Artificial intelligence for treatment planning and soft tissue outcome prediction of orthognathic treatment: A systematic review.

BACKGROUND: The accuracy of artificial intelligence (AI) in treatment planning and outcome prediction in orthognathic treatment (OGT) has not been systematically reviewed. OBJECTIVES: To determine the accuracy of AI in treatment planning and soft tissue outcome prediction in OGT. DESIGN: Systematic review. DATA SOURCES: Unrestricted search of indexed databases and reference lists of included studies. DATA SELECTION: Clinical studies that addressed the focused question 'Is AI useful for treatment planning and soft tissue outcome prediction in OGT?' were included. DATA EXTRACTION: Study screening, selection and data extraction were performed independently by two authors. The risk of bias (RoB) was assessed using the Cochrane Collaboration's RoB and ROBINS-I tools for randomised and non-randomised clinical studies, respectively. DATA SYNTHESIS: Eight clinical studies (seven retrospective cohort studies and one randomised controlled study) were included. Four studies assessed the role of AI for treatment decision making; and four studies assessed the accuracy of AI in soft tissue outcome prediction after OGT. In four studies, the level of agreement between AI and non-AI decision making was found to be clinically acceptable (at least 90%). In four studies, it was shown that AI can be used for soft tissue outcome prediction after OGT; however, predictions were not clinically acceptable for the lip and chin areas. All studies had a low to moderate RoB. LIMITATIONS: Due to high methodological inconsistencies among the included studies, it was not possible to conduct a meta-analysis and reporting biases assessment. CONCLUSION: AI can be a useful aid to traditional treatment planning by facilitating clinical treatment decision making and providing a visualisation tool for soft tissue outcome prediction in OGT. REGISTRATION: PROSPERO CRD42022366864.

La pelvis: fractura conminuta en columna sacro-coccigea por herida con arma de fuego en una paciente embarazada es analizada / The pelvis: it fractures conminuta in column sacrococcigeal for wound with firearm in a pregnant patient it is analyzed

Paciente femenina de 37 años de edad, raza blanca de oficios del hogar, con 26 semanas de gestación, presenta posterior a herida por arma de fuego fractura Conminuta de columna sacrococcigea. Revisamos su historia clínica analizando el manejo jerárquico del tratamiento instituido por un equipo multidisciplinario. De esta manera destacamos las heridas por arma de fuego como causas de fractura de pelvis. Consideramos que las heridas por arma de fuego como causas de fractura pélvicas son poco frecuentes, dado a los pocos portes encontrados en la literatura y a que no tenemos registros de esya en nuestra estadística del hospital, sin embargo han venido aumentando progresivamente en nuestro medio.

Tratamiento conservador de la aplopejia hipofsiaria como una forma rara de resolver un macroadenoma hipofisiario: a propósito de un caso / Conservator treatment of the pituitary apoplexy as rare form to resolve pituitary macroadenoma: to purpose of a case

Damos a conocer el caso de un paciente de 36 años de edad quien presentaba Macroadenoma hipofisiario de 2,1 x 2,4 cms. El cual posterior a un evento hemorrágico, se manejó conservadoramente. Como una forma rara forma de resercar un adenoma hipofisiario. Revisamos el cuadro clínico de un paciente de 36 años de edad quien presentaba Loe hipofisiario y es ingresado de emergencia en nuestro centro, con pérdida súbita del estado de conciencia, cefalea, nauseas, vómitos, visión doble horizontal y altitudinal, visión borrosa. Se le realizó TAC de emergencia; RMN cerebral control 1 mes después