Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients.

INTRODUCTION: In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. METHODS: This retrospective study included 57 patients whose orthodontic treatment involved the extraction of 4 first premolars because of bialveolar protrusion. A total of 27 patients were treated with Invisalign (mean age, 25.5 ± 5.2 years) and 30 patients with the fixed appliance (mean age, 24.4 ± 5.8 years). The angular and linear changes of the maxillary and mandibular central incisors, second premolars, first molars, and second molars were measured from the recordings on the basis of the lateral cephalograms taken before and after treatment. The angular changes of the canines and second premolars were measured using panoramic radiographs. RESULTS: The overbite and interincisal angle increased significantly in the Invisalign group compared with in the conventional fixed appliance group (P <0.05). The maxillary central incisors showed increased lingual tipping in the Invisalign group (P <0.05), whereas there was no statistically significant difference in the angular change of the mandibular incisors between groups (P >0.05). The maxillary first and second molars showed mesial tipping in the Invisalign group (P <0.05). The maxillary second premolars, first and second molars, and the mandibular second molars showed mesial movement in the Invisalign group (P <0.05). CONCLUSIONS: The Invisalign group showed more statistically significant lingual tipping of the maxillary central incisors, distal tipping of the maxillary canines, and mesial tipping of the maxillary first and second molars after maximum retraction of the anterior teeth compared with the fixed appliance group.

Gamma analysis dependence on specified low-dose thresholds for VMAT QA.

The American Association of Physicists in Medicine Task Group 119 instructed institutions to use a low-dose threshold of 10% or a region of interest determined by the jaw setting when they collected gamma analysis quality assurance (QA) data for the planar dose distribution. However, there are no clinical data to quantitatively demonstrate the impact of the low-dose threshold on the gamma index. Therefore, we performed a gamma analysis with various low-dose thresholds in the range of 0% to 15% according to both global and local normalization and different acceptance criteria (3%/3 mm, 2%/2 mm, and 1%/1 mm). A total of 30 treatment plans--10 head and neck, 10 brain, and 10 prostate cancer cases--were randomly selected from the Varian Eclipse treatment planning system (TPS). For the gamma analysis, a calculated portal image was acquired through a portal dose calculation algorithm in the Eclipse TPS, and a measured portal image was obtained using an electronic portal-imaging device. Then, the gamma analysis was performed using the Portal Dosimetry software (Varian Medical Systems, Palo Alto, CA). The gamma passing rate (%GP) for the global normalization decreased as the low-dose threshold increased, and all low-dose thresholds led to %GP values above 95% for both the 3%/3 mm and 2%/2 mm criteria. However, for the local normalization, %GP for a low-dose threshold of 10% was 7.47%, 10.23%, and 6.71% greater than the low-dose threshold of 0% for head and neck, brain, and prostate for the 3%/3 mm criteria, respectively. The results indicate that applying the low-dose threshold to global normalization does not have a critical impact on patient-specific QA results. However, in the local normalization, the low-dose threshold level should be carefully selected because the excluded low-dose points could cause the average %GP to increase rapidly.

Dendropanax morbifera Branch Water Extract Increases the Immunostimulatory Activity of RAW264.7 Macrophages and Primary Mouse Splenocytes.

Polyacetylenes in the bark of Dendropanax morbifera trees have been reported to promote immune cell proliferation and to strengthen the innate immune system. The immunomodulatory potential of D. morbifera branch water extract (DBW) was evaluated by determining its effect on cell viability and the expression of cytokines and immune effector molecules in mouse RAW264.7 macrophages and splenocytes. Production of nitric oxide (NO), inducible nitric oxide synthase (iNOS), and cytokines (interleukin [IL]-1ß, IL-2, and IFN-γ) in RAW264.7 macrophages increased after treatment with DBW. The activation of components of the NF-κB signaling pathway, including the phospho-IκBα and the expression and translocation of p65, a subunit of NF-κB, were also increased in RAW264.7 mouse macrophage cells after treatment with DBW. In addition, when mice were orally administered DBW, splenocyte cytokines and NO production were increased in a dose-dependent manner relative to control-treated mice. Furthermore, natural killer cell activity in DBW-treated mice was determined by lactate dehydrogenase (LDH) release assay. LDH release also increased in response to DBW treatment. Taken together, these results indicate that D. morbifera extract enhances innate immunity by promoting NF-κB signaling, leading to increased expression of proinflammatory cytokines and effector molecules. DBW therefore has potential therapeutic use in the context of immune stimulation.