Abstract: In this study, we aimed to identify factors associated with performing dental imaging examinations in public health services. Brazilian data at the municipal level (n = 5,564) in two time periods, P0 (2005–2007) and P1 (2014–2016), were collated from health information systems. The increase in the municipal rates of intraoral and extraoral radiographic imaging procedures was the outcome. Changes in the use of clinical procedures and the rates of dentists and equipment were the main predictors. Multiple logistic regression analysis was performed to estimate the adjusted odds ratio (OR). Approximately 35.3% of the Brazilian municipalities increased the dental radiography equipment rate, 9.9% increased the fan-beam computed tomography (CT) equipment rate, and 5.9% increased the magnetic resonance imaging (MRI) equipment rate. In addition, 31.8% increased the periapical/interproximal radiography rate, 10.5% increased the CT rate, and 4.4% increased the MRI rate. Increases in the dental radiography, CT, and MRI rates were associated with higher chances of periapical/interproximal images (OR = 1.90, p < 0.01), face and neck images (OR =1 5.3, p < 0.01), and MR images (OR = 18.1, p < 0.01), respectively. Municipalities that increased the rates of endodontists increased the rates of periapical/interproximal (OR = 2.50, p < 0.01) and occlusal (OR = 1.60, p < 0.01) imaging procedures, and those that increased the rates of radiologists also increased the rates of occlusal (OR = 2.00, p < 0.01) and panoramic (OR = 1.70, p < 0.01) imaging procedures. The implementation of a secondary dental care center, Centro de Especialidades Odontológicas (CEO) was associated with an increase in the chances of performing periapical/interproximal and panoramic radiographic procedures in 1.5 and occlusal radiographic examinations in 2.0. The rates of dentists, equipment, specialized dental centers, and specific dental procedures were associated with the increased use of imaging procedures in dentistry in the Brazilian public health system.

Abstract This study analyzed the impact of CBCT on the level of confidence in diagnostic and treatment thinking in mandibular lower molar (M3M) clinical management. Thirty cases for which panoramic radiographs and CBTC images were available were selected and classified according to radiologic signs indicating the proximity of the M3M to the mandibular canal (interruption of the radiopaque borders of the canal of the mandibular canal wall, darkening of the roots, and diversion or narrowing of the canal, n = 10 for each classification). Twelve oral and maxillofacial surgeons (OMS) contributed to this study by answering two questionnaires. The first questionnaire contained a clinical description of the case and a panoramic radiograph. After 30 days, a second questionnaire with the same clinical illustrations and tomographic multiplanar reconstruction images was administered. Both questionnaires asked specialists to rate diagnostic confidence, the surgical complexity, chosen treatment, and surgical confidence. In approximately 40% of answers, CBCT images had a positive impact on ratings of diagnostic confidence and treatment thinking confidence, and in 24.4%, they increased the surgical complexity score. There was no change in the treatment plan following the use of CBCT, but the CBCT examination was a determining factor for diagnosis and treatment planning in 72.8% of the answers CBCT improved the confidence level in diagnostic and treatment thinking of the M3M management while also increasing the perceived level of surgical complexity. The findings of this study support the need to consider using CBCT in diagnosis and treatment planning for M3Ms with radiographic signs such as darkening of the roots, interruption of the radiopaque borders of the mandibular canal, or deviation of the mandibular canal and narrowing of the roots.

Resumo O objetivo foi analisar a série temporal de procedimentos de imagem em Odontologia realizados entre os anos de 2000 e 2016 no Sistema Único de Saúde (SUS). Os dados foram obtidos do Sistema de Informações Ambulatoriais (SIA-SUS). Foram analisadas a influência da Política Nacional de Saúde Bucal de 2004, da Portaria nº 600/2006 (institui o financiamento dos Centros de Especialidades Odontológicas - CEOs) e Portaria nº 1.234/2013 (Incentivo financeiro do Programa de Melhoria do Acesso e da Qualidade - PMAQ-CEO). Apresentou-se análises descritivas dos anos inicial e final da série temporal, avaliando tendências e sazonalidade em sete tipos de procedimentos. A série temporal das taxas de exames radiográficos periapicais/interproximais demonstrou tendência de aumento moderado e foi a única em que se observou o impacto da política de implementação financeira dos CEOs, mas não do PMAQ-CEO. Os exames extraorais como: radiografia panorâmica, Tomografia Computadorizada (TC) da face/Articulação Temporomandibular (ATM) e Ressonância Magnética (RM) da ATM possuem forte tendência de aumento apesar das taxas serem muito baixas. Conclui-se que entre os anos 2000 e 2016, a política de expansão da atenção secundária, aumentou o uso de exames de imagem periapical/interproximal.

Abstract The scope of this paper was to analyze the time series of dental procedures performed between 2000 and 2016 in the Brazilian Unified Health System (SUS). The data were obtained from the Outpatient Information System of the SUS (SIA-SUS). The influence of the 2004 National Oral Health Policy of Ordinance No. 600/2006 (which instituted the financing of Dental Specialty Centers - CEOs), and Ordinance No. 1,234/2013 (Financial incentive for the Program for Enhancement of Quality and Access - PMAQ-CEO) were analyzed. Descriptive analyses of the initial and final years of the time series were presented, assessing trends and seasonality in seven types of imaging procedures. The time series of rates of periapical/bitewing radiographic exams revealed a trend of moderate increase and was the only area in which the impact of the financial implementation policy of the CEOs was observed, though not of the PMAQ-CEO. Extraoral imaging exams, such as panoramic radiography, facial CT/TMJ and TMJ MRI revealed a strong upward trend, despite the very low rates. The conclusion reached is that between 2000 and 2016, the policy of expansion of secondary care increased the use of periapical/bitewing imaging exams.

Resumo O objetivo foi analisar a série temporal de procedimentos de imagem em Odontologia realizados entre os anos de 2000 e 2016 no Sistema Único de Saúde (SUS). Os dados foram obtidos do Sistema de Informações Ambulatoriais (SIA-SUS). Foram analisadas a influência da Política Nacional de Saúde Bucal de 2004, da Portaria nº 600/2006 (institui o financiamento dos Centros de Especialidades Odontológicas - CEOs) e Portaria nº 1.234/2013 (Incentivo financeiro do Programa de Melhoria do Acesso e da Qualidade - PMAQ-CEO). Apresentou-se análises descritivas dos anos inicial e final da série temporal, avaliando tendências e sazonalidade em sete tipos de procedimentos. A série temporal das taxas de exames radiográficos periapicais/interproximais demonstrou tendência de aumento moderado e foi a única em que se observou o impacto da política de implementação financeira dos CEOs, mas não do PMAQ-CEO. Os exames extraorais como: radiografia panorâmica, Tomografia Computadorizada (TC) da face/Articulação Temporomandibular (ATM) e Ressonância Magnética (RM) da ATM possuem forte tendência de aumento apesar das taxas serem muito baixas. Conclui-se que entre os anos 2000 e 2016, a política de expansão da atenção secundária, aumentou o uso de exames de imagem periapical/interproximal.

Abstract The scope of this paper was to analyze the time series of dental procedures performed between 2000 and 2016 in the Brazilian Unified Health System (SUS). The data were obtained from the Outpatient Information System of the SUS (SIA-SUS). The influence of the 2004 National Oral Health Policy of Ordinance No. 600/2006 (which instituted the financing of Dental Specialty Centers - CEOs), and Ordinance No. 1,234/2013 (Financial incentive for the Program for Enhancement of Quality and Access - PMAQ-CEO) were analyzed. Descriptive analyses of the initial and final years of the time series were presented, assessing trends and seasonality in seven types of imaging procedures. The time series of rates of periapical/bitewing radiographic exams revealed a trend of moderate increase and was the only area in which the impact of the financial implementation policy of the CEOs was observed, though not of the PMAQ-CEO. Extraoral imaging exams, such as panoramic radiography, facial CT/TMJ and TMJ MRI revealed a strong upward trend, despite the very low rates. The conclusion reached is that between 2000 and 2016, the policy of expansion of secondary care increased the use of periapical/bitewing imaging exams.

ABSTRACT: Central ossifying fibroma is a lesion in which diagnosis has proved intriguing and unclear for presenting clinical, radiographic, and even histopathological similarities to other types of lesions such as the fibrous dysplasia of bone and cement-bone dysplasia. It is a benign neoplasm of uncertain etiology and slow development in which the mandible is affected more frequently than the maxilla. We described a case of central cemento-ossifying fibroma involving the right mandible of a thirty-five-female patient by presenting its clinical, radiographic, and histological characteristic sand discussing some differential diagnoses.

RESUMEN: El fibroma cemento-osificante central es una lesión que requiere un diagnóstico diferencial ya que muestran similitud clínica, histológica y radiológica con la displasia fibrosa y con la displasia cemento-ósea. Esta lesión es un tumor benigno de etiología incierta, presenta crecimiento lento y afecta principalmente la mandíbula más que el maxilar. Se reporta un caso de un paciente de sexo femenino de 35 años, diagnosticada con fibroma cementoosificante central que le afectó el lado derecho de la mandíbula. Se describen las características clínicas, histológicas y radiológicas de la paciente y se discuten los diversos diagnósticos diferenciales.