Rosa Cibrián

A comparison between dental measurements taken from CBCT models and those taken from a Digital Method

The aims of the study were to assess speed, reliability, accuracy, and reproducibility in measuring mesiodistal tooth sizes, bicanine widths, bimolar widths, and arch lengths (ALs) using cone beam computed tomography (CBCT) and to compare them with the same measurements obtained using a two-dimensional (2D) Digital Method. Plaster study models were made for 27 patients and then digitalized and measured using a 2D Digital Method. CBCTs were undertaken on the same 27 patients using the Dental Picasso Master 3D® and the images obtained were then analysed using the InVivoDental program. The correlation study of the two measuring methods, which were compared by determining the regression parameters and the values of one method as opposed to the other, show how both methods are comparable, although the mean and standard deviation of all the measurements analysed present statistically significant differences for the first upper right premolar, first upper left molar, first lower left premolar, and second lower right premolar, as well for the lower intercanine distance and lower AL. The differences, however, are less than 1 per cent. CBCT digital models are as accurate and reliable as the digital models obtained from plaster casts. The differences existing between both methods are clinically acceptable.

Cephalometric measurements from 3D reconstructed images compared with conventional 2D images

OBJECTIVE To assess whether the values of different measurements taken on three-dimensional (3D) reconstructions from cone-beam computed tomography (CBCT) are comparable with those taken on two-dimensional (2D) images from conventional lateral cephalometric radiographs (LCRs) and to examine if there are differences between the different types of CBCT software when taking those measurements. MATERIAL AND METHODS Eight patients were selected who had both an LRC and a CBCT. The 3D reconstructions of each patient in the CBCT were evaluated using two different software packages, NemoCeph 3D and InVivo5. An observer took 10 angular and 3 linear measurements on each of the three types of record on two different occasions. RESULTS Intraobserver reliability was high except for the mandibular plane and facial cone (from the LCR), the Na-Ans distance (using NemoCeph 3D), and facial cone and the Ans-Me distance (using InVivo5). No statistically significant differences were found for the angular and linear measurements between the LCRs and the CBCTs for any measurement, and the correlation levels were high for all measurements. CONCLUSION No statistically significant differences were found between the angular and linear measurements taken with the LCR and those taken with the CBCT. Neither were there any statistically significant differences between the angular or linear measurements using the two CBCT software packages.

A study on the reproducibility of cephalometric landmarks when undertaking a three-dimensional (3D) cephalometric analysis

Objectives: Cone Beam Computerized Tomography (CBCT) allows the possibility of modifying some of the diagnostic tools used in orthodontics, such as cephalometry. The first step must be to study the characteristics of these devices in terms of accuracy and reliability of the most commonly used landmarks. The aims were 1- To assess intra and inter-observer reliability in the location of anatomical landmarks belonging to hard tissues of the skull in images taken with a CBCT device, 2- To determine which of those landmarks are more vs. less reliable and 3- To introduce planes of reference so as to create cephalometric analyses appropriated to the 3D reality. Study design: Fifteen patients who had a CBCT (i-CAT®) as a diagnostic register were selected. To assess the reproducibility on landmark location and the differences in the measurements of two observers at different times, 41 landmarks were defined on the three spatial axes (X,Y,Z) and located. 3.690 measurements were taken and, as each determination has 3 coordinates, 11.070 data were processed with SPSS® statistical package. To discover the reproducibility of the method on landmark location, an ANOVA was undertaken using two variation factors: time (t1, t2 and t3) and observer (Ob1 and Ob2) for each axis (X, Y and Z) and landmark. The order of the CBCT scans submitted to the observers (Ob1, Ob2) at t1, t2, and t3, were different and randomly allocated. Multiple comparisons were undertaken using the Bonferroni test. The intra- and inter-examiner ICC´s were calculated. Results: Intra- and inter-examiner reliability was high, both being ICC ≥ 0.99, with the best frequency on axis Z. Conclusions: The most reliable landmarks were: Nasion, Sella, Basion, left Porion, point A, anterior nasal spine, Pogonion, Gnathion, Menton, frontozygomatic sutures, first lower molars and upper and lower incisors. Those with less reliability were the supraorbitals, right zygion and posterior nasal spine. Key words:Cone Beam Computed Tomography, cephalometry, landmark, orthodontics, reliability.

A New, Accurate and Fast Digital Method to Predict Unerupted Tooth Size

The sum of the lower incisor tooth width has been proposed as the best predictor for calculating unerupted canine and premolar mesiodistal tooth sizes. The aims of this study were to develop a new, fast, and accurate computerized method to predict unerupted mesiodistal tooth sizes and to determine which reference tooth or combination of reference teeth was the best predictor for canines and premolars in a Spanish sample. The dental casts of 100 Spanish adolescents with permanent dentition were measured to the nearest 0.05 mm with a two-dimensional computerized system. The goal was to predict unerupted canine and premolar mesiodistal tooth sizes using the sizes of the upper central incisor, upper and lower first molar, or a combination of these as a reference and using a specific mesiodistal tooth-size table. The results showed that the Digital Method proposed was very accurate in predicting unerupted canine and premolar tooth size. The combination of the sums of the permanent upper central incisor and the lower first molar was the best predictor for canines and premolars in this sample. Upper arch teeth were better predicted than lower arch teeth. The upper lateral incisor provided the worst predictions.

Effect of saliva contamination on bracket failure with a self-etching primer: A prospective controlled clinical trial

INTRODUCTION The aim of this study was to evaluate in vivo the effect of saliva contamination at different stages of the bonding procedure on the bond failure rate and the adhesive remaining on teeth after debonding brackets bonded with a hydrophilic self-etching primer (Transbond Plus self-etching primer [TSEP], 3M Unitek, Monrovia, Calif). METHODS This was a prospective controlled clinical trial. The sample consisted of 46 patients with similar treatment plans and mechanotherapies. Stainless steel brackets (n = 531) were bonded with TSEP. The patients were divided into 2 groups: contamination with saliva before TSEP application and contamination with saliva after TSEP application. In both groups, saliva was applied in a split-mouth design. Diagonally opposite quadrants were allocated to either the contaminated group (contamination before [153 teeth] or after [115 teeth] TSEP application) or to the uncontaminated control group (263 teeth). Recording of failed brackets involved only first-time failures, and the observation period was a minimum of 6 months. RESULTS The chi-squared test showed no significant differences (P = 0.11) in bracket failures between the groups. Kaplan-Meier survival analysis detected no significant differences in the survival rates between the 3 groups (P = 0.51). Most bond failures occurred during the first 3 months. In all 3 groups, the adhesive remaining on teeth after debonding tended to be less than half. CONCLUSIONS These findings suggest that saliva contamination before or after application of self-etching primer does not increase the clinical risk of bond failure.

Monitoring of the action of drugs in melanoma cells by dynamic laser speckle.

Abstract. This work presents the development of a protocol based on the dynamic laser speckle designed to monitor the reaction of cancer cells of line MEL-RC08 to the application of the drug Colcemid in two different concentrations: 0.2 and 0.4  μg/mL. The protocol was designed using the forward scattering approach with an He-Ne laser of 632.8 nm illuminating the samples, a control, and two variations of Colcemid, being monitored along 8 h. The data were analyzed numerically in the time and in the frequency domain, and the results presented the ability of the technique to monitor the action of the drug, particularly Colcemid (0.4  μg/mL).

Infrared thermography is useful for ruling out fractures in paediatric emergencies

AbstractMusculoskeletal injuries are a leading cause of paediatric injuries and emergency department visits in Western countries. Diagnosis usually involves radiography, but this exposes children without fractures to unnecessary ionising radiation. We explored whether infrared thermography could provide a viable alternative in trauma cases. We compared radiography and thermal images of 133 children who had been diagnosed with a trauma injury in the emergency unit of a Spanish hospital. As well as the thermal variables in the literature, we introduced a new quantifier variable, the size of the lesion. Decision tree models were built to assess the technique’s accuracy in diagnosing whether a bone had been fractured or not. Infrared thermography had a sensitivity of 0.91, a specificity of 0.88 and a negative predictive value of 0.95. The new lesion size variable introduced appeared to be of main importance to the discriminatory power of the method. Conclusion: The high negative predictive value of infrared thermography suggests that it is a promising method for ruling out fractures.

Infrared Thermal Imaging in the Diagnosis of Musculoskeletal Injuries: A Systematic Review and Meta-Analysis

OBJECTIVE Musculoskeletal injuries occur frequently. Diagnostic tests using ionizing radiation can lead to problems for patients, and infrared thermal imaging could be useful when diagnosing these injuries. CONCLUSION A systematic review was performed to determine the diagnostic accuracy of infrared thermal imaging in patients with musculoskeletal injuries. A meta-analysis of three studies evaluating stress fractures was performed and found a lack of support for the usefulness of infrared thermal imaging in musculoskeletal injuries diagnosis.

Prediction of arch length based on intercanine width

Arch length (AL), intercanine width (ICW), and intermolar width (IMW) are essential for diagnosis and treatment planning and are closely related factors in orthodontics. The aim of the present study was to determine correlations between these measurements and to predict some of these measurements based on others. The dental casts of 197 Spanish patients (119 females and 78 males) with a mean age of 18 years (11-26 years) in the permanent dentition attending the Orthodontic Department of the University of Valencia, Spain, were selected. ICW, IMW, and AL on each dental cast were measured using a previously tested digital method. Correlation between variables was determined using Pearsons correlation coefficient. Linear regression analysis was applied and the 95 per cent confidence intervals (CIs) for slope and intercept were determined. The data showed very high correlations between ICW and AL, both for the upper and lower arches and for males and females, r = 0.925. This coefficient was very close to 1, indicating a linear relationship. The regression equation for AL and ICW was AL = 1.36 ICW + 29.39 for both arches. There was very high correlations between AL and ICW for the upper and lower arches and a regression equation between both magnitudes was established indicating that the size of one factor can be predicted by knowing the other. For an increase of 1 mm in ICW, the AL increases approximately 1.36 mm with a 95 per cent CI (1.30-1.42).

Study between anb angle and Wits appraisal in cone beam computed tomography (CBCT)

Objectives: To analyse the ANB and Wits values and to study correlations between those two measurements and other measurements in diagnosing the anteroposterior maxilo-mandibular relationship with CBCT. Study Design: Ninety patients who had previously a CBCT (i-CAT®) as a diagnostic register were selected. A 3D cephalometry was designed using one software package, InVivo5®. This cephalometry included 3 planes of reference, 3 angle measurements and 1 linear measurement. The means and standard deviations of the mean of each measurement were assessed. After that, a Pearson´s correlation coefficient has been performed to analyse the significance of each relationship. Results: When classifying the sample according to the anteroposterior relationship, the values obtained of ANB (Class I: 53%; Class II: 37%; Class III: 10%) and Wits (Class I: 35%; Class II: 56%; Class III: 9%) did not coincide, except for the Class III group. However, of the patients classified differently (Class I and Class II patients) by ANB and Wits, a high percentage of individuals (n=22; 49%), had a mesofacial pattern with a mandibular plane angle within normal values. A correlation has been found between ANB and Wits (r=0,262), occlusal plane angle and ANB (r=0,426), and mandibular plane angle and Wits (r=0,242). No correlation was found between either Wits or ANB in relation with the age of the individuals. Conclusions: ANB and Wits must be included in 3D cephalometric analyses as both are necessary to undertake a more accurate diagnosis of the maxillo-mandibular relationship of the patients. Key words:Cone beam computed tomography, ANB, Wits, cephalometrics.