Clinical Photographs Research Articles

One-Year Results of Ear Reconstruction with 3D Printed Implants.

External ear reconstruction has been a challenging subject for plastic surgeons for decades. Popular methods using autologous costal cartilage or polyethylene still have their drawbacks. With the advance of three-dimensional (3D) printing technique, bioscaffold engineering using synthetic polymer draws attention as an alternative. This is a clinical trial of ear reconstruction using 3D printed scaffold, presented with clinical results after 1 year. From 2021 to 2022, five adult patients with unilateral microtia underwent two-staged total ear reconstruction using 3D printed implants. For each patient, a patient-specific 3D printed scaffold was designed and produced with polycaprolactone (PCL) based on computed tomography images, using fused deposition modeling. Computed tomography scan was obtained preoperatively, within 2 weeks following the surgery and after 1 year, to compare the volume of the normal side and the reconstructed ear. At 1-year visit, clinical photo was taken for scoring by two surgeons and patients themselves. All five patients had completely healed reconstructed ear at 1-year follow-up. On average, the volume of reconstructed ear was 161.54% of that of the normal side ear. In a range of 0 to 10, objective assessors gave scores 3 to 6, whereas patients gave scores 8 to 10. External ear reconstruction using 3D printed PCL implant showed durable, safe results reflected by excellent volume restoration and patient satisfaction at 1 year postoperatively. Further clinical follow-up with more cases and refinement of scaffold with advancing bioprinting technique is anticipated. The study's plan and results have been registered with the Clinical Research Information Service (CRIS No. 3-2019-0306) and the Ministry of Food and Drug Safety (MFDS No. 1182).

A faster CO2 fractional scanner system mode for skin rejuvenation. A clinical study.

The market requires ever-faster techniques, in particular for pre-rejuvenation condition. The purpose of this study was to assess if a fractional CO2 scanner modality (called moveo) results in a faster full-face rejuvenation treatment in comparison to the standard mode, currently existing in the scanner system. A total of 12 female patients affected by fine lines participated in a split-face clinical investigation and underwent to two sessions with a fractional CO2 laser system equipped with an existing and a faster dedicated scanner units. Pain was assessed using VAS. Three-dimensional clinical photographs were captured before, immediately after, 3 days, 14 days after the first treatment and immediately after the second treatment and 1 months after the last one. The uniformity and aesthetic coverage of treatments were assessed using dermatoscopy. Global aesthetic improvement scale (GAIS) was used. The time taken to treat the two sides of the face and all possible side effects were monitored. Following only two treatment session with both scanner modes, the patient's skin texture improved significantly, with fine lines reduction. There is no statistically significant difference in perceived pain between patients. The GAIS score showed satisfactory results following both modalities. The time parameters indicated that with the faster scanner mode the full-face treatment time was reduced by 30% compared to the standard one. No adverse effects were observed. The moveo modality provide faster treatment and a better final dermal aesthetic outcome than the standard procedure while maintaining the same safety profile.

The use and ethics of dental photography and social media at an oral healthcare training centre in South Africa.

The ethics surrounding the use and sharing of photographs on social media has come under the spotlight as the Protection of Personal Information Act (POPI Act) has come into play. The aim is to determine the use, ethical practice and sharing of dental photography on social media among qualified and undergraduate oral health practitioners at a dental school in South Africa. A cross-sectional study design was used on staff and students at the University of the Western Cape's Dental Faculty in 2022. Chi-squared and Fisher's exact tests were used to determine associations between the different graduation statuses and various demographic factors. From the 80 undergraduate students and 46 qualified oral healthcare practitioners, the majority were aware that photography could be used in dentistry, and 87.3% (n = 110) took photographs of the dental treatments performed on their patients. Only 60.3% of the participants attended an ethical course that addressed issues with social media and digital photography. Almost 80% (n = 100) of the participants did not feel that they needed to mention all the social media platforms that they would use with their patients' photographs before sharing. Dental photography is being used and sometimes shared on social media platforms by some students and staff at university level. Not all participants have attended an ethical course on clinical photography. Dental training needs to include an ethical course on dental photography and the use of sharing photographs on social media. Good ethical practice regarding clinical photographs in all undergraduate and postgraduate curriculums, to eliminate any uncertainty.

Comparing the efficacy, safety, and satisfaction for moderate to severe glabellar frown lines between abobotulinum toxin A and incobotulinum toxin A: a multicenter randomized study

Background Botulinum toxin type A is widely used to improve facial wrinkles associated with aging, and various types are available. However, the efficacy, particularly the duration of effect, varies among these types, and research on this subject is limited. This study aimed to compare the efficacy and safety of incobotulinum toxin A and abobotulinum toxin A.Methods This prospective analysis included cases of moderate to severe glabellar lines treated with either incobotulinum toxin A or abobotulinum toxin A. After a 24-week follow-up, clinical photos were taken at each visit. The severity of the glabellar lines was evaluated by three groups: the investigator, the patients, and an independent evaluator.Results The study included a total of 42 patients. When comparing the improvement rates of glabellar lines at maximum frown for both groups at the week-4 visit, which was the primary efficacy endpoint, no statistically significant difference was observed. However, the abobotulinum toxin A group demonstrated a higher improvement at the week-24 visit, as evaluated by the investigator, and this difference was statistically significant.Conclusions Overall, the abobotulinum toxin A group exhibited a higher improvement rate in the glabellar lines at the frown state. The difference in the improvement rate at the week-24 visit was 36.86%, which was statistically significant.

The Difference in the Morphometric Assessment of Gingival Biotype by Using Periodontal Probe Transparency Method and Photogrammetry

Objective: To evaluate the photogrammetric assessment of gingival biotype against the clinical gold standard method of probe transparency in terms of their consistency in assessment Study Design and Setting: Cross-sectional comparative; Periodontology Department, Institute of Dentistry, CMH Medical and Dental College, Lahore Methodology: The study targeted 149 adult subjects aged 18-30 years reporting to dental out patient department for routine dental treatment. A periodontal probe was inserted into the marginal gingiva of maxillary right central incisor and probe visibility through the gingival soft-tissues was judged. A probe visible through the tissues yielded thin gingiva and vice versa. For morphometric analysis, standardized clinical photographs were captured using digital DSLR camera. A photoshop software was used to measure crown width, crown height and papillary height for maxillary central incisor on all photographs. A crown width-to-height ratio >0.75 and a papillary height <4.5 mm indicated thick gingiva and vice versa. Data was analyzed via Statistical Package for Social Sciences version 24. Descriptive statistics were calculated. An inter-method reliability analysis using Cohen’s Kappa was performed to determine the consistency among the two methods in diagnosing gingival biotype. p=0.05 was taken as significant. Results: About 54.4% subjects were identified having a thin gingival biotype. A significant difference was observed between males and females as well as between age groups for gingival biotypes (p<0.001). Using Cohen’s Kappa, a “perfect agreement” between probe transparency and photogrammetric methods was observed (ê = 1, p<0.001) Conclusion: Photogrammetry offers a reliable and noninvasive method for evaluation of gingival thickness

Inclusion of clinical photographs with general dental practitioner electronic referrals of patients with oral mucosal disease to secondary care: a service review.

Introduction This service evaluation reviewed how the inclusion of photographs in dentist referrals to an oral medicine specialist service can improve the service for triage, prioritisation and diagnosis.Materials and methods Data were prospectively collected from e-referrals over a four-month period. Any change in appointment prioritisation resulting from review of photographs at the vetting stage was recorded.Results Only 29.5% (82 of 367) of referrals included a photograph. Of these, 5% were 'rejected with advice' since the photograph indicated the patient did not require a secondary care appointment. Additionally, 14% of all referrals were upgraded in urgency, five of which were due to concerns of malignancy, and three of five were upgraded solely based on the photographs as they showed features of possible malignancy, where the written element of the referral did not describe nor raise such concerns.Discussion and conclusions Including a photograph with a referral can often make up for inaccurate or insufficient written content, allowing appropriate and safe prioritisation, especially where the referrer has failed to recognise possible malignancy. Photographs can also prevent unnecessary referral upgrades, ensure an appointment is necessary and can be invaluable as a baseline comparator.

Evaluation of Interdental Papilla Regeneration Using Injectable Hyaluronic Acid: A Clinical Study.

This study aimed to assess the efficacy of hyaluronic acid (HA) gel injections in deficient papillae and record the effects for four weeks. Fifteen deficient class 1 papilla sites according to Nordland and Tarnow classification were included. After scaling and root planing, 0.5 ml HA gel was injected into the papillae. Measurements of black triangle height (BTH) and black triangle area (BTA) from the contact point to the most coronal level of the visible papilla tip weredone on the clinical photographs using ImageJ software at baseline, one week, and four weeks postoperatively, and a comparison was made. Descriptive data were examined using the mean and standard deviation (SD). Paired t-test was used for intragroup comparisons, with p-values <0.05 considered significant. All the data analysis was done using SPSS software version 25.0. There was a mean decrease in the BTA from baseline (0.54 mm2), one week (0.13 mm2), to four weeks (0.26 mm2) with a slight loss of papilla volume from the first week to the fourthweek, and this decrease in area was statistically significant. A mean decrease in the BTH throughout the follow-ups from baseline (1.36 mm) to the first week (0.30 mm) to the fourth week (0.73) was recorded with a slight loss of papilla volume from the first week to the fourthweek, and this decrease in height was also statistically significant (p < 0.05). However, the decrease in the BTA and BTH recorded was more from baseline to the first week as compared to baseline to the fourth week postoperatively. HA gel is an effective treatment for minimally invasive papilla augmentation, particularly in class I Nordland and Tarnow papilla deficits.

Bracing of children with pectus carinatum: A literature review

BACKGROUND: Conservative treatment of children with carinatum is currently an urgent and unresolved problem despite the wide range of techniques available. Conservative treatment stops the progression of deformation and reduces the degree of deformation or eliminates it. Methods of evaluating treatment results include clinical (photo–video assessment, questionnaire survey, and chest measurements) and instrumental diagnostics (radiography, computed tomography [CT], and 3D scanning); however, no method of correction and orthosis that would consider all the tasks of conservative treatment, method of evaluating conservative treatment, and uniform protocol have been established. AIM: This study aimed to analyze the literature containing information on the conservative treatment of patients with pectus carinatum. MATERIALS AND METHODS: The study presents the results of a search in PubMed, Cochrane, and eLibrary using combinations of operators and keywords. A total of 54 foreign and domestic sources were extracted, and the search was not limited retrospectively. RESULTS: Orthosis is effective and positively perceived by doctors and patients. The most modern designs in the treatment of carinatum included dynamic orthoses FMF-DCS and Braceworks (Calgary). Recent studies have reported a strong correlation between 3D scanning and CT to assess treatment outcomes. However, no single option for conservative correction of deformity allowed for achieving all treatment goals. The assessment of the effectiveness of orthosis using photos, videos, and questionnaire, and chest measurement is subjective. CONCLUSIONS: The disadvantages of prosthetics determine the need to develop a clear treatment algorithm, methodology, and objective assessment of treatment outcomes, requiring further research.

Inter-examiner Reliability of Two Methods for Scoring Post-Orthodontic White Spot Lesions from Digital Photographs.

To compare the reliability of two scoring systems for detecting white spot lesions (WSLs) from clinical photographs captured during debonding of fixed orthodontic appliances. Digital images of 58 healthy adolescents (34 females and 24 males) were examined, depicting 384 buccal surfaces of maxillary incisors, canines, and first premolars. Three trained examiners (E1, E2 and E3) independently evaluated the fully anonymized photos in a randomized order using the Gorelick index (GI) and the modified International Caries Detection and Assessment System (ICDAS II). A 1-2-week interval separated the scorings. Spearman's rank correlation coefficient, Fisher's z-test, and the interclass correlation coefficient (ICC) were applied to compare the scoring methods and express examiner agreement. The two scoring systems showed a moderate to strong positive relationship, but inter-examiner variations were significant (p<0.05). We found moderate to good reliability (ICC 0.60 to 0.84) with the ICDAS II system and good to excellent values with the GI (ICC 0.72 to 0.94), depending on the examiner. The agreement concerning the sound surfaces and the most severe WSLs was perfect, whereas the scoring of the milder lesion stages appeared more uncertain. A moderate to strong positive relationship was demonstrated between the two methods when scoring the presence and severity of WSLs from digital images. Significant inter-examiner variations affected reliability.

The latest IC3D classification of corneal dystrophies-Overview and changes of the 3rd edition

The International Committee on Classification of Corneal Dystrophies (IC3D) was founded in 2005 to address difficulties arising from the outdated nomenclature for corneal dystrophies (CD) and to correct misconceptions in the literature. For each of the 22CDs, aseparate template was created to represent the current clinical, pathological and genetic knowledge of the disease. In addition, each template contains representative clinical photographs as well as light and electron microscopic images and, if available, confocal microscopic and coherence tomographic images of the respective CD. After the first edition was published in 2008, the revised version followed in 2015. The third edition of the IC3D was published as open access in February 2024. The latest edition is intended to serve as areference work in everyday clinical practice and facilitate the diagnosis of CD, which might sometimes be difficult. This article provides an overview of the diagnostic and treatment principles of CD and presents the IC3D and its changes over time.

Dentists' knowledge and attitudes regarding PFPT: A single study in East Java, Indonesia

ObjectivePigmented fungiform papillae of the tongue (PFPT) are infrequently encountered and inadequately documented pigmented lesions that pose challenges in diagnosis and subsequent treatment planning. The study was aimed at analyzing dentists' knowledge and attitudes regarding PFPT morphologies, to determine diagnosis and subsequent treatment planning. MethodsA cross-sectional study was conducted among dentists in East Java through an online questionnaire. Four clinical photographs of PFPT were presented, accompanied by seven questions assessing dentists' knowledge of PFPT, including lesion types, tongue structure involvement, Holzwanger classification, lesion patterns, suspected diagnoses and the nature of the lesion (benign or malignant). Additional questions to evaluate attitudes included prior experience with PFPT in practice, potential malignant transformation, diagnostic investigation and required treatment. Knowledge-associated attitude differences were statistically analyzed with the Mann–Whitney test with a threshold of p < 0.05. ResultA total of 117 dentists participated, most of whom were women (69.23%) and were 26–30 years of age (44.44%). Dentists 41–50 years of age had superior knowledge to those 20–30 years of age (p = 0.005). Practitioners with 1–5 years of experience showed significant differences in knowledge regarding PFPT (p < 0.05). No significant differences in knowledge level and attitudes were observed, particularly regarding PFPT treatment and supporting investigation (p > 0.05). However, prior encounters with PFPT cases were significantly associated with treatment decisions and supporting investigations for diagnosis (p < 0.05). ConclusionMost participating dentists had substantial knowledge of PFPT cases. Dentists' understanding, as reflected in their attitudes toward investigating and treating PFPT, was notably influenced by prior encounters with PFPT cases.

Caries and white spot lesion trajectories of orthodontic patients across an observation period of 20 years

ObjectivesFixed orthodontic appliances may increase the risk for caries and white spot lesions. The aim of this retrospective study was to determine the long-term associations between both in orthodontic patients.Materials and methods103 patients aged 36.6 ± 6.5 years whose fixed appliance orthodontic treatment had finished at least 15 years ago were included. Current clinical data and photographs (T3), panoramic x-ray and photographs from before treatment (T0), after debonding (T1) and at 2-year follow-up (T2) were available. Parameters of interest were dentine caries, “Missing/Filled Teeth” (MFT), “White Spot Lesion” (WSL) index and “Periodontal Screening and Recording” index (PSR; T3 only).ResultsAt T0, 30.4% had no caries experience decreasing to 25.6%, 22.4% and 6.8% at T1, T2 and T3 resp. The median MFT (95% CI) at T0, T1, T2 and T3 was 2 (1;3), 3 (2;4), 3 (2;4) and 7 (6;9) resp. increasing significantly at each time point (p < 0.001 each); 30.1% had WSL at debonding. Patients with caries experience at T0 had a 2.4-fold increased risk of WSL at debonding. Dentine caries, caries experience and WSL at T1 were significantly associated with incident caries at T2, but not at T3. PSR at T3 had a significant association with previous caries incidence and WSL.ConclusionsCaries experience prior to orthodontic treatment may constitute a risk indicator for WSL, and caries experience and WSL at its end for caries incidence in the near term.Clinical Relevance Present caries and WSL may help identifying orthodontic patients with special need for prevention and counselling.

Advancements in diagnosing oral potentially malignant disorders: leveraging Vision transformers for multi-class detection

ObjectivesDiagnosing oral potentially malignant disorders (OPMD) is critical to prevent oral cancer. This study aims to automatically detect and classify the most common pre-malignant oral lesions, such as leukoplakia and oral lichen planus (OLP), and distinguish them from oral squamous cell carcinomas (OSCC) and healthy oral mucosa on clinical photographs using vision transformers.Methods4,161 photographs of healthy mucosa, leukoplakia, OLP, and OSCC were included. Findings were annotated pixel-wise and reviewed by three clinicians. The photographs were divided into 3,337 for training and validation and 824 for testing. The training and validation images were further divided into five folds with stratification. A Mask R-CNN with a Swin Transformer was trained five times with cross-validation, and the held-out test split was used to evaluate the model performance. The precision, F1-score, sensitivity, specificity, and accuracy were calculated. The area under the receiver operating characteristics curve (AUC) and the confusion matrix of the most effective model were presented.ResultsThe detection of OSCC with the employed model yielded an F1 of 0.852 and AUC of 0.974. The detection of OLP had an F1 of 0.825 and AUC of 0.948. For leukoplakia the F1 was 0.796 and the AUC was 0.938.ConclusionsOSCC were effectively detected with the employed model, whereas the detection of OLP and leukoplakia was moderately effective.Clinical relevanceOral cancer is often detected in advanced stages. The demonstrated technology may support the detection and observation of OPMD to lower the disease burden and identify malignant oral cavity lesions earlier.

Nasal Deviation and Facial Asymmetry in Patients Undergoing Rhinoplasty.

The existing literature is conflicted on whether nasal deviation is primarily attributable to trauma or the result of asymmetric facial development. The aim of this study was to establish the prevalence of nasal trauma and facial asymmetry in patients undergoing rhinoplasty, and to determine if a correlation exists between the laterality of facial asymmetry and nasal deviation. A retrospective review was undertaken of patients who had undergone primary rhinoplasty with the senior author over a 12-month period. Patient charts were reviewed and clinical photographs were analyzed. In total, 144 patients underwent rhinoplasty over the study period; 68 patients underwent revision rhinoplasty and were excluded. Of the 76 patients who underwent primary rhinoplasty, 9% reported prior nasal trauma, 68% had deviated nasal bones, 46% had deviated nasal tips, 70% had asymmetric midfaces, and 36% had deviated chins. In patients without prior trauma history, nasal bones were most commonly deviated towards the side of midface hypoplasia (53%, P = .008). The nasal tip was most commonly deviated contralateral to the side of septal deviation (59%, P = .001). There was no association between nasal bone and chin deviation. Nasal tip deviation was not associated with midface hypoplasia or chin deviation. Nasal deviation is primarily driven by asymmetric facial growth rather than being the result of nasal trauma.

Sequential Assessment of External Nasal Deviation Angle Changes in Patients With a Deviated Nose Who Underwent Bilateral Osteotomy.

A deviated nose is traditionally classified as bony, cartilaginous, or combined deviation. Osteotomy is commonly used to correct bony deviation, and accurate surgical techniques and postoperative patient management are important for favorable outcomes. The authors investigated the change in the external nasal deviation angle over time using sequential clinical photographs to identify the optimal postoperative follow-up duration. Medical records and sequential standardized clinical photographs of 22 patients who underwent bilateral medial and lateral osteotomies without dorsal augmentation from January 1, 2014 to May 31, 2021, were retrospectively reviewed. Clinical photographs were classified into 4 periods: "a" preoperative, "b" postoperative day (POD) ≤3 weeks, "c" POD ≤9 weeks, and "d" POD >9 weeks. The angle of deviation (AoD) was measured in both frontal and chin-on-chest views for each period. Differences in AoD between temporally adjacent periods were analyzed. Nineteen men and 3 women (mean age: 28.8y) were included. Thirteen patients showed rightward deviation, whereas 9 showed leftward deviation. Eleven patients underwent surgery through an endonasal approach, whereas the other 11 underwent surgery through an external approach. In the frontal view, AoD differences (mean ± SD) between periods "a" and "b," "b" and "c," and "c" and "d" were 5.79 ± 3.36 degrees (P < 0.001), 1.44 ± 1.14 degrees (P < 0.001), and 1.07 ± 1.24 degrees (P < 0.05), respectively. In the chin-on-chest view, the values were 5.17 ± 2.69 degrees (P < 0.001), 2.06 ± 2.63 degrees (P < 0.001), and 1.46 ± 1.31 degrees (P < 0.001), respectively. No statistically significant difference in AoD differences was observed between the two approaches. Angle of deviation can change even 9 weeks after bilateral osteotomy. Thus, long-term follow-up using sequential clinical photographs is mandatory. If needed, close follow-up with early postoperative interventions may be required. The chin-on-chest view showed better sensitivity for assessing AoD than the frontal view.

The investigation and comparison of the efficacy and safety of stromal vascular fraction (SVF), platelet rich plasma (PRP), and 1064-nm Q-switched Nd:YAG laser in reducing nanofat treated infraorbital dark circles and wrinkles: A controlled blinded randomized clinical trial.

To evaluate the efficacy and safety of stromal vascular fraction (SVF), platelet rich plasma (PRP), and 1064-nm Q-switched Nd:YAG laser in reducing nanofat treated dark circles and wrinkles under the eyes. This study was a single-blinded randomized clinical trial conducted on patients with suborbital darkening under the eyes that randomly divided into control and case groups. In the control group, 15 patients were treated with one session of nanofat injection only, and five patients of each intervention groups received one session of nanofat+SVF injection, nanofat+PRP injection, and nanofat injection+Nd:YAG laser, respectively. Assessments methods were (1) evaluation of the degree of darkness and repair under the eyes by a blinded dermatologist based on clinical photographs, (2) investigating patient satisfaction, (3) using biometric variables for color, thickness, and density of the skin (only 3 months after the treatment), and (4) recording the possible adverse effects. In terms of the extent of reduction in the intensity of darkness under the eyes, the combined treatment of nanofat injection together with SVF, PRP, and Nd:YAG laser had a much greater therapeutic effect than nanofat injection alone. In all three groups of combined treatments, patients were 100% satisfied. In terms of biometric variables, amount of changes in colorimeter, complete and dermal thickness, complete and dermal density, between the different groups was statistically significant. The use of combined treatments including nanofat with SVF injection, PRP, and 1064 Q-switched Nd:YAG laser may be more effective than nanofat alone, in reducing infraorbital dark circles and wrinkles.

Role of Topical 5-Fluorouracil in Demodex -Associated Blepharitis.

The aim of this study was to report clinical observations suggesting the efficacy of topical 1% 5-fluorouracil (5-FU) in treating Demodex -associated blepharitis. An observational retrospective review of 13 eyes from 13 individuals with conjunctival neoplastic lesions and concomitant Demodex lash infestation that received topical 1% 5-FU eye drops. Patients underwent slit-lamp examination at each follow-up visit. Clinical photographs of the lash line were obtained after treatment initiation. In a subset of patients, lashes were epilated bilaterally and microscopically analyzed for presence of Demodex mites before and after treatment initiation. The mean age of the population was 68 ± 14 years (range: 30-84 years) and 92% were male. In all 13 patients, a marked reduction in cylindrical dandruff was noted in the treated eye by slit-lamp examination after 2 cycles of 5-FU. There was complete resolution of cylindrical dandruff in 10 of 13 treated eyes compared with 0 resolution of cylindrical dandruff in untreated eyes ( P = 0.0001). In the 6 patients who received epilation, the lashes from the treated eye showed no Demodex , whereas lashes from the fellow untreated eye revealed persistent Demodex . Topical 1% 5-FU shows efficacy in treating Demodex -associated blepharitis. Further studies are indicated to reproduce our findings and evaluate the potential use of 5-FU as a treatment ingredient.

Artificial Intelligence (AI)-Based Detection of Anaemia Using the Clinical Appearance of the Gingiva.

Background and aim Millions suffer from anaemiaworldwide, and systemic disorders like anaemia harm oral health. Anaemia is linked to periodontitis as certain inflammatory cytokines produced during periodontal inflammation candepress erythropoietin productionleading to the development of anemia. Thus, detecting and treating it is crucial to tooth health. Hence, this study aimed to evaluate three different machine-learning approaches for the automated detection of anaemia using clinical intraoral pictures of a patient's gingiva. Methodology Orange was employed with squeeze net embedding models for machine learning. Using 300 intraoral clinical photographs of patients' gingiva, logistic regression, neural network, and naive Bayes were trained and tested for prediction and detection. Accuracy was measured using a confusion matrix and receiver operating characteristic (ROC) curve. Results In the present study, three convolutional neural network (CNN)-embedded machine-learning algorithms detected and predicted anaemia. For anaemia identification, naive Bayes had an area under curve (AUC) of 0.77, random forest plot had an AUV of 0.78, and logistic regression had 0.85. Thus, the three machine learning methods detected anaemia with 77%, 78%, and 85% accuracy, respectively. Conclusion Using artificial intelligence (AI) with clinical intraoral gingiva images can accurately predict and detect anaemia. These findings need to be confirmed with larger samples and additional imaging modalities.

Long-Term Clinical Outcomes Following Nonsurgical Management of Salter-Harris Type II Fractures of the Proximal Phalanx of the Small Finger: A Prospective Cohort Study

Juxta-physeal fractures at the base of the proximal phalanx (FBPP) of the small finger are one of the most common hand fractures in children. Although many of these fractures are treated nonsurgically, it is unclear which fractures benefit from surgery or the degree of acceptable angulation appropriate for nonsurgical management. Our study aimed to assess long-term, patient-reported outcomes regarding function, appearance, and pain after nonsurgical management of FBPP of the small finger in a pediatric population. Our hospital Picture Archiving and Communication Systems database was queried to identify radiographs of the small finger of children between the ages of 8 and 16 years old taken from 2011 to 2021. Displacement on initial injury radiographs was calculated using the diaphyseal-metacarpal head angle. Patient-reported function, appearance, and pain were measured using standardized assessment tools sent to patients and parents electronically. Optional clinical photographs were uploaded by parents and assessed for residual clinical deformity. One hundred eighty-one eligible subjects were identified. Eighty (44%) agreed to participate, and 40 (22%) parent and 38 patient surveys were completed. The mean age at the time of injury was 11 years old (8-14 years), and the mean age at the time of survey completion was 17 years old (11-23 years). Patient T-scores were higher than the average reference T-score on the Patient-Reported Outcomes Measurement Information System Short Form v2.0-Upper Extremity. Overall, greater than 78% of patients and parents reported appearance as 8/10 or above on a VAS. Ninety-five percent (108/114) of patients reported no pain (0/10) for pain during activities and at rest. Children with up to 26° of initial coronal plane angulation reported better function than a reference population, good appearance, and no pain, at a mean of 6 years after injury. Our findings support nonsurgical management of most FBPP of the small finger in children. Therapeutic IV.

A COMPARATIVE STUDY OF THE EFFICACY OF NANOCRYSTALLINE SILVER WITH COLLAGEN BASE CREAM AND 1% SILVER SULFADIAZINE (SSD) CREAM ON THE HEALING OF BURN WOUND

Background:The aim of burn management is to prevent hypovolemic shock ,infection ,septic shock, to promote early epithelialization as well as healing of wound . The present study aimed to compare the effects of Nano crystalline silver with collagen base cream and 1% silver sulfadiazine cream on the healing of burn wounds. Materials &amp; Methods: A clinical prospective observational studyPatients with burn wounds were divided into two groups , one group was dressed with 1% silver sulfadiazine cream and the other group of patients was dressed with nano crystalline silver with collagen base cream. The wound dressing was changed everyday after washing the wound with normal saline. Wound parameters were assessed regularly , using clinical methods and photographs. The clinical data were statistically analyzed and results produced. Results: In this department study ,using silver sulphadiazine cream &amp;nano crystalline silver with collagen base cream , enhanced epithelisation&amp; granulation tissue following decreased slough was observed and the results were better with nano crystalline silver with collagen base cream because of early and increased appearance of granulation tissue in the wounds &amp; this was also proved by statistical analysis.The mean hospital stay was less in patients who were undergoing dressing with nanocrystalline silver with collagen base cream. Conclusions: The effect of nanocrystalline silver with collagen base cream on the reduction of the healing time and necrotic tissue amount and increasing the granulation, epithelialization, and decreasing the necrotic tissue/slough was greater when compared to application of 1% SSD cream. Considering the above findings nanocrystalline silver with collagen base cream is more recommended to be used for burn wounds.