Associations of variability in body mass index with cardiovascular outcomes in the general population: A systematic review.

In today's world, high variability of body mass index (BMI) is known as a significant global health problem that can lead to many negative impacts on the cardiovascular system, including atrial fibrillation (AF) and coronary heart disease. The current systematic review aims to elucidate the effect of variability in BMI on the risk of cardiovascular outcomes. Four databases, including PubMed, Scopus, MEDLINE, and CENTRAL, were searched. All related articles up to 10 June 2022, were obtained. Titles, abstracts, and full texts were reviewed. After screening abstracts and full texts, four articles were included in our study. In these four cohort studies, 7,038,873 participants from the USA and South Korea were involved. These articles generally considered the BMI and outcomes including cardiovascular disease, AF, and coronary heart disease. All these articles reported an association between the variability of BMI and increased risk of cardiovascular outcomes. Due to the negative impact of the high variability of BMI on the risk of cardiovascular outcomes, health policymakers and practitioners should pay more attention to the significant role of BMI in health problems and physicians might better check the variability of BMI visits to visit.

Pharmacotherapeutic potential of Vitis vinifera(grape) in age-related neurological diseases / Potencial farmacoterapéutico de Vitis vinifera(uva) en enfermedades neurológicas asociadas a la edad

Age-related neurological disorders (ANDs), including neurodegenerative diseases, are complex illnesses with an increasing risk with advancing years. The central nervous system's neuropathological conditions, including oxidative stress, neuroinflammation, and protein misfolding, are what define ANDs. Due to the rise in age-dependent prevalence, efforts have been made to combat ANDs. Vitis viniferahas a long history of usageto treat a variety of illness symptoms. Because multiple ligand sites may be targeted, Vitis viniferacomponents can be employed to treat ANDs. This is demonstrated by the link between the structure and action of these compounds. This review demonstrates that Vitis viniferaand its constituents, including flavonoids, phenolic compounds, stilbenoidsandaromatic acids, are effective at reducing the neurological symptoms and pathological conditions of ANDs. This is done by acting as an antioxidant and anti-inflammatory. The active Vitis vinifera ingredients have therapeutic effects on ANDs, as this review explains.

Las enfermedades neurológicas asociadas a la edad (AND, por su sigla en inglés) incluyendo las enfermedades neurodegenerativas, son enfermedades complejas con un riesgo creciente con la edad. Las condiciones neuropatológicas del sistema nervioso central, que incluyen el estrés oxidativo, la neuro inflamación, y el plegado erróneo de proteínas, son lo que define las AND. Debido al aumento en la prevalencia dependiente de la edad, se han hecho esfuerzos para combatir las AND. Vitis vinifera tiene una larga historia de uso para el tratamiento de síntomas. Puesto que puede hacer objetivo a muchos sitios ligando, los componentes de Vitis viniferase pueden utilizar para tratar AND. Esto se demuestra por el vínculo entre la estructura y la acción de estos compuestos. Esta revisión demuestra que la Vitis viniferay sus constituyentes, incluídos los flavonoides, componentes fenólicos, estilbenoides, y ácidos aromáticos, son efectivos para reducir los síntomas neurológicos y las condiciones patológicas de AND. Esto se produce por su acción como antioxidante y antiinflamatorio. Los ingredientes activos de Vitis vinifera tienen efectos terapéuticos en AND, y esta revisión lo explica.

The difference between 2-hour post-challenge and fasting plasma glucose associates with the risk of cardiovascular disease in a normoglycemic population: the Tehran lipid and glucose study.

BACKGROUND: Elevated fasting plasma glucose (FPG) and 2-hour post-challenge glucose (2hPG) levels are known to be independent risk factors for cardiovascular disease (CVD). However, there is limited data on the association of the difference between these measures and the risk of CVD. This study aims to investigate this association in normoglycemic Iranian adults, particularly in those with low-normal FPG levels. METHODS: This prospective cohort study included 4,594 30-65-year-old participants from the Tehran Lipid and Glucose Study. Using multivariable Cox proportional hazards regression models adjusting for age, sex, body mass index, hypertension, hypercholesterolemia, smoking, education level and FPG, hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated for the association between 2hPG-FPG, both as continuous and categorical variables, and the CVD risk. Analyses of receiver operating characteristic curves were undertaken to determine the optimal 2hPG-FPG cut-off value. RESULTS: During a median of 17.9 years of follow-up, 459 CVD events occurred. A one-unit increase in 2hPG-FPG was significantly associated with an elevated risk of cardiovascular disease in both normoglycemic (HR 1.10, 95% CI (1.01-1.19)) and low-normal FPG individuals (HR 1.16, 95% CI (1.04-1.30)); this association resisted adjustment for Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) among normoglycemic individuals. However, those with 2hPG levels greater than FPG levels had a non-significant increased risk of incident CVD compared to those with 2hPG levels of less than or equal to FPG, with corresponding HR values of 1.18 (95% CI: 0.95-1.46) in normoglycemic and 1.32 (95% CI: 0.98-1.79) in low-normal FPG, respectively. For incident CVD, the optimal cut-off value for the 2hPG-FPG was found to be 1.06 mmol/L, which was applicable for both normoglycemic and low FPG populations; using this criterion, the corresponding risks for incident CVD were 1.36 (95% CI: 1.12-1.64) and 1.57 (95% CI: 1.22-2.03), respectively. CONCLUSIONS: The difference between 2hPG and FPG levels within the normoglycemic range is related to an increased risk of CVD, an issue that was independent of HOMA-IR. A cut-off point for 2hPG-FPG > 1.06 mmol/L may stratify persons at higher risk. These findings were particularly notable in those with low-normal FPG.

A challenging transseptal mitral valve in valve case report: Success and safety.

Key Clinical Message: Transcatheter mitral valve implantation (TMVI) is considered a less-invasive approach than open-heart surgery, favored in high-risk patients elected for valve replacement. Although seemingly suitable, this procedure is highly operator-dependent. Abstract: Transcatheter mitral valve implantation (TMVI) is an alternative in high-risk patients. We reported a 72-year-old patient with mitral bioprosthesis degeneration successfully receiving TMVI. The procedure has lower morbidity and mortality rate than the surgical approach but can be accompanied by several complications, especially when conducted by an inexperienced operator.

Saffron and Sleep Quality: A Systematic Review of Randomized Controlled Trials.

Background: Sleep quality is defined as an individual's consent to sleep experience. Poor sleep quality has important adverse health outcomes. There are drugs to treat sleep disorders but consumption of these drugs is accompanied by adverse effects whereas herbal treatments have fewer side effects. Saffron is spice obtained from Crocus sativus flower. Several articles have been done on its effects on the quality of sleep and its safety. This review for the first time critically evaluates effect of saffron on sleep quality improvement. Method: The search technique aims to get all related published data-based up to 2022 articles. PubMed, Central, Google Scholar, and Scopus were examined. Only full reports were evaluated (abstracts were excluded). The first screening was done by title and abstract. Then full text of articles was read and irrelevant articles were removed. Duplicate articles were also removed by Endnote. By using Cochrane risk of bias tool assessment, a quality score based on probability of bias was given. Methodological characteristics were also evaluated using the criteria of Stevinson and Ernst. Result: In the systematic review, 5 randomized clinical trials with 379 participants from 3 countries were identified. In placebo-comparison trials, saffron contains a large treatment. Conclusion: It seems that saffron has a beneficial influence on duration and quality of sleep. Saffron, crocin, and safranal induce hypnotic effects by increasing the duration of sleep. Research conducted so far provides initial support and safety for use of saffron to improve sleep quality.

Gender differences in the impact of 3-year status changes of metabolic syndrome and its components on incident type 2 diabetes mellitus: a decade of follow-up in the Tehran Lipid and Glucose Study.

Background: The aim of this study was to examine the gender differences in the association between status changes of metabolic syndrome (MetS) and its components, using Joint Interim Statement (JIS) criteria, with the risk of type 2 diabetes mellitus (T2DM) among an urban population. Methods: The study included 4,463 Iranian adult participants (2,549 women) aged ≥20 years. Based on status changes of MetS and its components during 3 years, subjects were categorized into four groups: MetS-free (reference), MetS-developed, MetS-recovery, and MetS-stable. A similar categorization was applied to MetS components. Multivariable Cox regression models were used for estimating hazard ratios (HRs) and women-to-men ratios of HRs (RHRs). Results: During a median follow-up of 9.3 years, 625 T2DM events (351 women) occurred. Compared with the reference, the HRs of the MetS-developed, -recovery, and -stable groups among men for incident T2DM were 2.90, 2.60, and 4.92; the corresponding values for women were 2.73, 2.88, and 5.21, respectively (all p-values < 0.01), without significant gender difference in these relationships. In both genders, the fasting plasma glucose (FPG) component, regardless of the change in status, was strongly and significantly associated with incident T2DM with HRs ranging from 2.49 to 9.42; a similar association was also found for high waist circumference (WC)-recovery and -stable groups, with HRs ranging from 1.58 to 2.85 (p-values ≤ 0.05). Regarding gender differences, the development and persistence of high blood pressure (BP) status exposed men to greater T2DM risk than women with women-to-men RHRs of 0.43 (0.26-0.72) and 0.58 (0.39-0.86), respectively. Moreover, stable low levels of high-density lipoprotein cholesterol (HDL-C) and high triglyceride (TG) levels conferred higher T2DM risk in women than in men, with women-to-men RHRs of 1.67 (0.98-2.86) and 1.44 (0.98-2.14), respectively (both p-values = 0.06). Conclusion: Among Tehranian adults, in both genders, all status changes of MetS, even those recovered from MetS, have a higher risk of T2DM compared to those who never had MetS. Also, all statuses of high FPG, in addition to recovered and stable high WC, were strongly associated with T2DM risk. Specifically, men with stable or developed high BP and women with stable dyslipidemic status were at differentially increased risk of incident T2DM.

Venous thromboembolism in viral diseases: A comprehensive literature review.

Venous thromboembolism (VTE) is known to be a common respiratory and/or cardiovascular complication in hospitalized patients with viral infections. Numerous studies have proven human immunodeficiency virus infection to be a prothrombotic condition. An elevated VTE risk has been observed in critically ill H1N1 influenza patients. VTE risk is remarkably higher in patients infected with the Hepatitis C virus in contrast to uninfected subjects. The elevation of D-dimer levels supported the association between Chikungunya and the Zika virus and the rise of clinical VTE risk. Varicella-zoster virus is a risk factor for both cellulitis and the consequent invasive bacterial disease which may take part in thrombotic initiation. Eventually, hospitalized patients infected with the coronavirus disease of 2019 (COVID-19), the cause of the ongoing worldwide pandemic, could mainly suffer from an anomalous risk of coagulation activation with enhanced venous thrombosis events and poor quality clinical course. Although the risk of VTE in nonhospitalized COVID-19 patients is not known yet, there are a large number of guidelines and studies on thromboprophylaxis administration for COVID-19 cases. This study aims to take a detailed look at the effect of viral diseases on VTE, the epidemiology of VTE in viral diseases, and the diagnosis and treatment of VTE.

The Treatment Dilemma of Arteriopathy in Takayasu Arteritis- A State-of-the-Art Approach.

Takayasu Arteritis (TA) is a chronic idiopathic granulomatous pan-arteritis affecting the pulmonary artery, the aorta, and its principal derived branches. The majority of TA patients are female (82.9%-97.0%). Due to the inflammatory character of the illness, arterial stenosis therapy must be treated differently than the atherosclerosis process. In this review paper, we outline a strategy using real-world challenging cases.

Percutaneous Transcatheter Closure of Post-Myocardial Infarction Ventricular Septal Rupture.

Post-myocardial infarction ventricular septal rupture is the most catastrophic mechanical complication with high morbidity and mortality, reaching 94% in patients treated conservatively and 47% in patients undergoing cardiac surgery procedures (30-day mortality). In this review article we tried to review trans-catheter closure approach and explain elaborately device selection based on real-world patients in this fatal complication.

From kitchen to clinic: Pharmacotherapeutic potential of common spices in Indian cooking in age-related neurological disorders.

Aging is described as an advanced time-related collection of changes that may negatively affect with the risk of several diseases or death. Aging is a main factor of several age-related neurological disorders, including neurodegenerative diseases (Alzheimer's disease, Parkinson's disease, and dementia), stroke, neuroinflammation, neurotoxicity, brain tumors, oxidative stress, and reactive oxygen species (ROS). Currently available medications for age-related neurological disorders may lead to several side effects, such as headache, diarrhea, nausea, gastrointestinal (GI) diseases, dyskinesia, and hallucinosis. These days, studies on plant efficacy in traditional medicine are being conducted because herbal medicine is affordable, safe, and culturally acceptable and easily accessible. The Indian traditional medicine system called Ayurveda uses several herbs and medicinal plants to treat various disorders including neurological disorders. This review aims to summarize the data on the neuroprotective potential of the following common Indian spices widely used in Ayurveda: cumin (Cuminum cyminum (L.), Apiaceae), black cumin (Nigella sativa (L.), Ranunculaceae), black pepper (Piper nigrum (L.), Piperaceae), curry leaf tree (Murraya koenigii (L.), Spreng Rutaceae), fenugreek (Trigonella foenum-graecum (L.), Fabaceae), fennel (Foeniculum vulgare Mill, Apiaceae), cardamom (Elettaria cardamomum (L.) Maton, Zingiberaceae), cloves (Syzygium aromaticum (L.) Merr. & L.M.Perry, Myrtaceae), and coriander (Coriandrum sativum (L.), Apiaceae) in age-related neurological disorders.

Comparison of Hydrocolloid Dressings and Silver Nanoparticles in Treatment of Pressure Ulcers in Patients with Spinal Cord Injuries: A Randomized Clinical Trial.

Introduction: There are numerous dressings used to treat pressure ulcers (PUs), depending on their advantages to achieve optimum patient outcomes. This study aimed to compare hydrocolloid dressings and silver nanoparticles in treating PUs among patients with spinal cord injury (SCI). Methods: This randomized clinical trial was conducted on 70 patients with SCI in Iran. Participants were randomly divided into two equal groups (n=35) receiving silver nanoparticle dressing and hydrocolloid dressing, respectively. The groups were evaluated in four assessment periods using the Bates-Jensen Wound Assessment Tool (BWAT). Data analysis was performed using SPSS software version 13, repeated measures ANOVA, non-parametric tests, and chi-square. Results: Chi-square test was used to investigate the difference between the scores before the intervention, the results of which were not statistically significant. In repetitive measurements, the results of the analysis of variance showed that the average assessment score in both groups decreased and both dressings were effective in the treatment process. Although PU improvement status in the group that received silver nanoparticles was better, between-group analysis of variance did not show any statistically significant difference between the two groups. Conclusion: Our results indicated that silver nanoparticles and hydrocolloid dressings can be used interchangeably in the treatment of PUs.

Endoplasmic reticulum as a target in cardiovascular diseases: Is there a role for flavonoids?

Flavonoids are found in natural health products and plant-based foods. The flavonoid molecules contain a 15-carbon skeleton with the particular structural construction of subclasses. The most flavonoid's critical subclasses with improved health properties are the catechins or flavonols (e.g., epigallocatechin 3-gallate from green tea), the flavones (e.g., apigenin from celery), the flavanones (e.g., naringenin from citrus), the flavanols (e.g., quercetin glycosides from berries, onion, and apples), the isoflavones (e.g., genistein from soya beans) and the anthocyanins (e.g., cyanidin-3-O-glucoside from berries). Scientific data conclusively demonstrates that frequent intake of efficient amounts of dietary flavonoids decreases chronic inflammation and the chance of oxidative stress expressing the pathogenesis of human diseases like cardiovascular diseases (CVDs). The endoplasmic reticulum (ER) is a critical organelle that plays a role in protein folding, post-transcriptional conversion, and transportation, which plays a critical part in maintaining cell homeostasis. Various stimuli can lead to the creation of unfolded or misfolded proteins in the endoplasmic reticulum and then arise in endoplasmic reticulum stress. Constant endoplasmic reticulum stress triggers unfolded protein response (UPR), which ultimately causes apoptosis. Research has shown that endoplasmic reticulum stress plays a critical part in the pathogenesis of several cardiovascular diseases, including diabetic cardiomyopathy, ischemic heart disease, heart failure, aortic aneurysm, and hypertension. Endoplasmic reticulum stress could be one of the crucial points in treating multiple cardiovascular diseases. In this review, we summarized findings on flavonoids' effects on the endoplasmic reticulum and their role in the prevention and treatment of cardiovascular diseases.

Automated estimation of echocardiogram image quality in hospitalized patients.

We developed a machine learning model for efficient analysis of echocardiographic image quality in hospitalized patients. This study applied a machine learning model for automated transthoracic echo (TTE) image quality scoring in three inpatient groups. Our objectives were: (1) Assess the feasibility of a machine learning model for echo image quality analysis, (2) Establish the comprehensiveness of real-world TTE reporting by clinical group, and (3) Determine the relationship between machine learning image quality and comprehensiveness of TTE reporting. A machine learning model was developed and applied to TTEs from three matched cohorts for image quality of nine standard views. Case TTEs were comprehensive studies in mechanically ventilated patients between 01/01/2010 and 12/31/2015. For each case TTE, there were two matched spontaneously breathing controls (Control 1: Inpatients scanned in the lab and Control 2: Portable studies). We report the overall mean maximum and view specific quality scores for each TTE. The comprehensiveness of an echo report was calculated as the documented proportion of 12 standard parameters. An inverse probability weighted regression model was fit to determine the relationship between machine learning quality score and the completeness of a TTE report. 175 mechanically ventilated TTEs were included with 350 non-intubated samples (175 Control 1: Lab and 175 Control 2: Portable). In total, the machine learning model analyzed 14,086 echo video clips for quality. The overall accuracy of the model with regard to the expert ground truth for the view classification was 87.0%. The overall mean maximum quality score was lower for mechanically ventilated TTEs (0.55 [95% CI 0.54, 0.56]) versus 0.61 (95% CI 0.59, 0.62) for Control 1: Lab and 0.64 (95% CI 0.63, 0.66) for Control 2: Portable; p = 0.002. Furthermore, mechanically ventilated TTE reports were the least comprehensive, with fewer reported parameters. The regression model demonstrated the correlation of echo image quality and completeness of TTE reporting regardless of the clinical group. Mechanically ventilated TTEs were of inferior quality and clinical utility compared to spontaneously breathing controls and machine learning derived image quality correlates with completeness of TTE reporting regardless of the clinical group.

Side-hole catheters have higher thrombus aspiration efficiency than regular end-hole catheters in an in vitro model.

PURPOSE: We aimed to evaluate and compare thrombus aspiration efficiency between side-hole and end-hole thrombus-aspirating catheters. METHODS: Using an in vitro model of acute thrombus occlusion, we performed thrombus aspiration with two catheter designs. Two end-hole and two side-hole catheters, 8 F and 10 F in diameter, were examined. Thrombus aspiration was performed with each catheter 30 times, and the amount of thrombotic material aspirated in each attempt was determined. The mean weight of the thrombotic material and the mean weight of the non-fluid thrombotic material extracted in all 30 attempts by each catheter were also determined. RESULTS: The 10 F side-hole catheter aspirated more thrombotic material than did the 10 F end-hole catheter (44.76 g vs. 28.35 g). The 8 F side-hole catheter had higher thrombus aspiration capacity than did the 8 F end-hole catheter in terms of the mean weight of the aspirated thrombus at each aspiration attempt (1.41 g vs. 0.58 g; P < 0.001) and the mean volume of the aspirated thrombotic material at each aspiration attempt (1.79 mL vs. 1.01 mL; P < 0.001). The mean weight of the non-fluid thrombotic material aspirated with the side-hole catheters was higher than that aspirated by the end-hole catheters with the same diameter size (31.06 g vs. 22.41 g for the 10 F catheters; P < 0.001; and 4.54 g vs. 2.99 g for the 8 F catheters; P < 0.001). CONCLUSION: Side-hole catheters are more effective in aspirating acute thrombi. The added benefit of the side-hole design is more remarkable in smaller-sized catheters. Animal models are needed to examine their aspiration capacity in a real elastic vascular conduit and in the presence of wall-adherent thrombi.

Fungal communities decline with urbanization-more in air than in soil.

Increasing evidence suggests that degradation of biodiversity in human populated areas is a threat for the ecosystem processes that are relevant for human well-being. Fungi are a megadiverse kingdom that plays a key role in ecosystem processes and affects human well-being. How urbanization influences fungi has remained poorly understood, partially due to the methodological difficulties in comprehensively surveying fungi. Here we show that both aerial and soil fungal communities are greatly poorer in urban than in natural areas. Strikingly, a fivefold reduction in fungal DNA abundance took place in both air and soil samples already at 1 km scale when crossing the edge from natural to urban habitats. Furthermore, in the air, fungal diversity decreased with urbanization even more than in the soil. This result is counterintuitive as fungal spores are known to disperse over large distances. A large proportion of the fungi detectable in the air are specialized to natural habitats, whereas soil fungal communities comprise a large proportion of habitat generalists. The sensitivity of the aerial fungal community to anthropogenic disturbance makes this method a reliable and efficient bioindicator of ecosystem health in urban areas.

Characterizing Motor Control of Mastication With Soft Actor-Critic.

The human masticatory system is a complex functional unit characterized by a multitude of skeletal components, muscles, soft tissues, and teeth. Muscle activation dynamics cannot be directly measured on live human subjects due to ethical, safety, and accessibility limitations. Therefore, estimation of muscle activations and their resultant forces is a longstanding and active area of research. Reinforcement learning (RL) is an adaptive learning strategy which is inspired by the behavioral psychology and enables an agent to learn the dynamics of an unknown system via policy-driven explorations. The RL framework is a well-formulated closed-loop system where high capacity neural networks are trained with the feedback mechanism of rewards to learn relatively complex actuation patterns. In this work, we are building on a deep RL algorithm, known as the Soft Actor-Critic, to learn the inverse dynamics of a simulated masticatory system, i.e., learn the activation patterns that drive the jaw to its desired location. The outcome of the proposed training procedure is a parametric neural model which acts as the brain of the biomechanical system. We demonstrate the model's ability to navigate the feasible three-dimensional (3D) envelope of motion with sub-millimeter accuracies. We also introduce a performance analysis platform consisting of a set of quantitative metrics to assess the functionalities of a given simulated masticatory system. This platform assesses the range of motion, metabolic efficiency, the agility of motion, the symmetry of activations, and the accuracy of reaching the desired target positions. We demonstrate how the model learns more metabolically efficient policies by integrating a force regularization term in the RL reward. We also demonstrate the inverse correlation between the metabolic efficiency of the models and their agility and range of motion. The presented masticatory model and the proposed RL training mechanism are valuable tools for the analysis of mastication and other biomechanical systems. We see this framework's potential in facilitating the functional analyses aspects of surgical treatment planning and predicting the rehabilitation performance in post-operative subjects.

On Modelling Label Uncertainty in Deep Neural Networks: Automatic Estimation of Intra- Observer Variability in 2D Echocardiography Quality Assessment.

Uncertainty of labels in clinical data resulting from intra-observer variability can have direct impact on the reliability of assessments made by deep neural networks. In this paper, we propose a method for modelling such uncertainty in the context of 2D echocardiography (echo), which is a routine procedure for detecting cardiovascular disease at point-of-care. Echo imaging quality and acquisition time is highly dependent on the operator's experience level. Recent developments have shown the possibility of automating echo image quality quantification by mapping an expert's assessment of quality to the echo image via deep learning techniques. Nevertheless, the observer variability in the expert's assessment can impact the quality quantification accuracy. Here, we aim to model the intra-observer variability in echo quality assessment as an aleatoric uncertainty modelling regression problem with the introduction of a novel method that handles the regression problem with categorical labels. A key feature of our design is that only a single forward pass is sufficient to estimate the level of uncertainty for the network output. Compared to the 0.11 ± 0.09 absolute error (in a scale from 0 to 1) archived by the conventional regression method, the proposed method brings the error down to 0.09 ± 0.08, where the improvement is statistically significant and equivalents to 5.7% test accuracy improvement. The simplicity of the proposed approach means that it could be generalized to other applications of deep learning in medical imaging, where there is often uncertainty in clinical labels.

Can 3D imaging and digital software increase the ability to predict dental arch form after orthodontic treatment?

INTRODUCTION: This study aimed to evaluate the ability of dental clinicians to predict posttreatment dental arch forms in patients with malocclusion with the aid of 3D imaging and digital software in comparison with a conventional method. METHODS: Pretreatment and posttreatment dental plaster casts of 100 patients (200 maxillary models and 200 mandibular models) were selected. Three orthodontists selected the best-fitted archwires among 5 commercially available preformed nickel-titanium archwires using 2 methods. In the conventional method, they fit the archwires to pretreatment casts, and in the digital method, they fit the scanned wire to a 3D digital model, using Ortho-Aid, a locally developed 3D software, using clinical bracket points as reference for wire fitness. The predicted posttreatment archwire in each method was compared with the best-fit archwire on the actual posttreatment model of each patient in both methods, and the level of agreement was calculated. The interobserver agreement between the 3 orthodontists in each method was evaluated using intraclass correlation coefficient and the Dahlberg formula. RESULTS: Orthodontists predicted the final treatment outcome in 50% of cases using the conventional method and 58% using the digital method. However, the range of method error was significantly higher in the conventional method (0.425-3.853 mm for the conventional vs 0.451-0.584 mm for the digital). CONCLUSIONS: Although the clinicians' ability to predict the final dental arch form after orthodontic treatment and the agreement between clinicians increased by the use of digital equipment, orthodontists can predict the final arch form in about 60% of patients.

Three-dimensional measurement of tooth inclination: A longitudinal study.

BACKGROUND: New tools have been introduced for tooth inclination measurement and assessment of its changes over time. This study aimed to measure the change in inclination of teeth after the periods of 2 and 4 years in adolescents with normal occlusion using three-dimensional (3D) software. MATERIALS AND METHODS: This retrospective longitudinal study was conducted on 54 pairs of dental casts of 24 adolescents between 9 and 13 years of age with normal occlusion. The inclination of teeth was determined by 3D measurements using OrthoAid software. After scanning the casts via stereophotogrammetric scanner, the mean and standard deviation of inclination of teeth were calculated at three time points. Change in these values was calculated after 2 and 4 years. The effect of sex, duration of follow-up, and the jaw (maxilla/mandible) on change of inclination was analyzed using the Mann-Whitney and Wilcoxon tests. P < 0.05 was considered statistically significant. RESULTS: Incisor teeth torque was positive in the maxilla (9.72 ± 8) and mandible (4.22 ± 6.09), but it was negative for the canine (-7.73 ± 6.3 for maxilla and -9.9 ± 5.22 for mandible), premolar (-10.35 ± 6.84 for maxilla and -26.51 ± 9.94 for mandible), and molar teeth (-13.23 ± 6.22 for maxilla and -39.78 ± 9.5 for mandible) in both jaws. Maxillary lateral incisor in boys showed the greatest change of inclination in both 2 and 4 years (about 7°) and the mandibular canine tooth in girls showed the least change of inclination in 4 years (4°). CONCLUSION: Sex significantly affected the changes in the inclination of teeth throughout the period of study. The variation of changes in torque was considerable, and no consistent pattern was defined.

Agreement of the clinician's choice of archwire selection on conventional and virtual models.

OBJECTIVES: To compare archwire selection on dental casts with archwire selection using a three-dimensional (3D) software program (OrthoAid) and assess agreement between clinicians. MATERIALS AND METHODS: The best-fitting archwires were selected for dental casts of 100 patients with malocclusion using two approaches by three orthodontists. The first method was to visually determine the fitness of five preformed nickel titanium archwires to the arch form on a dental cast (subjective method). The second method was archwire selection on a virtual image of the same cast by means of 3D software (objective method). Agreement between selections performed by the orthodontists was calculated using Kappa statistics. The accuracy of fit of the archwires to the curves fitted to the arch form was also calculated or reversely assessed by means of the root mean square (RMS) for both methods using the Dahlberg formula. RESULTS: The mean RMS of the distances between the patient arch forms and the archwires for the subjective method was 1.163-1.366 mm. The agreement of selections between orthodontists was 42%-58% (Kappa ranged from .074 to .382). Using the 3D software (objective method), the mean RMS decreased to 0.966-1.171 mm, and agreement increased to 47% to 84% (Kappa ranged from .444 to .747). CONCLUSIONS: The use of 3D computer software for archwire selection in patients with malocclusion provided better adaptation and interexaminer reliability.