Reduced Treatment Time Research Articles

Comparison of fixed braces and clear braces for malocclusion treatment

BackgroundTo study and compare the effects of clear aligners without brackets and traditional fixed aligners in orthodontic treatment.MethodsThe samples were collected from January 2022 to April 2023. The control group (n = 26) received orthodontic treatment using traditional fixed appliances. The research group (n = 20) received orthodontic treatment using the clear aligners without brackets. Compare the therapeutic effects and related evaluation indicators between two groups.ResultsThe total effective ratio was compared between the 2 groups, and the study group was greater(P < 0.05). After treatment, the detected values of the periodontal condition indicators (plaque index, debris index, and gingival bleeding index), serum inflammatory factors (CRP, IL-6 and TNF-α) of the two groups, were less than before, also were all less than the control group. (P < 0.05). After therapy, in comparison of the control group, the value of mastication efficiency, comfort and psychological evaluation, sleep indicators and the points of the four dimensions of life quality in the study group was greater, and the detection results were obviously greater than before(P < 0.05).ConclusionIn the orthodontic therapy of sufferers with malocclusion, compared with the traditional fixed appliance, the clear aligners without brackets can enhance the treatment effects, improve the periodontal condition and masticatory function, and reduce the inflammatory responses, so that patients can feel more comfortable, thereby improving their psychology, sleep and quality of life. In the future, with the continual advancement of technology and people’s pursuit of beauty, the application of clear aligners without brackets in orthodontic treatment will become more and more extensive. The continuous introduction of new materials and new technologies will further improve the effects and comfort of the clear aligners without brackets, reduce treatment time and discomfort, and also reduce patients’ resistance to aligners, bringing patients a better treatment experience.

Clinical and preclinical evidence on the bioeffects and movement-related implications of photobiomodulation in the orthodontic tooth movement: A systematic review.

Photobiomodulation (PBM) has been demonstrated as a non-invasive and painless technique with great potential to accelerate orthodontic tooth movement (OTM). However, there is a great inconsistency among PBM protocols and reported outcomes, probably due to the poor translatability of preclinical knowledge into early clinical practice. Hence, this review aims to fill this gap by establishing the state-of-the-art on both preclinical and clinical applications of PBM, and by comprehensively discussing the most suitable stimulation protocols described in the literature. This review was conducted according to PRISMA guidelines. A bibliographic search was carried out in the PubMed, Scopus and Cochrane databases using a combination of keywords. Only studies written in English were eligible and no time limit was applied. A total of 69 studies were selected for this review. The revised literature describes that PBM can effectively reduce orthodontic treatment time and produce analgesic and anti-inflammatory effects. We found that PBM of 640 ± 25, 830 ± 20 and 960 ± 20 nm, delivered at a minimum energy density per irradiation point of 5 J/cm2 daily or every other day sessions is robustly associated with increased tooth movement rate. Pain relief seems to be achieved with lower irradiation doses compared to those required for OTM acceleration. For the first time, the bioeffects induced by PBM for the acceleration of OTM are comprehensively discussed from a translational point of view. Collectively, the evidence from preclinical and clinical trials supports the use of PBM as a coadjuvant in orthodontics for enhancing tooth movement and managing treatment-associated discomfort. Overall, the revised studies indicate that optimal PBM parameters to stimulate tissue remodelling are wavelengths of 830 ± 20 nm and energy densities of 5-70 J/cm2 applied daily or every other day can maximize the OTM rate, while lower doses (up to 16 J/cm2 per session) delivered in non-consecutive days seem to be optimal for inducing analgesic effects. Future research should focus on optimizing laser parameters and treatment protocols customized for tooth and movement type. By fine-tuning laser parameters, clinicians can potentially reduce treatment times, improve patient comfort and achieve more predictable outcomes, making orthodontic care more efficient and patient-friendly, thus consolidating PBM usage in orthodontics.

Biomechanical innovations in correcting severe malocclusions

The correction of severe malocclusions presents significant challenges in orthodontics due to the complexity and precision required for effective treatment. Recent biomechanical innovations have transformed the landscape of orthodontic care, offering more precise, efficient, and patient-friendly solutions. Advancements in orthodontic bracket systems, including the development of self-ligating brackets and heat-activated arch wires, have enhanced the control and comfort of tooth movements, reduced treatment times and improving patient outcomes. Temporary anchorage devices (TADs) have provided stable anchorage points, enabling complex tooth movements that were previously difficult to achieve. TADs have proven particularly effective in managing open bites and class II malocclusions, offering non-surgical alternatives for severe cases. The integration of digital technology in orthodontics, such as 3D imaging and computer-aided design/manufacturing (CAD/CAM), has further revolutionized treatment planning and execution. These technologies facilitate accurate diagnostics and the creation of customized orthodontic appliances, ensuring precise and predictable treatment outcomes. Clear aligner therapy, initially limited to simple cases, has advanced through the use of improved thermoplastic materials and digital customization, allowing for the treatment of more complex malocclusions. Innovative force application techniques, including the use of attachments and elastics, have expanded the capabilities of aligners, making them a versatile and effective alternative to traditional braces. Collectively, these biomechanical innovations have significantly improved the management of severe malocclusions, enhancing treatment efficiency, precision, and patient comfort. The ongoing development of these technologies promises to further advance the field of orthodontics, providing more effective and aesthetically pleasing solutions for patients with complex dental alignment issues.

An innovative design and metrological testing to evaluate the performance of UV phototherapy devices

Narrowband UVB is the main type of light used to treat various dermatological conditions by administering appropriate doses. In this study, a new design was developed for an open-plan phototherapy device and assessed whether this could improve uniformity and deliver a higher dose, thus reducing treatment times. On the other hand, the uniformity and irradiation dose of a current model of (UV) phototherapy device were investigated. A simulation software was used to present the comparison of the simulated irradiation measurements and uniformity estimation for both the present device and the proposed device. In comparison to a present model of UV therapy device measurements, the results showed that the suggested (UV) phototherapy design device increased the irradiation dose value by 10%, improved the uniformity by 9.3%, and consequently reducing the exposure time by 13%. On the other hand, for both the current (UV) phototherapy equipment and the suggested design device, the irradiation loss value resulting from any UV lamp inefficiency was also calculated. The current model device’s loss value percentage was 15%, however, the loss value of the suggested design for the UV phototherapy device was between 3 and 4%. Based on the results discussed throughout the paper, the findings indicate that the suggested design is promising for UV phototherapy applications.

Enhancing dewaterability of water resource recovery facility solids with electrochemical treatment through synergetic effects of acidification and cation removal

Solids dewaterability is vital for water resource recovery facilities to effectively manage and dispose treatment residuals, and current methods for improving dewaterability is at the expense of chemical consumption. Herein, an electrochemical approach that integrates anodic acidification, electrooxidation, and cation removal was investigated to enhance solids dewaterability. The results show that the specific resistance to filtration (SRF) was decreased by > 97 % for raw solids before anaerobic digestion, anaerobically digested solids (ADS), and primary solids. ADS exhibited the highest conductivity and required the least energy (34.9 ± 1.3 kWh m−3 treated solids). Increasing the applied current density reduced treatment time but demanded greater energy consumption. Both acidification and cation removal were critical to dewaterability enhancement: acidification facilitated the flocculation of solids flocs through protonation of functional groups and the leaching of divalent ions, while cation removal reduced competition for proton binding, leading to improved dewaterability. The input of electrical energy for the electrochemical treatment can potentially be offset by revenue from recovered nutrient products and use of renewable energy. This study has demonstrated the feasibility of using electrochemical processes for solids treatment and resource recovery.

Corticotomy as a stage of complex treatment of orthodontic patients. Review.

In this article, we consider an urgent problem of modern orthodontic dentistry - the acceleration of treatment periods. The average duration of traditional orthodontic treatment is significantly high and is 24-28 months, which requires long-term cooperation of patients and doctors. In particular, in adult patients, this process is more complex and prolonged, which can lead to refusals of treatment. The article also discusses the biological basis of orthodontic tooth movement associated with the restructuring of the alveolar bone and research aimed at accelerating this process. The authors discuss various methods of corticotomy and other innovative approaches to reduce treatment time and improve results. Important attention is paid to the introduction of minimally invasive and predictable surgical methods. The studies of domestic and foreign authors are analyzed for a better understanding of this problem.

Effect of low-temperature thermal-alkali pre-treatment on waste activated sludge solubilisation

The study was aimed to examine the effects of alkaline and thermal-alkaline pre-treatment on sewage sludge solubilisation with different alkali and its doses ranging from 40 mg alkali/g TS to 120 mg alkali/g TS. Initially, the effect of alkali pre-treatment was monitored with four alkali at room temperature, to further enhance soluble chemical oxygen demand (sCOD) and reduce treatment time, thermal-alkaline pre-treatment was performed with varying temperature from 40 to 70 °C. To explore and optimise the effects of temperature, alkali, and alkali doses on COD solubilisation, response surface methodology was employed. Statistical analysis of the variance was conducted to identify the relationship between experimental data and the proposed model. The thermal-alkaline process was optimised for maximum COD solubilisation with optimal conditions achieved at 65.61 °C of 66.57 mg alkali /g TS for NaOH and 27 °C of 20 mg/g TS for KOH. The maximum COD solubilisation achieved at these optimised conditions for NaOH and KOH was 21.28 % and 16.13 %, respectively. The results demonstrated a significant improvement in protein and carbohydrate concentration and a 16–20 % reduction in sludge solid content after thermal-alkali pre-treatment.

ПРИМЕНЕНИЕ СОВРЕМЕННЫХ ПРЕПАРАТОВ В ЛЕЧЕНИИ КОРОВ, БОЛЬНЫХ ГНОЙНО-КАТАРАЛЬНОЙ ФОРМОЙ МАСТИТА, В УСЛОВИЯХ РЕСПУБЛИКИ СЕВЕРНАЯ ОСЕТИЯ-АЛАНИЯ

Today for veterinary specialists the selection of effective treatment regimens for mastitis in cows in order to reduce treatment time with complete restoration of mammary gland function is an urgent task. For this purpose, we conducted research on the basis of the Iraf-Agro livestock complex in North Ossetia-Alania, on cows with various forms of mastitis. To determine the effectiveness of treatment regimens for mastitis in cows, we formed two groups of 12 heads each and an average weight of 350-400 kg. Nitotx and Cobactan were used as antibacterial drugs, which in a short time have a detrimental effect on both conditionally pathogenic and pathogenic microflora. Cows in the control group were administered Nitox intramuscularly at 48-hour intervals at a dose of 1 ml per 10 kg of live weight in combination with intracisternal injection of Mastifort into the affected quarter of the udder once a day for three days. The experimental group was treated with Cobactan at a dose of 2 ml per 45 kg of live weight, and Mastifort was administered to the affected quarter once and Dexofort 0.02 mg per kg of live weight was administered intramuscularly once. The therapeutic effectiveness of complex treatment of mastitis in cows of the experimental group before recovery from mild and moderate forms of mastitis averaged from 92 to 100%. While in the control this figure was 87-100%. The duration of treatment for cows in the experimental group for purulent catarrhal mastitis was on average 5 days, while for cows in the control group it was 8 days. The reduction in treatment time occurred due to the correctly selected combination of broad-spectrum antibacterial drugs in the form of complex therapy for purulent catarrhal mastitis in cows. Thus, the use of these drugs can reduce the time required to restore milk production.

Evaluating the safety of high-intensity focused ultrasound treatment for rectal endometriosis: results from a French prospective multicentre study including 60 patients.

Is increasing the intensity of high-intensity focused ultrasound (HIFU) by 30% in the treatment of rectal endometriosis a safe procedure? This study demonstrates the safety of a 30% increase in the intensity of HIFU in the treatment of rectal endometriosis, with no Clavien-Dindo Grade III complications overall, and namely no rectovaginal fistulae. A feasibility study including 20 patients with rectal endometriosis demonstrated, with no severe complications, a significant improvement in digestive disorders, dysmenorrhoea, dyspareunia, and health status, although the volume of the endometriosis nodule did not appear to be reduced. A prospective multicentre cohort study was conducted between 2020 and 2022 with 60 patients with symptomatic rectal endometriosis. Following the failure of medical treatment, HIFU treatment was offered as an alternative to surgery. As the main objective of this study was to examine safety, all adverse events observed during the 6 months of follow-up were analysed and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) and Clavien-Dindo classifications. Secondary objectives included evaluating the evolution of symptoms using validated questionnaires: gynaecological and digestive pain symptoms with a visual analogue scale, health status with the Medical Outcomes Study 36-item Short Form (SF-36) questionnaire, average post-operative daily pain level, and analgesic medication required in the 10 days following treatment. MRI was also performed at Day 1 to detect early complications. Finally, we performed a blinded MRI review of the evolution of the nodule at 6 months post-treatment. The procedure was performed under spinal anaesthesia for 30% of the patients. The median duration of treatment was 32 min. Fifty-five patients left the hospital on Day 1. MRI scans performed on Day 1 did not highlight any early-onset post-operative complication. Using the Clavien-Dindo classification, we listed 56.7% Grade I events, 3.4% Grade II events, and no events Grade III or higher. At 1, 3, and 6 months, all gynaecologic, digestive and general symptoms, as well as health status, had significantly improved. The evolution of the nodule was also significant (P < 0.001) with a 28% decrease in volume. The main objective was safety and not effectiveness. The study was not randomized and there was no control group. HIFU treatment for rectal endometriosis results in an improvement of symptoms with low morbidity; as such, for selected patients, it could be a valuable alternative to surgical approaches following the failure of medical treatment. The study was funded by the company EDAP TMS. Professors Dubernard and Rousset are consultants for EDAP TMS. Dubernard received travel support from EDAP-TMS. Dr F. Chavrier received industrial grants from EDAP-TMS. He has developed a device for generating focused ultrasonic waves with reduced treatment time. This device has been patented by EDAP-TMS. Dr Lafon received industrial grants from EDAP-TMS; he declares that EDAP-TMS provided funding directly to INSERM to support a young researcher chair in therapeutic ultrasound, which is unrelated to the current study. ClinicalTrials.gov identifier NCT04494568.

Accessories in clear aligner therapy: Laypeople's expectations for comfort and satisfaction.

This study explored the layperson's perception of comfort, satisfaction, and willingness to use various accessories in clear aligner therapy. A total of 267 people analyzed standardized intraoral photographs of a female model in orthodontic treatment using: 1) only clear aligner (CA), the control group; 2) clear aligner+attachments (AT); 3) clear aligners+Cl II elastics (EL); 4) clear aligner+hybrid treatment with esthetic braces (HEB); 5) Clear aligner+hybrid treatment with metallic braces (HMB); 6) clear aligner+mini-implants (MI); 7) clear aligner+mini-implants and elastics for intrusion (MIE). In addition, a social media questionnaire was distributed to assess the willingness to undergo orthodontic treatment with various accessories. There was a significant difference between CA and all the other groups (P<0.001), with CA being considered more comfortable and providing greater satisfaction compared to other accessories. Moreover, AT showed a significant difference in reducing treatment time compared to other groups. The CA was the most comfortable, exhibiting a higher satisfaction rate and a greater willingness to use it. The AT therapy was perceived as more comfortable and was associated with higher satisfaction and a greater likelihood of use, especially if it resulted in reduced treatment time. On the other hand, the participants reported that the HMB, MI, and MIE accessories were less comfortable.

Optimal minimum MU for intensity-modulated proton therapy with pencil-beam scanning proton beams.

A higher minimum monitor unit (minMU) for pencil-beam scanning proton beams in intensity-modulated proton therapy is preferred for more efficient delivery. However, plan quality may be compromised when the minMU is too large. This study aimed to identify the optimal minMU (OminMU) to improve plan delivery efficiency while maintaining high plan quality. We utilized clinical plans including six anatomic sites (brain, head and neck, breast, lung, abdomen, and prostate) from 23 patients previously treated with the Varian ProBeam system. The minMU of each plan was increased from the current clinical minMU of 1.1 to 3-24 MU depending on the daily prescribed dose (DPD). The dosimetric parameters of the plans were evaluated for consistency against a 1.1-minMU plan for target coverage as well as organs-at-risk dose sparing. DPD/minMU was defined as the ratio of DPD to minMU (cGy/MU) to find the OminMU by ensuring that dosimetric parameters did not differ by>1% compared to those of the 1.1-minMU plan. All plans up to 5 minMU showed no significant dose differences compared to the 1.1-minMU plan. Plan qualities remained acceptable when DPD/minMU ≥35 cGy/MU. This suggests that the 35 cGy/MU criterion can be used as the OminMU, which implies that 5 MU is the OminMU for a conventional fraction dose of 180 cGy. Treatment times were decreased by an average of 32% (max 56%, min 7%) and by an average of 1.6min when the minMU was increased from 1.1 to OminMU. A clinical guideline for OminMU has been established. The minMU can be increased by 1 MU for every 35 cGy of DPD without compromising plan quality for most cases analyzed in this study. Significant treatment time reduction of up to 56% was observed when the suggested OminMU is used.

Reduction of surface treatment time by combination of citric acid and ascorbic acid while restoring shear bond strength of metal brackets bonded to bleached enamel: a pilot study

BackgroundTo investigate the effect of a 50% ascorbic acid with 50% citric acid solution on the immediate shear bond strength (SBS) of metallic brackets after tooth bleaching. The enamel etching pattern and the required quantity of these combined acids as antioxidants following 35% hydrogen peroxide (HP) bleaching were also determined.MethodsThe stability of the solution at room temperature was assessed at various time intervals. Fifty teeth were randomly divided into five groups: non-bleached (G1), bleached then acid etched (G2), bleached followed by a 10-minute treatment with 10% sodium ascorbate and acid etched (G3), 5-minute treatment with 50% ascorbic acid (G4), and 5-minute treatment with a combination of 50% ascorbic acid and 50% citric acid (G5). Groups G2, G3, G4 and G5 were bleached by 35% HP gel for a total of 32 min. Acid etching in groups G1, G2, and G3 was performed using 37% phosphoric acid (Ormco®, Orange, CA, USA) for 15 s. In all groups, metal brackets were immediately bonded using Transbond™ XT primer and Transbond™ PLUS adhesive, with light curing for 40 s. The SBS was tested with a universal testing machine, and statistical analysis was conducted using one-way ANOVA followed by Tukey’s HSD test. The level of significance was set at p < 0.05 for all statistical tests.ResultsStability tests demonstrated that the combined acids remained effective for up to 21 days. Group G5 significantly increased the SBS of bleached teeth to the level of G1 (p < 0.05), while G3 did not achieve the same increase in SBS (p > 0.05). SEM analysis revealed enamel etching patterns similar to those of both control groups (G1 and G2). Kinetic studies at 6 min indicated that the antioxidation in G5 reacted 0.2 mmole lower than in G3 and G4.Conclusion5-minute application of the combined acids enhanced the SBS of bleached teeth comparable to unbleached teeth. The combined acids remain stable over two weeks, presenting a time-efficient, single-step solution for antioxidant application and enamel etching in orthodontic bracket bonding.

Comparison Flattening Filter and Flattening Filter-Free Techniques in Small-Fields Dosimetry with Various Types of Detectors.

The aim of this study was to investigate the detector size effect on small-field dosimetry and compare the performance of 6MV WFF/FFF techniques. We investigated the detector size effect on small-field dosimetry and compared the performance of 6MV WFF/FFF techniques. PDD, profile curves, and absorbed dose were measured in water under reference conditions with 6MV (WFF/FFF) techniques. We employed Farmer FC65-P, CC13, CC01, and IBA Razor diode, with Versa Lineac. Subsequently, we replicated this assessment for small-fields under 5cmx5cm dimensions. For both 6MV WFF/FFF, significant dose differences (Dmax=1.47cm), were ±4.55%, ±6.7, ±12.75% and ±33.3% for 4cmx4cm, 3cmx3cm, 2cmx2cm, and 1cmx1cm, respectively. The average difference relative to D10 was observed to be ±4.66%, ±5.73%, ±6.58%, and ±8.75% for the previous field sizes. Differences between WFF/FFF are neglected values at all field sizes>2.3%, also, the output of the largest detector FC65-P is lower at 55% in the smallest field size. Variation in the profile doesn't exceed a difference of >5% in flatness between WFF/FFF at depth10cm, across all fields, while symmetry is >1%, but radiation output is considerably lower at 55% for FC65-P chamber in 2cmx2cm, 1cmx1cm compared to the CC01 chamber and Razor diode. Significant differences in 1cmx1cm, where FC65-P chamber exhibits around 49% difference compared to Razor diode with 6MV (WFF/FFF). Conclusions: Significant differences were observed in doses with various detectors. Detector-size influences the dose. WFF/FFF techniques show no major differences in small-fields dosimetry. Utilize some situations the advantage of FFF boasting a higher dose rate, consequently reducing treatment time to half.

Modulated Arc Therapy for hippocampal-avoidance whole brain radiation therapy: planning comparison with intensity modulated Radiation Therapy.

This study aimed to evaluate the modulated arc therapy (mARC) technique as a planning and treatment option for hippocampal sparing whole brain radiotherapy (HS-WBRT) following the Radiation Therapy Oncology Group (RTOG) 0933 dosimetric criteria. Computed tomography (CT) and magnetic resonance imaging (MRI) were selected retrospectively for 15 patients. Two types of plans were created for each patient, namely an intensity-modulated radiation therapy (IMRT) and a mARC plan. IMRT and mARC plans were compared in terms of plan quality indices, absorbed dose to organs at risk (OARs), number of monitor units (MUs), and treatment time. All plans in both techniques were considered clinically acceptable for treatment. However, IMRT plans presented a higher conformity (p = 0.01) as well as a higher homogeneity as compared to mARC plans, but this difference was not statistically significant (p > 0.05). In terms of the preservation of the hippocampus, it was observed that the IMRT plans achieved significantly lower doses for both 100% of its volume and for its maximum dose (p < 0.001). The evaluation of the remaining OARs showed that the IMRT technique resulted in lower doses, and significant differences were observed for the following organs: left cochlea (p < 0.001), left eye (p < 0.001), right eye (p = 0.03), both lenses of the eye (p < 0.001), and right optic nerve (p = 0.02). Despite these differences, the absolute differences in all dosimetric parameters were low enough to bear any clinical relevance. A drastic (close to 65%) and significant (p < 0.001) decrease was observed in the number of MUs for the mARC plans. This resulted in a substantial decrease in treatment time (60.45%, p < 0.001). It is concluded that the mARC technique is a feasible planning and treatment solution for HS-WBRT that meets the RTOG 0933 criteria. The main advantage of using mARC over IMRT for HS-WBRT is the considerable reduction in MUs and treatment time.

Dynamic Magnetic Field Analysis and Delivery Strategy Optimization for Scanning Magnet in Proton Therapy System

In pencil beam scanning proton therapy, the regulation and stabilization of the scanning magnetic field between two spots should be completed as quickly as possible in order to reduce treatment time. Because of the eddy current effect, the dynamic magnetic field lags behind the excitation current. It is significant to analyze the dynamic field and reduce the field stability time to minimize the delivery time and improve the therapy efficiency. In this paper, dynamic magnetic field simulation is carried out with a full lamination model of the scanning magnet in the Huazhong University of Science and Technology Proton Therapy Facility. In addition, a single lamination model instead of a full lamination model is explored to reduce time cost and memory for lamination of no more than 1-mm thickness. The eddy current diffusion trend and the influence of lamination on the eddy current are investigated. Moreover, the effect of lamination thickness (ranging from 5 to 0.1 mm) and current ramp rate (ranging from 20 to 100 A/ms) on the magnetic field stability time is studied. In addition, the characteristic of magnetic stability time for various spot steps is analyzed. Considering two spot patterns with discrete or clustered spots, an optimized delivery strategy with various scanning dead times according to the step is presented. When the lamination is 1 mm, the scanning time can be reduced by 39.2% for a clustered pattern and 38.4% for a discrete pattern using a genetic algorithm based on the different scanning dead-time strategy instead of the fixed dead-time strategy. With a thinner 0.1-mm lamination, the scanning time can be reduced by 49.8% for the clustered pattern and 43.3% for the discrete pattern, compared to that of the 1-mm lamination.

Перспектива фотодинамической терапии в лечении гипертрофической формы онихомикоза

Onychomycosis is an infectious disease of the nail apparatus caused by pathogenic fungi (dermatophytes, non-dermatophytes and yeasts), clinically manifested most often by onycholysis of the nail plate, its thickening and subungual hyperkeratosis with significant physical, aesthetic and psychosocial consequences. When the prescription of systemic antimycotics is impossible or undesirable, the dermatovenerologist comes to the aid of hardware methods of influencing the affected tissue. Photodynamic therapy (PDT) is a worthy, non-invasive, safe method that will significantly reduce treatment time and reduce the number of relapses. However, it is advisable to use PDT only as part of a therapeutic complex.

Impact of flattening filter-free beams on remaining volume at risk in lung cancer treatment.

Modern radiotherapy machines offer a new modality, like flattening filter-free beam (FFF), which is used especially in stereotactic body radiation therapy (SBRT) to reduce treatment time. The remaining volume at risk (RVR) is known as undefined normal tissue, and assists in evaluating late effects such as carcinogenesis. This study aimed to compare the effects of flattening and un-flattened beams on RVR in lung cancer treated by conventional doses using volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT). Twenty-three lung cancer patients with a prescribed dose of 60Gy delivered in 30 fractions were selected retrospectively. Four treatment plans were generated for each case (VMAT FF, VMAT FFF, IMRT FF and IMRT FFF). Mean doses to RVR and volumes that received low doses (V15Gy, V10Gy and V5Gy) were introduced as RVR evaluation parameters. Variance percentage comparison between flattening filter (FF) and FFF for the RVR evaluation parameters gave 2.38, 1.10, 1.80 and 2.22 for VMAT, and 1.73, 1.18, 1.62 and 1.81 for IMRT. In contrast, VMAT and IMRT RVR evaluation parameters resulted in variance percentage differences of 10.29, 5.02, -8.84 and -4.82 for FF, and 11.18, 4.96, -8.59 and -4.48for FFF. It is concluded that in terms of RVR evaluation parameters, FFF is clinically beneficial compared to FF for RVR, due to the decrease in mean RVR dose and low-dose irradiated RVR volume. Furthermore, VMAT is preferred in the mean RVR dose and V15Gy, while IMRT is better in V10Gy and V5Gy for RVR.

Efficacy and safety of electrophysical agents in tibial lengthening by the Ilizarov method: a protocol of systematic review

Introduction: The Ilizarov method, a circular external fixator, is the most commonly used approach to assist in bone union for tibial fractures. Electrophysical agents play a crucial role in rehabilitation, offering significant benefits in speeding up the recovery process and reducing treatment time. Objective: To evaluate the efficacy and safety of using electrophysical agents as adjunct treatment in the rehabilitation of tibial lengthening with the Ilizarov method. Methods: A systematic review of randomized clinical trials (RCTs) will be conducted. The review protocol has been registered on the PROSPERO platform (CRD42023432698). Adults aged 18 years and older undergoing tibial lengthening using the Ilizarov method will be included. Searches will be performed in the following databases: Medical Literature Analysis and Retrieval System Online (Medline) via PubMed, Brazil Scientific Eletrononic Library Online (SciElo), Latin American and Caribbean Health Sciences Literature (LILACS) via Virtual Health Library, Physiotherapy Evidence Database (PEDro), Web Of Science, Sciverse Scopus and Excerpta Medica dataBASE (Embase) via Elsevier, with no language or publication year restrictions. The methodological rigor and certainty of evidence of the included studies will be assessed using the Risk of Bias tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, respectively. Study selection, data extraction, and methodological quality assessment will be conducted by two independent researchers. Expected outcomes: To provide robust information on how rehabilitation through electrophysical agents can impact bone lengthening using the Ilizarov method. Keywords: Ilizarov Technique; Rehabilitation; Systematic Review.

Innovating Prosthodontic Rehabilitation: A Streamlined Two-Step Technique for Mobile Denture Fabrication

This manuscript introduces a novel two-step technique for fabricating mobile dentures post-extraction to streamline prosthodontic rehabilitation. The study utilizes various materials, including dental polymers, metals, ceramics, and composite materials, each chosen for their unique properties that contribute to the final prosthesis’s functionality, durability, and esthetics. The detailed procedure involves an initial occlusal registration immediately following tooth extraction, capturing precise occlusal relationships and a comprehensive dental impression. This approach reduces clinical visits and leverages optimal alveolar ridge morphology. The expected results highlight the efficiency of the technique, reducing treatment time without compromising quality and potentially improving patient satisfaction and prosthodontic outcomes. This innovative method conclusively promises rapid, efficient, and patient-centered dental rehabilitation, emphasizing the need for future research to validate its effectiveness and explore long-term outcomes.

Improving the Efficiency of Single-Isocenter Multiple Metastases Stereotactic Radiosurgery Treatment

PurposeMultiple brain metastases can be treated efficiently with Stereotactic Radio Surgery (SRS) using a Single Isocenter Dynamic Conformal Arc (SIDCA) technique. Currently plans are manually optimized, which may lead to unnecessary table angles and arcs being used. This study aimed to evaluate an automatic 4π-optimization SIDCA algorithm for treatment efficiency and plan quality.Methods and MaterialsAutomatic 4π-optimized SIDCA plans were created and compared to the manually optimized clinical plans for 54 patients who received single-fraction SRS to 2-10 metastases. The number of table angles and arcs were compared with a paired t-test using a Bonferroni-corrected significance level of p<0.05/4=0.0125. The reduction in treatment time was estimated from the difference in the number of table angles and arcs. Plan quality was assessed through the volume-averaged inverse Paddick Conformity Index (CI) and Gradient Index (GI), and the volume of normal brain surrounding each metastasis receiving 12 Gy (local V12 Gy). For a five-patient subset the automatic plans were manually adjusted further. CI and GI were assessed for non-inferiority using a one-sided t-test with the non-inferiority limit equal to the 95% inter-observer reproducibility limit from a separate planning study (corrected significance level p<0.05/(4−1)=0.017).ResultsThe automatic plans significantly improved treatment efficiency with a mean reduction in the number of table angles and arcs of −0.5±0.1 and −1.3±0.2 respectively (± standard error, both p<0.001). Estimated treatment time saving was −2.7±0.5minutes, 14% of the total. The volume-averaged CI and GI were non-inferior to the clinical plans (both p<0.001), although there was a small systematic shift in CI of 0.07±0.01. The resulting difference in local V12 Gy, 0.25±0.04cm3, was not clinically significant. Minor manual adjustment of the automatic plans removed these slight differences whilst preserving the improved treatment efficiency.ConclusionsAutomatic 4π-optimization can generate SIDCA SRS plans with improved treatment efficiency and non-inferior plan quality.