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1.
Medicine (Baltimore) ; 99(2): e18069, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914012

RESUMO

This study aims to find and locate foramens exactly in maxilla and mandible in case of complications during surgeries.Computer topographic angiography (CTA) images of 120 cases were reviewed. The measurements were performed on coronal, sagittal and axial planes after the 3 dimension volume reconstruction. The distances among foramens, bony landmarks, teeth, and facial artery were all measured with the angles as adjustments.The incisive foramen (IF) was measured 20.55 ±â€Š2.81 mm to margo inferior of incisor, and 45.27 ±â€Š5.27 degree from the axial midline. The greater palatine foramen located 43.17 ±â€Š2.55 mm from the IF, while 21.08 ±â€Š3.75 degree from the midline in axial plane. The lesser palatine foramina located 44.56 ±â€Š5.74 mm from the IF and 20.05 ±â€Š3.59 degree to the midline. The Mandibular foramen (MBF) was 91.15 ±â€Š1.86 mm horizontally to the margo inferior of incisor. The angle that the MBF-margo inferior of incisor line made with the axial midline was 31.25 ±â€Š2.89 degree. The shortest horizontal distance from the mental foramen (MF) to the facial artery in sagittal plane was 21.90 ±â€Š1.86 mm, while it became 13.00 ±â€Š2.05 mm in coronary section. The horizontal distance from the MF to the margo inferior of incisor in sagittal plane was 22.04 ±â€Š3.22 mm. It turned out to be 25.78 ±â€Š5.23 mm between MF and mid-sagittal line in coronary section. The vertical distance was 25.20 ±â€Š3.06 mm from the upper margin of the second premolar to the MF.The foramens were clearly seen through CTA. Moreover, linear and angular measurements were presented, which makes it safer and wiser for surgeons to consider the biometric data before operations.


Assuntos
Pontos de Referência Anatômicos/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Mandíbula/anatomia & histologia , /diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/cirurgia , Criança , Face/irrigação sanguínea , Face/diagnóstico por imagem , Feminino , Humanos , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Pessoa de Meia-Idade , Adulto Jovem
2.
Radiol Med ; 125(1): 48-56, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31522345

RESUMO

PURPOSE: Development of a fully automatic algorithm for the automatic localization and identification of vertebral bodies in computed tomography (CT). MATERIALS AND METHODS: This algorithm was developed using a dataset based on real-world data of 232 thoraco-abdominopelvic CT scans retrospectively collected. In order to achieve an accurate solution, a two-stage automated method was developed: decision forests for a rough prediction of vertebral bodies position, and morphological image processing techniques to refine the previous detection by locating the position of the spinal canal. RESULTS: The mean distance error between the predicted vertebrae centroid position and truth was 13.7 mm. The identification rate was 79.6% on the thoracic region and of 74.8% on the lumbar segment. CONCLUSION: The algorithm provides a new method to detect and identify vertebral bodies from arbitrary field-of-view body CT scans.


Assuntos
Algoritmos , Árvores de Decisões , Aprendizado de Máquina , Tomografia Computadorizada Multidetectores/métodos , Coluna Vertebral/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Pontos de Referência Anatômicos/diagnóstico por imagem , Conjuntos de Dados como Assunto , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
3.
Forensic Sci Int ; 306: 110095, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31841934

RESUMO

Manual landmarking is used in several manual and semi-automated prediction guidelines for approximation of the nose. The manual placement of landmarks may, however, render the analysis less repeatable due to observer subjectivity and, consequently, have an impact on the accuracy of the human facial approximation. In order to address this subjectivity and thereby improve facial approximations, we are developing an automated three-dimensional (3D) method based on an automatic dense landmarking procedure using non-rigid surface registration. The aim of this study was to validate the automatic landmarking method by comparing the intra-observer errors (INTRA-OE) and inter-observer errors (INTER-OE) between automatic and manual landmarking. Cone beam computed tomography (CBCT) scans of adult South Africans were selected from the Oral and Dental Hospital, University of Pretoria, South Africa. In this study, the validation of the automatic landmarking was performed on 20 3D surfaces. INTRA-OE and INTER-OE were analyzed by registering 41 craniometric landmarks from 10 hard-tissue surfaces and 21 capulometric landmarks from 10 soft-tissue surfaces of the same individuals. Absolute precision of the landmark positioning (both on the samples as well as the template) was assessed by calculating the measurement error (ME) for each landmark over different observers. Systematic error (bias) and relative random error (precision) was further quantified through repeated measures ANOVA (ANOVA-RM). The analysis showed that the random component of the ME in landmark positioning between the automatic observations were on average on par with the manual observations, except for the soft-tissue landmarks where automatic landmarking showed lower ME compared to manual landmarking. No bias was observed within the craniometric landmarking methods, but some bias was observed for capulometric landmarking. In conclusion, this research provides a first validation of the precision and accuracy of the automatic placement of landmarks on 3D hard- and soft-tissue surfaces and demonstrates its utilization as a convenient prerequisite for geometric morphometrics based shape analysis of the nasal complex.


Assuntos
Pontos de Referência Anatômicos , Tomografia Computadorizada de Feixe Cônico , Nariz/diagnóstico por imagem , Grupo com Ancestrais do Continente Africano , Antropologia Forense , Humanos , Imagem Tridimensional , Nariz/anatomia & histologia , Reprodutibilidade dos Testes , África do Sul
4.
Br J Radiol ; 93(1105): 20190677, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31593485

RESUMO

The retrotympanic anatomy is complex and variable but has received little attention in the radiological literature. With advances in CT technology and the application of cone beam CT to temporal bone imaging, there is now a detailed depiction of the retrotympanic bony structures.With the increasing use of endoscopes in middle ear surgery, it is important for the radiologist to appreciate the nomenclature of the retrotympanic compartments in order to aid communication with the surgeon. For instance, in the context of cholesteatoma, clear imaging descriptions of retrotympanic variability and pathological involvement are valuable in pre-operative planning.The endoscopic anatomy has recently been described and the variants classified. The retrotympanum is divided into medial and lateral compartments with multiple described potential sinuses separated by bony crests.This pictorial review will describe the complex anatomy and variants of the retrotympanum. We will describe optimum reformatting techniques to demonstrate the structures of the retrotympanum and illustrate the associated anatomical landmarks and variants with CT. The implications of anatomical variants with regards to otologic surgery will be discussed.


Assuntos
Orelha Média/anatomia & histologia , Orelha Média/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Membrana Timpânica/anatomia & histologia , Membrana Timpânica/diagnóstico por imagem , Pontos de Referência Anatômicos , Colesteatoma da Orelha Média/diagnóstico por imagem , Colesteatoma da Orelha Média/cirurgia , Tomografia Computadorizada de Feixe Cônico , Humanos , Otoscopia
5.
Ann Otol Rhinol Laryngol ; 129(1): 12-17, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31394908

RESUMO

OBJECTIVE: To define a new anatomic relationship in pediatric sinus surgery, assessing the maxillary roof as a constant safe landmark to avoid skull base injury in the pediatric population. STUDY DESIGN: Retrospective analysis. SETTING: Tertiary care children hospital. SUBJECTS AND METHODS: A retrospective analysis was performed of all computed tomography scans of the sinuses and facial bones at the emergency department of a tertiary children's hospital over the course of a year. Radiographic measurements included the lowest cribriform plate and planum sphenoidale (PS) heights, or posterior skull base when not yet pneumatized, as well as the highest maxillary roof height. The nasal floor was used for reference. Statistics were performed via Shapiro-Wilks test with a P-value of .05 indicating statistical significance. RESULTS: Three hundred and seven unique scans were reviewed (38.9% female; n = 122; P = .58). Age stratification was based on previously described sinus growth patterns. In all patients, the maximum maxillary height was inferior to the lowest measured cribriform lamella and PS (P < .001; CI, 98.5%-99%). Inter- and intrarater reliability and accuracy were verified through blinded review and re-review (ρ = .99 and .98 respectively, P ≤ .001). The validity of sole coronal measurements due to incomplete sagittal reformatting was also confirmed (ρ = 1.00, P ≤ .001). CONCLUSION: Despite variation in sinus growth and development in children, the current study demonstrated the validity of the maxillary sinus roof as a constant safe landmark in the pediatric population, offering a novel anatomic relationship for teaching safety in performing pediatric sinus surgery. LEVEL OF EVIDENCE: 4.


Assuntos
Pontos de Referência Anatômicos , Endoscopia/métodos , Seio Maxilar/diagnóstico por imagem , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Base do Crânio/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Seio Maxilar/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Base do Crânio/cirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
6.
Br J Radiol ; 92(1104): 20190221, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31596118

RESUMO

OBJECTIVE: Early detection of tibialis posterior tendon changes and appropriate intervention is necessary to prevent disease progression to flat-foot deformity and foot/ankle dysfunction, and the need for operative treatment. Currently, differentiating between early-stage tibialis posterior tendon deficiency patients who will benefit from conservative vs more aggressive treatment is challenging. The objective of this work was to establish a quantitative MRI T2* mapping method and subregion baseline values in the tibialis posterior tendon in asymptomatic ankles for future clinical application in detecting tendon degeneration. METHODS: 26 asymptomatic volunteers underwent T2* mapping. The tendon was divided axially into seven subregions. Summary statistics for T2* within each subregion were calculated and compared using Tukey post-hoc pairwise comparisons. RESULTS: Results are reported for 24 subjects. The mean tibialis posterior tendon T2* was 7 ± 1 ms. Subregion values ranged from 6 ± 1 to 9 ± 2 ms with significant between-region differences in T2*. Inter- and intrarater absolute agreement intraclass correlation coefficient (ICC) values were all "excellent" (0.75 < ICC=1.00) except for regions 5 through 7, which had "fair to good" interrater and/or and intrarater ICC values (0.4 < ICC=0.75). CONCLUSION: A tibialis posterior tendon T2* mapping protocol, subregion division method, and baseline T2* values for clinically relevant regions were established. Significant differences in T2* were observed along the tendon length. ADVANCES IN KNOWLEDGE: This work demonstrates that regional variation exists and should be considered for future T2*-based research on posterior tibias tendon degeneration and when using T2* mapping to evaluate for potential tibialis posterior tendon degeneration.


Assuntos
Pontos de Referência Anatômicos/diagnóstico por imagem , Perna (Membro)/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tendões/diagnóstico por imagem , Adulto , Pontos de Referência Anatômicos/anatomia & histologia , Doenças Assintomáticas , Feminino , Humanos , Perna (Membro)/anatomia & histologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ossos do Tarso/anatomia & histologia , Ossos do Tarso/diagnóstico por imagem , Tendinopatia/diagnóstico por imagem , Tendinopatia/patologia , Tendões/anatomia & histologia , Adulto Jovem
7.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(5): 937-943, 2019 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-31624402

RESUMO

OBJECTIVE: To compare four different three-dimensional horizontal planes and detect anatomical landmarks so as to provide theoretical reference for horizontal reference plane constructed by three-dimensional cephalometry. METHODS: The subjects of this study were 32 facial symmetry patients (menton from midsagittal plane ≤2 mm). Cone-beam computed tomography (CBCT) was obtained before orthodontic treatment, and the data were imported into Dolphin imaging soft in DICOM format. The sagittal plane was passing through the Nasion, Sella and Dent. Four horizontal reference planes were constructed by three points of bilateral porion and bilateral orbitale. Plane 1: horizontal reference plane constructed by right porion and bilateral orbitale. Plane 2: horizontal reference plane constructed by left porion and bilateral orbitale. Plane 3: horizontal reference plane constructed by bilateral porion and right orbitale. Plane 4: horizontal reference plane constructed by bilateral porion and left orbitale. Pitch, yaw, roll for four planes were measured three dimensionally. All the samples were measured two times by one judge at an interval of two weeks. The two times measuring results were evaluated with Intraclass correlation coefficient (ICC) for verifying reliability. The multiple sets of repeated measurement analysis were used to compare the four different planes. Based on ages, the samples were divided into two groups (group 1: ages 13 to 17, group 2: over 18 years), the mean and standard deviation of landmark coordinates measured with Dent as the origin point, the circumference formula was applied to calculate the change of landmark position generated by head rotation. RESULTS: No significant differences of pitch, yaw and roll among the four planes (P=0.196, 0.314, and 0.341). One degree of pitch rotation made changes of porion and orbitale approximate 0.5 mm, and 1.6 mm, respectively. One degree of yaw rotation made changes of porion and orbitale approximate 1.1 mm, and 1.5 mm, respectively. One degree of roll rotation made changes of porion and orbitale approximate 1.2 mm, and 0.7 mm, respectively. CONCLUSION: There was no significant difference among the four horizontal planes constructed by any three points of bilateral orbitales and bilateral porions. It has the highest concordance using bilateral orbitales and one porion to construct horizontal plane in this study, probably the best option in clinical practice. Different head rotation generated different distance changes of anatomical landmarks.


Assuntos
Pontos de Referência Anatômicos , Imagem Tridimensional , Adolescente , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Reprodutibilidade dos Testes
8.
Forensic Sci Int ; 304: 109963, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31610335

RESUMO

Clinical radiology is increasingly used as a source of data to test or develop forensic anthropological methods, especially in countries where contemporary skeletal collections are not available. Naturally, this requires analysis of the error that is a result of low accuracy of the modality (i.e. accuracy of the segmentation) and the error that arises due to difficulties in landmark recognition in virtual models. The cumulative effect of these errors ultimately determines whether virtual and dry bone measurements can be used interchangeably. To test the interchangeability of virtual and dry bone measurements, 13 male and 14 female intact cadavers from the body donation program of the Amsterdam UMC were CT scanned using a standard patient scanning protocol and processed to obtain the dry os coxae. These were again CT scanned using the same scanning protocol. All CT scans were segmented to create 3D virtual bone models of the os coxae ('dry' CT models and 'clinical' CT models). An Artec Spider 3D optical scanner was used to produce gold standard 'optical 3D models' of ten dry os coxae. The deviation of the surfaces of the 3D virtual bone models compared to the gold standard was used to calculate the accuracy of the CT models, both for the overall os coxae and for selected landmarks. Landmark recognition was studied by comparing the TEM and %TEM of nine traditional inter-landmark distances (ILDs). The percentage difference for the various ILDs between modalities was used to gauge the practical implications of both errors combined. Results showed that 'dry' CT models were 0.36-0.45mm larger than the 'optical 3D models' (deviations -0.27mm to 2.86mm). 'Clinical' CT models were 0.64-0.88mm larger than the 'optical 3D models' (deviations -4.99mm to 5.00mm). The accuracies of the ROIs were variable and larger for 'clinical' CT models than for 'dry' CT models. TEM and %TEM were generally in the acceptable ranges for all ILDs whilst no single modality was obviously more or less reliable than the others. For almost all ILDs, the average percentage difference between modalities was substantially larger than the average percentage difference between observers in 'dry bone' measurements only. Our results show that the combined error of segmentation- and landmark recognition error can be substantial, which may preclude the usage of 'clinical' CT scans as an alternative source for forensic anthropological reference data.


Assuntos
Imagem Tridimensional , Ossos Pélvicos/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Pontos de Referência Anatômicos , Cadáver , Simulação por Computador , Feminino , Antropologia Forense , Humanos , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/anatomia & histologia
9.
Rev Col Bras Cir ; 46(4): e2249, 2019 Sep 09.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31508736

RESUMO

OBJECTIVE: to evaluate whether the lateral projection of the thyroid gland, called Zuckerkandl's tubercle (ZT), can assist the surgeon in identifying the inferior laryngeal nerve during conventional open thyroidectomy. METHODS: we conducted a prospective study with 51 patients submitted to thyroidectomy, with a total of 100 resected thyroid lobes, and observed the presence or absence of ZT in sufficient dimensions to be identified without image magnification, its base and height, its location in the gland, and its anatomical relationship with the inferior laryngeal nerve. RESULTS: ZT was present in 68 of the 100 thyroid lobes analyzed (68%). The mean base was 6.7mm on the right side and 7.1mm on the left side, and the average height was 5.7mm on the right side and 6.1mm on the left side. In most of the lobes studied, the tubercle had a minimum height of 5mm (55.9%), with no significant difference between the right and left lobes of the thyroid gland. During surgery, 100% of the identified ZTs were anterior to the inferior laryngeal nerve, just below the nerve entry in the larynx. CONCLUSION: the ZT is a quite frequent entity and large enough to serve as an intraoperative anatomical reference for the inferior laryngeal nerve, next to its entry in the larynx, along with other anatomical references.


Assuntos
Pontos de Referência Anatômicos , Nervo Laríngeo Recorrente/anatomia & histologia , Glândula Tireoide/anatomia & histologia , Glândula Tireoide/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adulto Jovem
10.
BMC Evol Biol ; 19(1): 179, 2019 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-31510915

RESUMO

BACKGROUND: Understanding the mechanisms promoting or constraining morphological diversification within clades is a central topic in evolutionary biology. Ecological transitions are of particular interest because of their influence upon the selective forces and factors involved in phenotypic evolution. Here we focused on the humerus and mandibles of talpid moles to test whether the transition to the subterranean lifestyle impacted morphological disparity and phenotypic traits covariation between these two structures. RESULTS: Our results indicate non-subterranean species occupy a significantly larger portion of the talpid moles morphospace. However, there is no difference between subterranean and non-subterranean moles in terms of the strength and direction of phenotypic integration. CONCLUSIONS: Our study shows that the transition to a subterranean lifestyle significantly reduced morphological variability in talpid moles. However, this reduced disparity was not accompanied by changes in the pattern of traits covariation between the humerus and the mandible, suggesting the presence of strong phylogenetic conservatism within this pattern.


Assuntos
Ecossistema , Toupeiras/anatomia & histologia , Pontos de Referência Anatômicos , Animais , Úmero/anatomia & histologia , Análise dos Mínimos Quadrados , Estilo de Vida , Mandíbula/anatomia & histologia , Toupeiras/classificação , Fenótipo , Filogenia , Análise de Componente Principal , Característica Quantitativa Herdável
11.
J Craniofac Surg ; 30(7): e611-e615, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31478954

RESUMO

As cone-beam computed tomography (CBCT) scans become increasingly common, it is vital to have reliable 3-dimensional (3D) landmarks for quantitative analysis of craniofacial skeletal morphology. While some studies have developed and used 3D landmarks, these landmark sets are generally small and derived primarily from previous 2-dimensional (2D) cephalometric landmarks. These derived landmarks lack information in parts of the skull such as the cranial base, which is an important feature for cranial growth and development. The authors see a real need for development and validation of 3D landmarks, particularly bilateral landmarks, across the skull for improved cephalometric analysis. The primary objective of this study is to develop and validate a set of 61 3D anatomical landmarks on the face, cranial base, mandible, and teeth for use in clinical and research studies involving CBCT imaging. Each landmark was placed 3 times by 3 separate trained observers on a set of 10 anonymized CBCT patient scans. Intra-rater and inter-rater estimates of consistency and agreement were calculated using the intraclass correlation coefficient. Measurement error was calculated per landmark and per X, Y, and Z landmark coordinate. The authors had high ICC estimates within rates, indicating high consistency, and high ICC estimates among raters, indicate good agreement across raters. Overall measurement error for each landmark and each X, Y, and Z coordinate was low. Our results confirm the accuracy of novel 3D landmarks including several on the cranial base that will serve researchers and clinicians for use in future studies involving 3D CBCT imaging and craniofacial development.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Pontos de Referência Anatômicos , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico/instrumentação , Humanos , Imagem Tridimensional/métodos , Mandíbula/anatomia & histologia , Reprodutibilidade dos Testes , Base do Crânio/anatomia & histologia
12.
Forensic Sci Int ; 303: 109929, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472305

RESUMO

In sex determination from crania, a "vertical" forehead is considered a female feature, while a "sloping" forehead is considered a male feature. Precise description of frontal inclination with a quantitative measure like an angle is considerably more difficult as it requires accurate identification of clearly defined craniometric points. In the literature, the morphognostic terms "frontal bone inclination," or "frontal profile," are defined in numerous ways. The aim of this study was to determine which of these frontal inclination definitions is best suited for sex estimation. In a study in the context of the digital forensic osteology project, 10 of the frontal angle definitions described in the literature were assessed for their usefulness in sex determination on 211 virtual crania, reconstructed from postmortem CT-data. Custom-developed software was used for the automated measurement of frontal bone inclination angles from lateral-profile, volume-rendered 3D cranial images in which 10 anthropometric landmarks had been manually marked. Discriminant function analysis was performed to determine if satisfactory accuracy rates for the classification of sex could be achieved with defined variables. Four of the ten examined definitions were found to be highly significant for sex determination; three of these, also provided satisfactory intra- and inter-observer reliability. The frontal angle according to Schwalbe provided the best accuracy rate of 75.4% and a critical discriminatory value (separation value) of 88.6°: angles greater than this, suggest female sex; angles smaller than this, suggest male sex. Further, the open-source, custom-developed software introduced here proved compatible with commonly used image-processing and statistical programs and allowed quick, automated, valid measurement of numerous cranial angles. Other craniometric angles can, thus, also be quickly and easily determined with this software.


Assuntos
Cefalometria , Osso Frontal/diagnóstico por imagem , Determinação do Sexo pelo Esqueleto/métodos , Tomografia Computadorizada por Raios X , Pontos de Referência Anatômicos , Análise Discriminante , Feminino , Antropologia Forense , Humanos , Imagem Tridimensional , Masculino , Software
13.
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
14.
Rev. bras. cir. plást ; 34(3): 331-335, jul.-sep. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047148

RESUMO

Introdução: Em 1988, Baroudi et al. publicaram um trabalho descrevendo a utilização de pontos de adesão entre o retalho dermoadiposo e a bainha anterior do músculo reto do abdome, no intuito de diminuir a formação de seroma. O presente estudo propõe-se a demonstrar uma provável correlação entre os pontos de adesão de Baroudi com a força tensional do retalho, através da medida da distância da cicatriz abdominal inferior ao xifoide antes e após os pontos de Baroudi, no transoperatório de dermolipectomia. Métodos: Trata-se de um estudo prospectivo observacional. Foram selecionadas submetidas a lipoabdominoplastia no Serviço de Cirurgia Plástica da Santa Casa de Misericórdia de Porto Alegre, no período de janeiro a abril de 2019. Aferiram-se as medidas transoperatórias da distância do apêndice xifoide esternal à cicatriz umbilical, e da primeira à cicatriz cirúrgica, pré e pós-realização dos pontos de adesão de Baroudi. A análise estatística foi realizada com o software Excel®. Resultados: Verificou-se a diminuição das distâncias apêndice xifoidecicatriz umbilical e apêndice xifoide-cicatriz após a realização da sutura de Baroudi (média de 1,5cm), pressupondo-se diminuição da tensão da cicatriz. Conclusão: As medidas aferidas no presente estudo mostraram uma diminuição da distância xifoide-cicatriz umbilical e xifoide-cicatriz abdominal inferior após a realização dos pontos de Baroudi, evidenciando uma menor tensão na cicatriz. Sugere-se estudos para avaliar como essas medidas se comportam a longo prazo e se realmente se correlacionam a uma cicatriz de melhor qualidade.


Introduction: In 1988, Baroudi et al. published a paper describing the use of adhesion points between the dermoadipose flap and the anterior rectus abdominis sheath to reduce seroma formation. This study aimed to demonstrate a probable correlation between the use of Baroudi adhesion points and reduction in flap tension force by measuring the distance from the lower abdominal scar to the xiphoid before and after using Baroudi points in dermolipectomy transoperatory. Methods: This was a prospective observational study that selected patients who underwent lipoabdominoplasty at the Santa Casa de Misericórdia Plastic Surgery Service of Porto Alegre from January to April 2019. The transoperatory measurements of distance from the sternal xiphoid appendix to the umbilical scar and from the pre-xiphoid to the postxiphoid scar before and after execution of Baroudi's adhesion points were compared. Statistical analysis was performed using Excel® software. Results: A reduction in the distances between the xiphoid-umbilical scar appendix and xiphoidscar appendix was verified after execution of Baroudi suture (mean 1.5 cm), indicating a decrease in scar tension. Conclusion: There was a decrease in the xiphoid-umbilical scar and xiphoid-lower abdominal scar distance after Baroudi stitches, indicating lower scar-tissue tension. Further studies should be conducted to evaluate these measurements in the long term and their correlation with a better-quality scar.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Pesos e Medidas , Análise Estatística , Estudos Prospectivos , Cicatriz , Pontos de Referência Anatômicos , Abdominoplastia , Pesos e Medidas/normas , Cicatriz/cirurgia , Cicatriz/complicações , Pontos de Referência Anatômicos/cirurgia , Pontos de Referência Anatômicos/lesões , Abdominoplastia/efeitos adversos , Abdominoplastia/métodos , /métodos
15.
Forensic Sci Int ; 302: 109916, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31426020

RESUMO

Several studies have shown variability in osteometric measurements of the skull between populations. Therefore, each population should have specific standards to optimize the accuracy of identification. The aim of this study was to evaluate the sexual dimorphism in metric relations between anatomical points of the skull using CT scans in a Jordanian population by means of discriminant function analysis, to determine which continuous variables discriminate between sexes, and to examine the craniofacial changes according to age. 500 CT scans (240 males and 260 females) were used and a total of 11 craniofacial parameters were studied. The data were analyzed using distriminant function analysis. Sexual dimorphism was found mainly in the young adult group. Significant age related changes were noticed in minimum frontal breadth, orbital height and orbital index. In all subjects, the analysis of multivariate (dimorphic variables) and stepwise functions gave an accuracy of 58.8% and 57.0% respectively. Using stepwise analysis, the most dimorphic variables to estimate sex were maximum frontal breadth, bimaxillary breadth and orbital index. The multivariate analysis of all variables gave an accuracy of 58.8%. The percentages of correct sexing in Jordanian population were high using the single variable analysis in females only. In females, classification accuracies of 70.4% using bimaxillary breadth, 70.0% using the orbital index, and 68.1% using maximum frontal breadth were obtained. Additionally, discriminant analysis was conducted separately for each age group. Higher percentages of correct sexing were obtained only in young adults. The results of the discriminant function analysis did not appear to be significant. The results of discriminant function were insignificant in middle aged and elderly groups. Being female and young increases the percentages of correct sexing. Generally, low levels of accuracy of sexual dimorphism were obtained in our study, suggesting that population estimates of dimorphism are highly variable and the equations derived from the discriminant function analysis are not reliable in sex estimation in Jordanians.


Assuntos
Determinação do Sexo pelo Esqueleto/métodos , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pontos de Referência Anatômicos , Análise Discriminante , Feminino , Antropologia Forense , Humanos , Processamento de Imagem Assistida por Computador , Jordânia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Adulto Jovem
16.
ScientificWorldJournal ; 2019: 1807257, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31427901

RESUMO

Objective: The present study compared the changes in the upper airway dimensions and sleep-related breathing disorder (SRBD) condition between functional treatment with the headgear Herbst (HG-Herbst) and headgear Twin Block (HG-TB) appliance. Soft tissues were assessed on lateral cephalometric X-ray and magnetic resonance imaging (MRI). Materials and Methods: Consecutive patients who sought orthodontic treatment at the Faculty of Dentistry of The University of Hong Kong were screened. Adolescents (12-17 year sold for boys and 10-15 years old for girls), with class II molar relationship and overjet >5 mm, with no severe transverse maxillary deficiency, were recruited. Patients were assigned either to the HG-Herbst or to the HG-TB treatment by stratified block randomisation, with sex as the stratification factor. Lateral cephalograms, magnetic resonance imaging (MRI), and the Paediatric Sleep Questionnaire (PSQ) were obtained at baseline and after treatment. Results: 28 patients were enrolled, and 26 patients (13 in each group) completed the treatment. Following 1 year of functional appliance treatment, a significantly lower increase of the lower anterior facial height was observed in the HG-Herbst group compared to the HG-TB group (p = 0.024). However, no significant differences were observed in the upper airway structures or SRBD between the two groups. Conclusion: The changes in upper airway dimensions and SRBD condition were not significantly different between the HG-Herbst and the HG-TB appliance treatment. Additional studies with larger sample size are warranted.


Assuntos
Cefalometria , Aparelhos de Tração Extrabucal , Imagem por Ressonância Magnética , Aparelhos Ortodônticos Funcionais , Sistema Respiratório/diagnóstico por imagem , Adolescente , Pontos de Referência Anatômicos , Criança , Feminino , Humanos , Masculino , Resultado do Tratamento
17.
ScientificWorldJournal ; 2019: 9093474, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379470

RESUMO

The mental foramen (MF) and accessory mental foramen (AMF) are the strategically important landmarks during surgical interventions and anaesthetic nerve blocks procedures involving the mental nerve. The study aimed at evaluating anthropometrics of MF and AMF in Zambian adult human mandibles and it was cleared for ethics from TDRC Ethics Review Committee (Reg. No.: 00002911; FWA: 00003729). A total of 33 Zambian adult human mandibles were evaluated for shape, position, and direction of opening of foramen. All measurements were performed using a Digital Vernier Calliper and statistically analysed for per cent frequency and mean and standard deviations, and we performed the one sample t-test for comparative analysis. Data were considered significant at p<0.05. All mandibles that were examined had bilateral MF while unilateral AMF was found in two mandibles (6%). The foramens were mostly oval in shape and their most common position was between the second premolar and first molar and the most common orientation was posterior-superior. The comparative analysis of mandibular anthropometrics showed significant variations (p<0.05) with different ethnic groups. The findings emphasize the ethnic variations and edify that the foramen position is not always as stated in reference textbooks. The clinical creditability of the study is cautioning the surgeons on possible variations of the MF and AMF anthropometrics compared to existing literature in order to avoid any unforeseen injury related to anaesthesia or dental surgeries. Further studies with large sample sizes representing whole country are recommended to establish the standard MF and AMF anthropometrics of Zambian population.


Assuntos
Antropometria , Mandíbula/anatomia & histologia , /anatomia & histologia , Adulto , Pontos de Referência Anatômicos , Grupos Étnicos , Feminino , Geografia , Humanos , Masculino , Dente/anatomia & histologia , Zâmbia
19.
Muscle Nerve ; 60(5): 582-585, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31443126

RESUMO

INTRODUCTION: Our aim in this work was to determine the safety and accuracy of the volar approach to the pronator quadratus (PQ) through cadaver dissection. METHODS: Twenty upper limbs from 10 fresh cadavers were investigated. At the level 3 cm proximal to the ulnar styloid process (USP), a needle was inserted just medial to the palmaris longus (PL) tendon. Distances of the median nerve (MN) and ulnar artery (UA) from the needle insertion point (IP) were measured using ultrasonography and cadaver dissection. RESULTS: The PQ was located at a depth of 10.8-19.9 mm from the skin and had a median thickness of 9.1 mm, measured 3 cm proximal to the USP. The median distances of the MN and UA from the IP were 7.6 and 13.4 mm, respectively. DISCUSSION: A needle insertion for the volar approach to the PQ was safe at 3 cm proximal to the USP, just medial to the PL tendon.


Assuntos
Pontos de Referência Anatômicos , Antebraço/anatomia & histologia , Nervo Mediano/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Artéria Ulnar/anatomia & histologia , Cadáver , Dissecação , Eletromiografia/métodos , Feminino , Antebraço/diagnóstico por imagem , Humanos , Masculino , Nervo Mediano/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Tendões , Artéria Ulnar/diagnóstico por imagem , Ultrassonografia
20.
Am J Orthod Dentofacial Orthop ; 156(2): 178-185, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375227

RESUMO

INTRODUCTION: This study aimed to identify significant factors affecting the spontaneous angular changes of impacted mandibular third molars as a result of second molar protraction. Temporary skeletal anchorage devices in the missing mandibular first molar (ML-6) or missing deciduous mandibular second molar (ML-E) with missing succedaneous premolar spaces provided traction. METHODS: Forty-one mandibular third molars of 34 patients (10 male and 24 female; mean age 18.3 ± 3.7 years) that erupted after second molar protraction were included in this study. They were classified into upright (U) and tilted (T) groups. Linear and angular measurements were performed at the time of treatment initiation (T1) and of ML-6 or ML-E space closure (T2). Regression analyses were used to identify significant factors related to third molar uprighting. RESULTS: Nolla stage (odds ratio [OR] 4.1), sex (OR 0.003 for male), third molar angulation at T1 (OR 1.1), missing tooth space (OR 0.006), rate of third molar eruption (OR 23.3), and rate of second molar protraction (OR 0.2) significantly affected third molar uprighting. Age, third molar angulation at T1, rate of third molar eruption, and rate of second molar protraction were significant factors for predicting third molar angulation at T2. CONCLUSIONS: Available space for third molar eruption before and after second molar protraction is not associated with uprighting of erupting third molars. Older patients whose third molars are in greater Nolla stage, are in a more upright position at T1, and have a greater eruption rate have a greater chance for third molar uprighting. Alternatively, an increase in second molar protraction rate results in mesial tipping of the third molars.


Assuntos
Má Oclusão/prevenção & controle , Má Oclusão/fisiopatologia , Mandíbula/fisiopatologia , Dente Serotino/fisiopatologia , Dente Impactado/fisiopatologia , Adolescente , Adulto , Pontos de Referência Anatômicos , Dente Pré-Molar , Feminino , Humanos , Masculino , Má Oclusão/diagnóstico por imagem , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Dente Molar/anatomia & histologia , Dente Molar/diagnóstico por imagem , Dente Molar/fisiopatologia , Dente Serotino/anatomia & histologia , Dente Serotino/diagnóstico por imagem , Aparelhos Ortodônticos , Fechamento de Espaço Ortodôntico , Ortodontia Corretiva , Erupção Dentária , Dente Decíduo , Dente Impactado/complicações , Dente Impactado/diagnóstico por imagem , Adulto Jovem
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