Restructuring a passive colloidal suspension using a rotationally driven particle.

The interaction between passive and active/driven particles has introduced a new way to control colloidal suspension properties from particle aggregation to crystallization. Here, we focus on the hydrodynamic interaction between a single rotational driven particle and a suspension of passive particles near the floor. Using experiments and Stokesian dynamics simulations that account for near-field lubrication, we demonstrate that the flow induced by the driven particle can induce long-ranged rearrangement in a passive suspension. We observe an accumulation of passive particles in front of the driven particle and a depletion of passive particles behind the driven particle. This restructuring generates a pattern that can span a range more than 10 times the driven particles radius. We further show that size scale of the pattern is only a function of the particles height above the floor.

Buccal bone defects and transversal tooth movement of mandibular lateral segments in patients after orthodontic treatment with and without piezocision: A case-control retrospective study.

INTRODUCTION: This study aimed to compare the extent of buccal bone defects (dehiscences and fenestrations) and transversal tooth movement of mandibular lateral segments in patients after orthodontic treatment with and without piezocision in cone-beam computed tomography and digital dental models. METHODS: The study sample of this study consisted of cone-beam computed tomography scans and digital dental models taken before (T0) and after (T1) orthodontic treatment of 36 patients with moderate mandibular anterior crowding. The experimental group consisted of 17 patients that had piezocision performed at the beginning of treatment with the goal of accelerating tooth movement, which was compared with 19 patients who did not receive piezocision. The measurement of bone defects, buccolingual inclination, and transversal distances of the tooth in the mandibular lateral segments (mandibular canines, premolars, and first molars) were evaluated at baseline and at the end of the orthodontic treatment. RESULTS: Overall, an increase in dehiscences, buccal inclination, and arch width from T0 to T1 was observed in both groups, but no statistically significant difference was found between groups. A significant increase in fenestrations from T0 to T1 was observed only for the canines in the experimental group. No statistically significant association was found between the increase of dehiscences and the amount of buccolingual inclination or transversal width changes. However, the changes in transversal width were statistically significantly associated with the increase in buccal inclination at the canines, first and second premolars. CONCLUSIONS: No significant differences were found in buccal dehiscences and transversal tooth movement (buccolingual inclination and arch width) of mandibular lateral segments between patients after orthodontic treatment with and without piezocision. Dehiscences, buccal inclination, and arch width significantly increased from T0 to T1 in both groups.

Comparison of linear and angular changes assessed in digital dental models and cone-beam computed tomography.

OBJECTIVE: To compare the three-dimensional (3D) linear displacements and the mesiodistal and buccolingual angulation changes after orthodontic treatment in digital dental models (DDMs) and 3D models derived from cone-beam computed tomography (CBCT). SETTINGS AND SAMPLE POPULATION: Digital dental model and CBCT scans were selected from 24 adults who had undergone orthodontic treatment for mandibular anterior crowding. MATERIAL AND METHODS: 3D linear displacements and changes in angular measurements (mesiodistal and buccolingual angulation) were assessed in pre- and post-treatment DDM and CBCT images using the software ITK-snap and 3D SlicerCMF. Intra- and inter-rater agreement of measurements in DDM and CBCT were tested using the intraclass correlation coefficient (ICC). DDM and CBCT measurements were compared using the Wilcoxon test (P < .05), ICC and Bland-Altman plots. RESULTS: Intra- and inter-rater agreement varied from good (ICC > 0.75) to excellent (ICC > 0.90) for both DDM and CBCT measurements. Although no significant difference between DDM and CBCT methods was observed for linear measurements of tooth movement, the angular assessments were different for most measurements. The agreement between measurements from both assessments varied from poor to excellent. CONCLUSIONS: Longitudinal assessments of tooth movements including 3D linear displacements and mesiodistal and buccolingual angulation are reproducible when using both DDM and CBCT. Changes in angular measurements due to orthodontic treatment are discordant when measured in the digital models (clinical crown) and in the CBCT images (whole tooth).

Pre-augmentation soft tissue expansion: an overview.

OBJECTIVES: The aim of this study was to explore the development of soft tissue expanders, their different types and their potential applications prior to bone augmentation and implant placement. MATERIAL AND METHODS: A review of pertinent literature was performed using PubMed to comprehend the dynamics of soft tissue expanders and determine the current position of their pre-augmentation applications. RESULTS: There is promising, albeit preliminary information regarding the benefits of pre-augmentation soft tissue expansion. Findings cannot be generalised due to relatively small sample size. CONCLUSIONS: Further clinical trials with larger sample sizes and long-term follow-up are needed before soft tissue expanders can be confidently applied in everyday clinical practice.

Preliminary insight into the periostin leverage during periodontal tissue healing.

BACKGROUND: Tissue repair and regeneration is assisted by the efficient coordination of cell and extracellular matrix interactions mediated by matricellular molecules such as periostin. Given its high expression around the teeth, the periodontal organ represents an ideal system to capture the protein dynamics during wound healing. METHODS: An observational prospective case-control study was designed to characterize periostin changes over time after periodontal surgery in tissue, oral fluids and serum by histological, protein and mRNA analyses. RESULTS: Histological analysis showed lower periostin with a diffuse local distribution pattern in disease patients. Levels of periostin in gingival crevicular fluid (GCF) increased over time for both groups, more noticeably in the periodontitis subjects. A transient and subtle change in circulating periostin levels was also noticed. The mRNA periostin levels contrasted with the protein levels and may indicate the underlying post-transcriptional regulatory process during chronic inflammation. Levels of known periodontal disease biomarkers such as IL-ß, IL1-α, TNF-α, MIP-1α and CRP served as tissue stability markers and complemented the clinical parameters recorded. CONCLUSION: The transient local increase in GCF periostin after eliminating the local etiology in periodontally affected sites suggests its importance in the maturation and stability of the connective tissue. The decreasing levels observed as the tissue healed highlight its spatial/temporal significance.

A randomized clinical trial evaluating the efficacy of the sandwich bone augmentation technique in increasing buccal bone thickness during implant placement. II. Tomographic, histologic, immunohistochemical, and RNA analyses.

OBJECTIVES: This study aimed to evaluate the biologic and structural phenotypes of the bone regenerated via the sandwich bone augmentation (SBA) technique, on buccal implant dehiscence defects. MATERIAL AND METHODS: Twenty-six patients with one buccal implant dehiscence defect each were randomly assigned to two groups. Both groups received a standardized amount of mineralized cancellous and cortical allogenic bone graft. In the test group, a bovine pericardium membrane was placed over the graft, while no membrane was placed in the control group. After 6 months of healing, a bone core biopsy of the regenerated bone was harvested and processed for histologic, immunohistochemical, mRNA, and micro-computed tomography (µCT) analyses. Of the 26 bone core biopsies, only six cores from the test group and six cores from the control group were suitable for the analysis. RESULTS: Bone volume (BV) in the test group was maintained, but tissue maturation appeared to be delayed. In contrast, tissue maturation appeared to be completed in the control group, but BV was compromised. Micro-CT analysis showed that specimens from the control group were more structured and mineralized compared with those from the test group. Histologic analysis showed more residual graft particles scattered in a loose fibrous connective tissue matrix with sparse bone formation in the test group, while the control group showed obvious vital bone formation surrounding the residual graft particles. Positive periostin (POSTN), sclerostin, and runt-related transcription factor-2 (RUNX2) immunoreactivities were detected in both the control and test groups. However, tartrate-resistant acid phosphatase (TRAP) positive was mostly noted in the control group. There were significant differences in POSTN, RUNX2 and VEGF expressions between the test and control groups. CONCLUSION: These findings indicated that the SBA technique was an effective method in preserving adequate structural volume while promoting new vital bone formation. Use of the collagen barrier membrane has successfully maintained the volumetric dimensions of the ridge but might have slowed down the complete maturation of the outermost layer of the grafted site.

Loss of DMP1 causes rickets and osteomalacia and identifies a role for osteocytes in mineral metabolism.

The osteocyte, a terminally differentiated cell comprising 90%-95% of all bone cells, may have multiple functions, including acting as a mechanosensor in bone (re)modeling. Dentin matrix protein 1 (encoded by DMP1) is highly expressed in osteocytes and, when deleted in mice, results in a hypomineralized bone phenotype. We investigated the potential for this gene not only to direct skeletal mineralization but also to regulate phosphate (P(i)) homeostasis. Both Dmp1-null mice and individuals with a newly identified disorder, autosomal recessive hypophosphatemic rickets, manifest rickets and osteomalacia with isolated renal phosphate-wasting associated with elevated fibroblast growth factor 23 (FGF23) levels and normocalciuria. Mutational analyses showed that autosomal recessive hypophosphatemic rickets family carried a mutation affecting the DMP1 start codon, and a second family carried a 7-bp deletion disrupting the highly conserved DMP1 C terminus. Mechanistic studies using Dmp1-null mice demonstrated that absence of DMP1 results in defective osteocyte maturation and increased FGF23 expression, leading to pathological changes in bone mineralization. Our findings suggest a bone-renal axis that is central to guiding proper mineral metabolism.

Visual labels to facilitate hygiene around implant-supported complete fixed dental prostheses.

This article reports a protocol for facilitating the oral hygiene and maintenance of supporting tissues in patients who wear implant-supported complete fixed dental prostheses. Small notches are placed on the acrylic resin below the prosthesis flange where the hygiene instrument should be inserted. These notches are filled with colored composite resin (blue) so that patients can see the sites of interest, which contributes to adequate plaque control and long-term periimplant health.

A robust finite-time model reference adaptive controller for arbitrary order disturbed LTI systems.

This manuscript deals with the trajectory-tracking problem for linear time-invariant systems with parameter uncertainties and time-dependent external perturbations. A robust finite-time model reference adaptive controller is proposed. In the absence of external perturbations, the proposed controller ensures finite-time convergence to zero of the tracking and parameter identification errors. In presence of time-dependent external perturbations, the tracking and parameter identification errors converge to a region around the origin in a finite time. The convergence proofs are developed based on Lyapunov and input-to-state stability theory. Finally, simulation results in an academic example and a flexible-joint robot manipulator show the feasibility of the proposed approach.

Changes in vascular access profile for pediatric hemodialysis patients over time: A registry-based study from Catalonia.

BACKGROUND: The criteria for vascular access (VA) selection in pediatric hemodialysis (HD) population has changed over time until the current patient-centered approach using the individualized Life-Plan. We analyzed the type of VA used by incident and prevalent end-stage kidney disease (ESKD) pediatric patients (pts) treated with HD in Catalonia. METHOD: Data from the Catalan Renal Registry of ESKD pts under 18 years of age undergoing kidney replacement therapy (KRT) were examined for a 22-year period (1997-2018). RESULTS: ESKD children starting KRT through HD decreased progressively from 55.6% (1997-2001) to 38.2% (2012-2018) and, conversely, there was an increase in pts starting KRT by preemptive kidney transplantation (KT) from 28.9% to 42.6% between the same periods (for both comparisons, p = 0.007). Most ESKD pts started HD by fistula (AVF) from 1997 to 2001 (56.5%) but this percentage decreased over time and no AVFs were used to start HD in children from 2012 to 2018. Likewise, the percentage of children starting HD by tunneled catheter increased progressively from 8.7% to 72.2% between the same periods (for both comparisons, p < 0.001). Regarding prevalent ESKD pts, children on HD decreased from 34.9% in 1997 to 4.7% in 2018 and, conversely, pts with a functioning kidney graft increased from 62.8% to 92.4% during the same periods (for both comparisons, p < 0.001). There was a progressive decrease in the percentage of children dialyzed by AVF from 100% in 1997 to 0% in 2018 (p < 0.001). The KT rate increased from 5.4 per million population (pmp) in 1997 to 17.1 pmp in 2018 (p = 0.007). The median time on HD prior to the first KT progressively decreased to 6.6 months (2014-2018). CONCLUSION: The high KT rate was a determining factor in choosing the VA type in the incident and prevalent pediatric population treated with HD in Catalonia.

A novel role of periostin in postnatal tooth formation and mineralization.

Periostin plays multiple functions during development. Our previous work showed a critical role of this disulfide-linked cell adhesion protein in maintenance of periodontium integrity in response to occlusal load. In this study, we attempted to address whether this mechanical response molecule played a direct role in postnatal tooth development. Our key findings are 1) periostin is expressed in preodontoblasts, and odontoblasts; and the periostin-null incisor displayed a massive increase in dentin formation after mastication; 2) periostin is also expressed in the ameloblast cells, and an enamel defect is identified in both the adult-null incisor and molar; 3) deletion of periostin leads to changes in expression profiles of many non-collagenous protein such as DSPP, DMP1, BSP, and OPN in incisor dentin; 4) the removal of a biting force leads to reduction of mineralization, which is partially prevented in periostin-null mice; and 6) both in vitro and in vivo data revealed a direct regulation of periostin by TGF-ß1 in dentin formation. In conclusion, periostin plays a novel direct role in controlling postnatal tooth formation, which is required for the integrity of both enamel and dentin.

Complications associated with implant migration into the maxillary sinus cavity.

BACKGROUND: Migration of dental implants into the maxillary sinus is an uncommon, but increasingly reported complication. Implant migration may result from initial lack of primary stability, intrasinusal and nasal pressure changes, autoimmune reaction to the implant or incorrect distribution of occlusal forces. This retrospective study aims at analyzing the factors that may influence implant migration into the maxillary sinus cavity. MATERIAL AND METHODS: Fourteen patients presenting a total 15 implants that migrated into the maxillary sinus were recruited. Diagnosis of this complication was based on imaging techniques, such as cone beam computerized tomography scan and panoramic radiography. Clinical data were recorded in all cases and processed for statistical analysis. RESULTS: ABH was below 6 mm in the majority of cases. However, almost 50% of the patients did not receive any site preparation treatment prior to implant insertion. Five patients (33.3%) were treated by osteotome techniques, but only one of them had bone grafting. Therefore, 73.3% of sites did not receive any biomaterial to increase available bone height. The most common complication-associated factors found on this study were related to implant design (cylindrical), implant dimension (diameter), implant restoration/rehabilitation method (partial removable denture), site-specific anatomy (initial residual bone height between 5 and 6.9 mm), demographics (age), and biomaterials. CONCLUSION: Patient selection and proper treatment planning, as well as the application of the appropriate sinus augmentation technique, are critical aspects that should be controlled to minimize the risk of implant migration into the maxillary sinus cavity.

Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report.

PURPOSE: The International Congress of Oral Implantologists has supported the development of this consensus report involving the use of Cone Beam Computed Tomography (CBCT) in implant dentistry with the intent of providing scientifically based guidance to clinicians regarding its use as an adjunct to traditional imaging modalities. MATERIALS AND METHODS: The literature regarding CBCT and implant dentistry was systematically reviewed. A PubMed search that included studies published between January 1, 2000, and July 31, 2011, was conducted. Oral presentations, in conjunction with these studies, were given by Dr. Erika Benavides, Dr. Scott Ganz, Dr. James Mah, Dr. Myung-Jin Kim, and Dr. David Hatcher at a meeting of the International Congress of Oral Implantologists in Seoul, Korea, on October 6-8, 2011. RESULTS: The studies published could be divided into four main groups: diagnostics, implant planning, surgical guidance, and postimplant evaluation. CONCLUSIONS: The literature supports the use of CBCT in dental implant treatment planning particularly in regards to linear measurements, three-dimensional evaluation of alveolar ridge topography, proximity to vital anatomical structures, and fabrication of surgical guides. Areas such as CBCT-derived bone density measurements, CBCT-aided surgical navigation, and postimplant CBCT artifacts need further research. ICOI RECOMMENDATIONS: All CBCT examinations, as all other radiographic examinations, must be justified on an individualized needs basis. The benefits to the patient for each CBCT scan must outweigh the potential risks. CBCT scans should not be taken without initially obtaining thorough medical and dental histories and performing a comprehensive clinical examination. CBCT should be considered as an imaging alternative in cases where the projected implant receptor or bone augmentation site(s) are suspect, and conventional radiography may not be able to assess the true regional three-dimensional anatomical presentation. The smallest possible field of view should be used, and the entire image volume should be interpreted.

Root resorption in relation to a modified piezocision technique.

OBJECTIVES: To evaluate root resorption of lower incisors and canines quantitatively in a group of patients who underwent orthodontic treatment with piezocision and/or a collagen reinforcement technique with a fully resorbable three-dimensional (3D) collagen xenograft matrix compared with a control group. MATERIALS AND METHODS: The study sample of this secondary analysis consisted of 32 periodontally healthy patients with angle Class I malocclusion or mild Class II or III malocclusion and moderate irregularity index scores who underwent orthodontic treatment and had before (T0) and after treatment (T1) cone-beam computed tomography scans. Root resorption of lower incisors and canines was assessed quantitatively in the following four groups: the control group received orthodontic treatment without piezocision, experimental group 1 received orthodontic treatment with piezocision, experimental group 2 received orthodontic treatment with piezocision and a 3D collagen matrix, and experimental group 3 received orthodontic treatment with a 3D collagen matrix. RESULTS: An overall statistically significant decrease in root length from T0 to T1 for all groups was observed (P < .05). However, there was no significant difference among the groups in the amount of root length decrease from T0 to T1. CONCLUSIONS: Orthodontic treatment combined with piezocision does not increase the risk of root resorption of lower incisors and canines when compared with orthodontic treatment without acceleration techniques. More studies with larger samples should be undertaken to confirm these results.

Towards the Integration of an Islet-Based Biosensor in Closed-Loop Therapies for Patients With Type 1 Diabetes.

In diabetes mellitus (DM) treatment, Continuous Glucose Monitoring (CGM) linked with insulin delivery becomes the main strategy to improve therapeutic outcomes and quality of patients' lives. However, Blood Glucose (BG) regulation with CGM is still hampered by limitations of algorithms and glucose sensors. Regarding sensor technology, current electrochemical glucose sensors do not capture the full spectrum of other physiological signals, i.e., lipids, amino acids or hormones, relaying the general body status. Regarding algorithms, variability between and within patients remains the main challenge for optimal BG regulation in closed-loop therapies. This work highlights the simulation benefits to test new sensing and control paradigms which address the previous shortcomings for Type 1 Diabetes (T1D) closed-loop therapies. The UVA/Padova T1DM Simulator is the core element here, which is a computer model of the human metabolic system based on glucose-insulin dynamics in T1D patients. That simulator is approved by the US Food and Drug Administration (FDA) as an alternative for pre-clinical testing of new devices and closed-loop algorithms. To overcome the limitation of standard glucose sensors, the concept of an islet-based biosensor, which could integrate multiple physiological signals through electrical activity measurement, is assessed here in a closed-loop insulin therapy. This investigation has been addressed by an interdisciplinary consortium, from endocrinology to biology, electrophysiology, bio-electronics and control theory. In parallel to the development of an islet-based closed-loop, it also investigates the benefits of robust control theory against the natural variability within a patient population. Using 4 meal scenarios, numerous simulation campaigns were conducted. The analysis of their results then introduces a discussion on the potential benefits of an Artificial Pancreas (AP) system associating the islet-based biosensor with robust algorithms.

FlyBy CNN: A 3D surface segmentation framework.

In this paper, we present FlyBy CNN, a novel deep learning based approach for 3D shape segmentation. FlyByCNN consists of sampling the surface of the 3D object from different view points and extracting surface features such as the normal vectors. The generated 2D images are then analyzed via 2D convolutional neural networks such as RUNETs. We test our framework in a dental application for segmentation of intra-oral surfaces. The RUNET is trained for the segmentation task using image pairs of surface features and image labels as ground truth. The resulting labels from each segmented image are put back into the surface thanks to our sampling approach that generates 1-1 correspondence of image pixels and triangles in the surface model. The segmentation task achieved an accuracy of 0.9.

Automatic Segmentation of Dental Root Canal and Merging with Crown Shape.

In this paper, machine learning approaches are proposed to support dental researchers and clinicians to study the shape and position of dental crowns and roots, by implementing a Patient Specific Classification and Prediction tool that includes RootCanalSeg and DentalModelSeg algorithms and then merges the output of these tools for intraoral scanning and volumetric dental imaging. RootCanalSeg combines image processing and machine learning approaches to automatically segment the root canals of the lower and upper jaws from large datasets, providing clinical information on tooth long axis for orthodontics, endodontics, prosthodontic and restorative dentistry procedures. DentalModelSeg includes segmenting the teeth from the crown shape to provide clinical information on each individual tooth. The merging algorithm then allows users to integrate dental models for quantitative assessments. Precision in dentistry has been mainly driven by dental crown surface characteristics, but information on tooth root morphology and position is important for successful root canal preparation, pulp regeneration, planning of orthodontic movement, restorative and implant dentistry. In this paper we propose a patient specific classification and prediction of dental root canal and crown shape analysis workflow that employs image processing and machine learning methods to analyze crown surfaces, obtained by intraoral scanners, and three-dimensional volumetric images of the jaws and teeth root canals, obtained by cone beam computed tomography (CBCT).

Relationship between the polymorphism in the interleukin 1-ß and the treatment time of patients subjected to a modified piezocision technique.

AIM: We aimed to evaluate the correlation between the polymorphism of the interleukin 1-Beta (IL1-ß, +3954 C>T) and tooth movement, in a group of Colombian patients undergoing surgically accelerated orthodontic tooth movement. METHODS: The study was nested to a controlled clinical trial. Blood samples were taken from 11 women and 29 healthy Colombian male volunteers between 18 and 40 years old, after 1 year of starting orthodontic treatment. The patients presented malocclusion class I, with grade II or III. To detect the genetic polymorphism of the nucleotide +3954 C to T in the IL-1ß gene, we used a real-time PCR assay. RESULTS: Eleven individuals presented the allele 2 (T) heterozygous with the allele 1 (T/C) and 19 individuals were homozygous for the allele 1 (C/C). When analyzing the presence of the SNP, no significant differences were found in any of the variables. The best treatment was reflected in Group 3 (selective upper and lower alveolar decortication and 3D collagen matrix) and Group 4 (only selective alveolar decortication in the upper arch, with 3D collagen matrix), with 27% and 35% more speed respectively than in the control group. CONCLUSIONS: Our analyses indicated that a reduction in the total treatment time can be mostly potentiated by using decortication and collagen matrices and not for the presence of the allele 2 in the IL-1ß. Nevertheless, it is important that further studies investigate if the polymorphism could be associated with the speed of tooth movement and analyze the baseline protein levels.

OBJETIVO: Evaluar la correlación entre el polimorfismo de la interleucina 1-Beta (IL1-ß, +3954 C> T) y el movimiento de los dientes, en un grupo de pacientes colombianos sometidos a un movimiento dental ortodóncico acelerado quirúrgicamente. MÉTODOS: Este fue un estudio secundario derivado de un ensayo clínico aleatorio controlado. Se tomaron muestras de sangre de 11 mujeres y 29 voluntarios varones colombianos sanos entre 18 y 40 años, después de 1 año de comenzar el tratamiento de ortodoncia. Los pacientes presentaron maloclusión clase I, con grado II o III. Para detectar el polimorfismo genético del nucleótido +3954 C a T en el gen IL-1ß, se usó un ensayo de PCR en tiempo real. RESULTADOS: 11 individuos presentaron el alelo 2 (T) heterocigoto con el alelo 1 (T / C) y 19 individuos fueron homocigotos para el alelo 1 (C / C). Al analizar la presencia del SNP, no se encontraron diferencias significativas en ninguna de las variables. El mejor tratamiento se reflejó en el Grupo 3 (decorticación alveolar superior e inferior selectiva y matriz de colágeno 3D) y el Grupo 4 (solo decorticación alveolar selectiva en el arco superior, con matriz de colágeno 3D), con un 27% y un 35% más de velocidad, respectivamente, que en el grupo de control. CONCLUSIONES: Los análisis indicaron que una reducción en el tiempo total de tratamiento puede potenciarse principalmente mediante el uso de decorticación y matrices de colágeno y no por la presencia del alelo 2 en la IL-1ß. Sin embargo, es importante que otros estudios investiguen si el polimorfismo podría estar asociado con la velocidad del movimiento de los dientes y analizar los niveles de proteína de referencia.

Patient Specific Classification of Dental Root Canal and Crown Shape.

This paper proposes machine learning approaches to support dentistry researchers in the context of integrating imaging modalities to analyze the morphology of tooth crowns and roots. One of the challenges to jointly analyze crowns and roots with precision is that two different image modalities are needed. Precision in dentistry is mainly driven by dental crown surfaces characteristics, but information on tooth root shape and position is of great value for successful root canal preparation, pulp regeneration, planning of orthodontic movement, restorative and implant dentistry. An innovative approach is to use image processing and machine learning to combine crown surfaces, obtained by intraoral scanners, with three dimensional volumetric images of the jaws and teeth root canals, obtained by cone beam computed tomography. In this paper, we propose a patient specific classification of dental root canal and crown shape analysis workflow that is widely applicable.