Tomografia computadorizada Cone Beam em Ortodontia - evolução ou revolução? visão geral, aplicações, vantagens/desvantagens e dose de radiação

Introduction: The request of three-dimensional images (3D) of the dentomaxillofacial complex has increased. Hence, new possibilities for assessment, treatment as well as follow-up after treatment have increased their importance with the use of cone beam computed tomography (CBCT). The images in two dimensions (2D) have inherent problems that can be solved with treedimensional images assessment. Objectives: To clarify the main doubts about the operational mechanism of complementary diagnostic method; to explain the advantages and disadvantages, to discuss the effective radiation dose and possible applications in orthodontia. Conclusion: The information generated by 2D images from the CBCT does not show differences that may endanger the orthodontic planning when compared with the images of 2D conventional radiographs. The effective radiation dose received by the patient should not be considered as a limiting factor of the tomography exam request.

Mandibular cortical bone evaluation on cone beam computed tomography images of patients with bisphosphonate related osteonecrosis of the jaws

Objectives The objective of this study was to develop a technique for detecting cortical bone dimensional changes in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ). Study Design Subjects with BRONJ who had cone-beam computed tomography imaging were selected, with age- and gender-matched controls. Mandibular cortical bone measurements to detect bisphosphonate-related cortical bone changes were made inferior to mental foramen, in 3 different ways: within a fixed sized rectangle, in a rectangle varying with the cortical height, and a ratio between area and height. Results Twelve BRONJ cases and 66 controls were evaluated. The cortical bone measurements were significantly higher in cases than controls for all 3 techniques. The bone measurements were strongly associated with BRONJ case status (odds ratio 3.36-7.84). The inter-rater reliability coefficients were high for all techniques (0.71-0.90). Conclusions Mandibular cortical bone measurement is a potentially useful tool in the detection of bone dimensional changes caused by bisphosphonates. Long-term administration of bisphosphonates (BPs) affects bone quality and metabolism following accumulation in bone.1 Since the first cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) were published in 2003,2 there has been a search for factors that can predict the onset of the condition. Oral and intravenous BPs reduce bone resorption, increase mineral content of bone, and alter bony architecture.3, 4, 5 and 6 Previous studies have demonstrated these changes both radiographically and following histologic analysis.1, 3, 7, 8, 9 and 10 The BP-related jaw changes may present radiological features, such as thickening of lamina dura and cortical borders, diffuse sclerosis, and narrowing of the mandibular canal3 and 11; however, oral radiographs of patients taking BPs do not consistently show radiographic changes to the jaws.11 and 12 The challenge is to find imaging tools that could improve the detection of changes in the bone associated with BP use. Various skeletal radiographic features associated with BRONJ in conventional periapical and panoramic radiographs, computed tomography, magnetic resonance imaging, and nuclear bone scanning have been described.3, 8, 9, 10 and 11 There has also been a search for BP-related quantitative methods for the evaluation of radiographic images, to avoid observer subjectivity in interpretation. Factors thought to be important include trabecular and cortical structure, and bone mineralization.4 Consequently, measurable bone data have been reported in subjects taking BPs through many techniques, including bone density, architecture, and cortical bone thickness.1, 4, 7 and 13 Trabecular microarchitecture of postmenopausal women has been evaluated with noninvasive techniques, such as high-resolution magnetic resonance images showing less deterioration of the bone 1 year after initiation of oral BP therapy.4 A decrease in bone turnover and a trend for an increase in the bone wall thickness has been detected by histomorphometry in subjects taking BPs.1 Alterations in the cortical structure of the second metacarpal have been detected in digital x-ray radiogrammetry of postmenopausal women treated with BPs.7 Mandibular cortical width may be measured on dental panoramic radiographs, and it has been suggested as a screening tool for referring patients for bone densitometry for osteoporosis investigation.14 and 15 Inhibition of the intracortical bone remodeling in the mandible of mice taking BPs has been reported.16 Thus, imaging evaluation of the mandibular cortical bone could be a biologically plausible way to detect BP bone alterations. Computed tomography can assess both cortical and trabecular bone characteristics. Cone-beam computed tomography (CBCT) can provide 3-dimensional information, while using lower doses and costing less than conventional CT. The CBCT images have been studied as a tool for the measurement of trabecular bone in patients with BRONJ.13 Therefore, cortical bone measurements on CBCT of the jaws might also help to understand bone changes in patients with BRONJ. There is no standard in quantifying dimensional changes of mandibular cortical bone. We explored several different approaches to take into consideration possible changes in length, area, and volume. These led to the 3 techniques developed in this study. This article reports a matched case-control study in which mandibular cortical bone was measured on CBCT images of subjects with BRONJ and controls. The aim of the study was to explore the usefulness of 3 techniques for detecting mandibular cortical bone dimensional changes caused by BP.

Nonlinear ball and beam control system identification

The Ball and Beam system is a common didactical experiment in control laboratories that can be used to illustrate many different closed-loop control techniques. The plant itself is subjected to many nonlinear effects, which the most common comes from the relative motion between the ball and the beam. The modeling process normally uses the lagrangean formulation. However, many other nonlinear effects, such as non-viscous friction, beam flexibility, ball slip, actuator elasticity, collisions at the end of the beam, to name a few, are present. Besides that, the system is naturally unstable. In this work, we analyze a subset of these characteristics, in which the ball rolls with slipping and the friction force between the ball and the beam is non-viscous (Coulomb friction). Also, we consider collisions at the ends of the beam, the actuator consists of a (rubber made) belt attached at the free ends of the beam and connected to a DC motor. The model becomes, with those nonlinearities, a differential inclusion system. The elastic coefficients of the belt are experimentally identified, as well as the collision coefficients. The nonlinear behavior of the system is studied and a control strategy is proposed.

Influence of nonlinear stiffness on the dynamics of a slender elastic beam under torsional oscillations

This study focuses on analysing the effects of nonlinear torsional stiffness on the dynam-ics of a slender elastic beam under torsional oscillations, which can be subject to helical buckling.The helical buckling of an elastic beam confined in a cylinder is relevant to many applications. Someexamples include oil drilling, medical cateters and even the conformation and functioning of DNAmolecules. A recent study showed that the formation of the helical configuration is a result of onlythe torsional load, confirming that there is a different path to helical buckling which is not related tothe sinusoidal buckling, stressing the importance of the geometrical behaviour of the beam. A lowdimensional model of an elastic beam under torsional oscillations is used to analyse its dynamical be-haviour with different stiffness characteristics, which are present before and after the helical buckling.Hardening and softening characteristics are present, as the effects of torsion and bending are coupled.With the use of numerical algorithms applied to nonlinear dynamics, such as bifurcation diagramsand basins of attraction, it is shown that the nonlinear stiffness can shift the bifurcations and inducechanges in the stability of the desirable and undesirable solutions. Therefore, the proper modellingof these stiffness nonlinearities seems to be important for a better understanding of the dynamicalbehaviour of such beams.

Task complexity reveals expertise of table tennis players

AIM: The purpose of this study was to examine the effect of intensive practice in table-­tennis on perceptual, decision-­making and motor-­systems. Groups of elite (HL=11), intermediate (LL=6) and control (CC=11) performed tasks of different levels. METHODS: All subjects underwent to reaction-­time-­test and response-­time-­test consisting of a pointing task to targets placed at distinct distances (15 and 25-­cm) on the right and left sides. The ball speed test in forehand and backhand condition just for HL and LL group. RESULTS: In CC group reaction time was higher compared to HL (P< 0.05) group. In the response-­time-­test, there was a significant main effect of distance (P< 0.0001) and the tennis-­table expertise (P= 0.011). In the ball speed test the HL were constantly faster compared to the LL in both forehand stroke (P< 0.0001) and backhand stroke (P< 0.0001). Overall, the forehand stroke was significantly faster than the backhand stroke. CONCLUSION: We can conclude that table-­tennis-­players have shorter response-­times than non-­athletes and the tasks of reaction-­time and response-­time are incapable to distinguish the performance of well-­trained table tennis players of the intermediate player, but the ball speed test seems be able to do it.

A matheuristic for the selection of beam directions and dose distribution in radiotherapy planning

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)