-related, other dental and maxillofacial changes were also evaluated. Conclusion: in spite of the limited sample, the present study demonstrated the clinical applicability of low dose CT for the evaluation of impacted canines, and characteristics related to these teeth, as well as to the adjacent teeth and regions. (AU)

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OBJECTIVES: To analyze the diagnostic accuracy of conventional and digital radiographic images and the impact of digital filters in evaluating the bone-implant interface. METHODS: Titanium implants were inserted into 74 fresh bovine ribs blocks, 37 fitting tight to the bone walls (simulating the existence of osseointegration) and 37 with a gap of 0.125 mm (simulating a failure in the osseointegration process). Periapical radiographs were taken with conventional film and two phosphor plate systems [VistaScan® (Dürr Dental, Bietigheim-Bissingen, Germany) and Express® (Instrumentarium, Tuusula, Finland)]. Digital radiographs were investigated with and without enhancement filters. Three blinded examiners assessed the images for the presence of juxtaposition in the bone-implant interface using a five-point Likert scale. Sensitivity, specificity and the area under the receiver-operating characteristic curve (AUC) and its 95% confidence interval (CI) were calculated for each variable. Intraexaminer and interexaminer agreements were analyzed using Kendall's concordance test. RESULTS: Intraexaminer and interexaminer agreements were >0.80 for both digital and conventional images. Conventional radiographs (AUC = 0.963/CI = 0.891 to 0.993) and digital images with high enhancement filters such as Caries2 (AUC = 0.964/CI = 0.892 to 0.993), Endo (AUC = 0.952/CI = 0.875 to 0.988) and Sharpen3 (AUC = 0.894/CI = 0.801 to 0.954) showed the greatest accuracy for evaluating the bone-implant interface. Original images from both digital systems and the further enhancement filters tested showed low sensitivity for the diagnosis task tested. CONCLUSIONS: Conventional radiographs or digital radiographs with high-pass filters could help enhance diagnosis on implant-bone interface.

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OBJECTIVES: To evaluate factors with impact on the conspicuity (possibility to detect) of the buccal bone condition around dental implants in cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS: Titanium (Ti) or zirconia (Zr) implants and abutments were inserted into 40 bone blocks in a way to obtain variable buccal bone thicknesses. Three combinations regarding the implant-abutment metal (TiTi, TiZr, or ZrZr) and the number of implants (one, two, or three) were assessed. Two CBCT units (Scanora 3D - Sc and Cranex 3D - Cr) and two voxel resolutions (0.2 and 0.13 mm) were used. Reconstructed sagittal images (2.0 and 5.0 mm thickness) were evaluated by three examiners, using a dichotomous scale when assessing the condition of the buccal bone around the implants. A multivariate logistic regression was performed using examiners' detection of the buccal bone condition as the dependent variable. Odds ratio (OR) were calculated separately for each CBCT unit. RESULTS: Implant-abutment combination (ZrZr) (OR Sc = 19.18, OR Cr = 11.89) and number of implants (3) (OR Sc = 12.10, OR Cr = 4.25) had major impact on buccal bone conspicuity. The thinner the buccal bone, the higher the risk that the condition of the buccal bone could not be detected. The use of lower resolution protocols increased the risk that buccal bone was not properly detected (OR Sc = 1.46, OR Cr = 2.00). For both CBCT units, increasing the image reconstruction thickness increased the conspicuity of buccal bone (OR Sc = 0.33, OR Cr = 0.31). CONCLUSIONS: Buccal bone conspicuity was impaired by a number of factors, the implant-abutment material being the most relevant. Acquisition and reconstruction factors had minor impact on the detection of the buccal bone condition.

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The purpose of this study was to evaluate the accuracy of airway measurements from lateral cephalograms, cone-beam computed tomographic (CBCT) lateral reconstructions, and CBCT axial planes, as well as to correlate these findings with area measurements acquired with the latter imaging method. Landmarks were defined for the measurements of naso- and oropharynx of 30 patients (12 males and 18 females, mean age 17.5 years), for different planes, using linear antero-posterior measurements and the corresponding area. Analysis of variance showed significant differences in the linear measurements of the oropharynx between the two methods, although all measurements assessed corresponded to the respective areas. The linear measurements of the airway space obtained using the different techniques correlated positively with the respective area measurements, which demonstrate the reliability of the investigated techniques.

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