Clinical Evaluation of Digital Dental Articulation for One-Piece Maxillary Surgery.
- 作者列表："Wong S","Deng H","Gateno J","Yuan P","Garrett FA","Ellis RK","English JD","Jacob HB","Kim D","Xia JJ
PURPOSE:Methods for digital dental alignment are not readily available to automatically articulate the upper and lower jaw models. The purpose of the present study was to assess the accuracy of our newly developed 3-stage automatic digital articulation approach by comparing it with the reference standard of orthodontist-articulated occlusion. MATERIALS AND METHODS:Thirty pairs of stone dental models from double-jaw orthognathic surgery patients who had undergone 1-piece Le Fort I osteotomy were used. Two experienced orthodontists manually articulated the models to their perceived final occlusion for surgery. Each pair of models was then scanned twice-while in the orthodontist-determined occlusion and again with the upper and lower models separated and positioned randomly. The separately scanned models were automatically articulated to the final occlusion using our 3-stage algorithm, resulting in an algorithm-articulated occlusion (experimental group). The models scanned together represented the manually articulated occlusion (control group). A qualitative evaluation was completed using a 3-point categorical scale by the same orthodontists, who were unaware of the methods used to articulate the models. A quantitative evaluation was also completed to determine whether any differences were present in the midline, canine, and molar relationships between the algorithm-determined and manually articulated occlusions using repeated measures analysis of variance (ANOVA). Finally, the mean ± standard deviation values were computed to determine the differences between the 2 methods. RESULTS:The results of the qualitative evaluation revealed that all the algorithm-articulated occlusions were as good as the manually articulated ones. The results of the repeated measures ANOVA found no statistically significant differences between the 2 methods [F(1,28) = 0.03; P = .87]. The mean differences between the 2 methods were all within 0.2 mm. CONCLUSIONS:The results of our study have demonstrated that dental models can be accurately, reliably, and automatically articulated using our 3-stage algorithm approach, meeting the reference standard of orthodontist-articulated occlusion.
目的: 数字牙齿对准的方法不容易用于自动表达上下颌模型。本研究的目的是通过与正畸医生-关节咬合的参考标准进行比较，评估我们新开发的3级自动数字关节方法的准确性。 材料和方法: 使用来自双颌正颌手术患者的30对结石牙模型，这些患者已经接受了1片Le Fort I截骨术。两名经验丰富的正畸医生手动将模型与他们感知的最终咬合进行手术。然后扫描每对模型两次-同时在正畸医师中-确定咬合，并且再次与上部和下部模型分开并随机定位。使用我们的3阶段算法将单独扫描的模型自动铰接至最终闭塞，产生算法-铰接闭塞 (实验组)。一起扫描的模型代表手动铰接的闭塞 (对照组)。由相同的正畸医师使用3点分类量表完成定性评估，他们不知道用于表达模型的方法。还完成了定量评估，以使用重复测量方差分析 (ANOVA) 确定算法确定的和手动铰接的闭塞之间的中线、犬和磨牙关系中是否存在任何差异。最后，计算平均值 ± 标准偏差值以确定两种方法之间的差异。 结果: 定性评估结果显示，所有算法-铰接式闭塞与手动铰接式闭塞一样好。重复测量的结果ANOVA发现两种方法之间没有统计学显著差异 [F(1,28) = 0.03; P = .87]。两种方法的平均差异均在0.2毫米以内。 结论: 我们的研究结果表明，使用我们的3阶段算法方法，可以准确、可靠、自动地铰接牙齿模型，符合正畸医生的参考标准-铰接咬合。
METHODS:OBJECTIVES:The aim was to evaluate the image quality and sensitivity to artifacts of compressed sensing (CS) acceleration technique, applied to 3D or breath-hold sequences in different clinical applications from brain to knee. METHODS:CS with an acceleration from 30 to 60% and conventional MRI sequences were performed in 10 different applications in 107 patients, leading to 120 comparisons. Readers were blinded to the technique for quantitative (contrast-to-noise ratio or functional measurements for cardiac cine) and qualitative (image quality, artifacts, diagnostic findings, and preference) image analyses. RESULTS:No statistically significant difference in image quality or artifacts was found for each sequence except for the cardiac cine CS for one of both readers and for the wrist 3D proton density (PD)-weighted CS sequence which showed less motion artifacts due to the reduced acquisition time. The contrast-to-noise ratio was lower for the elbow CS sequence but not statistically different in all other applications. Diagnostic findings were similar between conventional and CS sequence for all the comparisons except for four cases where motion artifacts corrupted either the conventional or the CS sequence. CONCLUSIONS:The evaluated CS sequences are ready to be used in clinical daily practice except for the elbow application which requires a lower acceleration. The CS factor should be tuned for each organ and sequence to obtain good image quality. It leads to 30% to 60% acceleration in the applications evaluated in this study which has a significant impact on clinical workflow. KEY POINTS:• Clinical implementation of compressed sensing (CS) reduced scan times of at least 30% with only minor penalty in image quality and no change in diagnostic findings. • The CS acceleration factor has to be tuned separately for each organ and sequence to guarantee similar image quality than conventional acquisition. • At least 30% and up to 60% acceleration is feasible in specific sequences in clinical routine.
METHODS:BACKGROUND:The main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques. OBJECTIVE:To explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage. METHODS:Five hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes. RESULTS:For the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40-<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551). CONCLUSION:Endoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.
METHODS:OBJECTIVE:The primary purpose of this study was to evaluate the effectiveness of a three-dimensional (3D) software tool (smart planes) for displaying fetal brain planes, and the secondary purpose was to evaluate its accuracy in performing automatic measurements. MATERIAL AND METHODS:This prospective study included singleton fetuses with a gestational age (GA) greater than 18 weeks. Transabdominal two-dimensional ultrasound (2DUS) and 3D smart planes images were respectively used to obtain the basic planes of the fetal brain, with five parameters measured. The images, by either two-dimensional (2D) manual or 3D automatic operation, were reviewed by two experienced sonographers. The agreements between two measurements were analyzed. RESULTS:A total of 226 cases were included. The rates of successful detection by automatic display were as high as 80%. There was substantial agreement between the measurements of the biparietal diameter, head circumference and transcerebellar diameter, but poor agreement between the measurements of cisterna magna and lateral ventricle width. CONCLUSIONS:Smart Planes might be valuable for the rapid evaluation of fetal brain, because it simplifies the evaluation process. However, the technology requires improvement. In addition, this technology cannot replace the conventional manual US scans; it can only be used as an additional approach.