Influência da aplicação de diferentes filtros no diagnóstico de alterações ósseas da articulação temporomandibular em exames de tomografia computadorizada de feixe cônico

Abstract

A variety of morphological changes in the bone of the mandibular condyle and articular eminence can occur in patients with tempormandibular joint disosders (TMD). Changes include flattening, osteophytes, erosions and sclerosis. Radiographic examination is an essential component of diagnostic evaluation of temporomandibular joint (TMJ). Currently cone-beam computed tomography (CBCT) has been widely used to evaluate TMJ. Many CBCT softwares has been designed to enhance images. Filters are a tool used to minimize image noise using mathematical algorithms to reduce or increase specific characteristics. The aim of this study was to determine if CBCT enhancement filters influence the diagnosis of morphological TMJ changes. Images of 100 TMJ were examined. All images were analyzed without filter application and with de following filters for XoranCat® software: Sharpen, Angio_Shapen_Low 3x3, Smooth e Angio_Sharpen_High 5x5. Each image were examined by two oral radiologists who classified them for the presence of morphological changes and for the image quality. Sensibility, specificity, accuracy, positive predictive value and negative predictive value were calculated for each filter in each condition. Cochran test was used to evaluate all images versus the original images, and Friedman test was used to evaluate the quality of image between all filters. Sensibility, specificity, accuracy, positive predictive value and negative predictive value had little variability. Only Angio_Sharpen_High 5x5 filter had influenced the diagnosis of sclerosis in the articular eminence (P<0,05). In general, filters didn`t influence the diagnosis of morphological changes of TMJ, but Sharpen and Angio_Sharpen_Low 3x3 filters were classified as excellent image quality, and became an alternative to diagnosis of TMJ changes.