Three-dimensional analysis of the change in the curvature of the smiling line following orthodontic treatment in incisor class II division 1 malocclusion.

OBJECTIVES: To investigate the different effects of changes in the occlusal plane, incisors inclination, and maxillary intercanine width on the curvature of the smiling line. MATERIALS: Records of 46 subjects (28 females and 18 males, mean age 16.6 ± 4.2 years) with incisor class II division 1 malocclusions were selected. All subjects had four premolar extractions and were treated with preadjusted edgewise appliances. METHODS: Pre- and post-treatment maxillary dental digital models were virtually aligned via corresponding landmarks to the respective lateral cephalograms. Subsequent two-dimensional superimposition of the aligned cephalograms facilitated the three-dimensional superimposition of the pre- and post-treatment models. This process allowed the quantification of the curvature from a frontal perspective of the models. The change in curvature was then correlated with changes in the cephalometric inclination of the anterior occlusal plane (AOP), functional occlusal plane (FOP), maxillary central incisor (U1), and the intercanine width. RESULTS: Orthodontic correction in this sample resulted in the clockwise rotation of the anterior occlusal plane (5.84 degrees), reduction in proclination of the incisors (-14.39 degrees), increase in intercanine width (2.48mm), and a corresponding increase in the curvature of the smiling line (6.83 degrees). CONCLUSIONS: The change in curvature of the smiling line in these subjects was found to be related more significantly to the magnitude of difference in the inclination between the pre-treatment AOP and FOP than to the change in the inclination of the maxillary incisors. With orthodontic treatment, the smiling line can be correlated with cephalometric data to improve or maintain the curvature.

Identification and characterization of a novel prespheroid 3-dimensional hepatocyte monolayer on galactosylated substratum.

Three-dimensional (3D) hepatocyte spheroids mimicking the structural and functional characteristics of hepatocytes in vivo were self-assembled onto a galactosylated polyethylene terephthalate (PET) substratum, and the dynamic process of spheroid formation was investigated using time-lapse confocal microscopy. Hepatocytes cultured on this galactosylated substratum formed small cell-aggregates within 12 h, which gradually merged into "island-like" clusters at approximately 1 day and spread to form prespheroid monolayer within 2 days; the prespheroid monolayer was stretched to fold into compact and larger 3D spheroids after 3 days. We compared the expressions of F-actin (cytoskeleton), phosphorylated focal adhesion kinase (p-FAK, cell-substratum interactions) and E-cadherin (cell-cell interactions) during the dynamic process of 3D hepatocyte spheroid formation with the dynamic process of 2D hepatocyte monolayer formation on collagen substratum. Hepatocytes in the prespheroid monolayer stage exhibited the strongest cell-substratum interactions of all 4 stages during spheroid formation with cell-cell interactions and F-actin distribution comparable with those of the 3D hepatocyte spheroids. The prespheroid monolayer also exhibited better hepatocyte polarity (multidrug resistance protein 2) and tight junction (zonula occludens-1) formation, more-differentiated hepatocyte functions (albumin production and cytochrome P450 1 A activity), and higher sensitivity to hepatotoxicity than the conventional 2D hepatocyte monolayer. The transient prespheroid 3D monolayer could be stabilized on a hybrid glycine-arginine-glycine-aspartic acid-serine (GRGDS)/galactose-PET substratum for up to 1 week and destabilized to form 3D spheroids in excess soluble GRGDS peptide.

A Semi-automatic Algorithm for Preliminary Assessment of Labial Gingiva and Alveolar Bone Thickness of Maxillary Anterior Teeth.

PURPOSE: Soft and hard tissue volumes are critical for implant placement and long-term stability. Although the literature has adequately addressed tissue biotypes of Western populations, pertinent information about Asian populations is limited. This study aimed to evaluate the soft and hard tissue profiles of the maxillary anterior teeth of the Taiwanese population using a semi-automatic algorithm. MATERIALS AND METHODS: Cone beam computed tomography images of 11 adults with well-aligned maxillary anterior teeth were overlaid with those of cast models, based on the tooth crowns manually outlined by two independent observers. Each tooth was digitally trisected mesiodistally and apicocoronally. The thicknesses of the labial gingiva and alveolar bone were measured using a customized software program. RESULTS: No obvious difference between the observers was noted regarding the dimension of tooth crowns. The average thicknesses of the labial gingiva, the labial alveolar bone, and the palatal alveolar bone were 1.76 ± 0.11 mm, 1.02 ± 0.12 mm, and 1.80 ± 0.31 mm, respectively, with no significant differences between teeth. All parameters were thicker in the apical region than in the cervical region, and the alveolar bone was thinner in the midlabial region of incisors than in the interproximal regions. The thinnest areas were the midcervical compartment of the right central incisor (0.53 ± 0.33 mm) for the labial gingiva, the midcervical compartment of the right lateral incisor (0.23 ± 0.10 mm) for the labial alveolar bone, and the mesiocervical compartment of the left central incisor (0.33 ± 0.09 mm) for the palatal alveolar bone. CONCLUSION: This study presents an objective and comprehensive methodology for evaluating the soft and hard tissue profiles of maxillary anterior teeth and may be of value for presurgical planning for immediate implant placement. The results suggest that profiles of the Taiwanese subjects are similar to profiles of Western populations.

Integrative haptic and visual interaction for simulation of PMMA injection during vertebroplasty.

In vertebroplasty, physician relies on both sight and feel to properly place the bone needle through various tissue types and densities, and to help monitor the injection of PMMA or cement into the vertebra. Incorrect injecting and reflux of the PMMA into areas where it should not go can result in detrimental clinical complication. This paper focuses on the human-computer interaction for simulating PMMA injection in our virtual spine workstation. Fluoroscopic images are generated from the CT patient volume data and simulated volumetric flow using a time varying 4D volume rendering algorithm. The user's finger movement is captured by a data glove. Immersion CyberGrasp is used to provide the variable resistance felt during injection by constraining the user's thumb. Based on our preliminary experiments with our interfacing system comprising simulated fluoroscopic imaging and haptic interaction, we found that the former has a larger impact on the user's control during injection.

A level-set based approach for anterior teeth segmentation in cone beam computed tomography images.

Cone beam CT (CBCT) has gained popularity in dentistry for 3D imaging of the jaw bones and teeth due to its high resolution and relatively lower radiation exposure compared to multi-slice CT (MSCT). However, image segmentation of the tooth from CBCT is more complex than from MSCT due to lower bone signal-to-noise. This paper describes a level-set method to extract tooth shape from CBCT images of the head. We improve the variational level set framework with three novel energy terms: (1) dual intensity distribution models to represent the two regions inside and outside the tooth; (2) a robust shape prior to impose a shape constraint on the contour evolution; and (3) using the thickness of the tooth dentine wall as a constraint to avoid leakage and shrinkage problems in the segmentation process. The proposed method was compared with several existing methods and was shown to give improved segmentation accuracy.

A two-stage rule-constrained seedless region growing approach for mandibular body segmentation in MRI.

PURPOSE: Extraction of the mandible from 3D volumetric images is frequently required for surgical planning and evaluation. Image segmentation from MRI is more complex than CT due to lower bony signal-to-noise. An automated method to extract the human mandible body shape from magnetic resonance (MR) images of the head was developed and tested. METHODS: Anonymous MR images data sets of the head from 12 subjects were subjected to a two-stage rule-constrained region growing approach to derive the shape of the body of the human mandible. An initial thresholding technique was applied followed by a 3D seedless region growing algorithm to detect a large portion of the trabecular bone (TB) regions of the mandible. This stage is followed with a rule-constrained 2D segmentation of each MR axial slice to merge the remaining portions of the TB regions with lower intensity levels. The two-stage approach was replicated to detect the cortical bone (CB) regions of the mandibular body. The TB and CB regions detected from the preceding steps were merged and subjected to a series of morphological processes for completion of the mandibular body region definition. Comparisons of the accuracy of segmentation between the two-stage approach, conventional region growing method, 3D level set method, and manual segmentation were made with Jaccard index, Dice index, and mean surface distance (MSD). RESULTS: The mean accuracy of the proposed method is [Formula: see text] for Jaccard index, [Formula: see text] for Dice index, and [Formula: see text] mm for MSD. The mean accuracy of CRG is [Formula: see text] for Jaccard index, [Formula: see text] for Dice index, and [Formula: see text] mm for MSD. The mean accuracy of the 3D level set method is [Formula: see text] for Jaccard index, [Formula: see text] for Dice index, and [Formula: see text] mm for MSD. The proposed method shows improvement in accuracy over CRG and 3D level set. CONCLUSION: Accurate segmentation of the body of the human mandible from MR images is achieved with the proposed two-stage rule-constrained seedless region growing approach. The accuracy achieved with the two-stage approach is higher than CRG and 3D level set.

A general strategy for anisotropic diffusion in MR image denoising and enhancement.

Anisotropic diffusion (AD) has proven to be very effective in the denoising of magnetic resonance (MR) images. The result of AD filtering is highly dependent on several parameters, especially the conductance parameter. However, there is no automatic method to select the optimal parameter values. This paper presents a general strategy for AD filtering of MR images using an automatic parameter selection method. The basic idea is to estimate the parameters through an optimization step on a synthetic image model, which is different from traditional analytical methods. This approach can be easily applied to more sophisticated diffusion models for better denoising results. We conducted a systematic study of parameter selection for the AD filter, including the dynamic parameter decreasing rate, the parameter selection range for different noise levels and the influence of the image contrast on parameter selection. The proposed approach was validated using both simulated and real MR images. The model image generated using our approach was shown to be highly suitable for the purpose of parameter optimization. The results confirm that our method outperforms most state-of-the-art methods in both quantitative measurement and visual evaluation. By testing on real images with different noise levels, we demonstrated that our method is sufficiently general to be applied to a variety of MR images.