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Acurácia diagnóstica de um sistema de inteligência artificial na detecção de lesões de cárie proximal: estudo retrospectivo com correlação clínico-radiográfica

Thu, 01 Jan 2026 00:00:00 GMT

Título: Acurácia diagnóstica de um sistema de inteligência artificial na detecção de lesões de cárie proximal: estudo retrospectivo com correlação clínico-radiográfica Autor(es): Carneiro, Jéssica Rodrigues Mendes Abstract: Dental caries remains the most prevalent oral health condition worldwide, with the early detection of proximal lesions representing a clinical challenge due to the limitations of visual examination and the inherent subjectivity of radiographic interpretation. In this context, artificial intelligence has been proposed as an auxiliary tool to enhance diagnostic precision and reduce inter-examiner variability. This study aimed to evaluate the diagnostic accuracy of an artificial intelligence system for detecting proximal caries lesions on digital bitewing radiographs, comparing its performance with that of human examiners and verifying the correspondence between radiographic lesion depth and therapeutic decisions recorded in dental charts. This was a retrospective, cross-sectional, analytical diagnostic accuracy study. The sample comprised 1,245 proximal surfaces of posterior teeth from 284 digital bitewing radiographs of 182 patients treated at the Universidade Federal do Ceará, Campus Sobral, obtained between January and December 2025. Images were analyzed by the Overjet® system, based on deep learning algorithms and convolutional neural networks, using the radiographic criteria of the American Dental Association (ADA) harmonized with the ICDAS (International Caries Detection and Assessment System) for lesion classification (E0–D3). The reference standard was established by consensus between two Oral Radiology specialists. Agreement between the artificial intelligence and the radiologists' consensus was moderate (κ = 0.598), a value numerically close to that observed between the radiologists themselves in independent assessment (κ = 0.580), suggesting that the system's diagnostic variability remained within the range expected among experienced examiners. The Restorative Dentistry specialists demonstrated near-perfect agreement among themselves (κ = 0.972). For global proximal caries detection, the artificial intelligence yielded sensitivity of 72.4%, specificity of 97.1%, accuracy of 83.9%, and an area under the ROC curve of 0.847 (95% CI: 0.829–0.866). For lesions with dentinal involvement, accuracy increased to 92.4% and the area under the ROC curve to 0.871. Analysis of the correspondence between radiographic depth and therapeutic decisions revealed a statistically significant therapeutic gradient [χ²(10) = 474; p < 0.001; contingency coefficient = 0.525], with a progressive increase in the frequency of invasive treatment from 0.9% in sound surfaces to 68.2% in lesions reaching the inner third of dentin. The proportion of surfaces with no recorded clinical decision was 61.1% of the total evaluated. It is concluded that the artificial intelligence system demonstrated diagnostic performance compatible with the variability observed among human specialists, with high specificity and good discriminative ability, particularly for lesions with dentinal involvement. The significant association between radiographic depth and therapeutic decisions reinforces the clinical relevance of the tool as an instrument to support evidence-based decision-making aligned with the principles of minimally invasive dentistry. Tipo: Tese

Efeitos da administração de fármacos para controle da nocicepção, inflamação e modulação do microambiente tumoral na carcinogênese oral induzida por 4-NQO em ratos

Thu, 01 Jan 2026 00:00:00 GMT

Título: Efeitos da administração de fármacos para controle da nocicepção, inflamação e modulação do microambiente tumoral na carcinogênese oral induzida por 4-NQO em ratos Autor(es): Alves, Joana Maria dos Santos Abstract: Oral squamous cell carcinoma (OSCC) is associated with important functional, aesthetic, and symptomatic repercussions for patients, among which pain stands out due to its significant impact on quality of life. Evidence indicates that pain may be modulated by alterations in the tumor microenvironment and that drugs used in its management may influence the immune system and tumor progression. Given the scarcity of studies addressing this interaction, this study evaluated the effect of different analgesic and anti-inflammatory drugs on the tumor microenvironment in an experimental model of oral carcinogenesis induced by 4-nitroquinoline 1-oxide (4-NQO) for 20 weeks. For this purpose, 70 male Wistar rats were distributed into seven groups: a control group and 4-NQO groups that received saline solution, dexamethasone, pregabalin, carbamazepine, morphine, or methotrexate, administered by oral gavage during the last two weeks of the experimental protocol. Animals in the 4-NQO groups showed a progressive reduction in nociceptive thresholds from the 12th week onward, and the different drugs promoted an increase in the nociceptive threshold after one week of treatment; however, only the carbamazepine- and morphine-treated groups maintained responses similar to the control at the end of the experiment. Histologically, 90% of the animals developed OSCC, and all treated groups exhibited reduced tumor dimensions. Morphine use was associated with increased VEGF expression in both tumor and non-tumor cells. In the intra- and peritumoral stroma, changes in different cellular populations were observed according to the administered drug, including reductions in FOXP3+ cells, mast cells, and CD163+ macrophages, along with an increase in CD68+ macrophages in the methotrexate-treated group. A decreased Wnt3A/β-catenin immunoexpression ratio was also observed in the dexamethasone, carbamazepine, and methotrexate groups, as well as increased μ-opioid receptor expression in the carbamazepine group. Overall, these findings indicate that, although effective for pain control, analgesics distinctly modulate the tumor microenvironment, influencing inflammation, angiogenesis, and neoplastic progression. In this context, morphine, despite being the gold standard, was associated with a pro-angiogenic and pro-tumoral profile, whereas dexamethasone reduced invasive neoplasms by inhibiting tumor initiation, underscoring the need for an individualized approach that balances analgesic efficacy and oncological safety. Tipo: Tese

Inserção de novas tecnologias em saúde através de um aplicativo para rastreamento de câncer oral por agentes comunitários de saúde

Thu, 01 Jan 2026 00:00:00 GMT

Título: Inserção de novas tecnologias em saúde através de um aplicativo para rastreamento de câncer oral por agentes comunitários de saúde Autor(es): Rêgo, Talita Jordânia Rocha do Abstract: Cancers diagnosed at early stages are more effectively treated, with lower treatment costs, reduced morbidity, and a higher likelihood of cure. Therefore, oral cancer screening can improve the prognosis of these lesions and significantly reduce healthcare costs and mortality rates. In an effort to reduce the costs associated with continuous training of Community Health Workers (CHWs) and to overcome geographical barriers in oral cancer diagnosis, the use of mobile applications (apps) and digital media systems appears to be a promising alternative. This study aims to promote the integration of new health technologies through a mobile application for oral cancer screening, Oral Cancer Screening (OCS), and to evaluate its use by CHWs in the municipality of Fortaleza, Ceará, Brazil. The study was conducted by installing the app on CHWs’ mobile devices, followed by their responses to the System Usability Scale (SUS) and the Technology Acceptance Model (TAM) questionnaires. The study population included CHWs from all health districts of Fortaleza, with a sample of 322 participants. Most participants (n = 280; 87%) were female, and 189 professionals (60.4%) had completed high school education. Regarding knowledge of oral cancer risk factors, 93.2% (n = 300) identified smoking as the primary associated factor, followed by alcohol consumption (90.1%) and sun exposure (86.3%). Cronbach’s alpha coefficient was 0.804 for the SUS instrument and 0.806 for TAM, indicating good internal consistency according to established psychometric parameters (α ≥ 0.70). The mean SUS score was 73.59, indicating good perceived usability. The mean acceptability score was 81.88, demonstrating a high level of acceptance among the evaluated professionals. Participants who identified smoking as a risk factor showed better usability outcomes. Those who considered poor oral hygiene as a risk factor exhibited lower acceptability (p < 0.013) and lower usability scores. Participants who indicated a high likelihood of using the app (scores 9 and 10) demonstrated better acceptability and usability. Additionally, Android and Xiaomi users showed higher usability scores compared to iOS and other platform users (p = 0.001). Data were expressed as absolute and relative frequencies and analyzed for internal consistency using Cronbach’s alpha coefficient. The scales were compared and correlated using the Wilcoxon test and Spearman’s correlation. Furthermore, after categorization based on cutoff points (≤70 and >70), Fisher’s exact test or Pearson’s chi-square test was used to assess associations with other variables. All analyses were conducted with a 95% confidence level using SPSS version 20.0 for Windows. The OCS app proved to be effective and easy to use, with excellent acceptance among Community Health Workers. The app may contribute to the early screening of oral lesions by dentists through risk-factor-based triage performed by CHWs. Tipo: Tese

Relação entre morfologia craniofacial e parâmetros polissonográficos em pacientes pediátricos com síndrome de prader–willi e revisão de escopo do fenótipo orofacial

Wed, 22 Apr 2026 00:00:00 GMT

Título: Relação entre morfologia craniofacial e parâmetros polissonográficos em pacientes pediátricos com síndrome de prader–willi e revisão de escopo do fenótipo orofacial Autor(es): Carvalho, Fernanda Matias de Abstract: Objectives: To evaluate cephalometric, anthropometric, and polysomnographic characteristics in children and adolescents with Prader–Willi syndrome (PWS) and to investigate possible associations between cephalometric and photoanthropometric profiles and polysomnographic findings in these patients. Additionally, to map and synthesize the available scientific evidence on orofacial characteristics described in these individuals through a scoping review of the literature. Materials and methods: Chapter 01 (Scoping review of the literature) was conducted in accordance with the methodological framework of the Joanna Briggs Institute and reported according to PRISMA-ScR recommendations. Searches were performed in six databases, complemented by grey literature and manual screening of reference lists. Studies reporting orofacial characteristics in individuals with genetically confirmed PWS were included. Screening, selection, and data extraction were performed by two independent reviewers. Chapter 02 (Case-control study) included children and adolescents with genetically confirmed PWS and non-syndromic individuals matched by age and sex. In both groups, lateral cephalograms and standardized frontal and profile facial photographs were obtained for cephalometric and photoanthropometric analyses. In the PWS group, all participants underwent full overnight polysomnography. A total of 27 cephalometric and 18 photoanthropometric parameters were analyzed. Comparisons between groups were performed using Student’s t-test, and associations between craniofacial, anthropometric, and polysomnographic variables were analyzed using Pearson’s correlation, adopting a significance level of 5%. Results: In the scoping review, 30 studies published between 1988 and 2026 were included, demonstrating methodological heterogeneity. Among the most frequently reported extraoral findings were almond-shaped eyes, upward-slanting palpebral fissures, downward-oriented labial commissures, and a thin upper lip. Cephalometric data revealed heterogeneous craniofacial patterns, including reduced mandibular and maxillary dimensions and variations in sagittal skeletal relationships. Among intraoral findings, caries experience, reduced salivary flow, thick or viscous saliva, enamel developmental defects, dental wear, occlusal alterations, periodontal conditions, tooth absence, and orofacial functional alterations were highlighted. In the case-control study, all patients with PWS presented obstructive sleep apnea (OSA) (n = 11). The syndromic group showed statistically significant differences in some cephalometric and photoanthropometric measurements, including greater cranial base lengths, facial heights, mandibular dimensions, and inferior displacement of the hyoid bone. Higher values of the Apnea–Hypopnea Index and greater severity of OSA were positively associated with cranial base angles, hyoid bone position, and abdominal circumference. Photoanthropometric parameters related to narrower facial proportions and reduced anterior projection of soft tissues showed a negative correlation with the AHI. Conclusion: The scoping review indicates that individuals with PWS present a wide spectrum of orofacial manifestations involving dental, salivary, craniofacial, and functional alterations, contributing to the understanding of the orofacial phenotype of the syndrome and to the planning of preventive and therapeutic strategies for these patients. The case-control study observed that children and adolescents with PWS present significant cephalometric and photoanthropometric differences compared to the control group, in addition to a high frequency of OSA and associations between craniofacial, anthropometric, and polysomnographic variables. Tipo: Tese