Shape Anomalies Research Articles

Elastic Depths for Detecting Shape Anomalies in Functional Data

We propose a new family of depth measures called the elastic depths that can be used to greatly improve shape anomaly detection in functional data. Shape anomalies are functions that have considerably different geometric forms or features from the rest of the data. Identifying them is generally more difficult than identifying magnitude anomalies because shape anomalies are often not distinguishable from the bulk of the data with visualization methods. The proposed elastic depths use the recently developed elastic distances to directly measure the centrality of functions in the amplitude and phase spaces. Measuring shape outlyingness in these spaces provides a rigorous quantification of shape, which gives the elastic depths a strong theoretical and practical advantage over other methods in detecting shape anomalies. A simple boxplot and thresholding method is introduced to identify shape anomalies using the elastic depths. We assess the elastic depth’s detection skill on simulated shape outlier scenarios and compare them against popular shape anomaly detectors. Finally, we use hurricane trajectories to demonstrate the elastic depth methodology on manifold valued functional data.

Patterns of dental anomalies in patients with nonsyndromic oral cleft

Aim: To characterize the patterns of dental anomalies (DA) in the mixed and permanent dentitions of patients with nonsyndromic oral cleft (NSOC). Methods: This cross-sectional, observational, case-control study included 173 patients, 61 with mixed dentition (NSOC=29 and control=32) and 112 with permanent dentition (NSOC=57 and control=55). All subjected were submitted to clinical and radiographic examination. Dental anomalies of eruption, number, size and shape outside the cleft area were considered. Results: Although there was no statistical significance among patients with mixed dentition, dental agenesis was the anomaly more common in this group. In patients with permanent dentition, a higher prevalence of DA in NSOC group compared to control group was observed (p=0.02). Gyroversion and dental agenesis were the DA more frequently observed in the permanent dentition and the second premolar was the tooth more affected (p=0.003). Mandible and the left side were more involved, and dental agenesis was more frequently found in patients with unilateral cleft lip with or without cleft palate (NSCL±P). Conclusion: Our findings show a higher frequency of DA in NSOCs than in the control group in patients with permanent dentition, mainly due to a higher occurrence of agenesis of second premolars in patients with unilateral NSCL±P.

Oral Clinical Manifestations of Neurofibromatosis Type 1 in Children and Adolescents

Background: Neurofibromatosis 1 (NF1) is an autosomal dominant genetic disorder. The expression of NF1 is extremely variable considering the broad spectrum of mutations affecting the gene(s) responsible for the pathology. Aim: To investigate the prevalence of oral manifestations in a group of children affected by neurofibromatosis type 1. Design: 100 pediatric patients, with genetically confirmed NF1 were enrolled in this study and matched to a total of 100 healthy children. Clinical examination was used to investigate: dental caries, dental abnormalities, periodontal health, neurofibromas, malocclusions, and enamel defects. Results: Mann Whitney’s test concerning prevalence of dental caries resulted in a no significant difference between the two groups (p = 0.90); a significant difference was highlighted as regards the other kinds of manifestations as well: enamel defects (p = 0.01), neurofibromas (p = 0.0043) and poor oral hygiene (p = 0.0002) with a higher prevalence of these features in NF1 patients than healthy controls. Similar results come out, regarding dental abnormalities in which can observe a significant difference between shape anomalies (p < 0.001). Conclusion: According to data obtained from the present study, it can be stated that NF1-related oral manifestations can be detected during childhood and adolescence. In particular for neurofibromas, enamel defects, shape anomalies, and poor oral hygiene.

Poland syndrome: Chest wall and breast repair

Introduction: Poland syndrome is a rare congenital disorder. Its main characteristics are deficiency of the sternocostal portion of the pectoralis major muscle and symbrachydactyly. However, it encompasses a wide spectrum of other chest, breast and upper extremity anomalies. Patients and Methods: The author’s personal experience with a small series of patients with Poland syndrome is retrospectively reviewed. Only chest and breast anomalies were surgically corrected. A bilateral augmentation mammoplasty using different size implants was performed in order to restore chest and breast asymmetry in female patients. The latissimus dorsi muscle was transferred in order to replace the absent pectoralis major in male patients. Results: Eleven adult patients were found. There were 8 female and 3 male patients (age 21-29, mean 23,5y). Two patients refused any kind of treatment. Nine patients (six females, three males) underwent surgical correction (right side n=8, left side n=1). The follow-up period ranged from 6 months to 14 years. There were no major complications. There was a minor complication (seroma) in a male patient after latissimus dorsi transfer, which resolved spontaneously. No capsular contracture has been detected to date and no revision or implant change has been necessary in any of the female patients. All patients were satisfied with the final outcome. Conclusions: The pedicled latissimus dorsi muscle is still the “golden standard” for replacement of the totally absent pectoralis major muscle especially in males. Breast implants are highly successful in correcting chest/ breast asymmetry (size and shape anomalies) in females. Remaining nipple/areola deformities can be easily tackled at a later stage.

Dental anomalies in the deciduous dentition of non-syndromic oral clefts patients

Abstract Objectives: to investigate the prevalence of dental anomalies in complete deciduous dentition of children with NSCL/P. Methods: this study included 75 children with NSCL/P and 286 healthy control. In both groups the children had deciduous dentition with ages varying from 4 to 6 years. Clinical examination, panoramic and periapical radiographies were performed and dental anomalies of number and shape were considered. Results: there was a higher prevalence of dental anomalies in the case group, compared to the control group. In all, 42 dental anomalies were identified, 25.33% in the case group and 8.04% in control group (p<0.001). Therewas a higher frequency of dental anomalies in NSCL/P (47.36%), followed by non-syndromic cleft lip (31.57%) and non-syndromic cleft palate (21.05%). The occurrence of agenesis (p= 0.005) and twinning (p = 0.029) were higher in the case group. Conclusions: the occurrence of agenesis and dental twinning was more frequent in the case group and may contribute to the definition of oral cleft subphenotype.

The differences in parallelism between ala-tragus line and occlusal plane of down syndrome and normal individuals

People with down syndrome have a different craniofacial structure compared to normal individuals. Commonly, down syndrome patients have abnormal ear morphology with smaller size, and lower ear position compared to that of normalsubjects. These patients also have smaller nose, shorter maxilla structure and facial height. Other disorders are anomalies in tooth shape, numbers and size. The ala-tragus line is one of the anatomical landmarks to determine the occlusal plane orientation. Abnormalities in the anatomical structure of people with down syndrome can affect the parallelism between the ala-tragus line and the occlusal plane. The purpose of this research was to determine the differences in parallelism between the ala-tragus line and the occlusal plane of people with down syndrome and normal individuals. The sample in this study were people with down syndrome and normal individuals. The sample was photographed using a digital camera with a fox plane attached to the oral cavity. Parallelism of the ala-tragus line and the occlusal plane was analyzed by tracing these photographs. Photo tracing was done using the Autocad 2013 software. The mean value of angle on people with down syndrome (5.852° ± 5.367°) was greater than that of normal individuals (2.169° ± 2.557°). Based on the research, it was concluded that the parallelism of the ala-tragus line to the occlusal plane in people with down syndrome was different from that in normal individuals. The ala-tragus inferior line in normal individuals was more parallel to the occlusal plane compared to that in people with down syndrome.

Incidental findings in a consecutive series of digital panoramic radiographs.

PurposeThe aim of this study was to determine the prevalence of incidental findings (IFs) on digital dental panoramic radiographs (DPRs) of asymptomatic patients attending a general dental practice.Materials and MethodsThis was a retrospective study of 6,252 consecutive digital (photostimulatable phosphor) DPRs of patients who visited a Canadian general dental practice for a complete new patient examination. The IFs were grouped into dental-related anomalies, radiopacities and radiopacities in the jaws, changes in the shape of the condyles, and other findings in the jaws, such as tonsilloliths and mucosal antral pseudocysts. Their prevalence was determined.ResultsThirty-two percent of the DPRs showed at least 1 IF. The highest prevalence was found for dental-related anomalies (29% of all DPRs), of which impacted teeth were the most prevalent finding (24% of all DPRs), followed by idiopathic osteosclerosis (6% of all DPRs). A lower prevalence was noted for tonsilloliths (3%), and the prevalence of root tips, mucosal antral pseudocysts, and anomalies in condylar shape was approximately 1% each.ConclusionThe observed prevalence of 32.1% for IFs of any type underscores the need for a dental practitioner to review the entire DPR when a patient presents for an initial dental examination (or check-up) or for dental hygiene. Only a single IF (a central giant cell granuloma) provoked alarm, as it was initially considered malignant. Similarly, impacted teeth and suspected cysts need careful evaluation upon discovery to determine how they may be optimally managed.

Sociodemographic and behavioral factors associated with developmental dental hard-tissue anomalies in children with primary dentition

Introduction: Developmental dental hard-tissue anomalies include anomalies of number, size, shape, and structure of the teeth. Anomalies in primary dentition are associated with anomalies in the permanent dentition. The present study identified the sociodemographic and behavioral factors associated with developmental dental hard-tissue anomalies in primary dentition. Materials and Methods: This was a cross-sectional study of 433 preschool children aged 5 years and below in Enugu East Local Government Area, Enugu, Nigeria. Data on sociodemographic profile were collected, and clinical examination was conducted on the children to record the presence of double tooth, hypodontia, hyperdontia (supernumerary), microdontia, talons cusp, hypoplasia, and Hutchinson's incisors. Results: The prevalence of developmental dental hard-tissue anomalies was 14 (3.2%). Five-year-old children (28.6%), male children (57.1%), and children belonging to high socioeconomic status (50.0%) had developmental dental hard-tissue anomalies, and there was a statistically significant association between past dental visit (P

PECULIARITIES OF THE COURSE AND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH SYNDROME OF UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA. (SYSTEMATIC LITERATURE REVIEW)

PECULIARITIES OF THE COURSE AND TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH SYNDROME OF UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA. (SYSTEMATIC LITERATURE REVIEW)

Planning of treatment in patients with orthodontic profile with registration of topography of key teeth

Aim. Determination of the position of the central point and canines in patients with anomalies in the shape and size of dental arches. Materials and methods. The materials of the research were the results of measurements of diagnostic gypsum models of dental rows of 63 people of the first period of adulthood with a full set of permanent teeth, physiological occlusion and 59 people with shape anomalies, the size of dental arches of the same age period. The width of the crowns of the teeth was measured in the mesial-distal direction. The width of the dental arch was determined between the points located on the vestibular distal tubercles near the occlusal contour of the crowns. The frontal-distal and canine diagonal was measured from the central point located between the medial incisors near the cutting edge to the points located on the molars and canines, respectively. The depth of the dental arch was determined from the central intercellular point to the line joining the antimers, in particular canines and molars. Results. Taking into account morphological, clinical studies and mathematical modeling, an algorithm for examining patients with anomalies in the shape and size of dental arches has been developed, which makes it possible to reveal the position of the central (inter cut) point. The basis of the algorithm is the measurement of the width of the dental arch between the second molars and the value of the front-distal diagonal, defined as the ratio of the half sum of 14 teeth to the coefficient of 1.04. It is established that the location of the canines is determined from the size of the frontal canine diagonal calculated as the ratio of the diagonal of the dental arch to the ratio of the length of the dental arch to the sum of the width of the crowns of six anterior teeth and using a correction factor of 0.1. Conclusion. Improving the methods of diagnosis of dentoalveolar anomalies allows not only minimizing errors associated with instrumental measurement techniques, but, due to the predictability of orthodontic treatment, to achieve optimal functional and aesthetic results. The introduction of the algorithm will, with a high degree of certainty, establish the position of the central point and key teeth. The use of these guidelines in patients with anomalies in the shape, size of the dental arches, due to a reasoned choice of tactics and the volume of manipulations conducted, will reduce the time spent in the diagnostic phase.

Developmental dental anomalies assessed by panoramic radiographs in a Greek orthodontic population sample

To assess developmental dental anomalies on panoramic radiographs in a Greek orthodontic population. The sample consisted of 1200 panoramic radiographs that have been taken as part of routine orthodontic treatment planning in children and adolescents. The following exclusion criteria were applied: systemic disorders such as syndromes or clefts, previous jaw surgery and poor quality of the radiograph. Dental anomalies were classified as anomalies of tooth shape, size, eruption-, position- or number anomalies or root alterations. The age range of the subjects (536 males and 664 females) was 7-17years with a mean age of 11.78years. The prevalence of dental anomalies was assessed with a Chi-squared test. The intraobserver agreement was evaluated by calculating Cohen's [Formula: see text]. Among the 1200 digital panoramic radiographs examined, a total of 224 (18.67%) presented dental anomalies, 92 (7.67%) males and 132 (16.67%) females. Moreover, 203 patients (16.92%) had 1 dental anomaly, whereas 19 (1.58%) and 2 (0.17%) patients had 2 or more than 2 dental anomalies, respectively. Oligodontia was the most prevalent dental anomaly and was presented in 6.4% of the subjects, while supernumerary teeth were detected in 1% of the patients. A significant number of orthodontic patients had at least one DDA. The most common DDA in this sample was oligodontia followed by impaction and supernumerary teeth. Comparison to our data with other studies revealed variation in their prevalence suggesting genetic and environmental influences.

S8A-06 SESSION 8A: METOPIC SYNOSTOSIS QUANTIFYING THE SEVERITY OF METOPIC CRANIOSYNOSTOSIS: A PILOT STUDY IN APPLICATION OF ADVANCED MACHINE LEARNING IN CRANIOFACIAL SURGERY

Introduction: Metopic Craniosynostosis refers to early fusion of the metopic suture. It can cause head shape anomalies and symptoms of elevated intracranial pressure. While the current standard for diagnosing the condition utilizes CT imaging and physical exam, there is no standardized method for predicting disease severity. Previous studies using interfrontal angles have looked at differences in specific skull landmarks, however these measurements are difficult to readily ascertain in clinical practice and fail to assess the complete skull contour. This pilot project employs machine learning algorithms to combine statistical shape information with expert ratings to generate a user-friendly method of measuring the severity of metopic craniosynostosis. Methods: Expert ratings of normal and metopic skull CT images were collected. Skull-shape analysis was conducted using ShapeWorks software. Advanced machine-learning was used to combine the expert ratings with our shape analysis model to predict the severity of metopic CS using CT images. Our model was then compared to the gold standard using interfrontal angles. Results: 17 metopic and 65 non-affected skull CT images of patients 5–15 months old were assigned a severity by 18 craniofacial surgeons. Our model accurately correlated the level of skull deformity with severity (p<0.10) and predicted the severity of metopic CS more often than models using interfrontal angles (χ2=5.46, p=0.019). Conclusion: This is the first study that combines shape information with expert ratings to generate an objective measure of severity for metopic craniosynostosis. This method will help clinicians easily quantify the severity and perform robust longitudinal assessments of the condition.

“Unexpected Item in the Bagging Area”: Anomaly Detection in X-Ray Security Images

The role of anomaly detection in X-ray security imaging, as a supplement to targeted threat detection, is described, and a taxonomy of anomaly types in this domain is presented. Algorithms are described for detecting appearance anomalies of shape, texture, and density, and semantic anomalies of object category presence. The anomalies are detected on the basis of representations extracted from a convolutional neural network pre-trained to identify object categories in photographs, from the final pooling layer for appearance anomalies, and from the logit layer for semantic anomalies. The distribution of representations in normal data is modeled using high-dimensional, full-covariance, Gaussians, and anomalies are scored according to their likelihood relative to those models. The algorithms are tested on X-ray parcel images using stream-of-commerce data as the normal class, and parcels with firearms present the examples of anomalies to be detected. Despite the representations being learned for photographic images and the varied contents of stream-of-commerce parcels, the system, trained on stream-of-commerce images only, is able to detect 90% of firearms as anomalies, while raising false alarms on 18% of stream-of-commerce.

Pancake kidney: An unusual type of renal fusion anomaly found in 99mTc-DMSA renal scintigraphy

A 2.5-year-old boy with a history of the previous incidental finding of an ectopic kidney in ultrasonography was referred to our nuclear medicine center for 99mTc-DMSA renal scintigraphy. The scan showed an unusual type of ectopic fused kidneys on the right side of the lower abdomen. In this anomaly, kidneys were fused completely across the medial portion of both upper and lower poles, as well as hilum with no septum. Each kidney, however, demonstrated separate consists of own collecting system. 99mTc-DMSA renal scintigraphy is a valuable imaging detection of different shape anomalies such as pancake kidney. We report this extremely rare case of ectopic fused types of renal anomaly including pancake kidney

Maxillary tooth transpositions and pressure root resorption: a case report

Introduction: Tooth developmental disturbances may occur by anomalies in position, number, shape and tooth size [1], and is genetic-related [2–4]. Transposition is an unique and extreme form of ectopic eruption in which a permanent tooth develops and erupts in the position normally occupied by another [5]. Although transpositions are quite common in canines [6–8], this condition rarely occurs with incisors or premolars [6,9]. On the other hand, pathologic root resorption can be observed during eruption of permanent dentition [10], but is very unusual in maxillary first molar. Materials and methods: A 12-year-old male was referred to the Orthodontics Department of Egas Moniz Dental Clinic complaining with severe pain on the left side of the maxillary and premolars transposition on the right side. After clinical and radiographic examination, through orthopantomography and cone-beam computerized tomography (CBCT) severe root resorption of the left maxillary first molar caused by abnormal eruption of the second premolar was diagnosed. Futhermore, the transposition of the upper right premolars was confirmed and severe transversal collapses (Pont’s Premolar Index: -13,5 mm; Pont’s Molar Index: -14,4 mm), ectopic upper canines, maxillary compression, crossbite between 1.6 and 4.6, skeletal Class I and unilateral Angle Class II, diagnosed. Discussion and conclusions: According to the literature, the frequency of tooth transposition is less than 0.4% [7,8,11,12]. In most cases they are more common with unilateral occurrence [4,8,9], on the left side as opposed to the right side [7,8], and have been found more often in the maxilla [4,7]. Our case is significant because this patient is male and typically this has been found more often in females [4,6,7] and tooth transpositions in premolars and pressure root resorption of the maxillary first molar are extremely rare [6,9,10]. Figure 1. Intraoral view of transposition of maxillary permanent first and second premolars, bilateral ectopic of maxillary permanent canines, absence of the second premolar. Central image show a radiographic view that demonstrates impacted tooth pressure root resorption of maxillary first molar by an impacted second premolar. Right image show transposition of maxillary permanent first and second premolars.

Gemination mandibular third molar – A rare case with use of CBCT in diagnosis and treatment planning

It is not uncommon to find dental anomalies in routine practice. Developmental dental anomalies may be seen in tooth number, size, shape, and structure. Gemination and fusion are anomalies of shape with close similarity but with different etiology. Differential diagnosis is difficult and so the term “double teeth” is often used. The incidence of double teeth is less than 1% and even more so in permanent dentition. Here, we present a unique case of gemination in mandibular third molar diagnosed effectively with the help of three-dimensional imaging and managed with the surgical technique.

Rare diseases and their clinical oral manifestations in two Hospitals in Yaoundé

IntroductionLes maladies rares ont pour certaines des manifestations orales. Celles-ci sont souvent sous-étudiées; ce qui contribue à limiter l'offre de soins bucco-dentaires pour cette catégorie de patients. Le but est de déterminer les aspects épidémiologiques et cliniques des manifestations bucco-dentaires dans les maladies rares dans notre milieu.MéthodesNous avons effectué une étude transversale et descriptive sur une durée de 7 mois, dans deux hôpitaux de référence de Yaoundé: les informations ont été recueillies des dossiers médicaux, de l'interrogatoire des parents ou tuteurs et de l'examen bucco-dentaire des patients. Le seuil de significativité considéré pour p < 0,05.RésultatsLes manifestations orales sur maladies rares sont variables et fonction du groupe d'affections, de la denture, et ont souvent un retentissement fonctionnel. Elles étaient présentes dans 97,2% de nos patients. En denture temporaire (59,4%), c'était plus des anomalies de forme et de position dentaire (conicité dentaire 7 cas/22, soit 32%), et en denture permanente des lésions carieuses (7 cas/10 soit 70%) et des anomalies de structure dentaire (4 cas/10 d'usure dentaire). Un lien significatif existait entre le type de denture, l'anomalie de structure (p=0,001) et de nombre (p=0,018). Les difficultés à la mastication (p=0,023) et à la succion (p=0,033) étaient liées aux groupes de maladies rares.ConclusionLes lésions orales dans les maladies rares bien que présentes dans notre milieu, sont souvent négligées. Les soins bucco-dentaires devraient être intégrés dans le paquet minimum des activités des formations sanitaires et rendus gratuits ou financièrement accessibles à ces patients handicapés ou présentant des besoins spécifiques.

Prevalence of Dental Anomalies in Indonesian Individuals with Down Syndrome

Objective: To determine the frequency distribution of dental anomalies in people with Down syndrome. Material and Methods: This cross-sectional study was developed in Jakarta, Indonesia, and evaluated 174 individuals with Down syndrome aged 14-53 years. Were collected information regarding the tooth number, tooth size, shape, and structure. Descriptive statistics were used to calculate the absolute and relative frequencies. The Pearson chi-square test was used in bivariate analysis. The significance threshold was set at 5%. Results: There were 70 female subjects (40.2%) and 104 male subjects (59.8%) with an average age of 19.2 years. In terms of anomalies of tooth number, hypodontia (80.9%), supernumerary teeth (12.4%), and combined hypodontia and supernumerary teeth (12.4%) were identified. In terms of anomalies of tooth size, microdontia (98.8%) is the most common anomaly. Anomalies of tooth shape included fusion (66.67%) and talon's cusp (33.3%), whereas anomalies of tooth structure included enamel hypoplasia (70.8%), enamel hypocalcification (4.2%), combined enamel hypoplasia and hypocalcification (12.5%), and tooth discoloration (12.5%). Conclusion: Individuals with Down syndrome in Jakarta showed a high prevalence of dental anomalies, with hypodontia and microdontia being the most common anomalies showing a tendency to occur predominantly in males.

Dental anomalies of form and number in primary dentition in a Mexican population

Abstract: To determine the frequency and distributionof dental anomalies of shape and numberin primary dentition.&#x0D; Methods: The study is retro-prolective, crosssectionaland descriptive. The sample was probabilistic,stratified for convenience by gender. Theclinical record of 1,568 patients was reviewed.These patients attended the Clinic of PediatricDentistry of FEBUAP during the period of 2012-2014, only 720 records of patients were includedin the study (321 girls and 399 boys) between theages of 1-10 years old, who provided complete,crisp radiographic studies with the presence ofdental anomalies of shape or number, the studywas divided into active and inactive patients.For inactive patients, photographs of x-rays withdental anomalies of shape and/or number weretaken. For cases with active patients, an interviewwith one of the parents was conducted andauthorization with informed consent was requested,also the child agreed to do a clinical examinationand take intraoral photographs.&#x0D; Results:A total of 63 children had anomalies (17girls and 46 boys). The total prevalence of dentalanomalies was 9%, of which 3.1% were (fusedand geminated teeth), 1.1% (agenesis) and 1.9%(supernumerary), 1.3% (supernumerary roots),0.27% (macrodontia), 0.11% (microdontia), andfinally 0.27% corresponded to (talon cusp).&#x0D; Conclusions: Although the prevalence of theseanomalies is not high, it is important to do a routineradiographic examination for early diagnosisand accordingly apply the correct preventivemeasures to establish the best treatment plan.

Direct pulp capping and class II composite resin restoration of right maxillary first molar fused to supernumerary tooth

Among developmental anomalies of tooth shape, fusion and gemination are comparatively common. Developed with different etiologies, both fusion and gemination show similar clinical features. Therefore, many clinicians have difficulty diagnosing those morpho-anatomic anomalies. The purpose of this study is to report malformed right maxillary first molar in a 20-year-old female. With the aid of computed tomography (CT), the tooth was diagnosed as fusion with supernumerary tooth and dental caries lesion was detected. After performing direct pulp capping, the tooth was permanently restored with microhybrid composite resin using direct method to alter union groove into smooth surface for improving oral hygiene management. Until 6 months of follow-up visits, patient's chief complaint was resolved and tooth is still vital. In conclusion, identifying exact anatomy, conservative treatment and improving oral hygiene are essential in managing unusual morphologic anomalies of tooth.