Measurement Of Angulation Research Articles

A new method for evaluating radial neck fractures based on Judet classification.

To propose a new method for evaluating paediatric radial neck fractures and improve the accuracy of fracture angulation measurement, particularly in younger children, and thereby facilitate planning treatment in this population. Clinical data of 117 children with radial neck fractures in our hospital from August 2014 to March 2023 were collected. A total of 50 children (26 males, 24 females, mean age 7.6 years (2 to 13)) met the inclusion criteria and were analyzed. Cases were excluded for the following reasons: Judet grade I and Judet grade IVb (> 85° angulation) classification; poor radiograph image quality; incomplete clinical information; sagittal plane angulation; severe displacement of the ulna fracture; and Monteggia fractures. For each patient, standard elbow anteroposterior (AP) view radiographs and corresponding CT images were acquired. On radiographs, Angle P (complementary to the angle between the long axis of the radial head and the line perpendicular to the physis), Angle S (complementary to the angle between the long axis of the radial head and the midline through the proximal radial shaft), and Angle U (between the long axis of the radial head and the straight line from the distal tip of the capitellum to the coronoid process) were identified as candidates approximating the true coronal plane angulation of radial neck fractures. On the coronal plane of the CT scan, the angulation of radial neck fractures (CTa) was measured and served as the reference standard for measurement. Inter- and intraobserver reliabilities were assessed by Kappa statistics and intraclass correlation coefficient (ICC). Angle U showed the strongest correlation with CTa (p < 0.001). In the analysis of inter- and intraobserver reliability, Kappa values were significantly higher for Angles S and U compared with Angle P. ICC values were excellent among the three groups. Angle U on AP view was the best substitute for CTa when evaluating radial neck fractures in children. Further studies are required to validate this method.

Spatial and angular alterations in the dental arch after premature loss of primary molars: Immediate and 9-month computed tomography evaluation.

Contemporary imaging methods and quickly advancing technologies have increased the number of diagnostic tools available in medicine and orthodontics. The current study aimed to determine three-dimensional (3D) space changes that occurred after the extraction of either the maxillary or mandibular primary molars during the mixed dentition period. The present study was a longitudinal split-mouth study with a study group and a control group. The sample consisted of 20 children aged between 6 and 9 years. Clinical examination, radiological analysis, and 3D digital images of the plaster casts were used sequentially to gather all the data. The dental cast measurements recorded were arch width, arch length, hemi-perimeter, dental space at the extraction site, and angulation of the first permanent molar. The children were recalled for follow-up after 9 months, and all dental cast measurements were repeated using nondestructive 3D computed tomography software. For repeated measurements, the test applied was a paired t-test, and for independent samples, the test was a Student's t-test. A significant decrease in arch width (P = 0.001), arch length (P < 0.001), hemi-perimeter (P < 0.001), D-space (P < 0.001), and E-space (P = 0.001) was observed following extraction. A significant increase in angulation measurements was observed (P = 0.001). The study revealed a comparative reduction in mandibular arch width, a reduction in arch length in both the maxilla and the mandible, a reduced hemi-perimeter of dental arches, loss of dental extraction space, and a change in angulation of the erupted first permanent molars following premature loss of the primary molar.

Changes in left ventricular-aortic angulation are associated with the development of obstruction in hypertrophic cardiomyopathy

ObjectiveTo characterize changes in ventricular morphology in patients with hypertrophic cardiomyopathy who develop left ventricular (LV) outflow tract obstruction. MethodsWe reviewed patients with hypertrophic cardiomyopathy with LV outflow tract obstruction who underwent septal myectomy from May 2012 to June 2023. Among 68 patients initially without obstruction documented up to 7.6 years (interquartile range, 6.3-9.4 years) before the operation, a comparison was made with 78 patients with nonobstructive hypertrophic cardiomyopathy over a similar period. Patients who did not develop obstruction were matched with those who did on sex, age, and maximum septal wall thickness during the initial echocardiography, identifying 41 matched pairs. Echocardiographic data, including 5 measures of angulation, were compared between the groups. ResultsThe median interval between echocardiographic assessments was 7.5 years (interquartile range, 6.3-8.1 years) among patients with obstruction versus 7.3 years (interquartile range, 6.2-9.0 years) in patients without nonobstruction. Patients with obstruction were more likely to have hypertension at both times. The maximum septal wall thickness increased within both groups (both P values < .001), but the magnitude of increase was not different between groups (P = .130). Patients with obstruction exhibited a greater increase in LV mass (P < .001) compared with patients without obstruction (P = .004). Aortic angulation significantly increased in 4 of the 5 measurements (all P values < .001) in patients with obstruction, whereas patients with no obstruction showed no change. Anterior and posterior mitral valve leaflet lengths and coaptation lengths remained similar in both groups over time. ConclusionsThe development of LV outflow tract obstruction in patients with hypertrophic cardiomyopathy was associated with progressive LV outflow tract angulation and increased LV hypertrophy, as reflected by LV mass. Progression to obstruction was not related to changes in the mitral valve leaflet morphology.

Proximal humeral fractures in children - controversies in decision making

BackgroundProximal humeral fractures in children are rare and usually treated non-operatively, especially in children younger than ten. The decision between operative and non-operative treatment is mostly based on age and fracture angulation. In the current literature, diverging recommendations regarding fracture angulation that is still tolerable for non-operative treatment can be found. Besides, there is no consensus on how fracture angulation should be determined. This study aimed to determine whether leading experts in pediatric trauma surgery in Germany showed agreement concerning the measurement of fracture angulation, deciding between operative and non-operative treatment, and choosing a treatment modality.MethodsTwenty radiographs showing a proximal humeral fracture and the patient’s age were assessed twice by twenty-two senior members of the “Section of Pediatric Traumatology of the German Association for Trauma Surgery”. Experts determined the fracture angulation and chose between several operative and non-operative treatment modalities. The mean of individual standard deviations was calculated to estimate the accuracy of single measurements for fracture angulation. Besides Intra-Class Correlation and Fleiss’ Kappa coefficients were determined.ResultsFor fracture angulation, experts showed moderate (ICC = 0.60) interobserver and excellent (ICC = 0.90) intraobserver agreement. For the treatment decision, there was fair (Kappa = 0.38) interobserver and substantial (Kappa = 0.77) intraobserver agreement. Finally, experts preferred ESIN over K-wires for operative and a Gilchrist over a Cuff/Collar for non-operative treatment.ConclusionsFirstly, there is a need for consensus among experts on how fracture angulation in PHFs in children should be reliably determined. Our data indicate that choosing one method everybody agrees to use could be more helpful than using the most sophisticated. However, the overall importance of fracture angulation should also be critically discussed. Finally, experts should agree on treatment algorithms that could translate into guidelines to standardize the care and perform reliable outcome studies.Level of evidenceIII.

Double lumen endobronchial tube intubation: lessons learned from anatomy

BackgroundDouble lumen endobronchial tubes (DLTs) are frequently used to employ single lung ventilation strategies during thoracic surgical procedures. Placement of these tubes can be challenging even for experienced clinicians. We hypothesized that airway anatomy, particularly of the glottis and proximal trachea, significantly impacts the ease or difficulty in placement of these tubes.MethodsImages from 24 randomly selected Positron Emission Tomography – Computed Tomography (PET-CT) scans were evaluated for several anatomic aspects of the upper airway, including size and angulation of the glottis and proximal tracheal using calibrated CT measurements and an online digital protractor. The anatomic issues identified were confirmed in cadaveric anatomic models.ResultsProximal tracheal diameter measurements in PET-CT scans demonstrated a mean ± standard deviation of 20.4 ± 2.5 mm in 12 males and 15.5 ± 0.98 mm in 12 females (p < 0.001), and both were large enough to accommodate 39 French and 37 French DLTs in males and females, respectively. Subsequent measurements of the posterior angulation of the proximal trachea revealed a mean angle of 40.8 ± 5.7 degrees with no sex differences. By combining the 24 individual posterior tracheal angles with the 16 angled distal tip measurements DLTs (mean angle 24.9 ± 2.1 degrees), we created a series of 384 patient intubation angle scenarios. This data clearly showed that DLT rotation to a full 180 degrees decreased the mean intubation angle between the DLT and the proximal trachea from a mean of 66.6 ± 5.9 to only 15.8 ± 5.9 degrees.ConclusionsRotation of DLTs a full 180 instead of the recommended 90 degrees facilitates DLT intubations.

Clinical and Radiographic Outcomes of Anterior Lumbar Interbody Fusion With Anterior Plate Fixation.

Reports on the outcomes following instrumented anterior lumbar interbody fusion (ALIF) with anterior plate fixation are limited. The aim of this study was to assess the clinical and radiographic outcomes of patients undergoing ALIF with anterior plate fixation. Methods: Medical records and radiographic imaging were reviewed for 100 patients who received ALIF with anterior plate fixation between 2008 to 2021 and completed at least one year of follow-up and postoperative imaging. Prospectively collected patient data included indication for surgery, BMI, age, number and location of levels treated, complications, reoperation rates, fusion rate, and measurements of global lordosis, disc space height, and segmental angulation. Results: A total of 100 patients were included in this study. The mean length of follow-up was 81.37 months. Changes in preoperative-to-postoperative Oswestry Disability Index (ODI) and Visual Analog Score (VAS) demonstrated improvements of 30.86% and 18.56%, respectively. Major vascular injuries occurred in 3% of the cases. A hardware failure rate of 5% was observed. The reoperation rate was 10%. The radiographic fusion rate derived from computed tomography (CT) and plain film was 95.45% and 88.87%, respectively. Postoperative global lordosis demonstrated a 6.08% increase. Postoperative segmental angulation measurements increased by 57.74%. No statistically significant differences in clinical or radiographic outcomes were observed based on the spine level of fusion or the number of fusions performed. Conclusions: ALIF with anterior plate fixation achieved an adequate fusion rate with improvements in ODI and VAS scores meeting minimal clinically important difference thresholds. Postoperative disc space heights demonstrated significant improvements compared to preoperative measurements.

3D-assisted corrective osteotomies of the distal radius: a comparison of pre-contoured conventional implants versus patient-specific implants

PurposeThere is a debate whether corrective osteotomies of the distal radius should be performed using a 3D work-up with pre-contoured conventional implants (i.e., of-the-shelf) or patient-specific implants (i.e., custom-made). This study aims to assess the postoperative accuracy of 3D-assisted correction osteotomy of the distal radius using either implant.MethodsTwenty corrective osteotomies of the distal radius were planned using 3D technologies and performed on Thiel embalmed human cadavers. Our workflow consisted of virtual surgical planning and 3D printed guides for osteotomy and repositioning. Subsequently, left radii were fixated with patient-specific implants, and right radii were fixated with pre-contoured conventional implants. The accuracy of the corrections was assessed through measurement of rotation, dorsal and radial angulation and translations with postoperative CT scans in comparison to their preoperative virtual plan.ResultsTwenty corrective osteotomies were executed according to their plan. The median differences between the preoperative plan and postoperative results were 2.6° (IQR: 1.6–3.9°) for rotation, 1.4° (IQR: 0.6–2.9°) for dorsal angulation, 4.7° (IQR: 2.9–5.7°) for radial angulation, and 2.4 mm (IQR: 1.3–2.9 mm) for translation of the distal radius, thus sufficient for application in clinical practice. There was no significant difference in accuracy of correction when comparing pre-contoured conventional implants with patient-specific implants.Conclusion3D-assisted corrective osteotomy of the distal radius with either pre-contoured conventional implants or patient-specific implants results in accurate corrections. The choice of implant type should not solely depend on accuracy of the correction, but also be based on other considerations like the availability of resources and the preoperative assessment of implant fitting.

Effect of reference objects on the accuracy of digital implant impressions in partially edentulous arches.

This study assesses the impact of additional reference objects (RO) on the trueness and precision of distance and angle measurements between scan bodies in digital scans with four different intraoral scanners (IOS) in partially edentulous models. Maxilla models (Frasaco, Frasaco GmbH, Tettnang, Germany) with one (3-U) and two (4-U) missing posterior teeth were 3D printed and fitted with dental implants and scan bodies. Four intraoral scanners (Primescan (Dentsply Sirona, Charlotte, NC, USA) (PS), Trios 3 (3Shape) (T3), Trios 4 (3Shape) (T4), and CS3600 (Carestream Dentistry) (CS)) captured digital implant impressions with and without additional RO. Scans were aligned and assessed for distance and angulation measurements between scan bodies. Statistical analyses compared trueness and precision across model groups using the Student t-test and Welch's ANOVA. CS consistently showed the highest distance values across IOS devices in both the 4-U and 3-U models (P < .05), both with and without RO. The distance values were not considerably affected by the presence of RO (P > .05), except for a few isolated cases in the PS and CS groups of 3-U models. When measuring angles, CS usually showed greater values than the other IOS devices, especially when RO was present both in the 4-U and 3-U variants (P < .05). The influence of additional reference objects on accuracy varies with different scanner types, irrespective of edentulous area length.

Assessment of anterior malar projections using cephalometric and clinical photographs in Gujarati population

Midface plays a vital role in contributing to facial aesthetics; despite this, there prevails a need for orthodontic literature to provide specific diagnostic criteria. We are blessed with ample literature to evaluate such, but due to some shortcomings, we lack to decide exact treatment plan. To clarify such limitations of various midface analysis, there is a need to consider the projections of the malar prominence in individuals with different skeletal mal-relationships. 40 subjects between the ages of 10 and 12 years, were equally divided into groups based on visual assessment of negative and positive vector relationships. Groups A and B comprised 20 subjects (10 male, 10 female) displaying a positive and negative vector relationship respectively. For both groups, Sella-nasion-Orbitale angulations were measured to evaluate the subjects’ anteroposterior position of the malar eminence relative to the cranial base. The angulation measurements obtained for SNO were smaller in the negative vector than the positive on an average of 5.9°, P &amp;#60; 0.05. No significant difference in values between males and females was observed. Visual assessment of vector relationships can effectively classify anterior malar projection which can be utilized to decide different orthodontic treatment modalities.

Normative Measurements of L1-S1 Segmental Angulation, Disk Space Height, and Neuroforaminal Dimensions Using Computed Tomography.

To establish normative anatomic measurements of lumbar segmental angulation (SA) and disk space height (DSH) in relation to neuroforaminal dimensions (NFDs), and to uncover the influence of patient demographic and anthropometric characteristics on SA, DSH, and NFDs. NFDs, SA, and anterior, middle, and posterior DSH were measured using computed tomography of 969 patients. NFDs were defined as sagittal anterior-to-posterior width, foraminal height, and area. Statistical analyses were performed to assess associations among SA, DSH, NFDs, and patient height, weight, body mass index, sex, and ethnicity. SA and DSH measurements increased moving caudally from L1 to S1. Foraminal width decreased moving caudally from L1 to S1. Foraminal height and area demonstrated unimodal distribution patterns with the largest values clustered at L2-L3 on the right side and L3-L4 on the left. Significant differences in SA, DSH, and NFD measurements were observed based on the disk level. Inconsistent, marginal NFD differences were observed based on laterality. Across all disk levels, only weak-to-moderate correlations were observed between SA and DSH in relation to NFDs. Patient height, weight, and body mass index were only weakly associated with SA, DSH, and NFDs. Based on patient sex, significant differences were observed for SA, DSH, and NFD measurements from L1 to S1, with males demonstrating consistently larger values compared with females. Based on patient race and ethnicity, significant differences in SA and NFD measurements were observed from L1 to S1. This study describes 48 450 normative measurements of L1-S1 SA, DSH, and NFDs. These measurements serve as representative models of normal anatomic dimensions necessary for several applications including surgical planning and diagnosis of foraminal stenosis. Normative values of SA and DSH are not moderately or strongly associated with NFDs. SA, DSH, and NFDs are influenced by sex and ethnicity, but are not strongly or moderately influenced by patient anthropometric factors.

Comparative Evaluation of the Horizontal Condylar Guidance Using Protrusive Interocclusal Records, OPG, and CBCT in Edentulous Patients: An In Vivo Study.

A clinical study to compare the horizontal condylar guidance using protrusive interocclusal records, orthopantomography (OPG), and cone-beam computed tomography (CBCT) in edentulous patients. Thirty-six edentulous subjects were selected as per predetermined criteria. Horizontal condylar guidance was recorded using protrusive interocclusal records (PIR), OPG, and CBCT for each patient. The PIR were obtained using extraoral Gothic arch tracers to program the Hanau articulator. The horizontal condylar guidance angles (HCGAs) were digitally constructed using appropriate software along the posterior slope of articular eminence for all radiographs. The collected data were recorded, tabulated, and statistically analyzed. The condylar guidance angle values were tested for significance to compare the different angles. The correlation of HCGA measurements on both sides between the three groups was analyzed. The PIR and OPG methods (p = 0.001), as well as the OPG and CBCT methods (p = 0.001), show substantial differences on both sides. On the contrary, the PIR and CBCT methods did not differ significantly (p = 0.11). Cone-beam computed tomography is as reliable and accurate as the clinical method. A significant correlation exists between the clinical method and CBCT. It can be used as a dependable adjunct to the clinical method of HCGA measurement. Cone-beam computed tomography can overcome the shortcomings of the conventional clinical methods to determine the accurate horizontal condylar guidance angulation measurement. It is safer with minimum discomfort and wastage of time for the patients.

Reliability and Validity of Use of A Smartphone Application For The Measurement of Gissane and Bohler’s Angles in Calcaneal Fractures

Objective: Calcaneus is the most often fractured bone of all the tarsal bones in the human skeleton. Initial evaluation of a suspected calcaneal fracture is often assessed with Böhler’s and Gissane’s angles. The aim of this study was to compare the reliability and consistency of measurements of Gissane and Böhler’s angles by using a smartphone application (iPinPoint) and a computer-based program&#x0D; Methods: A total of 41 patients were included. The measurement of fracture angulation was done by two orthopaedic surgeons twice one month apart using iPinPoint and Sectra. The inter- and intraobserver reliability was measured using intraclass correlation coefficients (ICCs). The intraobserver variabilities between the SECTRA and iPinPoint measurements for each participant were evaluated. Interobserver variability was also determined by comparing the results of Böhler’s and Gissane angles among the surgeons&#x0D; Results: The mean difference between the two techniques were 0.9° and 0.4° for Gissane and Böhler’s angles, respectively. The intraobserver reliability of Gissane and Bohler’s angles between smartphone and computer for each observer was very good (ICC=0.938 vs. 0.943, ICC= 0.970 vs 0.979, respectively). Interobserver reliability between two observers for SECTRA and iPinPoint results were very good (ICC=0.955, ICC=0.905 respectively).&#x0D; Conclusion: iPinPoint application can be used for the measurement of Gissane and Bohler’s angles safely. In addition, there are very good results that support it as a reliable and reproducible tool for SECTRA measurements.

Comparative study of the reliability and accuracy of anterior tooth root angulation measurements in lateral skull tele-radiography and CBCT from an image bank of the faculty of dentistry of the University of Cuenca

Purpose: The aim of the present study was to compare the reliability and accuracy of central incisor root angulation measurements performed by two different methods: CBCT and lateral skull teleradiography. Materials and methods: The inclination angle in the vestibule-lingual direction of the upper and lower central incisor of 40 patients was measured by lateral skull teleradiography and CBCT and used excel 2016. Results: The angulation of anterior tooth roots presented a statistically significant difference in the measurements performed in the lateral skull teleradiography and CBCT (p &lt; 0.05). Conclusion: Measurements of the vestibule­lingual inclination of the upper and lower central incisors performed on CBCT showed greater efficacy and reliability compared to measurements taken on TeleRx.

Maxillary transverse deficiency diagnosed by 3 methods and its relationship with molar angulation in patients with skeletal Class III malocclusion

The objective of this study was to evaluate the relationship between maxillary transverse deficiency (MTD) diagnosed by 3 methods and molar angulation measured in 3-dimensions in patients with skeletal Class III malocclusion, which could give reference to the selection of diagnostic methods in MTD patients. Cone-beam computed tomography data of 65 patients with skeletal Class III malocclusion (mean age 17.35 ± 4.45 years) were selected and imported into MIMICS software. Transverse deficiencies were evaluated by 3 methods, and molar angulations were measured after reconstructing 3-dimensional planes. Two examiners performed repeated measurements to assess the intraexaminer and interexaminer reliability. Pearson correlation coefficient analyses and linear regressions were performed to determine the relationship between a transverse deficiency and molar angulations. One-way analysis of variance was used to compare the diagnostic results of 3 methods. The novel molar angulation measurement method and 3 MTD diagnostic methods have the interexaminer and intraexaminer intraclass correlation coefficient values>0.6. The transverse deficiency diagnosed by 3 methods was significantly and positively correlated with the sum of molar angulation. There was a statistically significant difference for the transverse deficiencies diagnosed by the 3 methods. The transverse deficiency was significantly higher in Boston University's analysis than in Yonsei's analysis. Clinicians ought to choose the diagnostic methods properly, considering the feature of the 3 methods and the individual difference of each patient.

SIGNIFICANCE OF NASAL SEPTUM ANGULATION AND ITS ASSOCIATION WITH RHINOSINUSITIS USING SYMPTOMS SCORES AND VISUAL ANALOGUE SCALE

Objective- The aim of the study is to determine the association of angulation of nasal septum with the severity of rhinosinusitis as measured by symptom score and visual analog score. Materials and methods- 50 patients who were diagnosed with rhinosinusitis and fullled the selection criteria were assessed for symptom score and VAS and measurement of angulation of nasal septum was performed through a coronal view of CT paranasal sinuses in bone window setting. Patients older than 18 years, diagnosed with rhinosinusit Inclusion criteria- is and carrying indications for CT scan of paranasal sinuses were included in the study. Patients with history of nasal Exclusion criteria trauma, septal surgery, septal haematoma ,septal perforation, concha bullosa, sinonasal tumors were excluded from the study. Results- The result obtained from one-way ANOVA test revealed a signicant association between category of severity of septal angulation and the symptom score of rhinosinusitis. Severity of nasal septum angulation may be signicantly asso Conclusion- ciated with severity of rhinosinusitis based on symptom score and VAS.these ndings could be used in management of patient with rhinosinusitis during functional endoscopic sinus surgery

Dynamic assessment of the left main-left circumflex bending angle: Implications for ostial left circumflex artery in-stent restenosis after successful two-stent PCI

BackgroundTwo-stent techniques for percutaneous coronary intervention (PCI) on left main (LM) bifurcation (LMB) lesions are associated with an increased risk of in-stent restenosis (ISR) at left circumflex artery (LCx) ostium but the underlying mechanisms are incompletely understood. This study sought to investigate the association between cyclic change of LM-LCx bending angle (BALM-LCx) and the risk of ostial LCx ISR following two-stent techniques. MethodsIn a retrospective cohort of patients undergoing two-stent PCI for LMB lesions, BALM-LCx and distal bifurcation angle (DBA) were computed with 3-dimensional angiographic reconstruction. The analysis was performed both at end-diastole and end-systole, and the angulation change throughout the cardiac cycle was defined as the cardiac motion-induced angulation change (∆CAngle). ResultsA total of 101 patients were included. The mean pre-procedural BALM-LCx was 66.8 ± 16.1° at end-diastole and 54.1 ± 13.3° at end-systole with a range of 13.0 ± 7.7°. Pre-procedural ∆CBALM-LCx > 16.4° was the most relevant predictor of ostial LCx ISR (adjusted OR 11.58, 95% CI 4.04–33.19; p < 0.001). Post-procedural ∆CBALM-LCx > 9.8° and stent-induced diastolic BALM-LCx change > 11.6° were also related with ostial LCx ISR. DBA was positively correlated with BALM-LCx and showed a weaker association of pre-procedural ∆CDBA > 14.5° with ostial LCx ISR (adjusted OR 6.87, 95% CI 2.57–18.37; p < 0.001). ConclusionsThree-dimensional angiographic bending angle is a feasible and reproducible novel method for LMB angulation measurement. A large pre-procedural cyclic change of BALM-LCx was associated with an increased risk of ostial LCx ISR following two-stent techniques.

Comparative study of the reliability and accuracy of posterior tooth root angulation measurements in lateral skull teleradiography and CBCT in a group of students of the Faculty of Dentistry of the University of Cuenca

The aim of this article is to analyze the reliability and accuracy of root angulation measurements of posterior teeth in lateral cephalic radiographs and cone beam tomography (CBCT) of a group of students of the Faculty of Dentistry of the University of Cuenca, by means of Nemocast. A total of 40 individuals were examined, of which, according to the inclusion and exclusion criteria, 12 ondividuals were excluded, having as a final sample 28 individuals, of which 28 cone-beam tomographies and 28 lateral cephalic radiographs were examined, the analysis of the inclination of 336 posterior pieces. The occlusal plane of each patient was identified, determined from the upper incisal edge of the central incisor to the mesiobuccal cusp of the maxillary first molar. Subsequently, lines were drawn at the level of the longitudinal axis of the maxillary and mandibular teeth to determine their inclination in the Nemocast program. Techniques such as observational and statistical were used where data was collected in Microsoft Excel 2010 tables. Regarding the results, it was determined that the CBCT has greater precision and reliability compared to the lateral teleradiography of the skull, where the average angulation of the posterior teeth is 90.26°. The upper right first premolars presented greater angulation (94.11°). The lower left first molars presented the lowest mesiodistal angulation of 87.83°. On the other hand, in lateral head radiographs the average angulation is 96.2°. The upper right first premolars presented the greatest angulation (105°) and the lower right second premolars presented the lowest angulation of 91.3°.

Accuracy and reliability of the expected root position setup to evaluate root proximity of an edentulous site

It is important to achieve proper root position during orthodontic treatment involving future dental implant placement. However, current methods to evaluate root position are either inaccurate or expose patients to relatively high radiation levels. A new approach using an expected root position (ERP) setup has previously demonstrated the potential to accurately monitor root position with minimal radiation. This study aimed to evaluate whether the ERP setup is an accurate and reliable method to determine if the roots adjacent to an edentulous site are appropriate for the anticipated dental implant. In this retrospective study, the ERP setup was generated for 22 edentulous sites selected from the University of California San Francisco Division of Orthodontics patient database. The mesiodistal angulation of all teeth adjacent to the edentulous sites and the mesiodistal space between the teeth were measured in the ERP setup and compared with the posttreatment cone-beam computed tomography (CBCT) scan, which served as the control. The intraoperator and interoperator reliability and agreement between the ERP setup and the posttreatment CBCT scan were assessed using Bland-Altman analysis. The correlation between measurements was further evaluated by the Pearson correlation coefficient. The Bland-Altman plots and the Pearson correlation coefficient displayed strong agreement between the ERP setup and the posttreatment CBCT scan, with only 11.4% mesiodistal angulation measurements beyond the clinically acceptable range of ± 2.5°. All mesiodistal angulations and distances were strongly correlated with high intraoperator and interoperator reliabilities. The method to generate an ERP set up to evaluate the mesiodistal angulation and space of an edentulous site prepared for a future dental implant has been demonstrated to be accurate and reliable.

Effect of horizontal slot of maxillary canines' brackets with varying wire angulations - An in vitro study.

A new device was developed to enable the visualization and measurement of canine angulation while at the same time visualizing and measuring the force transmitted to adjacent teeth. This study aimed to evaluate the mesiodistal tilt angle of the upper canine brackets, the wire deflection, and its effects on adjacent teeth with five different slot designs of upper canines. Wires (0.020" and 0.019" x 0.025") were tested on different five bracket types at five different distal angles. The force applied to adjacent teeth was measured as the angle was increased, and its consequences were observed in the posterior and anterior regions as well. The force tension (gf) was measured in a universal testing machine. Data were submitted to a 3-way ANOVA and Tukey's test (α=0.05). For both arches, regardless of the type of tooth and bracket type, the highest means tension mean values were shown by the 20° angle, followed by the 15°,10°, and 5° angles, which differed statistically among themselves. Overall, for 5°, 10°, and 15° angles, conventional and versatile brackets showed significantly higher force values in all teeth, tip-edge and control brackets showed the lowest. The highest force values were observed in central and lateral incisors with conventional and versatile brackets and on first and second premolar teeth with self-ligating passive and control brackets. Conventional brackets presented the highest forces, tip-edge and control brackets showed the lowest. The teeth that suffered the greatest forces were lateral incisors, and those that suffered the least were second premolars.

An original mininvasive corporoplasty technique for penile curvature without circumcision

We describe an original minimally invasive penile plication technique with scrotal or infrapubic access, not requiring circumcision, for penile curvature of different severity and types. This technique can be used to correct both congenital and acquired curvatures, mono or bidirectional deformities. Between 2012 and 2018 we treated 134 patients suffering from congenital curvature (33) and acquired curvature from Peyronie's disease (101). The average curvature was 62.2° (± 30.4°). Preoperative evaluation included prostaglandin E1 injection with photographic documentation and measurement of penile angulation, administration of IIEF- 15, vasoactive penile Doppler ultrasound, analysis of thermal and vibratory sensitivity with Genito-Sensory-Analyzer (GSA) and assessment of nocturnal penile stiffness with Rigiscan, performed twice, for a detailed evaluation of patient's erectile function. Scrotal access was performed in patients with dorsal and/or lateral penile curvature; the infrapubic access was performed in patients with ventral curvature. After preparation and incision of Colles' fascia, penis was partially degloved and an original plication technique called "binary corporoplasty" was performed at the site or sites established at preoperative assessment, with non-resorbable synthetic multifilament (Premicron®) suture. Complete correction of penile curvature was achieved in 96.8 % of patients. No major complications were reported, and no patients suffered worsening in erectile function or in penile sensitivity. The average shortening of convex side was 1.65 cm (± 0.7 cm) and all patients report easy intercourse after correction. The average time of surgery was 46 minutes (± 11 min) and all procedures were performed as a day-hospital or ambulatory settings, with local anesthesia and light sedation. Overall satisfaction rate is 96%. This is a simple and rapid technique that perfectly corrects even the most severe and complex penile curvatures. In comparison to traditional techniques, such as Nesbit procedure, this technique is associated with low morbidity, a very low recurrence rate and a great aesthetic results. Aesthetic and functional patients' satisfaction was excellent.