Three-dimensional imaging techniques: A literature review

Comparison of two CBCT analysis techniques with conventional periapical radiographs in assessment of tertiary dentin after indirect pulp capping in young permanent teeth

BACKGROUND AND AIM

To compare two cone beam computed tomography (CBCT) analysis techniques for measuring tertiary dentin (TD) volume, density, and root length increase, after indirect pulp therapy (IPT) in young permanent teeth with conventional periapical radiographs.

DESIGN

Comparative study design: Sixty-nine CBCT scans were taken initially (T1) and after 1 year (T2) of IPT. New CBCT analysis technique A, standardization, segmentation, and registration of T1 and T2 scans were performed using ITK-SNAP and 3D Slicer CMF to measure TD volume (mm3), density (gray-level intensity), and root length increase (mm). In the traditional CBCT analysis technique B, analyses were conducted using the In-Vivo software to calculate TD thickness (mm), radiodensity (HU%), and root length increase (mm). Paired t-test and the intraclass correlation coefficient were calculated to compare and assess the reliability of all techniques.

RESULTS

No significant difference between the two techniques existed in the measurement of TD mineral density (Mean [SD]:A = 22.4 [15.4]; B = 24.4 [15.4]; p = .47). Technique A resulted in significantly higher root length increase values (Mean [SD]: A = 1.3 [0.6]; B = 1.1 [0.5]; p = .03). The two techniques showed acceptable reliability levels (0.76-0.99).

CONCLUSION

CBCT analysis techniques yielded similar findings for mineral density. The new CBCT volumetric analysis technique, although more laborious, produced higher values for root length increase, and allowed for measurement of dentin volume.

Accuracy of Smartphone-Based Three-Dimensional Facial Scanning System: A Systematic Review

BACKGROUND

Recently, the integration of 3D face scanning into smartphones has raised vast interest in plastic surgery. With the release of smartphones featuring 3D face scanning technology, users now can capture detailed 3D models of their faces using their smartphones. However, trueness and precision of this system is less well established.

METHODS

PubMed, Cochrane Library, Embase, ScienceDirect, Scopus, and Web of Science databases were searched for studies evaluating 3D scanning of smartphone devices and conventional 3D imaging systems from January 1, 2017, to June 1, 2023. A qualitative systematic review was conducted by two review authors after independently selecting studies, extracting data, and assessing the risk of bias of included studies.

RESULTS

A total of 11 studies were included, all focusing on the accuracy of smartphone 3D facial scanning. The results show that although smartphones perform poorly on deep and irregular surfaces, they are accurate enough for clinical applications and have the advantage of being economical and portable.

CONCLUSIONS

Smartphone-based 3D facial scanning has been basically validated for clinical application, showing broad clinical application prospects in plastic surgery.

LEVEL OF EVIDENCE II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Duchenne and Becker muscular dystrophy: Cellular mechanisms, image analysis, and computational models: A review

The muscle is the principal tissue that is capable to transform potential energy into kinetic energy. This process is due to the transformation of chemical energy into mechanical energy to enhance the movements and all the daily activities. However, muscular tissues can be affected by some pathologies associated with genetic alterations that affect the expression of proteins. As the muscle is a highly organized structure in which most of the signaling pathways and proteins are related to one another, pathologies may overlap. Duchenne muscular dystrophy (DMD) is one of the most severe muscle pathologies triggering degeneration and muscle necrosis. Several mathematical models have been developed to predict muscle response to different scenarios and pathologies. The aim of this review is to describe DMD and Becker muscular dystrophy in terms of cellular behavior and molecular disorders and to present an overview of the computational models implemented to understand muscle behavior with the aim of improving regenerative therapy.

Current and emerging 3D visualization technologies in radiology

As the field of three-dimensional (3D) visualization rapidly advances, how healthcare professionals perceive and interact with real and virtual objects becomes increasingly complex. Lack of clear vocabulary to navigate the changing landscape of 3D visualization hinders clinical and scientific advancement, particularly within the field of radiology. In this article, we provide foundational definitions and illustrative examples for 3D visualization in clinical care, with a focus on the pediatric patient population. We also describe how understanding 3D visualization tools enables better alignment of hardware and software products with intended use-cases, thereby maximizing impact for patients, families, and healthcare professionals.

Revolutionizing bone tumor management: cutting-edge breakthroughs in limb-saving treatments

Limb salvage surgery has revolutionized the approach to bone tumors in orthopedic oncology, steering away from historical amputations toward preserving limb function and enhancing patient quality of life. This transformative shift underscores the delicate balance between tumor eradication and optimal postoperative function. Primary and metastatic bone tumors present challenges in early detection, differentiation between benign and malignant tumors, preservation of function, and the risk of local recurrence. Conventional methods, including surgery, radiation therapy, chemotherapy, and targeted therapies, have evolved with a heightened focus on personalized medicine. A groundbreaking development in limb salvage surgery is the advent of 3D-printed patient-specific implants, which significantly enhance anatomical precision, stability, and fixation. These implants reduce soft tissue disruption and the associated risks, fostering improved osseointegration and correction of deformities for a more natural and functional postoperative outcome. Biological and molecular research has reshaped the understanding of bone tumors, guiding surgical interventions with advancements such as genomic profiling, targeted intraoperative imaging, precision targeting of molecular pathways, and immunotherapy tailored to individual tumor characteristics. In the realm of imaging technologies, MRI, CT scans, and intraoperative navigation systems have redefined preoperative planning, minimizing collateral damage and optimizing outcomes through accurate resections. Postoperative rehabilitation plays a crucial role in restoring function and improving the quality of life. Emphasizing early mobilization, effective pain management, and a multidisciplinary approach, rehabilitation addresses the physical, psychological, and social aspects of recovery. Looking ahead, future developments may encompass advanced biomaterials, smart implants, AI algorithms, robotics, and regenerative medicine. Challenges lie in standardization, cost-effectiveness, accessibility, long-term outcome assessment, mental health support, and fostering global collaboration. As research progresses, limb salvage surgery emerges not just as a preservation tool but as a transformative approach, restoring functionality, resilience, and hope in the recovery journey. This review summarizes the recent advances in limb salvage therapy for bone tumors over the past decade.

Semi or fully automatic tooth segmentation in CBCT images: a review

Cone beam computed tomography (CBCT) is widely employed in modern dentistry, and tooth segmentation constitutes an integral part of the digital workflow based on these imaging data. Previous methodologies rely heavily on manual segmentation and are time-consuming and labor-intensive in clinical practice. Recently, with advancements in computer vision technology, scholars have conducted in-depth research, proposing various fast and accurate tooth segmentation methods. In this review, we review 55 articles in this field and discuss the effectiveness, advantages, and disadvantages of each approach. In addition to simple classification and discussion, this review aims to reveal how tooth segmentation methods can be improved by the application and refinement of existing image segmentation algorithms to solve problems such as irregular morphology and fuzzy boundaries of teeth. It is assumed that with the optimization of these methods, manual operation will be reduced, and greater accuracy and robustness in tooth segmentation will be achieved. Finally, we highlight the challenges that still exist in this field and provide prospects for future directions.

Frontiers in Three-Dimensional Surface Imaging Systems for 3D Face Acquisition in Craniofacial Research and Practice: An Updated Literature Review

Digitalizing all aspects of dental care is a contemporary approach to ensuring the best possible clinical outcomes. Ongoing advancements in 3D face acquisition have been driven by continuous research on craniofacial structures and treatment effects. An array of 3D surface-imaging systems are currently available for generating photorealistic 3D facial images. However, choosing a purpose-specific system is challenging for clinicians due to variations in accuracy, reliability, resolution, and portability. Therefore, this review aims to provide clinicians and researchers with an overview of currently used or potential 3D surface imaging technologies and systems for 3D face acquisition in craniofacial research and daily practice. Through a comprehensive literature search, 71 articles meeting the inclusion criteria were included in the qualitative analysis, investigating the hardware, software, and operational aspects of these systems. The review offers updated information on 3D surface imaging technologies and systems to guide clinicians in selecting an optimal 3D face acquisition system. While some of these systems have already been implemented in clinical settings, others hold promise. Furthermore, driven by technological advances, novel devices will become cost-effective and portable, and will also enable accurate quantitative assessments, rapid treatment simulations, and improved outcomes.

A look at radiation detectors and their applications in medical imaging

The effectiveness and precision of disease diagnosis and treatment have increased, thanks to developments in clinical imaging over the past few decades. Science is developing and progressing steadily in imaging modalities, and effective outcomes are starting to show up as a result of the shorter scanning periods needed as well as the higher-resolution images generated. The choice of one clinical device over another is influenced by technical disparities among the equipment, such as detection medium, shorter scan time, patient comfort, cost-effectiveness, accessibility, greater sensitivity and specificity, and spatial resolution. Lately, computational algorithms, artificial intelligence (AI), in particular, have been incorporated with diagnostic and treatment techniques, including imaging systems. AI is a discipline comprised of multiple computational and mathematical models. Its applications aided in manipulating sophisticated data in imaging processes and increased imaging tests' accuracy and precision during diagnosis. Computed tomography (CT), positron emission tomography (PET), and Single Photon Emission Computed Tomography (SPECT) along with their corresponding radiation detectors have been reviewed in this study. This review will provide an in-depth explanation of the above-mentioned imaging modalities as well as the radiation detectors that are their essential components. From the early development of these medical instruments till now, various modifications and improvements have been done and more is yet to be established for better performance which calls for a necessity to capture the available information and record the gaps to be filled for better future advances.

Cost-effective 3D scanning and printing technologies for outer ear reconstruction: current status

Current 3D scanning and printing technologies offer not only state-of-the-art developments in the field of medical imaging and bio-engineering, but also cost and time effective solutions for surgical reconstruction procedures. Besides tissue engineering, where living cells are used, bio-compatible polymers or synthetic resin can be applied. The combination of 3D handheld scanning devices or volumetric imaging, (open-source) image processing packages, and 3D printers form a complete workflow chain that is capable of effective rapid prototyping of outer ear replicas. This paper reviews current possibilities and latest use cases for 3D-scanning, data processing and printing of outer ear replicas with a focus on low-cost solutions for rehabilitation engineering.

3D Technology Used for Precision in Orthodontics

One of the most crucial technologies used by orthodontists to assess and document the dimensions of craniofacial features is imaging. Orthodontists frequently employ two-dimensional (2D) imaging methods, although 2D imaging cannot localize or determine the depth of structures. Early in the 1990s, three-dimensional (3D) imaging was invented, and it has since become a crucial part of dentistry, especially in orthodontics. One of the newest and most important breakthroughs in dentistry is 3D technology. Clinicians have been able to significantly improve patient care while also shortening the time spent on treatment planning due to these technologies, which include intra-oral scanning, 3D imaging, computed-axial tomography (CAT) scan, cone-beam computed tomography (CBCT), computer-aided design/computer-aided manufacturing (CAD/CAM), and 3D software. 3D models of maxillary and mandibular arches can take the place of conventional plaster casts and their limits for planning treatments, appliance production, and estimated treatment results as part of this continuous progress. Digital orthodontics procedures have become more popular in the recent past. The development of "personalized" orthodontic appliances makes use of technology. These technologies' overall improvement can increase clinicians' productivity and efficiency by simplifying traditional methods that are seen to be particularly laborious. The objectives of this review are to provide an overall description of the 3D technology nowadays and to assess its orthodontic applications.

Three-Dimensional (3D) Analysis of Orbital Morphometry in Healthy Anatolian Adults: Sex, Side Discrepancies, and Clinical Relevance

Background and objective The complex structural integrity of the orbit is crucial for visual functions. Three-dimensional (3D) reconstructions from radiological images have revolutionized anatomical understanding, eliminating the limitations of two-dimensional (2D) imaging and offering intricate spatial details for complex structures. The aim of this study was to analyze the detailed morphometry of the orbit in healthy Anatolian adults, considering sex, side discrepancies, and clinical relevance using 3D models reconstructed from multidetector computed tomography (MDCT) images. Materials and methods Fifty-six (44.44%) males and 70 (55.56%) females (total: 126, mean age: 48.62) MDCT images were randomly selected and 3D skull models were reconstructed using 3D Slicer software. Measurements were conducted in millimeters (mm) for transverse and vertical diameters, circumference of the orbital opening, orbital wall lengths, as well as intraorbital and extraorbital distances. Results The method of measurements showed high reproducibility of results. The mean values for transverse and vertical diameters, circumference of the orbital opening, medial and lateral wall lengths, roof and floor lengths, and intraorbital and extraorbital distances were 40.23±2.12 mm (p<0.001), 34.94±2.16 mm (p=0.365), 44.74 ±3.02 mm (p<0.001), 46.30±2.69 mm (p<0.001), 51.26±2.91 mm (p<0.001), 49.01±3.22 mm (p<0.001), 126.10±5.71 mm (p<0.001), 19.63±2.35 mm (p=0.026), and 94.09±4.84 mm (p<0.001), respectively. Conclusion The study's high measurement reproducibility contributes significantly to the existing literature and clinical practice. These findings offer specific insights into Anatolian orbital morphometry, aiding in surgical planning, implant placement, and diagnostic assessments. The precise measurement values serve as a reliable reference for clinicians, facilitating the identification of normal and abnormal orbital anatomy and enhancing patient care. We believe this study provides valuable data for craniofacial and ophthalmological research, benefiting both clinical practice and future research endeavors in these fields.

Development and accuracy of artificial intelligence-generated prediction of facial changes in orthodontic treatment: a scoping review

Artificial intelligence (AI) has been utilized in soft-tissue analysis and prediction in orthodontic treatment planning, although its reliability has not been systematically assessed. This scoping review was conducted to outline the development of AI in terms of predicting soft-tissue changes after orthodontic treatment, as well as to comprehensively evaluate its prediction accuracy. Six electronic databases (PubMed, EBSCOhost, Web of Science, Embase, Cochrane Library, and Scopus) were searched up to March 14, 2023. Clinical studies investigating the performance of AI-based systems in predicting post-orthodontic soft-tissue alterations were included. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and Joanna Briggs Institute (JBI) appraisal checklist for diagnostic test accuracy studies were applied to assess risk of bias, while the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) assessment was conducted to evaluate the certainty of outcomes. After screening 2500 studies, four non-randomized clinical trials were finally included for full-text evaluation. We found a low level of evidence indicating an estimated high overall accuracy of AI-generated prediction, whereas the lower lip and chin seemed to be the least predictable regions. Furthermore, the facial morphology simulated by AI via the fusion of multimodality images was considered to be reasonably true. Since all of the included studies that were not randomized clinical trials (non-RCTs) showed a moderate to high risk of bias, more well-designed clinical trials with sufficient sample size are needed in future work.

A Bibliometric Study on the Top 101 Most-Cited Articles of Dental Journals of the Middle East/North Africa Countries From 2011 to 2021

Introduction: This retrospective descriptive study evaluated the Scopus-indexed dental journals and their most-cited documents affiliated with the Middle East and North Africa (MENA) countries from 2011 to 2021. Methods: Dental journals affiliated with MENA countries, their bibliometric indicators (SJR, CiteScore, SNIP, and H-index), and the 101 most cited articles of the considered journals were extracted and studied through descriptive statistics. In addition, the "citation per year" of each top 101 articles was calculated. Spearman's rho test was used for pairwise comparisons of the correlation coefficient values between each two of the considered bibliometric indicators. Results: The number of citations of the 101 most-cited papers ranged from 35 to 203. The mean (SD) citations of studied articles were 61.33 (37.58) and the median was 46. Furthermore, CiteScore had the highest significant correlation with SJR (r=0.828, P˂0.001). Moreover, the citation per year of the top 101 documents had no significant relationship with any of the journals' bibliometric indicators. Conclusion: Because journal performance and citation rate are multi-dimensional concepts, a single metric cannot express them thoroughly despite correlations between indices. "European Journal of Dentistry" from Turkey, "Saudi Dental Journal" from Saudi Arabia, and "Iranian Endodontic Journal" and "Journal of Lasers in Medical Sciences" both from Iran had the highest ranks in the SCImago portal and the highest scores in bibliometric indices amongst the MENA dental journals.

Accuracy (trueness and precision) of four tablet-based applications for three-dimensional facial scanning: an in-vitro study.: Tablet-based applications for 3D facial scanning

OBJECTIVES

This study aimed to investigate the overall and regional accuracy (trueness and precision) of digital three-dimensional (3D) facial scans obtained from four tablet-based applications, which were (Bellus) the Bellus Dental Pro® (Bellus3D, Inc. Campbell, CA, USA), (Capture) the Capture®: 3D Scan Anything (Standard Cyborg, Inc. San Francisco, CA, USA), (Heges) the Heges® (by Marek Simonik, Ostrava, North Moravia, Czech Republic), and (Scandy) the Scandy Pro 3D Scanner® (Scandy LLC, New Orleans, LA, USA).

METHODS

A mannequin's face was marked with 63 landmarks. Subsequently, it was scanned 5 times using each scan application on an iPad Pro® (Apple Inc., Cupertino, CA, USA). The digital measurements were obtained with MeshLab® (CNR-ISTI, Pisa, Tuscany, Italy) and compared to the manual measurements using a digital vernier caliper (Truper Herramientas S.A., Colonia Granada, Mexico City, Mexico). The absolute mean difference and the standard deviation of the dimensional discrepancies were calculated. Moreover, the data were analysed by using one-way ANOVA, Levene's test, and Bonferroni´s correction.

RESULTS

The absolute mean trueness values were Bellus 0.41 ± 0.35 mm, Capture 0.38 ± 0.37 mm, Heges 0.39 ± 0.38 mm, and Scandy 0.47 ± 0.44 mm. Moreover, precision values were Bellus 0.46 mm, Capture 0.46 mm, Heges 0.54 mm, and Scandy 0.64 mm. Comparing the regions, Capture and Scandy showed the highest absolute mean difference, which was 0.81 mm in the Frontal and Zygomaticofacial regions, respectively.

CONCLUSIONS

The trueness and precision of all four tablet-based applications were clinically acceptable for diagnosis and treatment planning.

CLINICAL SIGNIFICANCE

The future of the three-dimensional facial scan is auspicious, and it has the potential to be affordable, accurate, and of great value for clinicians in their daily practice.

Accuracy between 2D Photography and Dual-Structured Light 3D Facial Scanner for Facial Anthropometry: A Clinical Study

(1) Background: Facial scanners are used in different fields of dentistry to digitalize the soft tissues of the patient's face. The development of technology has allowed the patient to have a 3-dimensional virtual representation, facilitating facial integration in the diagnosis and treatment plan. However, the accuracy of the facial scanner and the obtaining of better results with respect to the manual or two-dimensional (2D) method are questionable. The objective of this clinical trial was to evaluate the usefulness and accuracy of the 3D method (a dual-structured light facial scanner) and compare it with the 2D method (photography) to obtain facial analysis in the maximum intercuspation position and smile position. (2) Methods: A total of 60 participants were included, and nine facial landmarks and five interlandmarks distances were determined by two independent calibrated operators for each participant. All measurements were made using three methods: the manual method (manual measurement), the 2D method (photography), and the 3D method (facial scanner). All clinical and lighting conditions, as well as the specific parameters of each method, were standardized and controlled. The facial interlandmark distances were made by using a digital caliper, a 2D software program (Adobe Photoshop, version 21.0.2), and a 3D software program (Meshlab, version 2020.12), respectively. The data were analyzed by SPSS statistical software. The Kolmogorov-Smirnov test revealed that trueness and precision values were normally distributed (p > 0.05), so a Student's t-test was employed. (3) Results: Statistically significant differences (p ≤ 0.01) were observed in all interlandmark measurements in the 2D group (photography) to compare with the manual group. The 2D method obtained a mean accuracy value of 2.09 (±3.38) and 2.494 (±3.67) in maximum intercuspation and smile, respectively. On the other hand, the 3D method (facial scanner) obtained a mean accuracy value of 0.61 (±1.65) and 0.28 (±2.03) in maximum intercuspation and smile, respectively. There were no statistically significant differences with the manual method. (4) Conclusions: The employed technique demonstrated that it influences the accuracy of facial records. The 3D method reported acceptable accuracy values, while the 2D method showed discrepancies over the clinically acceptable limits.

Positional Features of the Mandibular Condyle in Patients with Facial Asymmetry

OBJECTIVE

To describe the position of the mandibular condyle, the size of the joint spaces and the condylar angulation in patients with facial asymmetry (FA), and to classify these results according to the type of FA and compare them with a reference group without FA. Materials and Methods/Patients: An observational, cross-sectional, descriptive study using computed tomography (CT) was conducted on a sample of 133 patients with a clinical diagnosis of FA derived from the following entities: hemimandibular elongation (HE) (n = 61), hemimandibular hyperplasia (HH) (n = 11), condylar hyperplasia in its hybrid form (HF) (n = 19), asymmetric mandibular prognathism (AMP) (n = 25), glenoid fossa asymmetry (GFA) (n = 9) and functional laterognathism (FL) (n = 8). Likewise, a group of 20 patients without clinical or tomographic characteristics of FA was taken and their complete cone beam tomography (CBCT) scans were analyzed. The quantified variables were joint spaces (anterior, middle and posterior), angle of the condylar axis and condylar position. All measurements were performed using the free, open-source Horos software.

RESULTS

Most of the subjects without FA had a right middle condylar position (55%), while in the patients with FA the anterior condylar position predominated. On the left side, the most frequent condylar position was anterior, including the group without FA, except in the HH group. Considering the measurements of the anterior, middle and posterior joint space (mm) on the right side (anterior JS: 1.9 mm, middle JS: 2 mm and posterior JS: 2.8 mm) and on the left side (anterior JS: 2.7 mm, middle JS: 2.1 mm and posterior JS: 2.6 mm) of the subjects without FA, compared to those with FA, the latter presented smaller distances in all diagnoses and only for the right posterior JS (1.9 mm) in HH, was not significant. The condylar axis of the AF group showed significant differences with smaller angles for the left side in those diagnosed with HE (65.4°) and HH (56.5°) compared to those without AF (70.4°).

CONCLUSIONS

The condylar position of patients with FA tends to be anterior, both on the right and left sides, while for cases without FA it is middle and anterior, respectively. Patients with FA have smaller joint spaces (mm) compared to patients without FA, with the exception of HH for the right posterior JS.

Evaluation of the accuracy of digital and conventional implant-level impression techniques for maxillofacial prosthesis

Objectives

This study aims to evaluate the accuracy of digital impression making based on trueness and precision measurements of dental implants placed in maxillofacial lesions to produce Maxillofacial prosthesis substructures.

Methods

Two intra-oral scanners (Trios 3 and CS 3700) and one Desktop scanner (open technology) were examined in this study. A Model of a patient with a lesion in the ear region was created as a reference. The reference model was scanned by each scanner 10 times. Standard Tessellation Language files were provided from each scanner and were examined in terms of Trueness and Precision aspects.

Results

In Distance 1, in the one-way analysis of variance test, there was a significant difference between the three scanners. The Trios group has less deviation than the Open Technology group (P = 0.015) compared with the CareStream (CS) group that showed more deviation (P < 0.000). There is a statistically significant difference in distance 2 among scanners. The Trios group showed more deviation as compared with the Open Technology group (P < 0.000). While this deviation is not statistically significant compared with the CS group (P = 0.0907). Open Technology Group compared with the CS group also has less deviation in distance 2, which has been statistically significant (P < 0.000). The preparation of a precise model of maxillofacial lesions is still difficult for some Intraoral scanners.

Conclusion

There were significant statistical differences in Trueness and Precision among scanners. Used scanners can be applied as an alternative to conventional impression methods.

Investigating the Effectiveness of Low-Level Laser in Reducing Root Resorption of the Upper Incisors During Intrusion Movement Using Mini-Implants in Adult Patients With Deep Overbite: A Randomized Controlled Clinical Trial

BACKGROUND

Deep bite is a common characteristic of malocclusion, and many methods are used to treat it, including mini-implants used for the intrusion of the upper incisors. Orthodontically induced inflammatory root resorption (OIIRR) is an inevitable and unexpected side effect of orthodontic therapy. However, resorption of the root could be affected by the type of tooth movement, such as intrusion. Several studies have indicated the effectiveness of low-level laser therapy (LLLT) in accelerating orthodontic movement, but studies that have evaluated the role of this laser in reducing the risk of OIIRR have been limited. This trial aimed to investigate the effectiveness of LLLT in reducing the resorption of the roots of the upper incisors during their intrusion in the context of deep bite correction.

MATERIALS AND METHODS

Thirty patients (13 males, 17 females; mean age 22.4±3.37 years) with deep overbite were recruited and allocated to the laser or the control groups. Mini-implants were inserted between the roots of the upper central incisors and the lateral incisors from the labial aspect at the gingival-mucosal junction on both sides with a force of 40 g on each side through an NiTi coil spring. A low-level laser (Ga-Al-As) with 808 nm wavelength in a continuous mode, with the parameters 250 milliwatt power output, 4 Joules/point energy density, and 16 seconds irradiation per point, was applied to the root of each of the upper incisors. The laser was applied on the first day of the upper incisor intrusion (T1), then on days 3, 7, and 14 of the first month. In the second month, the laser was applied every 15 days, adjusting the spring strength every four weeks until the end of the intrusion stage (T2), which was determined by reaching a normal overbite. As for patients in the control group, the strength of the nickel-titanium springs was adjusted every four weeks to the required strength of 40 g on each end until reaching a normal overbite.

RESULTS

There was a volumetric decrease in both groups' upper central and lateral incisors roots, and this decrease was statistically significant (P<0.001). However, the difference between the two groups was not statistically significant in each central and lateral incisor volume root (P=0.345 and 0.263 for U1 and U2, respectively). Also, both groups had a linear decrease in upper central and lateral incisors roots, which was statistically significant (P<0.001). At the same time, the difference between the two groups was not statistically significant in each central and lateral incisor root length (P=0.343 and 0.461 for U1 and U2, respectively).

CONCLUSION

The low-level laser irradiation using the current protocol did not significantly affect the amount of root resorption induced by incisor intrusion in the experimental group compared to the control group.

Efficient Storage and Encryption of 32-Slice CT Scan Images Using Phase Grating

Medical images are treated as sensitive as it carries patients' confidential information and hence must be protected from unauthorized access. So, a strong encryption mechanism is a primary criterion to transmit these images over the internet to protect them from intruders. In many existing algorithms, noise affection in the extracted images is high, hence not suitable for medical data encryption. Here, we present a new method using phase grating to multiplex as well as encrypting 32 cross-sectional CT scan images (slices) in a single canvas for optimization of storage space and improvement of security. The entire process is divided into a few steps. Before transmission, the main canvas is encrypted with the help of a random phase matrix. The main canvas is further encrypted by the transposition method to enhance security. After decryption, inverse Fourier transform is applied at the proper location of the decrypted canvas to extract the images from the spectra. Quality is measured with peak-signal-to-noise ratio and correlation coefficient methods. Here, it is greater than 38 and the correlation coefficient is close to 1 for all images, thereby indicating of good quality of extracted images. The effect of three common cyber-attacks (viz. known-plaintext attack, chosen-plaintext attack, and chosen-ciphertext attack) is also presented here. The correlation coefficient during cyber-attacks is found to be close to zero, which implies the robustness of the algorithm against cyber-attacks. Finally, a comparison with existing techniques shows the effectiveness of the proposed method.

Facial Scanners in Dentistry: An Overview

Purpose: This narrative review aims to explore the current status of facial scanning technology in the dental field; outlining the history, mechanisms, and current evidence regarding its use and limitations within digital dentistry. Methods: Subtopics within facial scanner technology in dentistry were identified and divided among four reviewers. Electronic searches of the Medline (PubMed) database were performed with the following search terms: facial scanner, dentistry, prosthodontics, virtual patient, sleep apnea, maxillofacial prosthetics, accuracy. For this review only studies or review papers evaluating facial scanning technology for dental or medical applications were included. A total of 44 articles were included. Due to the narrative nature of this review, no formal evidence-based quality assessment was performed and the search was limited to the English language. No further restrictions were applied. Results: The significance, applications, limitations, and future directions of facial scanning technology were reviewed. Specific subtopics include significant history of facial scanner use and development for dentistry, different types and mechanisms used in facial scanning technology, accuracy of scanning technology, use as a diagnostic tool, use in creating a virtual patient, virtual articulation, smile design, diagnosing and treating obstructive sleep apnea, limitations of scanning technology, and future directions with artificial intelligence. Conclusions: Despite limitations in scan quality and software operation, 3D facial scanners are rapid and non-invasive tools that can be utilized in multiple facets of dental care. Facial scanners can serve an invaluable role in the digital workflow by capturing facial records to facilitate interdisciplinary communication, virtual articulation, smile design, and obstructive sleep apnea diagnosis and treatment. Looking into the future, facial scanning technology has promising applications in the fields of craniofacial research, and prosthodontic diagnosis and treatment planning.

Dental Lesion Segmentation Using an Improved ICNet Network with Attention

Precise segmentation of tooth lesions is critical to creation of an intelligent tooth lesion detection system. As a solution to the problem that tooth lesions are similar to normal tooth tissues and difficult to segment, an improved segmentation method of the image cascade network (ICNet) network is proposed to segment various lesion types, such as calculus, gingivitis, and tartar. First, the ICNet network model is used to achieve real-time segmentation of lesions. Second, the Convolutional Block Attention Module (CBAM) is integrated into the ICNet network structure, and large-size convolutions in the spatial attention module are replaced with layered dilated convolutions to enhance the relevant features while suppressing useless features and solve the problem of inaccurate lesion segmentations. Finally, part of the convolution in the network model is replaced with an asymmetric convolution to reduce the calculations added by the attention module. Experimental results show that compared with Fully Convolutional Networks (FCN), U-Net, SegNet, and other segmentation algorithms, our method has a significant improvement in the segmentation effect, and the image processing frequency is higher, which satisfies the real-time requirements of tooth lesion segmentation accuracy.

Facial Scanning Accuracy with Stereophotogrammetry and Smartphone Technology in Children: A Systematic Review

The aim of the study was to systematically review and compare the accuracy of smartphone scanners versus stereophotogrammetry technology for facial digitization in children. A systematic literature search strategy of articles published from 1 January 2010 to 30 August 2022 was adopted through a combination of Mesh terms and free text words pooled through boolean operators on the following databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and OpenGrey. Twenty-three articles met the inclusion criteria. Stationary stereophotogrammetry devices showed a mean accuracy that ranged from 0.087 to 0.860 mm, portable stereophotogrammetry scanners from 0.150 to 0.849 mm, and smartphones from 0.460 to 1.400 mm. Regarding the risk of bias assessment, fourteen papers showed an overall low risk, three articles had unclear risk and four articles had high risk. Although smartphones showed less performance on deep and irregular surfaces, all the analyzed devices were sufficiently accurate for clinical application. Internal depth-sensing cameras or external infrared structured-light depth-sensing cameras plugged into smartphones/tablets increased the accuracy. These devices are portable and inexpensive but require greater operator experience and patient compliance for the incremented time of acquisition. Stationary stereophotogrammetry is the gold standard for greater accuracy and shorter acquisition time, avoiding motion artifacts.

Effect of cut-out rescan procedures on the accuracy of an intraoral scanner used for digitizing an ear model: An in vitro study

PURPOSE

The purpose of this study was to evaluate the impact of the rescanning of mesh holes of different diameters on the accuracy of an intraoral scanner (IOS) used to digitize an ear model.

MATERIALS AND METHODS

An ear model was digitized using an intraoral scanner (Medit i500) to obtain a reference mesh. A baseline experimental scan was created by editing a duplicate of the reference mesh using the cut-out tool of the IOS software. Three equal groups were created based on the diameter of the cut-out areas: 2-mm (G1), 5mm (G2), and 8-mm (G3) (n = 15). The cut-out areas were rescanned and a total of 45 digital files were exported. The discrepancy between the reference and the experimental digital scans was measured using the root mean square calculation (RMS). The data were analyzed by a Kruskal-Wallis test followed by a post hoc Dunn's test with Bonferroni correction.

RESULTS

The trueness values ranged from 19.53 to 27.13 μm. There were significant differences in the RMS error values among the groups tested (p<.001) and post hoc multiple comparisons showed significant differences between the G1 and G2 groups (p = .04), G1 and G3 groups (p<.001), and G2 and G3 groups (p = .004). Overall, the precision values ranged from 4.93 to 7.73 μm and significant differences in the RMS values were only found between the G1 and G2 groups (p = .014).

CONCLUSIONS

Mesh hole rescanning affected the scanning accuracy (trueness and precision) of the IOS tested. The larger the diameter of the mesh holes, the less the trueness of the IOS tested. The precision values seemed to be less affected compared with the trueness by the cut-out and rescanning procedures. This article is protected by copyright. All rights reserved.

The usefulness of vertebral needle targeting simulation training system using ray-summation imaging: experimental study

PURPOSE

Using the multi-detector computed tomography and related three-dimensional imaging technology, we developed a vertebral needle targeting simulation training system named spinal needling intervention practice using ray-summation imaging (SNIPURS). Herein, we assessed the utility of SNIPURS by evaluating changes in the learning curves of SNIPURS trainees.

METHODS

Twenty-one examinees were enrolled: seven experienced operators (expert group), seven trainees with coaching (coaching group), and seven trainees without coaching (non-coaching group). They performed six tests of vertebral needle targeting simulation on the workstation-generated spinal ray-summation images of six patients with vertebral fractures. In each test, they determined the bilateral trans-pedicular puncture points and angles on two thoracic and two lumbar vertebrae on ray-summation imaging (i.e., 8 simulations per test). The coaching group received coaching by a trainer after Tests 1 and 4, while the others did not. Scores were given based on the trans-pedicular pathway (1 point) or not (0 point). Eight virtual needles were evaluated in each of Tests 1-6.

RESULTS

Among the three groups, the expert group had the highest average scores on Tests 1-4 (expert: 3.86, 6.57, 7.43, and 7.57; coaching: 1.86, 6.14, 6, and 6.29; and non-coaching: 1.14, 4.14, 4.71, and 4.86). The coaching group's scores caught up with the expert groups' average scores on Tests 5 and 6, whereas those of the non-coaching group did not (expert and coaching: 7.86 and 8.00, non-coaching: 5.86 and 7.14). All examinees in the expert and coaching groups achieved a perfect score on the final Test 6, whereas three of the seven non-coaching trainees did not.

CONCLUSION

SNIPURS might be suitable for vertebral needle targeting training. The coaching provided during SNIPURS training helped the trainees to acquire the spinal puncture techniques in PVP.

Foot Orthosis and Sensorized House Slipper by 3D Printing

BACKGROUND

In clinical practice, specific customization is needed to address foot pathology, which must be disease and patient-specific. To date, the traditional methods for manufacturing custom functional Foot Orthoses (FO) are based on plaster casting and manual manufacturing, hence orthotic therapy depends entirely on the skills and expertise of individual practitioners. This makes the procedures difficult to standardize and replicate, as well as expensive, time-consuming and material-wasting, as well as difficult to standardize and replicate. 3D printing offers new perspectives in the development of patient-specific orthoses, as it permits addressing all the limitations of currently available technologies, but has been so far scarcely explored for the podiatric field, so many aspects remain unmet, especially for what regards customization, which requires the definition of a protocol that entails all stages from patient scanning to manufacturing.

METHODS

A feasibility study was carried out involving interdisciplinary cooperation between industrial engineers and podiatrists. To that end: (i) For patient-specific data acquisition, 3D scanning of the foot is compared to traditional casting. (ii) a modelling GD workflow is first created to design a process permitting easy creations of customized shapes, enabling the end user (the podiatrist) to interactively customize the orthoses. Then, (iii) a comparison is made between different printing materials, in order to reproduce the same mechanical behavior shown by standard orthoses. To do this, the mechanical properties of standard materials (Polycarbonate sheets), cut and hand-shaped, are compared with four groups of 3D printed samples: poly(ethylene glycol) (PETG), poly(acrylonitrile-butadiene.styrene) (ABS), polycarbonate (PC) and poly(lactic acid) (PLA) obtained by Fused Filament Fabrication (FFF).

RESULTS

Differences found between the foot plaster model obtained with the plaster slipper cast in a neutral position and the model of the real foot obtained with 3D scanning in the same position can be ascribed to the non-stationarity of the patient during the acquisition process, and were limited by a locking system with which no substantial differences in the almost entire sole of the foot scan were observed.

CONCLUSIONS

Using the designed GD workflow, podiatrists with limited CAD skills can easily design and interactively customize foot orthoses to adapt them to the patients' clinical needs. 3D printing enables the complex shape of the orthoses to be reproduced easily and quickly. Compared to Polycarbonate sheets (gold standard), all the printed materials were less deformable and reached lower yield stress for comparable deformation. No modifications in any of the materials as a result of printing process were observed.

Enhancing Anatomical Instruction: Impact of a Virtual Canine Anatomy Program on Student Outcomes

Innovative reforms in medical education will require instructional tools to support these changes and to give students more flexibility in where and how they learn. At Colorado State University, the software program Virtual Canine Anatomy (VCA) was developed to assist student learning both inside and outside the anatomical laboratory. The program includes interactive anatomical photographs of dissected canine cadavers, dissection instructions with accompanying videos and diagrams, radiographs, and three-dimensional models. There is a need to evaluate the effectiveness of instructional tools like VCA so that decisions on pedagogical delivery can be evidence-based. To measure the impact of VCA on student outcomes in a dissection laboratory, this study compared student attitudes, quiz scores, dissection quality and accuracy, and instructor reliance between students with and without access to VCA. Students with VCA needed less time with teaching assistants (P < 0.01), asked teaching assistants fewer questions (P = 0.04), felt that the dissection was easier (P = 0.02), and were in stronger agreement that they had access to adequate resources (P = 0.02). No differences were found in the dissection quality or accuracy, quiz scores, or attitudes regarding overall enjoyment of the activity between the two groups. This study shows that VCA increases student independence and can be used to enhance anatomical instruction.

Application of Three-Dimensional Digital Technology in Orthodontics: The State of the Art

Three-dimensional technologies are one of the most recent and relevant advancements in the field of Dentistry. These systems, including intraoral scans, 3D imaging exams (CAT scan, CBCT and MRI), CAD/CAM 3D printing devices and 3D computer software, have enabled clinicians to greatly improve patient care along with reducing treatment planning time. The present descriptive study aims to explore possible applications of 3D technologies during the diagnosis, treatment plan, case monitoring and result assessment in orthodontics. The overall upgrade provided by these technologies can improve the clinicians’ workflow and effectiveness by simplifying conventional techniques considered to be especially arduous.

Craniofacial Phenomics: Three-Dimensional Assessment of the Size and Shape of Cranial and Dentofacial Structures

Craniofacial phenomics has opened up numerous opportunities to correlate genetic and epigenetic factors to craniofacial phenotypes in order to improve our understanding of growth and development in health and disease. Three-dimensional (3D) imaging has played a key role in advancing craniofacial phenomics by facilitating highly sensitive and specific characterizations of craniofacial and dental morphology. Here we describe the use of micro-computed tomography (micro-CT) to image the murine craniofacial complex, followed by surface reconstruction for traditional morphometric analyses. We also describe the application of geometric morphometrics, based on Generalized Procrustes Analysis, for use in human premolars. These principles are interchangeable between various vertebrate species, and between various surface imaging techniques (including micro-CT and 3D surface scanners), offering a high level of versatility and precision for extensive phenotyping of the entire craniofacial complex.

Current and Future Photography Techniques in Aesthetic Surgery

Background

The rapidly increasing modalities and mediums of clinical photography, use of 3-dimensional (3D) and 4-dimensional (4D) patient modeling, and widening implementation of cloud-based storage and artificial intelligence (AI) call for an overview of various methods currently in use as well as future considerations in the field.

Objectives

Through a close look at the methods used in aesthetic surgery photography, clinicians will be able to select the modality best suited to their practice and goals.

Methods

Review and discussion of current data pertaining to: 2-dimensional (2D) and 3D clinical photography, current photography software, augmented reality reconstruction, AI photography, and cloud-based storage.

Results

Important considerations for current image capture include a device with a gridded viewing screen and high megapixel resolution, a tripod with leveling base, studio lighting with dual-sourced light, standardized matte finish background, and consistency in patient orientation. Currently, 3D and 4D photography devices offer advantages such as improved communication to the patient on outcome expectation and better quality of patient service and safety. AI may contribute to post-capture processing and 3D printing of postoperative outcomes. Current smartphones distort patient perceptions about their appearance and should be used cautiously in an aesthetic surgery setting. Cloud-based storage provides flexibility, cost, and ease of service while remaining vulnerable to data breaches.

Conclusions

While there are advancements to be made in the physical equipment and preparation for the photograph, the future of clinical photography will be heavily influenced by innovations in software and 3D and 4D modeling of outcomes.

Accuracy of 3-dimensional stereophotogrammetry: Comparison of the 3dMD and Bellus3D facial scanning systems with one another and with direct anthropometry

INTRODUCTION

The objective of this study was to compare the accuracy of 3-dimensional (3D) digital facial photographs taken by the Bellus3D Face Camera Pro (Bellus3D) (Bellus3D Inc, Los Gatos, Calif) and the 3dMDface system (3dMD) (3dMD Inc, Atlanta, Ga) with one another and with direct anthropometry (DA).

METHODS

A mannequin head was selected as the research object. Twenty facial landmarks were labeled on the basis of the 8 interlandmark distances and 5 angles that were defined. A 150-mm digital Vernier caliper (Mitutoyo Inc, Tokyo, Japan) with an accuracy of 0.02 mm was applied to directly measure the interlandmark distances, and the angles were calculated according to the law of cosines. All the measurements were conducted 3 times by each operator under identical conditions. Then, each scanner was used to acquire 3D photographs 5 times, generating 10 digital stereophotographs. Linear distances and angles were measured on the 3D facial photographs reconstructed with open-source MeshLab software (ISTI [Italian National Research Council], Rome, Italy). Each linear distance and angle were measured 3 times by 1 operator, and 3 examiners conducted the measurements independently. To obtain the trueness, equivalence tests were applied to compare the measurements of the 2 scanners and DA. In addition, the average absolute deviations were calculated to directly compare the trueness of 3 methods (Bellus3D vs 3dMD vs DA). Finally, the intraclass correlation coefficient was used to assess the interobserver agreement and the precision of 2 scanners.

RESULTS

As for the trueness, 7 out of 8 of the linear distance measurements (N-Pn, Sn-Pog, ORE-IRE, OLE-ILE, RLC-RMC, LLC-LMC, and CR-CL) and 3 out of 5 of the angular measurements (MLA, NFA, and INI) obtained by 3dMD were equivalent to those obtained by DA. Five out of 8 measurements (N-Pn, Sn-Pog, RLC-RMC, LLC-LMC, and CR-CL) and 1 out of 5 of the angular measurements (MLA) obtained by Bellus3D were equivalent to the measurements obtained with DA. All but 3 of the measurements (ORE-IRE, NFA, and INI) obtained with Bellus3D were equivalent to 3dMD. The mean absolute difference between 3dMD and DA was 0.36 ± 0.20 mm and 0.45° ± 0.56°; the deviation between Bellus3D and DA was 0.61 ± 0.47 mm and 0.99° ± 0.61°; and the deviation between Bellus3D and 3dMD was 0.38 ± 0.37 mm and 0.62° ± 0.39°. Regarding the precision of the 2 scanners, the intraclass correlation coefficient value of 3dMD was approximately 1.00, and that of Bellus3D was 0.99. The interobserver agreement for each linear and angular measurement was 0.99.

CONCLUSIONS

The trueness of each scanner was clinically acceptable for diagnosis and treatment planning. The precision of 3D photographs obtained by 3dMD and Bellus3D showed good scanning repeatability. The interobserver agreement between the 3 operators was rated as excellent (0.99).

Automated chart filing on panoramic radiographs using deep learning

OBJECTIVE

The aim of this study is to automatically detect, segment and label teeth, crowns, fillings, root canal fillings, implants and root remnants on panoramic radiographs (PR(s)).

MATERIAL AND METHODS

As a reference, 2000 PR(s) were manually annotated and labeled. A deep-learning approach based on mask R-CNN with Resnet-50 in combination with a rule-based heuristic algorithm and a combinatorial search algorithm was trained and validated on 1800 PR(s). Subsquently, the trained algorithm was applied onto a test set consisting of 200 PR(s). F1 scores, as a measure of accuracy, were calculated to quantify the degree of similarity between the annotated ground-truth and the model predictions. The F1-score considers the harmonic mean of precison (positive predictive value) and recall (specificity).

RESULTS

The proposes method achieved F1 scores up to 0.993, 0.952 and 0.97 for detection, segmentation and labeling, respectivley.

CONCLUSION

The proposed method forms a promising foundation for the further development of automatic chart filing on PR(s).

CLINICAL SIGNIFICANCE

Deep learning may assist clinicians in summarizing the radiological findings on panoramic radiographs. The impact of using such models in clinical practice should be explored.

Failure rates associated with guided versus non-guided dental implant placement: a systematic review and meta-analysis

Objective

The purpose of the systematic review and meta-analysis was to evaluate implant failure rates and their association with guided and free-hand implant placement techniques.

Materials and methods

A literature search was conducted across PubMed, Medline via Ovid, Cochrane database, and Google Scholar. The search was completed in September 2020. Series of meta-analyses were conducted to compare implant failure rates with guided and free-hand techniques.

Results

A total of 3387 articles were identified from the electronic search. After applying the inclusion criteria, eight articles were selected for qualitative assessment and four for quantitative synthesis (meta-analysis). The included studies had a risk ratio of 0.29 (95% CI: 0.15, 0.58), P < 0.001 for the use of guided implant placement. Implant failure rates were affected by the different placement techniques indicated by the test for overall effect (Z = 3.53, P = 0.0004). The incidence of implant failure in guided surgery versus free-hand surgery was found to be 2.25% and 6.42%, respectively.

Conclusion

Both guided and free-hand implant placement techniques resulted in a high implant survival rate. However, implant failure rates were almost three times higher in the free-hand implant placement category. A guided implant placement approach is recommended for a successful outcome.

[Validation of the digital integration technology for evaluating the nasolabial morphology variation after the cross-arch fixed restoration of maxillary implant-supported prostheses]

OBJECTIVE

To explore the applicability of integration between three-dimensional (3D) facial and dental data to evaluate the nasolabial morphology variation before and after the cross-arch fixed restoration of the maxillary implant-supported prostheses.

METHODS

Twelve patients (4 women and 8 men), mean age (54.82±5.50) years (from 45 to 62 years) referred to the Department of Oral Implan-tology, Peking University School and Hospital of Stomatology, were selected and diagnosed with edentulous maxilla. For all the patients, 4 to 6 implants were inserted into the maxilla. Six months later, the final cross-arch fixed prostheses were delivered. The 3D facial images were collected before and after the final restoration. The 3D data of prostheses were also captured. All the 3D data were registered and measured in the same coordinate system. Then the displacement of all the landmarks [cheilion left (CHL), cheilion right (CHR), crista philtri left (CPHL), crista philtri right (CPHR), labrale supe-rius (LS), subnasale (SN), stomion (STO), upper incisor (UI), upper flange border of the prostheses (F-point, F)], and the variation of the distances between these landmarks (SN-LS, CPHR-CPHL, CHR-CHL, LS-STO) were analyzed and compared.

RESULTS

The consistency test among three measurements of the length of F-SN indicated that the integration method of the dental prostheses and soft tissue had the good repetitiveness, ICC=0.983 (95%CI: 0.957-0.995). After wearing the final cross-arch maxillary implant-supported prostheses, all the landmarks on the soft tissue moved forward. The nasal base area changed minimally, and the shift of SN in the sagittal direction was only (0.61±0.44) mm. But the sagittal shift of LS was (3.12±1.38) mm. In the vertical direction, SN, LS, CPHL, and CPHR moved upward. But STO, CHL, and CHR moved downward a little. Except for the slight decrease of the length of philtrum (SN-LS), the length of CHL-CHR, CPHL-CPHR, and the height of upper lip were increased together (P < 0.01). In the direction of Z axis, the strong correlations were found not only between the movements of SN and F (r=0.904 3) but also between the movements of LS and UI (r=0.958 4).

CONCLUSION

The integration method of 3D facial and dental data showed good repetitiveness. And the strong correlations between the landmarks of prostheses and nasolabial soft tissue in the sagittal direction were found by this new method.

[Validation of the digital integration technology for evaluating the nasolabial morphology variation after the cross-arch fixed restoration of maxillary implant-supported prostheses]

OBJECTIVE

To explore the applicability of integration between three-dimensional (3D) facial and dental data to evaluate the nasolabial morphology variation before and after the cross-arch fixed restoration of the maxillary implant-supported prostheses.

METHODS

Twelve patients (4 women and 8 men), mean age (54.82±5.50) years (from 45 to 62 years) referred to the Department of Oral Implan-tology, Peking University School and Hospital of Stomatology, were selected and diagnosed with edentulous maxilla. For all the patients, 4 to 6 implants were inserted into the maxilla. Six months later, the final cross-arch fixed prostheses were delivered. The 3D facial images were collected before and after the final restoration. The 3D data of prostheses were also captured. All the 3D data were registered and measured in the same coordinate system. Then the displacement of all the landmarks [cheilion left (CHL), cheilion right (CHR), crista philtri left (CPHL), crista philtri right (CPHR), labrale supe-rius (LS), subnasale (SN), stomion (STO), upper incisor (UI), upper flange border of the prostheses (F-point, F)], and the variation of the distances between these landmarks (SN-LS, CPHR-CPHL, CHR-CHL, LS-STO) were analyzed and compared.

RESULTS

The consistency test among three measurements of the length of F-SN indicated that the integration method of the dental prostheses and soft tissue had the good repetitiveness, ICC=0.983 (95%CI: 0.957-0.995). After wearing the final cross-arch maxillary implant-supported prostheses, all the landmarks on the soft tissue moved forward. The nasal base area changed minimally, and the shift of SN in the sagittal direction was only (0.61±0.44) mm. But the sagittal shift of LS was (3.12±1.38) mm. In the vertical direction, SN, LS, CPHL, and CPHR moved upward. But STO, CHL, and CHR moved downward a little. Except for the slight decrease of the length of philtrum (SN-LS), the length of CHL-CHR, CPHL-CPHR, and the height of upper lip were increased together (P < 0.01). In the direction of Z axis, the strong correlations were found not only between the movements of SN and F (r=0.904 3) but also between the movements of LS and UI (r=0.958 4).

CONCLUSION

The integration method of 3D facial and dental data showed good repetitiveness. And the strong correlations between the landmarks of prostheses and nasolabial soft tissue in the sagittal direction were found by this new method.

Application of macro photography in dental materials science

OBJECTIVES

The goal of this study was to show the potential of the inexpensive macro photography technique for application in various fields of contemporary dental materials science. The method was used for studying surface characteristics for fractographic evaluation, topography analysis, and for the measurement of optical properties such as translucency and opalescence.

MATERIALS AND METHODS

The variable test setup consisted of a digital camera with macro or microscopic objectives (combined with a lens tube and an objective adapter). The distance between object surface and objectives was controlled by an automatic stacking unit with a software-controlled mobile object slide. The exposure was carried out by LED light sources and a standard illuminant (D55).

RESULTS

Highly resolved pictures with fine details, high focal depth, flexible imaging by adjusting the illuminates in different angles, and the possibility of 3D topography imaging are the main reasons why macro photography proved to be a suitable imaging method for fractographic analyses. The automatic focal stacking technique was a powerful tool for imaging distinct topographies in high-resolution with nearly unlimited focal depth and 3D surface visualisation. Translucency as well as opalescence, measured with the macro photography produced differed from the measurements performed with a conventional spectrophotometer.

CONCLUSIONS

The modular structure of the cost-effective macro photography setup enables diverse applications such as identification of material groups, fractography analysis, and 3D surface visualisation. Quantification of colour, translucency, as well as opalescence under condition of the microscopic scale requires further research.

Accuracy and Reliability of Soft Tissue Landmarks Using Three-Dimensional Imaging in Comparison With Two-Dimensional Cephalometrics: A Systematic Review

Background:

Concerns about the accuracy and reliability of soft tissue landmarks using two-dimensional (2D) and three-dimensional (3D) imaging.

Objective:

The aim of the systematic review is to estimate accuracy and reliability of soft tissue landmarks with 2D imaging and 3D imaging for orthodontic diagnosis planning and treatment planning purposes.

Data Sources:

Electronic database search was performed in MEDLINE via PubMed, Embase via embase.com, and the Cochrane library website.

Selection Criteria:

The data were extracted according to two protocols based on Centre for Evidence-Based Medicine (CEBM) critical appraisal tools. Next, levels of evidence were categorized into three groups: low, medium, and high.

Data Synthesis:

Fifty-five publications were found through database search strategies. A total of nine publications were included in this review.

Conclusion

According to the available literature, 3D imaging modalities were more accurate and reliable as compared to 2D modalities. Cone beam computed tomography (CBCT) was considered the most reliable imaging tool for soft tissues.

Comparison of three-dimensional soft-tissue evaluations between skeletal and pseudo-class III malocclusions

The aim of our study was to compare soft tissue measurements with 3D imaging methods in individuals with untreated skeletal and pseudo-Class III malocclusions. The study sample consisted of 75 patients (38 males, 37 females, mean age 12.41 ± 2.35 years) with pseudo- and true skeletal Class III malocclusions and skeletal Class I malocclusions. Soft tissue evaluations of all patients were performed using 3D stereophotogrammetric facial images. In our study, 26 landmarks, 17 linear measurements, 13 angular measurements, and 5 volume measurements were made using the 3dMD Vultus software. The significance was determined to be p < 0.05 in ANOVA, Tukey tests. No significant differences were found among the groups in terms of demographic data (p > 0.05). The skeletal Class I control group had a significantly more extended upper lip and vermillion length as compared to the Class III groups. The soft tissue convexity angle and upper nasal angle were found to be wider in the Class III malocclusion group compared to those in the Class I control group. While the pseudo-Class III group had a significantly lower midface volume, chin volume was significantly higher in the skeletal class group. Upper lip volume was significantly higher in the Class I group. Using 3dMD for guiding clinicians in the differential soft and hard tissue diagnosis of pseudo-Class III malocclusions, differences were revealed in Class I patients in the middle part of the face. In the differential diagnosis of true Class III malocclusions, chin volume was found to be different from that of Class I patients.

Three dimensional (3D) imaging techniques in orthodontics-An update

3D imaging is a technique which develops or creates the impression of depth within an image by deploying 2D data into 3-dimensional format. To aid in quality regulating processes for industrial purposes, 3D imaging has become an extremely valuable factor. Owing to their various drawbacks, a wide range of investigative methods formulated for demonstration of facial structures and the dentition were dilapidated. Currently in medicine, the most prevalent method is perhaps 3D imaging technique renders thorough and problem specific information regarding hard and the soft tissues, such as Computerized Tomography (CT), Cone Beam Computerized Tomography (CBCT), Micro Computerized Tomography (MCT), 3D laser scanning, structured light technique, stereophotogrammetry or 3D surface imaging systems (3dMD), 3D facial morphometry (3DFM), Tuned Aperture Computed Tomography (TACT), and Magnetic Resonance Imaging (MRI). 3D imaging techniques in orthodontics plays an important role by facilitating more elaborated diagnostic information on the precise cases like patients having craniofacial anomalies. Hence, the aim of this study was to review advances in 3D imaging with in the field of orthodontics.

Design and Development of a Novel Oral Care Simulator for the Training of Nurses

OBJECTIVE

A Novel Oral Care Simulator was designed and developed to measure and visualise the facial and lingual forces exerted on teeth by the action of tooth brushing, considering the irregular geometry and structural composition of human dentition and the emulation of the realistic biomechanical deflection of the teeth.

METHOD

FEA simulations were carried out on a central incisor under facial loading and an appropriate force sensing mechanism was designed. An anatomically accurate mandibular jaw and 16 teeth were 3D printed, on which 16 force sensing structures were embedded. The signals from the sensors were amplified using a multichannel signal amplifier built using instrumentation amplifiers which were then visualised through a GUI.

RESULTS

The developed simulator is capable of indicating the magnitude of a force upto 15 N exerted on to the facial and lingual surfaces of teeth at a frequency of 60 Hz and above and it is capable of alerting the user if the force exceeds a pre-specified threshold.

CONCLUSION

The designed force sensing mechanism considers the irregular geometry and structural composition of human dentition in measuring the facial and lingual forces. It provides a reliable feedback by indicating the force and emulating the realistic biomechanical deflection of teeth.

SIGNIFICANCE

Nurses who care for the disabled, elderly and sick have explicitly stated the requirement for a simulator to train themselves on brushing the teeth of their subjects as their incorrect technique can cause longterm dental damage, for which a device has not been developed to date.

Approach to Analysis the Surface Geometry Change in Cultural Heritage Objects

The three-dimensional digitization of the cultural heritage objects during different stages of the conservation process is an important tool for objective documentation. Further data analysis is also important to monitor, estimate and understand any possible change as accurately as possible. In this work, the cultural heritage (CH) objects were selected for 3D scanning, analysis and visualisation of the change or degradation on their surface over time. The main goal of this work is to develop analysis, and visualization methods for CH object to assess local change in their surface geometry to support conservation processes documentation. The analysis was based on geometrical analysis of change in global distance between before and after chemical cleaning for a chosen object. The new local neighborhood distance histogram has been proposed as a local measure of surface change based on optimized k-neighborhood search algorithm to assess the local geometry change of a focus point.

Perspective Morphometric Criteria for Facial Beauty and Proportion Assessment

Common sense usually considers the assessment of female human attractiveness to be subjective. Nevertheless, in the past decades, several studies and experiments showed that an objective component in beauty assessment exists and can be strictly related, even if it does not match, with proportions of features. Proportions can be studied through analysis of the face, which relies on landmarks, i.e., specific points on the facial surface, which are shared by everyone, and measurements between them. In this work, several measures have been gathered from studies in the literature considering datasets of beautiful women to build a set of measures that can be defined as suggestive of female attractiveness. The resulting set consists of 29 measures applied to a public dataset, the Bosphorus database, whose faces have been both analyzed by the developed methodology based on the expanded set of measures and judged by human observers. Results show that the set of chosen measures is significant in terms of attractiveness evaluation, confirming the key role of proportions in beauty assessment; furthermore, the sorting of identified measures has been performed to identify the most significant canons involved in the evaluation.

Spatial analysis of mandibular condyles in patients with temporomandibular disorders and normal controls using cone beam computed tomography

OBJECTIVES

The aim of the study is to investigate the condylar position and its relation to articular eminence and axial condylar angle in temporomandibular joint disorder (TMD) patients and in normal controls using cone beam computed tomography (CBCT).

MATERIALS AND METHODS

CBCT temporomandibular joint (TMJ) images of 70 participants (38 males and 32 females, mean age 26.4 years) were analyzed. They were divided into control group (including 35 subjects) and study group (including 35 subjects). Linear measurements of joint space and condyle determined the condylar position of each TMJ. Articular eminence height and inclination were also measured with axial condylar angle to determine its relation to condylar position. Independent and paired sample t-test was applied to compare between the groups and TMJ sides of the same group at significance level of 0.05.

RESULTS

Statistical significant differences were found between males and females of both groups regarding superior joint space (SJS), lateral joint space, A-P, and M-L condyle distance (P < 0.05). SJS, medial joint space (MJS), and eminence angle were greater (P < 0.01) in male's joints with TMD with flatter axial condylar angle (P < 0.05), when compared with normal TMJ counterpart. Females TMJs showed significantly higher values of MJS of affected side when compared with normal counterpart with flatter axial condylar angle (P < 0.05).

CONCLUSION

Superior and MJS parameters were the ones that showed significant differences between affected and nonaffected joints. The mean axial condylar angle was smaller in joints with abnormal TMJ. This indicates that the condyles of the affected joints may rotate inward.

Three-dimensional photographic analysis of the face in European adults from southern Spain with normal occlusion: reference anthropometric measurements

Background

Recent non-invasive 3D photography method has been applied to facial analysis, offering numerous advantages in orthodontic. The purpose of this study was to analyze the faces of a sample of healthy European adults from southern Spain with normal occlusion in order to establish reference facial soft tissue anthropometric parameters in this specific geographic-ethnic population, as well as to analyze sexual dimorphism.

Methods

A sample of 100 healthy adult volunteers consisting of 50 women (mean age, 22.92 ± 1.56 years) and 50 men (mean age, 22.37 ± 2.12 years) were enrolled in this study. All participants had normal occlusion, skeletal Class I, mesofacial pattern, and healthy body mass index. Three-dimensional photographs of the faces were captured non-invasively using Planmeca ProMax 3D ProFace^®. Thirty landmarks related to the face, eyes, nose, and orolabial and chin areas were identified.

Results

Male displayed higher values in all vertical and transversal dimensions, with the exception of the lower lip height. Larger differences between sexes were observed in face, mandible, and nose. Male also had higher values in the angular measurements which referred to the nose. No sex differences were found in transverse upper lip prominence or transverse mandibular prominence. No differences were found in the ratio measurements, with the exception of intercantal width/nasal width, which was higher in women than in men.

Conclusions

Reference anthropometric measurements of facial soft tissues have been established in European adults from southern Spain with normal occlusion. Significant sexual dimorphism was found, with remarkable differences in size between sexes

Electronic supplementary material

The online version of this article (10.1186/s12903-019-0898-y) contains supplementary material, which is available to authorized users.

Predicting hepatocellular carcinoma recurrences: A data-driven multiclass classification method incorporating latent variables

Hepatocellular carcinoma (HCC), a malignant form of cancer, is frequently treated with surgical resections, which have relatively high recurrence rates. Effective recurrence predictions enable physicians' timely detections and adequate therapeutic measures that can greatly improve patient care and outcomes. Toward that end, predictions of early versus late HCC recurrences should be considered separately to reflect their distinct onset time horizons, clinical causes, underlying clinical etiology, and pathogenesis. We propose a novel Bayesian network-based method to predict different HCC recurrence outcomes by considering the respective recurrence evolution paths. Typical patient information obtained in early stages is insufficiently informative to predict recurrence outcomes accurately, due to the lack of subsequent patient progression information. Our method alleviates such information deficiency constraints by incorporating an independent latent variable, dominant recurrence type, to regulate recurrence outcome predictions (early, late, or no recurrence). We use a real-world HCC data set to evaluate the proposed method, relative to three prevalent benchmark techniques. Overall, the results show that our method consistently and significantly outperforms all the benchmark techniques in terms of accuracy, precision, recall, and F-measures. For increased robustness, we use another data set to perform an out-of-sample evaluation and obtain similar results. This study thus contributes to HCC recurrence research and offers several implications for clinical practice.

Digital Workflow of Auricular Rehabilitation: A Technical Report Using an Intraoral Scanner

Prosthodontic rehabilitation of a congenital or acquired defect of the ear is considered a challenging and skill-dependent procedure. This technical report describes a novel approach for direct digital scanning of the unaffected contralateral ear using an intraoral scanner and external markers. The obtained digital data of the ear was exported, digitally mirrored, and successfully positioned to a virtual model of a human head with a missing ear. This technique demonstrates the potential application of CAD/CAM in the design and fabrication of an auricular prosthesis for patients with a unilateral ear defect.

Usefulness of measuring bone density of mandibular condyle in patients at risk of osteoporosis: A cone beam computed tomography study

Objective:

Using cone beam computed tomography (CBCT) images, the aim of the study was to evaluate the usefulness of measuring bone density of mandibular condyle (BDMC) in patients at risk of osteoporosis.

Materials and Methods:

Two hundred and four mandibular condyles (46 condyles from males and 158 condyles from females) were examined by CBCT. Using inVivo software (Anatomage, San Jose, Calif), BDMC and mental index (MI) were measured by two observers and correlated using Pearson's correlation coefficients. Patients were divided into high risk and low risk of osteoporosis using 3.1 mm of MI as a cutoff value, and the mean value of BDMC was compared and correlated using independent samples t-test and regression analysis. Receiver-operating characteristic (ROC) curve analyses were also used to examine the predictive power of BDMC.

Results:

The mean value of BDMC was moderately correlated with MI (r = 0.38), and in female patients at low risk of osteoporosis, the mean value of BDMC was significantly higher than in patients at high risk of osteoporosis. In multivariate linear regression analysis, being at risk of osteoporosis is significantly affected by BDMC, age, and gender. ROC analysis showed that the mean value of BDMC had a moderate predictive power for predicting patients at risk of osteoporosis (area under the curve = 0.621 for females and 0.649 for males).

Conclusions:

Measuring BDMC is considered useful in predicting patients at risk of osteoporosis.

Assessment of the fit of removable partial denture fabricated by computer-aided designing/computer aided manufacturing technology

Objective:

To assess the level of evidence that supports the quality of fit for removable partial denture (RPD) fabricated by computer-aided designing/computer aided manufacturing (CAD/CAM) and rapid prototyping (RP) technology.

Methods:

An electronic search was performed in Google Scholar, PubMed, and Cochrane library search engines, using Boolean operators. All articles published in English and published in the period from 1950 until April 2017 were eligible to be included in this review. The total number of articles contained the search terms in any part of the article (including titles, abstracts, or article texts) were screened, which resulted in 214 articles. After exclusion of irrelevant and duplicated articles, 12 papers were included in this systematic review.

Results:

All the included studies were case reports, except one study, which was a case series that recruited 10 study participants. The visual and tactile examination in the cast or clinically in the patient’s mouth was the most-used method for assessment of the fit of RPDs. From all included studies, only one has assessed the internal fit between RPDs and oral tissues using silicone registration material. The vast majority of included studies found that the fit of RPDs ranged from satisfactory to excellent fit.

Conclusion:

Despite the lack of clinical trials that provide strong evidence, the available evidence supported the claim of good fit of RPDs fabricated by new technologies using CAD/CAM.

Evaluation of the 3dMDface system as a tool for soft tissue analysis

OBJECTIVES

To evaluate the accuracy of three-dimensional stereophotogrammetry by comparing values obtained from direct anthropometry and the 3dMDface system. To achieve a more comprehensive evaluation of the reliability of 3dMD, both linear and surface measurements were examined.

SETTING AND SAMPLE POPULATION

UCLA Section of Orthodontics. Mannequin head as model for anthropometric measurements.

MATERIAL AND METHODS

Image acquisition and analysis were carried out on a mannequin head using 16 anthropometric landmarks and 21 measured parameters for linear and surface distances. 3D images using 3dMDface system were made at 0, 1 and 24 hours; 1, 2, 3 and 4 weeks. Error magnitude statistics used include mean absolute difference, standard deviation of error, relative error magnitude and root mean square error. Intra-observer agreement for all measurements was attained.

RESULTS

Overall mean errors were lower than 1.00 mm for both linear and surface parameter measurements, except in 5 of the 21 measurements. The three longest parameter distances showed increased variation compared to shorter distances. No systematic errors were observed for all performed paired t tests (P<.05). Agreement values between two observers ranged from 0.91 to 0.99.

CONCLUSIONS

Measurements on a mannequin confirmed the accuracy of all landmarks and parameters analysed in this study using the 3dMDface system. Results indicated that 3dMDface system is an accurate tool for linear and surface measurements, with potentially broad-reaching applications in orthodontics, surgical treatment planning and treatment evaluation.