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1.
Bone Joint J ; 101-B(10): 1218-1229, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564157

RESUMO

AIMS: Abnormal femoral torsion (FT) is increasingly recognized as an additional cause for femoroacetabular impingement (FAI). It is unknown if in-toeing of the foot is a specific diagnostic sign for increased FT in patients with symptomatic FAI. The aims of this study were to determine: 1) the prevalence and diagnostic accuracy of in-toeing to detect increased FT; 2) if foot progression angle (FPA) and tibial torsion (TT) are different among patients with abnormal FT; and 3) if FPA correlates with FT. PATIENTS AND METHODS: A retrospective, institutional review board (IRB)-approved, controlled study of 85 symptomatic patients (148 hips) with FAI or hip dysplasia was performed in the gait laboratory. All patients had a measurement of FT (pelvic CT scan), TT (CT scan), and FPA (optical motion capture system). We allocated all patients to three groups with decreased FT (< 10°, 37 hips), increased FT (> 25°, 61 hips), and normal FT (10° to 25°, 50 hips). Cluster analysis was performed. RESULTS: We found a specificity of 99%, positive predictive value (PPV) of 93%, and sensitivity of 23% for in-toeing (FPA < 0°) to detect increased FT > 25°. Most of the hips with normal or decreased FT had no in-toeing (false-positive rate of 1%). Patients with increased FT had significantly (p < 0.001) more in-toeing than patients with decreased FT. The majority of the patients (77%) with increased FT walk with a normal foot position. The correlation between FPA and FT was significant (r = 0.404, p < 0.001). Five cluster groups were identified. CONCLUSION: In-toeing has a high specificity and high PPV to detect increased FT, but increased FT can be missed because of the low sensitivity and high false-negative rate. These results can be used for diagnosis of abnormal FT in patients with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy. However, most of the patients with increased FT walk with a normal foot position. This can lead to underestimation or misdiagnosis of abnormal FT. We recommend measuring FT with CT/MRI scans in all patients with FAI. Cite this article: Bone Joint J 2019;101-B:1218-1229.


Assuntos
Artroscopia/métodos , Impacto Femoroacetabular/cirurgia , Imagem Tridimensional , Metatarso Valgo/diagnóstico por imagem , Metatarso Varo/diagnóstico por imagem , Osteotomia/efeitos adversos , Adulto , Análise de Variância , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Impacto Femoroacetabular/diagnóstico por imagem , Fêmur/fisiopatologia , Seguimentos , Humanos , Modelos Lineares , Imagem por Ressonância Magnética/métodos , Masculino , Metatarso Valgo/epidemiologia , Metatarso Varo/epidemiologia , Pessoa de Meia-Idade , Osteotomia/métodos , Prevalência , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodos , Anormalidade Torcional/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
2.
Prosthes. Esthet. Sci ; 8(31): 63-68, abr./mai./jun. 2019.
Artigo em Português | BBO - Odontologia | ID: biblio-1016238

RESUMO

A era digital está acontecendo na odontologia. Cada vez mais empresas surgem com inovações no mundo digital, que antes só era dominado por grandes empresas, como Amanngirrbach, Zirkonzahn, Straumann e Holland, empresas as quais dominam o mercado de fresadoras odontológicas. Mas, com a prototipagem 3D das impressoras tudo isso mudou, empresas de menor porte têm a opção de trazer para o mercado máquinas que nos deixam com uma opção muito ágil na área odontológica. Trabalhos como provisórios, dentaduras e protocolos acrílicos podem ser impressos em tempo recorde, e a parte de fresagem de cera, que as fresadoras fazem, a impressora consegue entregar com maestria, com tempo e custo operacional inferior.(AU).


Digital age is happening in dentistry. More and more companies are coming up with innovations in the digital world that were once dominated by large companies such as Amanngirrbach, Zirkonzahn, Straumann and Holland, which dominate the dental milling machines market. But with 3D printing prototyping all this has changed, smaller companies have the option of bringing into the machines that leave us with a very nimble option in the dental area. The work with provisionals, dentures, and acrylic protocols can be printed out in a Record time, and the wax milling that milling machines make are delivered masterfully by the printer within less time and lower operating costs.


Assuntos
Tecnologia Odontológica , Informática Odontológica , Impressão Tridimensional , Imagem Tridimensional
3.
Rev Assoc Med Bras (1992) ; 65(8): 1055-1060, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31531601

RESUMO

OBJECTIVE: This study aims to investigate the causes of misdiagnosis in assessing tubal patency by transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy), in order to improve the diagnostic efficiency of TVS RT-3D-HyCoSy. METHODS: A total of 162 oviducts of 83 infertility patients were examined by TVS RT-3D-HyCoSy. These results were compared with the gold standard for laparoscopic dye studies, and the misdiagnosed cases were analyzed. RESULTS: TVS RT-3D-HyCoSy revealed that 68 oviducts were unobstructed and 94 obstructed. The results for the 144 oviducts were in line with the gold standard, while those for 18 oviducts were not. The accuracy rate of the TVS RT-3D-HyCoSy was 88.9%, and the misdiagnosis rate was 11.1%. The main causes of misdiagnosis included contrast medium countercurrent and diffusion, oviduct spasm, abnormal shape or position of the oviduct, pelvic adhesion, and poor imaging operation. CONCLUSION: TVS RT-3D-HyCoSy can well-evaluate tubal patency, and understand and improve the cause of misdiagnosis. Furthermore, the diagnostic efficiency of TVS RT-3D-HyCoSy can still be further improved.


Assuntos
Tubas Uterinas/diagnóstico por imagem , Infertilidade Feminina/diagnóstico por imagem , Adulto , Erros de Diagnóstico , Endossonografia , Testes de Obstrução das Tubas Uterinas/métodos , Feminino , Humanos , Histerossalpingografia , Imagem Tridimensional , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
4.
Medicine (Baltimore) ; 98(37): e17142, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517856

RESUMO

Morphological data of talus are important for the design of talar prostheses. The talar morphology of Chinese population has been rarely reported. This study adopted a three-dimensional (3D) measurement approach to provide accurate data for the anatomical morphology of talus in Northeast Chinese population and compared it with that of foreigners.One hundred forty-six healthy subjects form Northeast China underwent computed tomography (CT) arthrography. 3D digital talar model was reconstructed and thirteen morphological parameters were measured through Mimics and Magics software. Length and breadth indexes of total talus, trochlea, medial and lateral malleolus articular surface were mainly selected. Statistical analysis was conducted by independent-samples and paired-samples t test through SPSS software.All the indexes were normally distributed. No significant difference between left and right talus was identified in either males or females (P > .05). Most of the indexes showed significant sexual differences except the radian of lateral malleolus articular surface and the posterior breadth of trochlea (P < .05). The talar anatomy of Chinese subjects is different from the published data in other populations.The promising approach adopted in this study addresses some inconvenience with previous conventional methods on cadaver specimens. The geometric parameters of talus in Chinese population differ from those in other populations. The talar measurements and morphology analysis in this study suggest that population characteristics should be taken into account. This study will provide references for the design of talar prostheses in Chinese population.


Assuntos
Imagem Tridimensional , Ossos do Tarso/anatomia & histologia , Ossos do Tarso/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , China , Feminino , Humanos , Imagem Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Tamanho do Órgão , Reprodutibilidade dos Testes , Caracteres Sexuais , Software , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
5.
Braz Oral Res ; 33: e079, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31531565

RESUMO

Cell therapy associated with guided bone regeneration (GBR) can be used to treat bone defects under challenging conditions such as osteoporosis. This study aimed to evaluate the effect of mesenchymal stem cells (MSCs) in combination with a poly(vinylidene-trifluoroethylene)/barium titanate (PVDF-TrFE/BT) membrane on bone repair in osteoporotic rats. Osteoporosis was induced in female rats by bilateral removal of the ovaries (OVX) or sham surgery (SHAM), and the osteoporotic condition was characterized after 5 months by microtomographic and morphometric analyses. Calvarial defects were created in osteoporotic rats that immediately received the PVDF-TrFE/BT membrane. After 2 weeks, bone marrow-derived MSCs from healthy rats, characterized by the expression of surface markers using flow cytometry, or phosphate-buffered saline (PBS) (Control) were injected into the defects and bone formation was evaluated 4 weeks post-injection by microtomographic, morphometric, and histological analyses. A reduction in the amount of bone tissue in the femurs of OVX compared with SHAM rats confirmed the osteoporotic condition of the experimental model. More bone formation was observed when the defects were injected with MSCs compared to that with PBS. The modification that we are proposing in this study for the classical GBR approach where cells are locally injected after a membrane implantation may be a promising therapeutic strategy to increase bone formation under osteoporotic condition.


Assuntos
Compostos de Bário/farmacologia , Regeneração Tecidual Guiada/métodos , Células-Tronco Mesenquimais/fisiologia , Osteogênese/efeitos dos fármacos , Osteoporose/terapia , Polivinil/farmacologia , Titânio/farmacologia , Animais , Compostos de Bário/química , Densidade Óssea , Regeneração Óssea/efeitos dos fármacos , Regeneração Óssea/fisiologia , Feminino , Citometria de Fluxo , Imagem Tridimensional , Células-Tronco Mesenquimais/química , Osteogênese/fisiologia , Osteoporose/fisiopatologia , Ovariectomia , Polivinil/química , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes , Fatores de Tempo , Titânio/química , Resultado do Tratamento
6.
Urologiia ; (4 ()): 12-18, 2019 Sep.
Artigo em Russo | MEDLINE | ID: mdl-31535792

RESUMO

AIM: to show the importance of interdisciplinary interaction in the process of applying 3D technologies in surgical treatment of patients with urological diseases starting from planning of the treatment tactics using a virtual surgical model with the possibility of preoperative training on a personalized 3D-printed model, ending with the use of the obtained data as navigation during real surgical intervention.


Assuntos
Imagem Tridimensional , Impressão Tridimensional , Urologia , Humanos , Modelos Anatômicos
7.
Am J Orthod Dentofacial Orthop ; 156(3): 326-336, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474262

RESUMO

INTRODUCTION: Orthodontic mini-implants aid in the correction of distocclusions via direct anchorage (pull from mini-implant to teeth) and indirect anchorage (teeth pulled against other teeth anchored by the mini-implant). The aim of this study was to compare stress levels on the periodontal ligament (PDL) of maxillary buccal teeth in direct and indirect distalization against orthodontic mini-implants and accounting for individual variation in maxillary anatomy and biomechanical characteristics of the compact bone. METHODS: A 3D model of the maxilla containing the different components (teeth, PDL, trabecular and cortical bones) was generated from a computed tomographic scan. Cortical bone was divided into several areas according to previously defined zones. Bone stiffness and thickness data, obtained from 11 and 12 cadavers, respectively, were incorporated into the initial model to simulate the individual cortical bone variation at the different locations. Subsequently, a finite element analysis was used to simulate the distalization modalities. RESULTS: Stresses at the buccal, palatal, mesial, and distal surfaces were significantly different between adjacent teeth under stiffness but not thickness variation. In both distalization modalities, low or no significant correlations were found between stress values and corresponding cortical bone thicknesses. High significant and inverted correlations were observed at the first molar between stress amounts and cortical bone stiffness (direct modality: -0.68 < r < -0.72; indirect modality: -0.80 < r < -0.82; P <0.05). CONCLUSIONS: With the use of a novel finite element approach that integrated human data on variations in bone properties, findings suggested that cortical bone stiffness may influence tooth movement more than bone thickness. Significant clinical implications could be related to these findings.


Assuntos
Análise do Estresse Dentário/métodos , Análise de Elementos Finitos , Técnicas de Movimentação Dentária/métodos , Fenômenos Biomecânicos , Parafusos Ósseos , Simulação por Computador , Implantes Dentários , Humanos , Imagem Tridimensional/métodos , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Modelos Anatômicos , Dente Molar , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico , Ligamento Periodontal , Estresse Mecânico , Técnicas de Movimentação Dentária/instrumentação , Torção Mecânica
8.
Am J Orthod Dentofacial Orthop ; 156(3): 337-344, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474263

RESUMO

INTRODUCTION: Clinical evaluation of the midface including the paranasal and upper lip regions is highly subjective and complex. Traditional and 3-dimensional cephalometrics were not developed with the clinical appearance of these midfacial areas in mind and are therefore inappropriate surrogates for the clinical appearance of the midface, making them unsuitable as aids in diagnosing dentofacial deformities. The aim of this study was to evaluate traditional as well as newly defined landmarks and measurements and their correlation with clinical appearance of the midface. METHODS: Fifty-two subjects who underwent full-field cone-beam computed tomography were recruited for this study. A single examiner assessed each subject's midfacial region (paranasal and upper lip), and a second examiner obtained traditional and newly defined cephalometric measurements for each subject. Both examiners were blinded to each other's data throughout the study. Statistical analysis was performed to assess the correlations of the traditional and novel cephalometric measurements with clinical midfacial findings. The impact of the soft tissue thickness in the paranasal region was also analyzed. The performance of any classification derived from statistically significant variables was analyzed with the use of micro-F scores and area under the receiver operating characteristic curve (AUC). RESULTS: Both traditional (SNA) and newly defined measurements (SNANS, SNPR, SNNP, SNh) had no statistically significant correlation with clinical paranasal diagnosis. However, in the absence of upper lip procumbency or protrusion, SNNP and SNh had statistically significant correlations with clinical paranasal diagnosis (P = 0.047 and P = 0.003, respectively). For upper lip analysis, both traditional (SNA) and newly defined measurements (SNCEJ) had strong correlations with clinical upper lip diagnosis (P < 0.001). All statistically significant cephalometric variables had good intra- and interobserver reliability (correlation coefficients ≥0.972 and ≥ 0.968, respectively) except SNA, which had a low interobserver reliability (correlation coefficient 0.739). Fitted models for paranasal and upper lip analyses showed low micro-F scores, indicating low precision and recall. However, AUC values of 0.7019 and 0.6362 for the paranasal and upper lip analysis, respectively, suggest improved performance of the model when properly trained with a larger sample size. CONCLUSIONS: Newly defined measurements SNh and SNNP correlated with clinical paranasal diagnosis only in the absence of upper lip procumbency and protrusion. SNA and SNCEJ were strongly correlated with clinical upper lip diagnosis. However, fitted models based on this study sample yielded low micro-F scores, making the fitted models currently unsuitable for anything besides correlation with clinical findings. A larger sample size will be necessary to further clarify the potential roles of these measurements, especially given the reasonable AUC values. The findings of this study demonstrate the highly subjective and relative nature of midfacial diagnosis and the importance of clinical judgment despite the potential utility of some traditional and new measurements.


Assuntos
Pontos de Referência Anatômicos/anatomia & histologia , Pontos de Referência Anatômicos/diagnóstico por imagem , Cefalometria/métodos , Imagem Tridimensional/métodos , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Adolescente , Adulto , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Face/anatomia & histologia , Face/diagnóstico por imagem , Feminino , Humanos , Imagem Tridimensional/estatística & dados numéricos , Lábio/anatomia & histologia , Lábio/diagnóstico por imagem , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
9.
Am J Orthod Dentofacial Orthop ; 156(3): 365-374, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474266

RESUMO

INTRODUCTION: We sought the 3-dimensional (3D) zone of the center of resistance (ZCR) of mandibular posterior teeth groups (group 1: first molar; group 2: both molars; group 3: both molars and second premolar; group 4: both molars and both premolars) with the use of 3D finite element analysis. METHODS: 3D finite element models comprised the mandibular posterior teeth, periodontal ligament, and alveolar bone. In the symmetric bilateral model, a 100-g midline force was applied on a median sagittal plane at 0.1-mm intervals to determine the anteroposterior and vertical positions of the ZCR (where the applied force induced translation). The most reliable buccolingual position of the ZCR was then determined in the unilateral model. The combination of the anteroposterior, vertical, and buccolingual positions was defined as the ZCR. RESULTS: The ZCRs of groups 1-4 were, respectively, 0.48, 0.46, 0.50, and 0.53 of the mandibular first molar root length from the alveolar crest level and located slightly distobuccally at anteroposterior ratios of 2:3.0, 2:2.3, 2:2.4, and 2:2.5 to each sectional arch length and at buccolingual ratios of 2:1.5, 2:1.1, 2:1.6, and 2:2.4 to the first molar's buccolingual width. CONCLUSIONS: The ZCR can be a useful reference for 3D movement planning of mandibular posterior teeth or segments.


Assuntos
Imagem Tridimensional/métodos , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Dente/anatomia & histologia , Dente/diagnóstico por imagem , Processo Alveolar/anatomia & histologia , Processo Alveolar/diagnóstico por imagem , Dente Pré-Molar/anatomia & histologia , Dente Pré-Molar/diagnóstico por imagem , Arco Dental , Modelos Dentários , Análise de Elementos Finitos , Humanos , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Ortodontia Corretiva , Ligamento Periodontal/anatomia & histologia , Ligamento Periodontal/diagnóstico por imagem , Técnicas de Movimentação Dentária
10.
Am J Orthod Dentofacial Orthop ; 156(3): 420-428, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474272

RESUMO

INTRODUCTION: This study aimed to test the accuracy of the 3-dimensional (3D) digital dental models generated by the Dental Monitoring (DM) smartphone application in both photograph and video modes over successive DM examinations in comparison with 3D digital dental models generated by the iTero Element intraoral scanner. METHODS: Ten typodonts with setups of class I malocclusion and comparable severity of anterior crowding were used in the study. iTero Element scans along with DM examination in photograph and video modes were performed before tooth movement and after each set of 10 Invisalign aligners for each typodont. Stereolithography (STL) files generated from the DM examinations in photograph and video modes were superimposed with the STL files from the iTero scans using GOM Inspect software to determine the accuracy of both photograph and video modes of DM technology. RESULTS: No clinically significant differences, according to the American Board of Orthodontics-determined standards, were found. Mean global deviations for the maxillary arch ranged from 0.00149 to 0.02756 mm in photograph mode and from 0.0148 to 0.0256 mm in video mode. Mean global deviations for the mandibular arch ranged from 0.0164 to 0.0275 mm in photograph mode and from 0.0150 to 0.0264 mm in video mode. Statistically significant differences were found between the 3D models generated by the iTero and the DM application in photograph and video modes over successive DM examinations. CONCLUSIONS: 3D digital dental models generated by the DM smartphone application in photograph and video modes are accurate enough to be used for clinical applications.


Assuntos
Confiabilidade dos Dados , Técnica de Moldagem Odontológica , Modelos Dentários , Processamento de Imagem Assistida por Computador/métodos , Imagem Tridimensional/métodos , Projeto Auxiliado por Computador , Arco Dental , Humanos , Má Oclusão/diagnóstico por imagem , Aparelhos Ortodônticos/normas , Aparelhos Ortodônticos Removíveis , Ortodontia/normas , Fotografia Dentária , Smartphone , Software , Estereolitografia , Tecnologia Odontológica/métodos , Técnicas de Movimentação Dentária , Gravação em Vídeo
11.
Anticancer Res ; 39(9): 5019-5026, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519609

RESUMO

BACKGROUND: Portal vein thrombosis (PVT) is a life-threatening complication after hepatectomy. However, the relationship between postoperative PVT and morphometric features of the PV has not been fully elucidated yet. PATIENTS AND METHODS: A total of 81 patients who underwent hepatectomy for perihilar cholangio-carcinoma (PHCC) were studied. We investigated the diameters and angles of PV using pre- and postoperative computed tomography (CT) reconstructed by SYNAPSE VINCENT®. RESULTS: The incidence of PVT after hepatectomy was 11.1%. There were significant differences with respect to the remnant liver PV diameter (p=0.015), the diameter ratio (p=0.001), and the postoperative PV angle (p=0.001) between patients with and without PVT. Multivariate analysis revealed that a postoperative PV angle of less than 90° (p=0.008) and a diameter ratio of less than 45% (p=0.041) were independent risk factors for PVT. CONCLUSION: A postoperative PV angle of less than 90° and diameter ratio of less than 45% eventually lead to PVT after hepatectomy for PHCC.


Assuntos
Hepatectomia/efeitos adversos , Tumor de Klatskin/complicações , Tumor de Klatskin/cirurgia , Veia Porta/patologia , Complicações Pós-Operatórias , Trombose Venosa/diagnóstico , Trombose Venosa/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia por Tomografia Computadorizada , Gerenciamento Clínico , Feminino , Hepatectomia/métodos , Humanos , Imagem Tridimensional , Masculino , Pessoa de Meia-Idade , Veia Porta/anatomia & histologia , Veia Porta/diagnóstico por imagem , Período Pós-Operatório , Prognóstico , Tomografia Computadorizada por Raios X
12.
J Appl Oral Sci ; 27: e20180722, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411266

RESUMO

OBJECTIVES: Age estimation is one of the most important factors in forensic medicine. Measuring secondary dentin deposition using cone-beam computed tomography images is an easy and noninvasive method. The aim of this study was to evaluate cone-beam computed tomography images as a reliable method to estimate chronological age by pulp/teeth ratio in anterior teeth in Iranian population. METHODOLOGY: A total of 649 CBCT images from 377 Iranian patients aged between 20 and 69 years were evaluated. Pulp/teeth ratio (PTR) in maxillary and mandibular canine and central incisor teeth was measured in the axial and sagittal sections using OnDemand 3D Dental software. The Pearson correlation coefficient was determined to evaluate the correlation between the variables. Linear regression analysis, as well as age estimation formula, was used for each tooth separately. RESULTS: The regression analyses indicated that maxillary central incisors were more reliable for age estimation (R2=0.586 and standard error of estimate=7.045) compared with the other anterior teeth studied. Maxillary canine teeth had the lowest predictive power (R2=0.392 and standard error of estimate=8.387). Also, comparison of the axial and sagittal sections showed that the axial sections had a higher predictive power. (R2=0.48 for axial plans and R2=0.328 for sagittal plans). CONCLUSION: The use of cone-beam computed tomography in age estimation by pulp/teeth ratio of anterior teeth is useful and a reliable method for age estimation in Iranian population.


Assuntos
Determinação da Idade pelos Dentes/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Polpa Dentária/anatomia & histologia , Polpa Dentária/diagnóstico por imagem , Dente/anatomia & histologia , Dente/diagnóstico por imagem , Adulto , Fatores Etários , Idoso , Dente Canino/anatomia & histologia , Dente Canino/diagnóstico por imagem , Feminino , Humanos , Imagem Tridimensional , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Valores de Referência , Reprodutibilidade dos Testes , Fatores Sexuais , Adulto Jovem
13.
Medicine (Baltimore) ; 98(33): e16849, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415413

RESUMO

RATIONALE: Combined hyperactive dysfunction syndrome (HDS) refers to a special type of HDS characterized by a combination of trigeminal neuralgia (TN), hemi facial spasm (HFS), and/or gloss pharyngeal neuralgia (GPN). Rostra ventrolateral medulla (RVLM) plays a crucial role in central cardiovascular regulation, and neurovascular compression of the RVLM has been identified as a contributor to essential hypertension. PATIENT CONCERNS: A 65-year-old female with a facial tic and pain located in the root of the tongue and throat on the same side; the systolic and diastolic blood pressure was approximately 170 and 100 mmHg. DIAGNOSIS: The patient was diagnosed with combined HDS (HFS-GPN) and essential hypertension. Brain magnetic resonance 3-dimensional time-of-flight imaging and digital subtraction angiography revealed vertebrobasilar artery compressed the left RVLM and contacted with the root entry zones of multiple cranial nerves. INTERVENTIONS: The patient was treated with microvascular decompression surgery OUTCOMES:: The symptoms were completely relieved, and blood pressure was well-controlled. LESSONS: The pathological association of hypertension and HDS should be highlighted, and microvascular decompression is an effective approach for relieving the hypertension.


Assuntos
Nervos Cranianos/cirurgia , Espasmo Hemifacial/cirurgia , Cirurgia de Descompressão Microvascular/métodos , Neuralgia do Trigêmeo/cirurgia , Idoso , Nervos Cranianos/diagnóstico por imagem , Hipertensão Essencial/complicações , Feminino , Espasmo Hemifacial/complicações , Espasmo Hemifacial/diagnóstico por imagem , Humanos , Imagem Tridimensional , Imagem por Ressonância Magnética , Síndrome , Neuralgia do Trigêmeo/complicações , Neuralgia do Trigêmeo/diagnóstico por imagem
14.
Am J Orthod Dentofacial Orthop ; 156(2): 210-219, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375231

RESUMO

INTRODUCTION: More patients are choosing customized orthodontic appliances because of their excellent esthetics. It is essential that clinicians understand the biomechanics of the tooth movement tendency in customized lingual orthodontics. This study aimed to evaluate the tooth movement tendency during space closure in maxillary anterior teeth with the use of miniscrew anchorage in customized lingual orthodontics with various power arm locations. METHODS: Three-dimensional finite element models of the maxilla were created with miniscrews and power arms; the positions were varied to change the force directions. A retraction force (1.5 N) was applied from the top of the miniscrews to the selected points on the power arm, and the initial displacements of the reference nodes of the maxillary teeth were analyzed. RESULTS: After applying force in different directions, power arms located at the distal side of the canines led to larger initial lingual crown tipping and occlusal crown extrusion of the maxillary incisors compared with power arms located at the midpoint between the lateral incisors and canines, and caused a decreasing trend of the intercanine width. CONCLUSIONS: In customized lingual orthodontic treatment, power arms located at the distal side of the canines are unfavorable for anterior teeth torque control and intercanine width control. Power arms located at the midpoint between the lateral incisors and canines can get better torque control, but still cannot achieve excepted torque without extra torque control methods, no matter whether its force application point is higher than, lower than, or equal to the level of the top of the miniscrews.


Assuntos
Parafusos Ósseos , Análise de Elementos Finitos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Fechamento de Espaço Ortodôntico , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Adulto , Fenômenos Biomecânicos , Simulação por Computador , Dente Canino/patologia , Humanos , Imagem Tridimensional/métodos , Incisivo/patologia , Maxila , Modelos Biológicos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fechamento de Espaço Ortodôntico/instrumentação , Fechamento de Espaço Ortodôntico/métodos , Fios Ortodônticos , Planejamento de Assistência ao Paciente , Estresse Mecânico , Coroa do Dente , Torque , Resultado do Tratamento
15.
Am J Orthod Dentofacial Orthop ; 156(2): 257-265, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375236

RESUMO

INTRODUCTION: Children with unilateral cleft lip and palate (UCLP) exhibit snoring and mouth breathing. They are also reported to show obstructive sleep apnea syndrome. However, their upper airway ventilation condition is not clearly understood. Therefore, this study was performed to evaluate upper airway ventilation condition in children with UCLP with the use of computational fluid dynamics. METHODS: Twenty-one children (12 boys, 9 girls; mean age 9.1 years) with UCLP and 25 children (13 boys, 12 girls; mean age 9.2 years) without UCLP who required orthodontic treatment underwent cone-beam computed tomography (CBCT). Nasal resistance and upper airway ventilation condition were evaluated with the use of computational fluid dynamics from CBCT data. The groups were compared with the use of Mann-Whitney U tests and Student t tests. RESULTS: Nasal resistance of the UCLP group (0.97 Pa/cm3/s) was significantly higher than that of the control group (0.26 Pa/cm3/s; P < 0.001). Maximal pressure of the upper airway (335.02 Pa) was significantly higher in the UCLP group than in the control group (67.57 Pa; P < 0.001). Pharyngeal airway (from choanae to base of epiglottis) pressure in the UCLP group (140.46 Pa) was significantly higher than in the control group (15.92 Pa; P < 0.02). CONCLUSIONS: Upper airway obstruction in children with UCLP resulted from both nasal and pharyngeal airway effects.


Assuntos
Fenda Labial/patologia , Fissura Palatina/patologia , Tomografia Computadorizada de Feixe Cônico/métodos , Hidrodinâmica , Laringe/anatomia & histologia , Nariz/anatomia & histologia , Tonsila Faríngea/anatomia & histologia , Pontos de Referência Anatômicos , Criança , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Epiglote/anatomia & histologia , Epiglote/diagnóstico por imagem , Feminino , Humanos , Osso Hioide/anatomia & histologia , Imagem Tridimensional/métodos , Laringe/diagnóstico por imagem , Má Oclusão de Angle Classe I , Nasofaringe/anatomia & histologia , Nasofaringe/diagnóstico por imagem , Nariz/diagnóstico por imagem , Respiração , Apneia Obstrutiva do Sono
16.
Am J Orthod Dentofacial Orthop ; 156(2): 275-282, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375238

RESUMO

This case report describes the interdisciplinary treatment of an ectopic horizontally placed maxillary right central incisor with severe root dilaceration. The root was distally angulated and entrapped by the root of the maxillary right lateral incisor. The initial force system was aimed at an occlusal displacement and applied to the crown. During the second phase, a button was cemented onto the apex of the impacted tooth. A force from the apex to a temporary anchorage device in the palate moved the root toward the midline. Finally, a root canal and an apectomy were performed and the central incisor could be moved to its ideal position. The treatment generated a normal height of the alveolar bone and an ideal occlusion with a healthy periodontium.


Assuntos
Incisivo/cirurgia , Técnicas de Movimentação Dentária/métodos , Raiz Dentária/cirurgia , Dente Impactado/cirurgia , Dente Impactado/terapia , Fenômenos Biomecânicos , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagem Tridimensional , Má Oclusão de Angle Classe I/terapia , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Aparelhos Ortodônticos Fixos , Extrusão Ortodôntica/métodos , Planejamento de Assistência ao Paciente , Tratamento do Canal Radicular , Coroa do Dente , Dente Impactado/diagnóstico por imagem , Resultado do Tratamento
17.
Sud Med Ekspert ; 62(4): 55-57, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31407707

RESUMO

Presents the possibilities, as well as an example of the practical application, of the 3D-microscopic modeling method in forensic medicine when conducting medical forensic studies of a patch of skin with a bullet hole wound.


Assuntos
Balística Forense/métodos , Imagem Tridimensional , Microscopia/métodos , Ferimentos por Arma de Fogo , Estudos de Viabilidade , Humanos
18.
Zhonghua Yi Xue Za Zhi ; 99(29): 2315-2318, 2019 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-31434410

RESUMO

Objective: To investigate the value of the area of levator hiatusin diagnosis of uterine prolapse. Methods: From September 2017 to December 2018, 80 patients diagnosed with uterine prolapse by Department of Gynecology, Xiangya Hospital of Central South University were selected as the case group, and 80 cases of normal women in the same period were selected as the control group. All subjects in both groups were examined by transperineal three-dimensional ultrasound. The anteroposterior and transverse diameters and the area of levator hiatus were measured at rest and during maximum Valsalva maneuver respectively. The ROC curve was drawn to determine the cut-off value of area of levator hiatus in diagnosis of uterine prolapse and to evaluate its diagnostic value. Results: At rest and during maximum Valsalva maneuver, the anteroposterior and transverse diameters and the area of levator hiatus in study group were larger than those in control group, the difference was statistically significant (P<0.05). During maximum Valsalva maneuver, the above values in both groups were greater than those of the same group at rest state, but there was no significant difference between the two groups (P>0.05). During maximum Valsalva maneuver, the best cut-off value of area of levator hiatus for the diagnosis of uterine prolapse was 22.09 cm(2), the area under curve was 0.893. The sensitivity, specificity and accuracy were 90.0%, 95.0% and 92.5%, respectively. Conclusion: Transperineal three-dimensional ultrasound can evaluate the morphological changes of levator hiatus in patients with uterine prolapse, and the area of levator hiatus has high diagnostic value for uterine prolapse.


Assuntos
Prolapso Uterino , Feminino , Humanos , Imagem Tridimensional , Diafragma da Pelve , Ultrassonografia , Manobra de Valsalva
19.
Zhongguo Gu Shang ; 32(7): 658-665, 2019 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-31382726

RESUMO

OBJECTIVE: Using the CT three-dimensional reconstruction to measure the activity degree of atlanto-occipital joint and the atlantoaxial joint in different directions and its coupling movement in healthy volunteers, and three dimensional motion range of the maximum rotation position of the upper cervical spine of cervical spondylosis patients, and to analyze the differences, verifing the reliability of the method at the meantime. METHODS: From January 2014 to June 2015, 20 healthy adult subjects(healthy adult group), and 26 patients with cervieal spondylosis(cervical spondylosis group) were selected. In healthy adult group, there were 11 males and 9 females, aged from 22 to 26 years old with an average of (24.0±1.2) years, and in cervical spondylosis group, there were 24 males and 2 females, aged from 36 to 72 years old with an average of (52.8±8.6) years. Healthy adults underwent CT examination in neutral position, maximum right rotation, maximum right lateral bending, maximum flexion and extention, and cervical spondylosis patients underwent CT examination in neutral position, maximum right rotation. Then the software Mimics was used to reconstruct occiput (Oc), atlas(C1) and axial(C2) vertebral three-dimensional image. Three virtual non-collinear markers were positioned on prominent structures of foramen magnum, C1 and C2. The 3D spatial coordinates of these virtual anatomical markers entail the definition of an anatomical local coordinate system which represent the position and orientation of the bones. Segmental motions were calculated using Eulerian angle in three major planes, and the difference between cervical spondylosis group and healthy adult group were compared. Due to the inaccuracy in anatomical landmark idenrification, two groups were measured 3 times, and the reliability of the experimental metnod was verified by the intra-group correlation (intra-group ICC) and the inter-group correlation coefficient(inter-group ICC). RESULTS: Reliability verification results:the intra-group ICC and inter-group ICC results were all above 0.90, and the measurement method had high reliability. Three-dimensional activity of the upper cervical spine in healthy adults:the atlanto-occipital joint had(-6.8±1.5)° coupled left lateral bending and (8.9±2.0)° coupled extension in the maximum right rotation position, and the motion of atlanto-occipital joint had low activity[maximum was(5.3±2.6)°] in the remaining 3 positions; the rotation of atlanto-axial joint was(37.9±5.1)°, accounting for 52.34% of the total cervical spine activity[(72.4±5.0)°] in the maximum right rotation position, and rotational motion was still prominent in the remaining three positions. The relative translations of the upper cervical spine in all direction were small. The average axial rotation angle [(62.0±3.4)] ° of the total cervical spine in cervical spondylosis group was significantly lower than that in the healthy adult group, but the mean axial rotation angles of the atlanto-occipital and the atlantoaxial joint were not significantly different from those of the healthy adults(P>0.05). CONCLUSIONS: The three-dimensional CT reconstruction method has high reliability, which can be applied to measure the movement of spine. The upper cervical spine contributed the most to the direction of rotation, and the movement in all directions are accompanied by coupled motion in the other direction. There was no significant difference in the rotation of the upper cervical spine between cervical spondylosis patients and normal subjects.


Assuntos
Articulação Atlantoaxial , Imagem Tridimensional , Adulto , Idoso , Fenômenos Biomecânicos , Vértebras Cervicais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Reprodutibilidade dos Testes , Rotação , Coluna Vertebral , Tomografia Computadorizada por Raios X , Adulto Jovem
20.
Medicine (Baltimore) ; 98(34): e16898, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441868

RESUMO

Both spiral plate and Herbert screw fixations have been clinically adopted for treating midshaft displaced clavicle fractures. However, the biomechanical properties of the 2 implant fixations have not yet been thoroughly evaluated. Here we report the results of a finite element analysis of the biomechanical properties of midshaft clavicle fractures treated with Herbert screw and spiral plate fixation. Hebert screw fixation showed stress distribution similar to intact clavicle under all loading conditions, but provided less stability than did spiral plate fixation. Postoperatively, excessive shoulder activities and weight-bearing should be avoided. Spiral plate fixation provides greater stability, but is associated with stress shielding. These results demonstrate that Herbert screw fixation is suitable for the treatment of simple displaced clavicluar fractures, but excessive shoulder activity and weight-bearing should be avoided after the operation. Therefore, spiral plate fixation may be preferred for patients requiring an early return to activity.


Assuntos
Clavícula/lesões , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Adulto , Fenômenos Biomecânicos , Placas Ósseas , Parafusos Ósseos , Clavícula/anatomia & histologia , Clavícula/diagnóstico por imagem , Feminino , Humanos , Imagem Tridimensional , Modelos Anatômicos , Melhoria de Qualidade , Adulto Jovem
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