Efficacy of Metal Artifact Reduction Algorithm of Cone-Beam Computed Tomography for Detection of Fenestration and Dehiscence around Dental Implants.

BACKGROUND: Beam hardening and scattering artifacts from high-density objects such as dental implants adversely affect the image quality and subsequently the detection of fenestration or dehiscence around dental implants. OBJECTIVE: This study aimed to assess the efficacy of metal artifact reduction (MAR) algorithm of two cone-beam computed tomography (CBCT) systems for detection of peri-implant fenestration and dehiscence. MATERIAL AND METHODS: In this experimental study, thirty-six titanium implants were placed in bone blocks of bovine ribs. Fenestration and dehiscence were created in the buccal bone around implants. CBCT images were obtained using Cranex 3D and ProMax 3D CBCT systems with and without MAR algorithm. Two experienced radiologists observed the images. Data were analyzed using SPSS software. The Kappa coefficient of agreement, the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and accuracy of different imaging modalities were calculated and analyzed. RESULTS: In both CBCT systems, the use of MAR algorithm decreased the area under the ROC curve and subsequently the diagnostic accuracy for the detection of fenestration and dehiscence. The sensitivity, specificity and accuracy of both CBCT systems were higher in absence of the MAR algorithm. The specificity of ProMax 3D for detection of fenestration was equal with/without the MAR algorithm. CONCLUSION: Although CBCT is suitable for detection of peri-implant defects, the application of the MAR algorithm does not enhance the detection of peri-implant fenestration and dehiscence.

Quality of Work Life in Family Physicians of Bam, Iran.

Objective: Quality of work life is one of the most important variables recently considered by many managers who seek to improve the quality of their human resources. Considering the vital factor of job satisfaction of family physicians as a service provider, this study was conducted to evaluate the quality of working life of family physicians in Bam. Materials and methods: This research is a cross-sectional and descriptive type. Research population includes all family physicians working at health centers in Bam. The Van Larr Quality of Work Life Questionnaire, which was validated by Nekoei Moghadam, was used. The questionnaire data is analyzed by SPSS 24 from statistical-descriptive tests (mean and standard deviation) and T-test and ANOVA. Results: Quality of work life score in family physicians is obtained 2.93 out of 5. Control ambiance in work (CAW) has the highest mean (3.16) and Work-life balance (WLB) has the lowest mean (2.29). Work experience has a meaningful relationship just with the two components of WLB and SAW in Quality of work life (p = 0.036). Furthermore, in the factor of GWB, the average score of unmarried physicians (Mean = 3.18) were more than the married ones (Mean = 3.05) (p = 0.010). The mean score of unmarried physicians was more than the married ones. Conclusion: The quality of work life from the family physicians is about upper-intermediate. Thus, authorities of the family physician concept in the ministry of Health, and also in the Bam city should pay more attention to the family physician's work life and consider programs and solutions in order to improve it.

Bone Marrow Edema Syndrome in the Foot and Ankle.

Bone marrow edema syndrome (BMES) is an uncommon and self-limited syndrome characterized by extremity pain of unknown etiology. Symptoms may include sudden or gradual onset of swelling and pain at rest or during activity, usually at night. This syndrome mostly affects middle-aged men and younger women who have pain in the lower extremities. The most common sites involved with BMES, in decreasing order of frequency, are the bones about the hip, knee, ankle, and foot. The diagnosis of BMES is confirmed with magnetic resonance imaging to exclude other causes of bone marrow edema. The correct diagnosis in the foot and ankle often is delayed because of the low prevalence and nonspecific signs. This delay may intensify bone pain and impair patient function and quality of life. The goal of BMES treatment is to relieve pain and shorten disease duration. Treatment options are limited and may include symptomatic treatment, pharmacologic treatment, and surgery. LEVEL OF EVIDENCE: Level V, expert opinion.

Distal Radioulnar Joint Instability.

Distal radioulnar joint (DRUJ) instability is a common clinical condition but a frequently missed diagnosis. Both surgical and nonsurgical treatments are possible for chronic cases of DRUJ instability. Nonsurgical treatment can be considered as the primary therapy in less active patients, while surgery should be considered to recover bone and ligament injuries if nonsurgical treatment fails to restore forearm stability and function. The appropriate choice of treatment depends on the individual patient and specific derangement of the DRUJ.