Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 13 de 13
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
2.
Surg Radiol Anat ; 42(2): 219-228, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31456002

RESUMO

PURPOSE: To evaluate the reliability of cone beam computed tomography (CBCT) imagining in the assessment of the frequency, location, and morphological characteristics of accessory maxillary ostia (AMOs), and to analyze a potential association with sinus and dentoalveolar pathologies. METHODS: CBCT scans with bilateral maxillary sinuses that were acquired from September 2016 to September 2018 were initially screened. A total of 160 CBCT scans (320 sinuses) that fulfilled the inclusion criteria were included for further analysis. The presence, location, and morphological characteristics of the AMOs were evaluated in axial, coronal, and sagittal CBCT views. The findings were correlated with age, gender, sinus, and dentoalveolar pathology to assess for potential influencing factors on AMOs. RESULTS: An AMO was present in 151 (47.2%) of the 320 sinuses. Most of the AMOs were located within the region of the nasal fontanelle or hiatus semilunaris (81.1%) presenting with an ovaloid (48.4%) or a round shape (39.0%). The average length of the AMOs was 2.33 ± 1.42 mm, occupying an area of 3.43 ± 4.51 mm2, respectively. Morphological changes of the maxillary sinus mucosa were positively associated with length and area of AMOs. Furthermore, the status of the dentition in the posterior maxilla seemed to be an influencing factor on AMO shape. CONCLUSIONS: Nearly half of the maxillary sinuses assessed in the present study population had an AMO. Pathologies of the maxillary sinus seem to have an impact on AMOs, which is demonstrated here by morphological changes of the sinus mucosa being associated with an increase in length and area of accessory ostia.

3.
Dentomaxillofac Radiol ; 49(1): 20190107, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31386555

RESUMO

OBJECTIVES: To investigate the current clinical applications and diagnostic performance of artificial intelligence (AI) in dental and maxillofacial radiology (DMFR). METHODS: Studies using applications related to DMFR to develop or implement AI models were sought by searching five electronic databases and four selected core journals in the field of DMFR. The customized assessment criteria based on QUADAS-2 were adapted for quality analysis of the studies included. RESULTS: The initial electronic search yielded 1862 titles, and 50 studies were eventually included. Most studies focused on AI applications for an automated localization of cephalometric landmarks, diagnosis of osteoporosis, classification/segmentation of maxillofacial cysts and/or tumors, and identification of periodontitis/periapical disease. The performance of AI models varies among different algorithms. CONCLUSION: The AI models proposed in the studies included exhibited wide clinical applications in DMFR. Nevertheless, it is still necessary to further verify the reliability and applicability of the AI models prior to transferring these models into clinical practice.


Assuntos
Inteligência Artificial , Radiografia Dentária , Radiologia , Algoritmos , Inteligência Artificial/normas , Inteligência Artificial/tendências , Humanos , Radiografia Dentária/métodos , Radiografia Dentária/tendências , Reprodutibilidade dos Testes
4.
Head Neck ; 41(9): 2860-2872, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30985039

RESUMO

BACKGROUND: To investigate the benefits of adjunctive Chinese herbal medicine (CHM) for patients with nasopharyngeal carcinoma (NPC). METHODS: We included all patients diagnosed with NPC during 1997-2009 and followed until 2011 in Taiwan. We used 1:1 frequency matching by age, sex, comorbidity, conventional treatment, and index year to compare the CHM users and non-CHM users (n = 2542 each). The prescribed CHM was further investigated with regard to its cytotoxicity. RESULTS: Compared with non-CHM users, adjunctive CHM users had a lower hazard ratio of mortality risk, and a better survival probability. Gan-Lu-Yin (GLY) was the most commonly prescribed CHM, and it reduced cell viability, inhibited tumor proliferation, and induced apoptosis through the poly (ADP-ribose) polymerase and caspase-3-dependent pathway in human NPC TW01 cells. Oral administration of GLY retarded NPC-TW01 tumor growth in the xenograft nude mouse model. CONCLUSION: Real-world data and laboratory experiments implied that adjunctive CHM might be beneficial for NPC patients.

5.
Clin Oral Investig ; 23(11): 3977-3986, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30737619

RESUMO

OBJECTIVES: This retrospective study evaluated the visibility, location, and morphology of the primary maxillary ostium (PMO), as well as the presence and number of accessory maxillary ostia (AMO) in the maxillary sinus using cone beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT scans with a large field of view with both maxillary sinuses entirely visible, acquired from February 2016 to February 2018, were initially screened. Patients were included if there was no history of surgical intervention/trauma in the sinus region. Two observers evaluated the CBCTs for PMO and AMOs independently. PMO and AMOs were evaluated in axial, coronal, and sagittal CBCT views. In case of disagreement, a third observer served as a referee. The findings were correlated with age, gender, condition of the sinus mucosa, and status of the dentition to assess for potential influencing factors. RESULTS: A total of 184 patients (368 maxillary sinuses) were included. PMO was present and patent in 346 (94.0%) of the 368 analyzed sinuses. Most of the PMOs were located above the attachment of and in the middle third of the inferior turbinate (76.1%) and exhibited a slit shape (71.1%). An AMO was present in 167 (45.5%) of the 368 analyzed sinuses, and 66 (17.9%) sinuses had multiple AMOs. Gender and sinus mucosa morphology were found to be influencing factors for the patency of the PMO. Furthermore, gender seems to be influencing the presence of an AMO. CONCLUSIONS: Most of the analyzed maxillary sinus cavities in the present population had a patent PMO. Being male and having morphological changes of the sinus mucosa were factors associated with a reduced prevalence of a patent PMO. CLINICAL RELEVANCE: A maxillary sinus with pathological findings of the mucosa seems to have a reduced prevalence of patent PMOs. Therefore, clinicians should take care to assess any clinical and radiographical sign indicating a potential maxillary sinusitis prior to surgical interventions in this region, especially in cases with planned sinus floor elevation.


Assuntos
Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Tomografia Computadorizada de Feixe Cônico Espiral , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Estudos Retrospectivos
6.
Clin Implant Dent Relat Res ; 21(2): 310-316, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30793468

RESUMO

BACKGROUND: Abnormalities of some facial bones derived from the ectomesenchyme have been found in ectodermal dysplasia (ED) patients, but the characteristics of the zygoma are unknown. PURPOSE: Comparison between ED patients and normal individuals to understand the anatomical features of the zygoma in ED patients. MATERIALS AND METHODS: Thirty patients diagnosed with ED based on clinical features and/or gene sequence tests and 80 normal individuals were recruited from 2016 to 2018. The thickness of the zygomatic body at 12 points on the superior, middle, and inferior areas and the length of four lines were measured on a three-dimensional cone beam computed tomography image. Differences between ED patients and normal individuals were then compared. RESULTS: The zygomatic thicknesses and lengths were smaller in ED patients than in normal individuals. For ED patients, the largest thicknesses on the superior, middle, and inferior areas of the zygoma were 8.47 ± 1.49, 7.03 ± 1.56, and 5.99 ± 1.22 mm. CONCLUSION: The development of zygomatic thickness on the inferior area and the zygomatic length were insufficient in ED patients with oligodontia. Consequently, zygomatic hypoplasia presented difficulties for the "quad approach" to zygomatic implants in this group of patients.


Assuntos
Anodontia , Implantes Dentários , Displasia Ectodérmica , Implantação Dentária Endo-Óssea , Humanos , Maxila , Zigoma
7.
Int J Oral Maxillofac Implants ; 34(1): 85­90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30521651

RESUMO

PURPOSE: Real-time surgical navigation has been increasingly applied in implant placement. The initial registration procedures were found to substantially affect the overall accuracy of the system for zygomatic implant placement, but the exact number and distribution of fiducial markers was yet undetermined. This study aimed to determine the minimal numbers and optimal distributions of fiducial markers to achieve clinically acceptable accuracy in surgical navigation, through systematically analyzing the effects of different setups of fiducial markers on target registration errors (TRE). MATERIALS AND METHODS: A maxillary phantom with bone-anchored fiducial markers was scanned using cone beam computed tomography, followed by data processing on Brainlab, a commercially available navigation system. A total of 10 mini-screws were inserted in the edentulous maxilla for configuration of fiducial markers, with another two mini-screws as implant targets to assess TRE in zygomatic bone. Data were then collected in nine configurations with distinct fiducial numbers and positions. Statistical analyses were performed with SPSS. RESULTS: Accuracy of the surgical navigation system was found to depend on both the numbers and positions of fiducial markers. No significant difference was observed in accuracy among groups with eight fiducials and with polygon span distribution (P > .05). When the fiducial numbers decreased to less than six, the markers inserted in a regular triangle area were more precise than in an inverse triangle configuration. When the number of fiducials was five with a polygonal distribution, a low TRE value of 0.59 mm was detected, which was comparable to the accuracy with more than eight fiducials in the study. CONCLUSION: A scattered distribution with a polygon span with at least five fiducial markers in the edentulous maxilla for registration seems to achieve an acceptable TRE value with a high accuracy for navigation in zygomatic implant placement.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Marcadores Fiduciais , Processamento de Imagem Assistida por Computador , Arcada Edêntula/cirurgia , Cirurgia Assistida por Computador/métodos , Zigoma/cirurgia , Humanos , Arcada Edêntula/reabilitação , Maxila/cirurgia , Imagens de Fantasmas
8.
J Oral Maxillofac Surg ; 76(1): 80-87, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28911958

RESUMO

PURPOSE: Computer-aided treatment technology has extended its applications to oral implantology. This report describes the authors' initial clinical experience on the application of a commercially available navigation system (VectorVision) in zygomatic implant (ZI) insertion in the severely atrophic maxilla. MATERIALS AND METHODS: This was a retrospective longitudinal study. Eligible patients with maxillary edentulism who were treated with ZI placement were enrolled. Treatment planning was performed on the computer based on previously obtained 3-dimensional imaging data. The surgical procedure was carried out under the guidance of a surgical navigation system. The outcome variable was safety and additional variables were ZI survival rate and radiologic bone-to-implant contact (rBIC) area in the zygoma. Statistical analysis was performed with SPSS 16.0 for Windows (SPSS, Inc, Chicago, IL). RESULTS: Fifteen patients (8 men, 7 women; age range, 30 to 69 yr; average age, 43 ± 3.5 yr) were eligible for the study and were enrolled from May 2015 through September 2016. Of the included patients, each of 4 patients received 1 ZI on each side of the zygomatic bone and 2 to 4 standard implants in the edentulous anterior maxilla; the other 11 received a ZI "quad approach" without standard implant insertion. All ZIs were anchored in the site of the maxillary alveolar process and zygomatic bone, and no critical anatomic structure injuries occurred during insertion and postoperative radiographic examination. All ZIs achieved osseointegration, for an overall survival rate of 100% after early healing. The overall rBIC area of ZIs in the study was 4.1 to 24.7 mm (average, 14.5 ± 4.6 mm). CONCLUSION: For the limited clinical cases treated in this study, the procedure for ZI placement was feasible and reliable with the guidance of the surgical navigation system. In addition, the potential risk of complications was minimized and ZIs were placed to make the best possible use of the available bone volume.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Maxila/cirurgia , Cirurgia Assistida por Computador , Zigoma/cirurgia , Adulto , Idoso , Feminino , Humanos , Arcada Edêntula/cirurgia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
9.
Clin Implant Dent Relat Res ; 19(5): 841-848, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28766912

RESUMO

BACKGROUND: The zygomatic implant is suggested to be placed in zygomatic areas with the largest thickness, but regions to obtain the largest bone-to-implant contact (BIC) were unknown. PURPOSE: To identify the zygomatic regions for placing quad zygomatic implants that obtain the largest BIC. MATERIALS AND METHODS: The zygomatic thicknesses of 300 zygomata were measured at total 12 points on the superior, middle, and inferior areas on the 3-dimensional reconstruction images. In 50 edentulous maxillae, the zygomatic BICs of virtually placed implants were measured and the incidence of the intrusion into the infratemporal fossa calculated at each point. RESULTS: The largest thickness in the superior, middle, and inferior regions were at Point A1 (8.01 ± 2.10 mm), Point B1 (7.02 ± 1.73 mm), and Point C0 (6.65 ± 1.66 mm), respectively. The virtually placed implants at Point A3 (16.70 ± 4.18 mm) and Point B1 (12.07 ± 3.84 mm) had the highest BICs while retaining the minimum incidence of the intrusion complications. CONCLUSION: To obtain the largest BICs and avoid the intrusion complications, results suggested that the postero-superior region (Point A3 ) and the center of zygoma (Point B1 ) were the optimal places for the placement of quad zygomatic implants.


Assuntos
Implantação Dentária , Implantes Dentários , Boca Edêntula/cirurgia , Zigoma/anatomia & histologia , Adulto , Idoso , Pesos e Medidas Corporais , Tomografia Computadorizada de Feixe Cônico , Planejamento de Prótese Dentária , Feminino , Humanos , Masculino , Maxila , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem , Zigoma/diagnóstico por imagem
10.
J Ethnopharmacol ; 199: 168-174, 2017 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-28163114

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Many patients with gastric cancer seek traditional medicine consultations in Asian countries. This study aimed to investigate the prescription of Chinese herbal medicine (CHM) and its benefits for the patients with gastric cancer in Taiwan. METHODS: From the Registry for Catastrophic Illness Patients Database, we included all patients with gastric cancer whose age at diagnosis was ≥18 from 1997 to 2010 in Taiwan. We used 1:1 frequency matching by age, sex, Charlson comorbidity score, treatment and index year to compare the CHM users and non-CHM users. We used the Cox regression model to compare the hazard ratios (HR) for the risk of mortality and the Kaplan-Meier curve for the survival time. RESULTS: There was a total of 1333 patients in the CHM-cohort and 44786 patients in the non-CHM cohort. After matching, we compared 962 newly diagnosed CHM users and 962 non-CHM users. Adjusted HRs (aHR) were higher among patients of above 60-year-old group, with a Charlson Comorbidity Index score ≥2 before the index date, and those who need surgery combined with chemotherapy or radiotherapy. CHM users had a lower HR of mortality risk (adjusted HR: 0.55, 95% CI: 0.48-0.62). Compared to the non-CHM users, the aHR among CHM-users is 0.37 (95% CI:0.2-0.67) for those who used CHM more than 180 days annually. The Kaplan-Meier curve revealed that the survival probability was higher for complementary CHM-users. Bai-Hua-She-She-Cao (Herba Hedyotidis Diffusae) was the most commonly used single herb and Xiang-Sha-Liu-Jun-Zi-Tang was the most commonly used herbal formula among CHM prescriptions. CONCLUSIONS: Complementary CHM improves the overall survival among patients with gastric cancer in Taiwan. Further ethnopharmacological investigations and clinical trials are required to validate the efficacy and safety.


Assuntos
Terapias Complementares/métodos , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa/métodos , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/mortalidade , Adolescente , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos , Neoplasias Gástricas/diagnóstico , Taxa de Sobrevida/tendências , Taiwan/epidemiologia , Adulto Jovem
11.
Clin Implant Dent Relat Res ; 19(3): 458-465, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28219120

RESUMO

BACKGROUND: A real-time surgical navigation system potentially increases the accuracy when used for quad-zygomatic implant placement. PURPOSE: To evaluate the accuracy of a real-time surgical navigation system when used for quad zygomatic implant placement. MATERIALS AND METHODS: Patients with severely atrophic maxillae were prospectively recruited. Four trajectories for implants were planned, and zygomatic implants were placed using a real-time surgical navigation system. The planned-placed distance deviations at entry (entry deviation)points, exit (exit deviation) points, and angle deviation of axes (angle deviation) were measured on fused operation images. The differences of all the deviations between different groups, classified based on the lengths and locations of implants, were analysed. A P value of < 0.05 indicated statistical significance. RESULTS: Forty zygomatic implants were placed as planned in 10 patients. The entry deviation, exit deviation and angle deviation were 1.35 ± 0.75 mm, 2.15 mm ± 0.95 mm, and 2.05 ± 1.02 degrees, respectively. The differences of all deviations were not significant, irrespective of the lengths (P = .259, .158, and .914, respectively) or locations of the placed implants (P = .698, .072, and .602, respectively). CONCLUSION: A real-time surgical navigation system used for the placement of quad zygomatic implants demonstrated a high level of accuracy with only minimal planned-placed deviations, irrespective of the lengths or locations of the implants.


Assuntos
Maxila/cirurgia , Doenças Maxilares/cirurgia , Próteses e Implantes , Zigoma/cirurgia , Atrofia , Humanos , Maxila/patologia , Projetos Piloto
12.
Int J Oral Maxillofac Implants ; 31(6): 1444-1449, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27861671

RESUMO

This case report describes the clinical application of a real-time surgical navigation system to guide zygomatic implants on their placement. With the assistance of this novel navigation system, constant visualization of the drilling trajectory and exact control of the drilling direction can be achieved, which could minimize the risk of penetration into critical anatomical structures. Moreover, implants might be accurately placed in accordance to the preoperative planned position. In this patient, who had previously undergone a hemimaxillectomy, three zygomatic implants were placed on the unilateral zygoma, and two conventional implants were placed on the unresected maxilla. Measurement of distributive deviation of implants between preoperative planning and the postoperative result showed the mean linear deviations at the entrance and apical point of the implant were 1.07 ± 0.15 mm (range: 0.9 to 1.1 mm) and 1.20 ± 0.46 mm (range: 0.7 to 1.6 mm), respectively. The mean angle deviation between the axes of the planned and the actual implant was 1.37 ± 0.21 degrees (range: 1.2 to 1.3 degrees). Therefore, this surgical navigation system represents a reliable approach to guide the placement of zygomatic implants.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Maxila/cirurgia , Cirurgia Assistida por Computador , Zigoma/cirurgia , Idoso , Processo Alveolar/cirurgia , Humanos , Masculino , Resultado do Tratamento
13.
Laryngoscope ; 122(12): 2818-23, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23239141

RESUMO

OBJECTIVES/HYPOTHESIS: The mechanisms of cholesteatoma proliferation and growth remain unclear. The objective of this study is to discover the potential mechanisms of the proliferation and growth of cholesteatoma by direct experimental assessments on cholesteatoma tissues from patients. STUDY DESIGN: Retrospective study by the comparisons between cholesteatoma tissues and retroauricular skin tissues from the patients. METHODS: Two-dimensional gel electrophoresis, LC-MS/MS analysis and immunohistochemistry were performed to investigate specific protein expression in cholesteatoma tissues compared with retroauricular skin tissues collected from the patients. Western blotting analysis was conducted to verify the regulation of specific proteins found by 2-DE, and to determine the changes of associated potential modulators in cholesteatoma proliferation and growth. RESULTS: Twelve serpin B3 isoforms were found by 2-DE and identified by LC-MS/MS analysis, which is coherent with the results exhibited by immunohistochemistry and western blot. Up-regulation of STAT3 and down-regulations of cathepsin K and cathepsin L were represented using western blot. CONCLUSIONS: The data in this study suggested serpin B3, STAT3, cathepsin K, and cathepsin L are associated with the proliferation and growth of cholesteatoma, and these proteins may be influential factors in cholesteatoma growth.


Assuntos
Antígenos de Neoplasias/genética , Colesteatoma da Orelha Média/genética , DNA/genética , Serpinas/genética , Regulação para Cima , Adolescente , Adulto , Idoso , Antígenos de Neoplasias/biossíntese , Western Blotting , Proliferação de Células , Criança , Colesteatoma da Orelha Média/metabolismo , Colesteatoma da Orelha Média/patologia , Progressão da Doença , Eletroforese em Gel Bidimensional , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Serpinas/biossíntese , Espectrometria de Massas em Tandem , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA