Inter-examiner Reproducibility Research Articles

Methodology exploration and reproducibility evaluation of TAI and TSI for quantitative ultrasound assessment of hepatic steatosis

Background and aimNew quantitative ultrasound techniques can be used to quantify hepatic steatosis, including tissue attenuation imaging (TAI), tissue scatter -distribution imaging (TSI), and the hepatorenal index (HRI). However, the measurement norms and the effects of fasting on these measurements remain unclear. The present study performed a methodological exploration and investigated the reliability of these measurements. MethodsIn total, 103 participants were prospectively recruited for ultrasonography and magnetic resonance imaging (MRI) scans. For the TAI and TSI data, the upper (2 cm), middle (4 cm) and lower (6 cm) areas determined according to the depth of the region of interest from the liver capsule, were sampled three times. Correlation analyses were performed to compare the measurements of TAI, TSI, and HRI with the controlled attenuation parameter (CAP) or MRI-proton density fat fraction (MRI-PDFF). Intra- and inter-operator repeatability was assessed using intraclass correlation coefficients. The effects of fasting on these measurements were then compared. ResultsThe TAI and TSI measurements obtained from the upper and middle depths exhibited stronger correlations with the CAP measurements than those obtained from the lower depth. Specifically, the mean TAI had a significant positive correlation with MRI-PDFF (r = 0.753, P<0.0001). TAI and TSI measurements exhibited excellent intra- (0.933 and 0.925, respectively) and inter- (0.896 and 0.766, respectively) examiner reliability. However, the correlation between HRI and CAP measurements was only 0.281, with no significant correlation with MRI-PDFF, and intra- and inter-examiner reproducibility of 0.458 and 0.343, respectively. Fasting did not affect these measurements. ConclusionsTAI and TSI measurements demonstrated good intra- and interobserver reliability and correlated well with CAP and MRI-PDFF measurements. However, in practice-based clinical applications, the sampling depth should be controlled within 2-4 cm of the hepatic capsule; no fasting is required before the examination.

Assessment of reproducibility and influence of different dental specialties on functional implant prosthodontic score: A prospective clinical study analyzing single-unit implant crowns.

Implant therapy in partially edentulous patients has become the most adapted and predictable treatment modality. The success rate of implants has been measured in terms of esthetic, biological, and technical factors such as radiographic bone loss, prosthetic complications, and stability. Despite the existence of several indices for the esthetic assessment of implant crowns, a need for functional evaluation of the implant crown with an objective and reproducible score has arisen. The study aims to validate the reproducibility of the functional implant prosthodontic score (FIPS) and the influence exerted by different dental specialties while evaluating posterior single-unit implant crowns. This was a prospective clinical study. Fifteen patients with cement-retained single-implant crowns in the posterior region of the jaws were included. Eight examiners, two prosthodontists, two periodontists, two oral surgeons, and two orthodontists evaluated 15 photographs of single-unit implant crowns during the 1-year follow-up examination. The examiners assessed the photographs for FIPS, which includes five parameters for objectively evaluating the single-unit implant crowns. Assessments were performed twice at a gap of 4 weeks. Pearson's correlation with a 95% confidence interval was calculated for the intra-examiner and the Kruskal-Wallis test for inter-examiner reproducibility. The mean total FIPS scores for all included examiners were 7.133 for time T1 and 7.074 for time T2, showing a strong Pearson correlation coefficient for intra-examiner reproducibility. No significant difference was analyzed among different specialties with statistically significant values of the Kruskal-Wallis test. Intra- and inter-examiner analysis showed very consistent results during the reproducibility assessment of FIPS. The results validated the use of FIPS as a long-term predictive functional evaluation tool for the single-implant crowns in posterior sites irrespective of the effect of different dental specialties. It could be used for risk estimation and prognosis for long-term survival and performance of implant crowns.

Performance of myotonometer in the assessment of skin involvement in systemic sclerosis.

A clinically practical tool to assess skin biomechanical properties rapidly and accurately is still lacking. Our aim was to examine the intra- and inter-observer reproducibility of a myotonometer for objective skin property assessment in systemic sclerosis (SSc), comparing it with the modified Rodnan skin score (mRSS), and distinguishing patients from healthy controls. Thirty-four patients (21 limited and 13 diffuse SSc), and 31 age and gender-matched healthy controls were enrolled. Skin tone and stiffness were measured at four different anatomical sites (the forearm, hand, leg, and foot) using a myotonometer. The correlation between the mRSS and skin properties was assessed. Also, hand functionality was evaluated for possible correlations between the variables. The differences in skin properties between dcSSc and lcSSc patients, and healthy controls were assessed using variance analysis. Intra- and inter-examiner reproducibility were excellent (ICC = 0.70 to 0.98) for tone and stiffness except for non-dominant hand tone, which showed good reliability (ICC = 0.64 to 0.74). Stiffness and tone values of the hands, forearms, and feet significantly correlated with mRSS total score (r = 0.40 to 0.71, p < 0.05). Additionally, tone and stiffness of the hands and forearms moderately correlated with hand function (p < 0.05). Tone and stiffness values increased in patients with dcSSc compared to healthy controls, or patients with lcSSc, at the hands, forearms, and legs (p < 0.05). Our findings emphasize the potential utility of the myotonometer for assessing skin properties and differentiating SSc patients from controls, demonstrating its promise as a valuable clinical evaluation tool in this context. Key Points •The myotonometer displayed excellent intra- and inter-examiner reproducibility for assessing skin properties. •Skin tone and stiffness parameters well correlated with the mRSS scores. •The myotonometer can distinguish patients with diffuse cutaneous SSc from healthy controls.

Quantification of Bone Height and Bone Volume Around Dental Implants After Open Maxillary Sinus Elevation Surgery Using CBCT.

Purpose: To assess, using CBCT, the volume and height of bone formation after open maxillary sinus elevation without the use of grafts. Materials and Methods: The study was retrospective and included 24 patients with a total of 67 implants. CBCT examinations were conducted at baseline (0 to 43 days postsurgery) and after an average healing period of 6.2 months (range: 5.1 to 7.8 months). The image analysis included metal artifact reduction, registration, and a standardized protocol for segmenting the anatomical structures of the maxillary sinus, including calculating the 3D volumetric changes after bone formation. Conventional manual 2D measurement of vertical bone formation was executed for comparison. Clinical factors assumed to be relevant for bone formation were obtained from patient medical records. Results: One implant was lost before prosthetic loading, representing an early implant loss rate of 1.5%. Differences in intra- and interexaminer reproducibility were registered for the conventional 2D method (P < .05). The average vertical bone formation measured with the 2D method was 4.8 mm (4.6 to 5.0 mm), covering 60.2% of the implant height within the sinus. The average volumetric bone formation measured with the developed 3D image-analysis method was 801 mm3 in total and 195 mm3 in a restricted region around each implant. Bone formation was registered in 62% of the volume of the restricted region. A correlation regarding bone formation was found between the two methods (R2 = 0.705). Clinical factors such as age, smoking, general health, and postoperative complications did not correlate with the amount of bone formed. Conclusion: CBCT image analysis is a promising method for objective 3D evaluation of bone formation after sinus elevation. A correlation was seen between the manually measured bone height (2D) and the bone volume in a restricted region around each implant using the developed method (3D). Reducing visual interpretation minimizes errors related to examiner reliability. Clinical factors did not significantly affect the volumetric bone formation.

Repeatability and reproducibility of anterior lens zonule length measurement using ArcScan insight 100 very high-frequency ultrasound

ABSTRACT Objectives This study aimed to evaluate the intra-examiner repeatability and inter-examiner reproducibility in lens zonular length measurements using very high-frequency digital ultrasound (Insight 100). Methods Two examiners performed ultrasound imaging independently in each subject. The length of temporal and nasal zonules were then measured with a built-in software. Coefficient of variations (CVs) of the three repeated measurements were used to determine intra-examiner variances. Inter-examiner reproducibility was evaluated using intraclass correlation coefficients (ICCs) and the Bland-Altman method. Results 40 eyes of 40 subjects (14male and 26female; mean age 23.9 ± 2.4 years) were included in the study. The CVs for intra-examiner measurement were 2.74% temporally and 4.32% nasally for Examiner 1, and were 1.96% temporally and 1.75% nasally for Examiner 2. For inter-examiner reproducibility, all ICCs were above 0.9. However, there were significant differences between the two examiners in temporal zonular length measurements (p = 0.001), and the differences mainly came from measuring the zonular length manually (p = 0.001) rather than recording images (p = 0.480). No significant differences were found between two measurements by the same examiner after one month (all p > 0.05, all ICCs > 0.8). Conclusion The Insight 100 device can be used to measure the length of anterior lens zonule with relatively good repeatability and reproducibility. Clinical trial registration www.clinicaltrials.gov identifier is NCT05657951

Inter-examiner and intra-examiner reliability of optical coherence tomography angiography in vascular density measurement of retinal and choriocapillaris plexuses in healthy children aged 6-15 years.

This study aimed to test the inter-examiner and intra-examiner reliability of macular vascular density (VD) measurement of retinal and choriocapillaris plexuses in healthy children using optical coherence tomography angiography (OCTA). Ninety-two school children were prospectively recruited. Macular OCTA images (6 × 6 mm2) were obtained thrice by two examiners using the RTVue-XR Avanti OCT system. The coefficient of variation (COV), intraclass correlation coefficient (ICC), and Bland-Altman plots were used to evaluate the repeatability and reproducibility. Ninety participants aged 6-15 years were enrolled; two participants were excluded because of low-quality images. In the retina, the reproducibility and repeatability of VD became poorer from superficial to deep retinal capillary plexus (superficial: COV = 4.61-11.11%; intermediate: COV = 7.73-14.15%; deep: COV = 14.60-32.28%). For both reproducibility and repeatability, the ICC ranged from moderate to high (superficial plexus: ICC = 0.570-0.976; intermediate plexus: ICC = 0.720-0.968; deep plexus: ICC = 0.628-0.954). In the choroid, the inter-examiner reproducibility and intra-examiner repeatability of the VD measurement of choriocapillaris were excellent in the macula, fovea, parafovea, and perifovea (COV = 1.00-6.10%; ICC = 0.856-0.950). The parameters of the foveal avascular zone (FAZ) also showed significant reproducibility and repeatability (COV = 0.01-0.21%; ICC = 0.743-0.994). The VD measurements of the choriocapillaris and FAZ parameters using OCTA showed excellent inter-examiner and intra-examiner reliability in school children. The reproducibility and repeatability of the VD of three retinal capillary plexuses depended on the depth of the retinal capillary plexus.

Evaluation of Reliability and Validity of Occlusal Caries Detection by Direct Visual, Indirect Visual and Fluorescence Camera Using ICDAS II (Codes 0, 1, and 2): An In Vivo Study.

Early detection of carious lesions paves the way for the preservation of tooth structures by remineralization strategies. Visual examination using international caries detection and assessment system (ICDAS) II has been validated with the gold standard of histological classification. A fluorescence camera is yet another diagnostic aid for the early detection of carious lesions based on the autofluorescence of the enamel and dentin. This study was done to evaluate the validity of the fluorescence camera (Soprocare and Acteone) in detecting early carious lesions. A total of 690 occlusal surfaces of non-cavitated premolars and molars were examined by examiners 1 and 2, trained in the ICDAS II grading system. The photographs of the occlusal surface and the fluorescence images, which were taken using a Soprocare (Acetone) intraoral camera, were examined by examiners 3 and 4. The scoring was tabulated and correlated. The κ values for interexaminer reproducibility of indirect visual was 0.841 (good), and his fluorescence camera was 1.00, which is very good. The correlation analysis revealed that there was a higher correlation between direct visual and indirect visual for both examiners when compared to direct and fluorescence cameras. There was a positive relationship between indirect visual and fluorescence cameras for both the experimenter). The indirect visual method for the detection of carries has high sensitivity and specificity irrespective of the examiner. Examination by fluorescence camera has a low sensitivity and high specificity. The specificity of the caries detection method by indirect visual examination based on ICDAS II coding that of the Soprocare fluorescence camera was consistent and reliable, whereas indirect visual examination had a high sensitivity for detecting ICDAS codes 1 and 2. Soprocare showed a very low sensitivity in detecting ICDAS code 1 and 2 lesions. Dhanavel C, Sai CK, Neelamurthy PS, et al. Evaluation of Reliability and Validity of Occlusal Caries Detection by Direct Visual, Indirect Visual and Fluorescence Camera Using ICDAS II (Codes 0, 1, and 2): An In Vivo Study. Int J Clin Pediatr Dent 2023;16(1):74-78.

High reproducibility of a novel supported anterior drawer test for diagnosing ankle instability

BackgroundThe manual traditional anterior drawer test (ADT) is essential for deciding the treatment for chronic ankle instability, but it has been shown to have a comparatively low reproducibility and accuracy, especially in less experienced hands. To clarify the inter-examiner reproducibility, we compared the actual distance of anterior translation between junior and senior examiners in ADT. We also evaluated the diagnostic abilities of traditional ADT, and a novel modified ADT (supported ADT).MethodsThirty ankles were included in this study, and ankle instability was defined using stress radiography. All subjects underwent two methods of manual ADT by junior and senior examiners, and ankle instability was judged in a blinded fashion. The anterior drawer distance was calculated from the lengthening measured using a capacitance-type sensor device.ResultsThe degree of anterior translation determined by the junior examiner was significantly lower than that determined by the senior examiner when traditional ADT was performed (3.3 vs. 4.5 mm, P = 0.016), but there was no significant difference in anterior translation between the two examiners when supported ADT was performed (4.6 vs. 4.1 mm, P = 0.168). The inter-examiner reliability of supported ADT was higher than that of traditional ADT. For the junior examiner, the diagnostic accuracy of supported ADT was higher than that of traditional ADT (sensitivity, 0.40 vs. 0.80; specificity, 0.75 vs. 0.80).ConclusionSupported ADT may have the advantage of being a simple manual test of ankle instability with less error between examiners.

The accuracy (trueness and precision) of Bellus3DARC-7 and an in-vivo analysis of intra and inter-examiner reliability of digital and manual anthropometry

Abstract Background Three dimensional (3D) facial imaging is becoming a popular method of facial analysis and a means of anthropometry. There is potential for 3D imaging to provide enough diagnostic information to parallel lateral cephalograms, which could, in time, reduce the need for radiation exposure to patients. The present study aimed to assess the accuracy of the Bellus3D ARC-7 (Bellus) camera by comparing the measurements of soft tissue facial landmarks obtained from Bellus scans to the measurements taken using Vernier callipers. Method Nineteen anatomical points were located on four subjects using a standard black ballpoint pen on a white, circular sticker. Distances were measured between these points using digital callipers, with the subject in a resting pose. This was repeated twice by two examiners for each subject. Two examiners subsequently performed measurements of each subject in a smiling pose. Following landmark identification, images were captured under standard conditions, using the Bellus camera. The same measurements were obtained digitally, repeated twice by two examiners for each subject in both resting and smiling poses. Results There was high precision in repeated measurements on the digital models, with less than 1.5 mm deviation between measurements. Both intra-examiner and inter-examiner reproducibility were greater following the digital measurements compared to manual measurements, with 100% of the digital measurements of landmarks falling within a set threshold deviation of ≤1.5 mm. When comparing the manual and digital measurements, the greatest deviations (&gt;1.0 mm) occurred in regions around the cheeks and lower third of the face, while the measurements for the ears and midline structures (forehead and nose bridge) deviated the least (≤1.0 mm). This was demonstrated in models at rest and smiling. Conclusions The Bellus system produced an accurate and true image of the face from which reproducible measurements can be made within and between examiners. 3D facial images from the Bellus3D ARC-7 system were comparable to direct anthropometry, therefore the use of 3D facial scanning in orthodontics for diagnosis and treatment planning appears promising.

Cultural adaptation and reliability assessment of the Hammersmith neonatal neurological examination for Brazilian newborns at risk of cerebral palsy

Reliable instruments that lead to early diagnosis for CP are extremely important so that these children are referred for early stimulation, benefiting their development. To perform a cross-cultural adaptation and reliability assessment of a Brazilian version of the Hammersmith Neonatal Neurological Examination (HNNE), expanded and summarized. A methodological, cross-sectional, nonexperimental quantitative analysis was conducted in two phases as follows: cultural adaptation of the HNNE, expanded and summarized, and reliability assessment of the Brazilian version of the HNNE. Phase one was developed in five stages (initial translation, synthesis of the translation, a committee of experts, backtranslation, and submission to the author), with the semantic questions, content, and face validity being evaluated. Phase two included 143 newborns and we analyzed the internal consistency, stability, and equivalence (intra- and interexaminer) of the instrument. Internal consistency was calculated using Cronbach's alpha, and intra- and interexaminer reliability and reproducibility assessed through test-retest were calculated using the intraclass correlation coefficient RESULTS: Although internal consistency, assessed using Cronbach's alpha, showed unsatisfactory results, the results of inter-and intraexaminer equivalence showed a high agreement between the evaluations in all domains. The test-retest also showed excellent agreement between the domains. The Brazilian HNNE expanded and summarized versions can be considered to be adapted and reliable for the neurological assessment of Brazilian newborns to identify changes in neurological development and early referral to the stimulation or early rehabilitation units and as a promising option to be used in the context of primary care in Brazil.

Reliability of probing depth assessments at healthy implant sites and natural teeth.

To evaluate the intra- and inter-examiner reliability in the assessment of probing depth (PD) measurements at healthy dental implant sites and periodontally healthy natural teeth. Five patients exhibiting 21 dental implants were enrolled in the study. Eight experienced examiners performed duplicate PD measurements at six sites of all implants and of preselected natural teeth. Intra-examiner accuracy was estimated using intra-examiner correlation coefficients (ICCs) with 95% confidence intervals (CI). A gold standard (GS) examiner was set. Inter-examiner accuracy compared to the GS examiner was assessed using pairwise inter-examiner ICCs. The intra-examiner ICC ranged from 0.759 (95% CI, 0.692-0.812) to 0.863 (95% CI, 0.826-0.892) for the measurements at teeth and from 0.712 (95% CI, 0.580-0.800) to 0.841 (95% CI, 0.774-0.888) for the PDs assessed at implants. The inter-examiner ICCs for tooth measurements varied from 0.197 (95% CI, - 0.280 to 0.511) to 0.791 (95% CI, 0.560-0.892). The corresponding values for the assessments at implants varied from 0.576 (95% CI, 0.286-0.734) to 0.794 (95% CI, 0.708-0.855). The intra- and inter-examiner reproducibility of repeated PD measurements assessed by experienced examiners tended to be higher for the measurements at periodontally healthy teeth compared to healthy dental implant sites. Experienced examiners demonstrated a higher degree of reliability of probing measurements around teeth compared to dental implants.

Repeatability and reproducibility of Cobra HD fundus camera meibography in young adults with and without symptoms of dry eye.

The inter-session repeatability (ISR), inter-examiner reproducibility (IER) and within-subject variability (WSV) of the Cobra HD fundus camera meibographer were examined in participants with and without dry eye symptoms. Symptoms were determined based on Ocular Surface Disease Index scores (≥13 being considered symptomatic), and subgroups were compared using the Mann-Whitney U-test. Images of meibomian glands (MGs) from the upper and lower right eyelids were captured by two examiners on the same day (S1) to determine IER. One examiner repeated the measurements on a second day (S2) to obtain the ISR. ISR, IER and WSV were calculated using Friedman,correlation tests and Bland and Altman analyses with mean differences (md) and 95% confidence intervals (CIs), within-subject standard deviations (Sw) and intra-class correlation coefficients (ICC). The ISR experiment included 72 participants (mean age: 23 ± 5 years, range: 19-43, 36 symptomatic). Mean MG loss of the upper (S1: 13.5 ± 9.5%, S2: 12.8 ± 8.5%) and lower eyelids (S1: 7.5 ± 6.9%, S2: 7.3 ± 6.3%) was not significantly different between sessions for all participants, symptomatic and asymptomatic subgroups for both eyelids. The ISR Sw for the upper and lower eyelids was 1.3% and 1.0%; md was 0.7 ± 3.5% (CI:-6.25% to 7.62%) and 0.1 ± 2.1% (CI: -3.94% to 4.17%), respectively. The IER experiment included 74 participants (mean age: 23 ± 5 years, range: 19-43, 37 symptomatic). Mean MG loss of the upper (Examiner 1: 12.7 ± 8.2%, Examiner 2: 13.1 ± 8.0%) and lower eyelids (Examiner 1: 7.0 ± 6.2%, Examiner 2: 7.4 ± 6.2%) was not significantly different between examiners for all participants, symptomatic and asymptomatic subgroups for both eyelids. The IER ICC values were >0.86 for all conditions, Sw was 1.3% and 1.2%, with a md of -0.4 ± 3.2% (CI: -6.65% to 5.90%) and -0.4 ± 2.9% (CI: -6.15% to 5.31%), respectively. The WSV Sw values were <1.4%, and ICC values were >0.89 for both eyelids, examiners and experimental sessions. The Cobra HD fundus camera demonstrates good repeatability, reproducibility and low WSV, and is a reliable clinical instrument for meibography.

Accuracy of dental calcification stages for the identification of craniofacial pubertal growth spurt: proposal of referral parameters.

This study primarily aimed to assess the accuracy of radiographic dental calcification parameters for the identification of specific craniofacial growth stages. Permanent mandibular canines, premolars, and second molars of 288 patients, from 6 to 15years old, were analysed on randomly selected panoramic radiographs, and categorised according to two calcification methods. Reproducibility analyses and data derived from panoramic records were correlated with the gold-standard method, as evaluated from lateral cephalometric teleradiographs. Accuracy tests were finally calculated, considering several cutoff points. Dental calcification methods showed "strong" to "almost perfect" intra- and inter-examiner reproducibility. Significant, although weak correlations were observed for all parameters. Canine and first premolar calcification stage 8 and second premolar and second molar stage 7 showed higher sensitivity rates for identifying the pubertal growth spurt period, as well as the stage F for these teeth. Canine and first premolar stages 10 and H obtained higher specificity rates for identifying the absence of post-pubertal period. The dental calcification parameters showed adequate reproducibility, in addition to significant correlations with cervical vertebrae stages. Radiographic dental calcification parameters used for the mandibular first premolar obtained high accuracy rates and were recommended for identifying specific craniofacial growth periods.

High Reproducibility of a Novel Fixed Anterior Drawer Test for Diagnosing Ankle Instability

Category: Ankle Introduction/Purpose: The manual traditional anterior drawer test (ADT) is essential for the treatment decision of chronic ankle instability, but have been pointed out of comparatively low reproducibility and accuracy, especially in less experienced hands. To clarify the inter-examiner reproducibility, we compared the actual distance of anterior translation between the junior and senior examiner in the ADT. We also evaluate the diagnostic abilities of the traditional ADT and a novel modified ADT, fixed ADT. Methods: Thirty ankles were included in this study and the ankle instability was defined by the stress radiography. All subjects were performed two methods of manual ADT by junior and senior examiner, and judged the ankle instability in a blinded fashion. The anterior drawer distance was calculated from the lengthening measured by the capacitance-type sensor device. Results: The amount of anterior translation of junior examiner was significantly lower than senior examiner in the traditional ADT (3.3 vs. 4.5 mm, p=0.016), while, there was no significant difference between two examiners in the fixed ADT (4.6 vs. 4.1 mm, p=0.168). The inter-examiner reliability of fixed ADT was higher than traditional ADT. In the junior examiner, the diagnostic accuracy of the fixed ADT was higher than that of traditional ADT (sensitivity, 0.40 vs. 0.80; specificity, 0.75 vs. 0.80, respectively). Conclusion: Fixed ADT may have advantage for a simple manual test of ankle instability as a method with less error between examiners.

Accuracy of integration of dental cast and cephalograms compared with cone-beam computed tomography: a comparative study.

This study proposes a method that integrates maxillary dental cast and cephalograms and evaluates its accuracy compared with cone-beam computed tomography (CBCT) scans. The study sample comprised 20 adult patients with records of dental casts, cephalograms, and craniofacial CBCT scans. The maxillary dental cast was integrated with lateral and frontal cephalograms based on best-fit registration of palatal and dental outline curves from dental cast with cephalogram tracings. Linear measurement was conducted to assess the intra- and inter-examiner reproducibility of the proposed integration method using intraclass correlation coefficients; linear and angular measurements were conducted to assess its accuracy with CBCT scans as a standard reference. Paired t test, one sample t test, and mean ± standard deviation of the absolute value of difference were used to compare the integrated images and CBCT. The integration method showed good intra- and inter-examiner reproducibility (intraclass correlation coefficients > 0.98). The differences in linear and angular measurements between the integrated images and CBCT were not statistically significant but with a large deviation. When absolute value of difference was computed, the linear distance error was 0.51 ± 0.34mm, the tooth point coordinate errors in X, Y and Z axes were 0.22 ± 0.22, 0.38 ± 0.32 and 0.21 ± 0.21mm, respectively; the angular error in pitch, roll and yaw of the dental cast was 0.82 ± 0.51, 0.92 ± 0.59 and 0.80 ± 0.41 degree, respectively. The proposed method for integration of dental cast and cephalograms showed good reproducibility and acceptable accuracy compared with CBCT. It could be helpful for researchers to study three-dimensional tooth growth changes using the existing craniofacial growth data especially cephalograms.

Intra- and inter-examination reproducibility of T2 mapping for temporomandibular joint assessment at 3.0 T

T2 mapping allows quantification of the temporomandibular joint (TMJ) ultrastructural degeneration. The study aimed to assess intra- and inter-examination reproducibility of T2 mapping for TMJ evaluation at 3.0 Tesla (T). Seventeen volunteers, regardless of temporomandibular disorder (TMD) diagnosis, received magnetic resonance (MR) examination at 3.0 T. T2 mapping was performed twice (> 5 min between sessions without repositioning) on 12 volunteers to ensure intra-examination reproducibility. Nine volunteers underwent two examinations (> 6 months) to ensure inter-examination reproducibility. The regions of interest (ROIs) of the articular disc and retrodiscal tissue were manually selected and calculated. The mean T2 values of the articular disc and retrodiscal tissue were 25.3 ± 3.0 and 30.0 ± 4.1 ms, respectively. T2 mapping showed excellent intra-examination intraclass correlation coefficients (ICCs) for both articular disc (0.923) and retrodiscal tissue (0.951). Very strong correlations (r) were observed in both articular disc (0.928) and retrodiscal tissue (0.953) (P < .001). Inter-examination reproducibility also demonstrated that the ICCs were excellent (0.918, 0.935) on both ROIs. T2 values between first and second examinations were strongly correlated (r = 0.921, 0.939) (P < .001). In conclusion, T2 mapping seems to be a promising tool for TMJ assessment, regardless of the TMJ condition.

Investigating Type B Basilar Invagination Through Cephalic Indices

We sought to compare the diagnostic accuracy of cephalic indices for type B basilar invagination (BI). This retrospective study examined head and neck magnetic resonance imaging sequences of 31 Group B BI cases and 96 controls. Two examiners blinded to diagnostic data evaluated the cephalic indices of each magnetic resonance imaging sequence, described as width/length (WLI) and height/width (HWI). The distance of the odontoid process apex to Chamberlain line and clivus canal angle were measured. The interexaminer and intraexaminer reproducibility of the cephalic indices was calculated using intraclass correlation coefficient. The diagnostic accuracy was discerned by the receiver operating characteristic (ROC) curve. All analyses were scrutinized with a 95% confidence interval. Cephalic indices showed interexaminer and intraexaminer reproducibility ≥94%. The areas under the ROC curve were 0.639 (WLI) and 0.874 (HWI) (95% confidence interval: P < 0.05). The HWI showed a sensitivity of 74.7% and a specificity of 85.5% for the cutoff criterion ≤58. The WLI presented a sensitivity of 53.3% and a specificity of 66.7% for the cutoff criterion ≥86. The HWI showed the largest area under the ROC curve in comparison with the WLI, with robust sensitivity and specificity values, indicating that the proportions between cranial height and width can help clinicians in investigating type B BI.

Diagnostic Validity in Occlusal Caries Detection of ICDAS II, DIAGNOdent, Radiography and a Combination of the Three Methods: An In Vitro Study.

In this study, we compare the efficacy and diagnostic concordance of the ICDAS, the radiographic criterion and the instrument known as the DIAGNOdent fluorescence laser pen on occlusal caries lesions using a histological section as the gold standard. Of 100 teeth that did not present cavitated occlusal lesions or occlusal fillings, 80 were chosen through a randomization program and examined by two previously trained and calibrated researchers. Subsequently, the teeth were sectioned with a diamond disk and observed under an optical microscope. The results were studied for caries with a limit established in enamel and caries with extension to dentin. The intra-examiner (0.821–0.933) and inter-examiner (0.817–0.924) reproducibility obtained for both ICDAS and DIAGNOdent for the diagnosis of borderline enamel caries was high. Similarly, intra-examiner (0.686–1.000) and inter-examiner (0.809–0.944) reproducibility for diagnosis of caries with dentin extension was also high for both methods. The sensitivity obtained was 0.76 (ICDAS), 0.87 (DIAGNOdent) and 0.58 (Rx), whereas the specificity obtained was 0.66 (ICDAS), 0.4 (DIAGNOdent) and 0.77 (Rx) for lesions limited to enamel. For lesions with extension to dentin, the sensitivity obtained was 0.73 (ICDAS), 0.82 (DIAGNOdent) and 0.09 (Rx), and the specificity obtained was 0.79 (ICDAS), 0.52 (DIAGNOdent) and 0.97 (Rx). Sensitivity increases in both cases by combining diagnostic methods. In conclusion, ICDAS and DIAGNOdent are better diagnostic methods than Rx for the detection of occlusal caries, and the combination of these methods helps to obtain a better diagnosis.

Interexaminer reproducibility for subjective refractions for an ametropic participant

ObjectiveTo investigate interexaminer reproducibility of non-cycloplegic subjective refractions. Subjective refractions are frequently determined, and it is important to know whether differences in refractive state over time constitute meaningful, non-random change.Methods...

VALIDAÇÃO DA MEDIÇÃO DAIP USANDO TC E COMPARAÇÃO COM RADIOGRAFIAS DA COLUNA TOTAL E LOMBOSSACRAL

ABSTRACT Objective: The objective of this study is to describe a new, extremely simple method for measuring pelvic incidence (PI) using computed tomography (CT) and to compare those measurements with measurements derived from whole spine and lumbosacral X-rays in a Brazilian population. Methods: Patients who had whole spine and lumbosacral X-rays and whole abdomen, pelvis, or lumbar spine CT performed within a period of less than three months were selected. Image overlay was used to measure PI from the CT. The PI was calculated by two independent examiners, and the PI for each exam was calculated twice, with an interval of two months between the assessments. The intra- and interexaminer reliability and reproducibility were evaluatedusing the intraclass correlation coefficient (ICC) and the repeatability coefficient, considering a 95% confidence interval. Results: Fifty-five patients of both sexes with a mean age of 58.7 years (±19) were analyzed. The mean PI angles in the analyses of both examiners at both evaluations were 54.85° (±13.73) for the whole spine X-ray, 54.06° (±11.67) for the lumbosacral spine X-ray, and 49.96° (±9.85) for the CT. There was good intra- and interexaminer reliability and reproducibility. There was also high concordancewith the whole spine and lumbosacral X-rays. Conclusion: CT is a reliable and reproducible alternative for measuring PI. Level of Evidence III; Prospective comparative.