Soft Tissue Movement Research Articles

Soft tissue movements after mandibular reconstruction using the vascularized iliac flap: patterns and predictions.

To investigate soft-to-hard tissue response following mandibular reconstruction and to develop a predictive model for projecting soft tissue movement. In this retrospective study, 18 patients receiving mandibular reconstruction using a vascularized iliac flap were enrolled. Various indicators for characterizing the movement of tissues were considered to identify the effective predictors for projecting soft tissue movements. Face-region-specific linear regression models for prediction were constructed and evaluated. The arithmetic mean of hard tissue movement in an extended area had the strongest correlation with the movement of the focal soft tissue, while the arithmetic mean in a regional area (Ram) was a more effective predictor. The linear regression model using Ram, global extrema and distances between them as the predictors performed the best in the lower margin of the face, with an average error of 1.51 ± 1.38mm. Soft tissue movement in the alveolar process was not correlated with the existence of dentition, only can be predicted by the soft tissue movement below it. The area of the masseter was strongly correlation with Ram, but no other factors. An accurate prediction of soft tissue movements in the lower margin and the alveolar process of the face can be achieved by considering hard tissue and adjacent soft tissue movements. No effective predictor in the masseter area was identified. We investigated the relationship between hard tissue movements and the soft tissue responses in the facial area. Through building predictive models for projecting postoperative soft tissue movements, we derive insights for the aesthetic outcome of face surgeries. This study was registered on the Chinese Clinical Trial Registry (registration number: ChiCTR2100054103).

Frequency of and risk factors associated with local recurrence after spinal stereotactic body radiation therapy without surgery.

This study aimed to identify factors associated with local recurrence after spinal stereotactic body radiation therapy (SBRT), focusing on patient movement during treatment and tumor characteristics. A total of 48 patients who underwent spinal SBRT alone without surgery from August 2017 to October 2022 were evaluated. Logistic regression analysis was conducted to identify factors associated with local recurrence, including patient movement and tumor characteristics such as soft tissue involvement and tumor volume. Patient movement during treatment was measured using cone beam computed tomography before and after irradiation. Among the included cases, 68.7% and 42.6% had soft tissue involvement and movement exceeding 1mm, respectively. The median follow-up duration for local recurrence was 11.6 (range: 0.7-44.9) months, whereas the median duration to local recurrence was 6.3 months. Within 12 months, 29.3% of the patients experienced local recurrence, among whom 43.9% moved ≥ 1mm during treatment, whereas 15.8% did not move. Univariable analysis found that both soft tissue involvement (OR = 10.3, 1.21-87.9; p = 0.033) and patient movement ≥ 1mm (OR = 5.75, 1.45-22.8; p = 0.013) were associated with local recurrence. Multivariable analysis identified patient movement as an independent prognostic factor for local recurrence (OR = 5.15, 1.06-25.0; p = 0.042). Our results suggest that patient movement during spinal SBRT was associated with local recurrence, emphasizing the need for better immobilization techniques and shorter delivery times to improve tumor control.

Predictive modelling of freeway space utilising clinical history, normalised muscle activity, dental occlusion, and mandibular movement analysis

This study aimed to predict dental freeway space by examining the clinical history, habits, occlusal parameters, mandibular hard tissue movement, soft tissue motion, muscle activity, and temporomandibular joint function of 66 participants. Data collection involved video-based facial landmark tracking, mandibular electrognathography, surface electromyography of mandibular range of motion, freeway space, chewing tasks, phonetic expressions, joint vibration analysis, and 3D jaw scans of occlusion. This resulted in a dataset of 121 predictor features, with freeway space as the target variable. Six models were trained on synthetic data ranging from 500 to 25,000 observations, with 65 original observations reserved for testing: Linear Regression, Random Forest, CatBoost Regressor, XGBoost Regressor, Multilayer Perceptron Neural Network (MPNN), and TabNet. Explainable AI indicated that key predictors of freeway space included phonetics, resting temporalis muscle activity, mandibular muscle activity during clenching, body weight, mandibular hard tissue lateral displacements, and dental arch parameters. CatBoost excelled with a test error of 0.65 mm using 5000 synthetic data points, while a refined MPNN achieved the best performance with 25,000 synthetic data points and 121 unique predictors, yielding an absolute error of 0.43 mm on the 65 original observations.

Autonomous Trajectory Planning for Ultrasound-Guided Real-Time Tracking of Suspicious Breast Tumor Targets

Ultrasound image guidance could display the movement of soft tissue in real time, which provides an important basis for the operation path selection of tumor for examinations and interventions such as precise localization and puncture biopsy. However, factors such as tissue deformation, patient motion, and instrument contact pose great challenges for real-time smooth localization tracking of target tissues and maintaining a suitable acoustic window. Not only does it reduce the accuracy of ultrasound examination, but also may prolong the examination time. In this paper, a real-time autonomous ultrasound robot trajectory planning framework is proposed to achieve global scanning of breast tissue and real-time local tracking of suspicious tumor targets. In addition, an ultrasound suspicious tumor target next moment motion attitude and position estimation algorithm and an acceleration-continuous online trajectory generation (ACOTG) algorithm are proposed. Experiments on breast phantom showed that the fluctuation difference of both global scanning and tracking scanning force was less than 5 N <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\pm$</tex-math> </inline-formula> 15%, and ACOTG takes less than 1 microsecond to calculate the next moment state. The position, velocity, and acceleration of the tracking path did not change abruptly when the unknown target changed. The ultrasound image of the suspected tumor target could always be smoothly maintained in a suitable acoustic window, while the errors between the center of the suspected tumor target image and the center of the acoustic window in the horizontal direction and the depth direction were less than <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\pm$</tex-math> </inline-formula> 1 mm and 30 mm <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\pm$</tex-math> </inline-formula> 10%, respectively. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —The motivation of this study was to solve the clinical problem of difficulty in keeping the suspected breast tumor target stably in the center of the field of view under the influence of tissue deformation, patient motion and instrument contact in ultrasound guidance. We proposed the idea of global conventional scanning and local online tracking to achieve the autonomous scanning, detecting and tracking of suspicious tumor targets within the global scope of the breast. ACOTG algorithm is proposed and implemented, which can make the ultrasound image of suspicious tumor target can be displayed stably in the center of the acoustic window. With the help of this system, the accuracy of ultrasound examination can be improved and the time of examination can be reduced. The proposed system can also be applied to ultrasound scanning of other parts of the body.

Crystal organisation and material properties of Chama and Glycymeris myostraca and shells

Movement of bivalve hard and soft tissue requires muscular action. Despite diverse bivalve lifestyles and living environments, the myostracum, a specific hard tissue formed where muscles attach to the shell, appears similar in structure for species of many bivalve orders.We investigated myostracal and non-myostracal, valve, microstructure, texture and material properties of Chamidae and Glycymerididae species with electron-backscatter-diffraction, laser-confocal and backscatter electron imaging and nanoindentation testing. Chamidae and Glycymerididae follow different lifestyles and live in distinct environments. Chamidae are cemented to substrate and live in wave-swept, shallow, waters. Glycymerididae dwell in calm water and burrow into sandy/muddy sediment.We found that myostracal aragonite of all investigated species has a crystal assembly pattern that reflects crystal growth through growth competition. Aragonite is extensively twinned in the myostracum and non-myostracal, valve, layers, not in the calcitic ornamentation. For myostracal aragonite, we found cyclic twinning, for non-myostracal aragonite the twinning was polysynthetic or polycyclic. We show how twinning and crystallographic texture are transmitted between myostracal and non-myostracal, valve, layers. Relative to non-biological aragonite, myostracal and non-myostracal, valve, indentation elastic modulus is reduced by 10–15 % and 15–20 %, respectively; myostracal and valve hardness is increased by 15–20 % and 5–10 %, respectively. Comparing modulus and hardness between aragonitic microstructures, we found that, relative to other microstructures, myostracal modulus is increased by 5 % and myostracal hardness by 15 %. Hence, the myostracal material shows a unique and specific microstructure, texture, modulus, and hardness that might be necessary for muscle attachment to enable the lifestyle-controlled requirements posed onto the organism.

Hard to Soft Tissue Profile Changes in Skeletal Class III Dentofacial Deformities After Maxillary Advancement and Mandibular Setback Orthognathic Surgery

Objective To correlate the sagittal hard tissue movement and soft tissue changes among patients with skeletal class III malocclusion following bimaxillary orthognathic surgery. Material and Methods Fifty-nine subjects with skeletal class III malocclusion treated consecutively with maxillary advancement and mandibular setback were assessed for skeletal and soft tissue linear changes using presurgical (T1) and post-treatment (T2) lateral cephalograms. Pearson’s correlation coefficient test was used to correlate hard and soft tissue parameters. Results The sagittal hard tissue movement and soft tissue changes for all the parameters assessed in maxilla and mandible showed statistically significant correlations. The ratios of changes for the maxillary protrusion [N-A (HP)] to horizontal subnasale (Sn), superior labial sulcus (Sls), and labrale superioris (Ls) were 0.574:1, 0.703:1, and 0.721:1 respectively. The ratio of horizontal labrale inferioris (Li), mentolabial fold (Mlf), and soft tissue (Pg′) to mandibular protrusion [N-B (HP)] were 0.992:1, 0.970:1, and 0.590:1 respectively and to chin protrusion [N-Pg (HP)] were 1.293:1, 1.252:1, and 1.001:1, respectively. The ratios were different for males and females in maxilla and mandible. Conclusion Sagittal hard tissue movement and soft tissue changes are significantly correlated. The soft tissue movement in the mandible were more proportionate compared to the maxilla. The sagittal hard tissue to soft tissues movement ratios were greater in maxilla and lesser at pogonion and mentolabial sulcus in females compared to males. The ratios obtained can be used for predicting postsurgical soft tissue changes.

Optimizing Esthetic Outcomes and Bone Stability: Chin Advancement Through Inverted V Osteotomy.

Traditional horizontal osteotomies for small and short chins often yield suboptimal results due to limited bone advancement, resulting in deep labiomental folds and heightened bone resorption risks. This study investigates the effectiveness of an innovative inverted V-shaped osteotomy technique in enhancing esthetic outcomes for patients with such chin concerns. Thirty-eight patients who underwent inverted V-shaped osteotomy for recessed chins between January 2018 and June 2022 were included. Excluding cases involving simultaneous mandibular contouring surgery, patients were followed up for a median duration of 1.2±0.5 years. Preoperation and postoperation soft tissue pogonion (Pg') and labiomental fold depth (LMF) changes were measured. IBM SPSS (version 27.0) was used for statistical analysis, with significance defined as P <0.05. Patient satisfaction was assessed using a visual analog scale. Successful advancement genioplasty was performed on all patients without any severe complications. The average change in soft tissue pogonion (Pg') measured 6.2 (1.9)mm, and the mean alteration in labiomental depth was 0.42 (0.4)mm. The procedure achieved a bone to soft tissue movement ratio of 1:0.96. Patient satisfaction was notably high, with a mean VAS score of 8.7. An inverted V-shaped osteotomy enables greater bone advancement for small and short chins, leading to improved esthetic outcomes and offering a mechanically advantageous condition for bone segments.

Effect of maxillary distraction osteogenesis and LeFort-1 advancement orthognathic surgery on soft-tissue thickness and anterior soft-tissue to hard-tissue movement ratios among patients with complete unilateral cleft lip and palate

Objectives: The objective of this study was to compare the soft-tissue thickness and anterior soft-tissue to hard-tissue movement ratios in patients with unilateral cleft lip and/or palate (UCLP) following maxillary distraction osteogenesis using rigid external distractor device and maxillary advancement at LeFort I level using lateral cephalograms. Material and Methods: This retrospective study was conducted on 20 patients with UCLP who underwent either LeFort I maxillary advancement or maxillary distraction osteogenesis. Non-syndromic patients with complete UCLP anomalies and skeletal class III patterns due to maxillary hypoplasia were included in the study. The patients with a pre-surgical negative overjet of ≥5 mm were treated by maxillary distraction osteogenesis, while a negative overjet of &lt;5 mm was managed with maxillary advancement orthognathic surgery. The growth completion in all the patients was assessed using the cervical vertebrae maturation index (CS 6) on a lateral cephalogram. The lateral cephalograms taken before surgery at (T0) and after a minimum interval of six months (T1) of surgery were assessed for changes in soft-tissue thickness and hard-tissue to soft-tissue movement ratios among the two groups. Paired t-test was used to compare the mean values obtained within the same group at two different time intervals. Unpaired t-test was used to compare mean values between the Groups 1 and 2. Pearson’s correlation coefficient (r) test was used to assess the associations between the mean changes in hard- and soft-tissue variables. Results: Group 1 showed significantly greater maxillary advancement compared to Group 2 with a mean difference of 5.80 mm at Point A and 7.65 mm at the upper incisal edge. Soft-tissue thickness decreased significantly after advancement in Group 1 at subnasale (P &lt; 0.05), labrale superius, stomion, and labrale inferius (P &lt; 0.01) and at subnasale (P &lt; 0.05), stomion and labrale inferius (P &lt; 0.01) in Group 2. There was a significantly strong correlation between the hard- and soft-tissue movement in sagittal plane in both Group 1 and Group 2. In Groups 1 and 2, a statistical highly significant strong positive correlation was found between vertical change in dU1 to soft-tissue dLs and dStms. In Group 2, a statistical highly significant strong positive correlation was found between vertical change in dA to soft-tissue dC and dStms. Conclusion: The soft-tissue thickness reduced in patients with UCLP after maxillary advancement in both groups. The soft tissue followed the hard tissue in both groups. There was a greater downward movement of the maxillary base and soft-tissue lengthening in Group 1 compared to Group 2.

Thighplasty at the Time of Stage-1 Bone-Anchored Osseointegration Surgery.

For patients with transfemoral amputations and difficulty tolerating conventional socket-based prostheses, osseointegrated (OI) implants have enabled increased prosthetic use, improved patient satisfaction, and shown promising functional outcomes1,2. Although the use of OI implants effectively eliminates the soft-tissue-related challenges that have plagued socket-based prostheses, the presence of a permanent, percutaneous implant imparts a host of new soft-tissue challenges that have yet to be fully defined. In patients undergoing OI surgery who have redundant soft tissue, we perform a thighplasty to globally reduce excess skin and fat, tighten the soft-tissue envelope, and improve the contour of the residual limb. First, the orthopaedic surgical team prepares the residual femur for implantation of the OI device. After the implant is inserted, the residual hamstrings and quadriceps musculature are closed over the end of the femur, and the subcutaneous tissue and skin are closed in a layered fashion. Although the anatomic location and amount of excess soft tissue are patient-dependent, we perform a standard pinch test to determine the amount of soft tissue that can be safely removed for the thighplasty. Once the proposed area of resection is marked, we proceed with longitudinal, sharp dissection down to the level of the muscular fascia. At this point, we use another pinch test to confirm the amount of soft-tissue resection that will allow for adequate resection without undue tension3. Excess subcutaneous fat and skin are carefully removed along the previously marked incisions, typically overlying the medial compartment of the thigh in the setting of patients with transfemoral amputations. The thighplasty incision is closed in a layered fashion over 1 or 2 Jackson-Pratt drains, depending on the amount of resection. Depending on the amount of redundant soft tissue, thighplasty may not be necessary at the time of OI surgery; however, in our experience, excess soft tissue surrounding the transcutaneous aperture can predispose the patient to increased shear forces at the aperture, increased drainage, and increased risk of infection4. Although superficial infectious complications are most common following OI surgery, the need for soft-tissue refashioning and excision is one of the most common reasons for reoperation1,5. Our group has been more aggressive than most in our use of a vertical thighplasty procedure to globally reduce soft-tissue motion in the residual limb to avoid reoperation. Although much of the OI literature has focused on infectious complications, recent studies have demonstrated reoperation rates of 18% to 36% for redundant soft tissue following OI surgery1,5. We believe that thighplasty at the time of OI not only reduces the likelihood of reoperation but may also decrease infectious complications by reducing relative motion and inflammation at the skin-implant interface4,6. The thighplasty procedure is ideally performed as part of the first stage of the OPRA (Osseointegrated Prosthesis for the Rehabilitation of Amputees) procedure to limit the likelihood of problematic ischemia-related complications.We utilize a confirmatory pinch test both before and throughout the thighplasty procedure to ensure adequate resection without undue tension.The thighplasty excision pattern utilizes a long vertical limb designed to decrease the circumferential laxity of the residual limb. Maximal tension is borne on the vertical limb and not on the transverse extensions, as these are prone to scar widening and distortion of surrounding tissues.Closed-suction drainage is utilized liberally to decrease the likelihood of a symptomatic seroma. OI = osseointegratedOPRA = Osseointegrated Prosthesis for the Rehabilitation of AmputeesPVNS = pigmented villonodular synovitisT-GCT = tenosynovial giant-cell tumor.BMI = body mass indexPMH = past medical history.

Predicting Leg Forces and Knee Moments Using Inertial Measurement Units: An In Vitro Study.

We compared the ability of seven machine learning algorithms to use wearable inertial measurement unit (IMU) data to identify the severe knee loading cycles known to induce microdamage associated with anterior cruciate ligament rupture. Sixteen cadaveric knee specimens, dissected free of skin and muscle, were mounted in a rig simulating standardized jump landings. One IMU was located above and the other below the knee, the applied three-dimensional action and reaction loads were measured via six-axis load cells, and the three-dimensional knee kinematics were also recorded by a laboratory motion capture system. Machine learning algorithms were used to predict the knee moments and the tibial and femur vertical forces; 13 knees were utilized for training each model, while three were used for testing its accuracy (i.e., normalized root-mean-square error) and reliability (Bland-Altman limits of agreement). The results showed the models predicted force and knee moment values with acceptable levels of error and, although several models exhibited some form of bias, acceptable reliability. Further research will be needed to determine whether these types of models can be modified to attenuate the inevitable in vivo soft tissue motion artifact associated with highly dynamic activities like jump landings.

SurgT challenge: Benchmark of soft-tissue trackers for robotic surgery

This paper introduces the “SurgT: Surgical Tracking” challenge which was organized in conjunction with the 25th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI 2022). There were two purposes for the creation of this challenge: (1) the establishment of the first standardized benchmark for the research community to assess soft-tissue trackers; and (2) to encourage the development of unsupervised deep learning methods, given the lack of annotated data in surgery. A dataset of 157 stereo endoscopic videos from 20 clinical cases, along with stereo camera calibration parameters, have been provided. Participants were assigned the task of developing algorithms to track the movement of soft tissues, represented by bounding boxes, in stereo endoscopic videos. At the end of the challenge, the developed methods were assessed on a previously hidden test subset. This assessment uses benchmarking metrics that were purposely developed for this challenge, to verify the efficacy of unsupervised deep learning algorithms in tracking soft-tissue. The metric used for ranking the methods was the Expected Average Overlap (EAO) score, which measures the average overlap between a tracker’s and the ground truth bounding boxes. Coming first in the challenge was the deep learning submission by ICVS-2Ai with a superior EAO score of 0.617. This method employs ARFlow to estimate unsupervised dense optical flow from cropped images, using photometric and regularization losses. Second, Jmees with an EAO of 0.583, uses deep learning for surgical tool segmentation on top of a non-deep learning baseline method: CSRT. CSRT by itself scores a similar EAO of 0.563. The results from this challenge show that currently, non-deep learning methods are still competitive. The dataset and benchmarking tool created for this challenge have been made publicly available at https://surgt.grand-challenge.org/. This challenge is expected to contribute to the development of autonomous robotic surgery and other digital surgical technologies.

Motion Decoupling Network for Intra-Operative Motion Estimation Under Occlusion.

In recent intelligent-robot-assisted surgery studies, an urgent issue is how to detect the motion of instruments and soft tissue accurately from intra-operative images. Although optical flow technology from computer vision is a powerful solution to the motion-tracking problem, it has difficulty obtaining the pixel-wise optical flow ground truth of real surgery videos for supervised learning. Thus, unsupervised learning methods are critical. However, current unsupervised methods face the challenge of heavy occlusion in the surgical scene. This paper proposes a novel unsupervised learning framework to estimate the motion from surgical images under occlusion. The framework consists of a Motion Decoupling Network to estimate the tissue and the instrument motion with different constraints. Notably, the network integrates a segmentation subnet that estimates the segmentation map of instruments in an unsupervised manner to obtain the occlusion region and improve the dual motion estimation. Additionally, a hybrid self-supervised strategy with occlusion completion is introduced to recover realistic vision clues. Extensive experiments on two surgical datasets show that the proposed method achieves accurate motion estimation for intra-operative scenes and outperforms other unsupervised methods, with a margin of 15% in accuracy. The average estimation error for tissue is less than 2.2 pixels on average for both surgical datasets.

Clinical Applications of Magnetic Resonance-Guided Radiotherapy: A Narrative Review.

Magnetic resonance-guided radiotherapy (MRgRT) represents a promising new image guidance technology for radiation treatment delivery combining an onboard MRI scanner with radiation delivery technology. By enabling real-time low-field or high-field MRI acquisition, it facilitates improved soft tissue delineation, adaptive treatment, and motion management. Now that MRgRT has been available for nearly a decade, research has shown the technology can be used to effectively shrink treatment margins to either decrease toxicity (in breast, prostate cancer, and pancreatic cancer) or facilitate dose-escalation and improved oncologic outcomes (in pancreatic and liver cancer), as well as enabling indications that require clear soft tissue delineation and gating (lung and cardiac ablation). In doing so, the use of MRgRT has the potential to significantly improve the outcomes and quality of life of the patients it treats. The present narrative review aims to describe the rationale for MRgRT, the current and forthcoming state of technology, existing studies, and future directions for the advancement of MRgRT, including associated challenges.

Three-material decomposition using a dual-layer flat panel detector in the presence of soft tissue motion.

Digital subtraction angiography (DSA) is a widely used technique for the visualization of contrast-enhanced structures. However, temporal subtraction DSA is challenged by misregistration artifacts due to patient motion and incomplete separation of iodine contrast agent from background soft tissue and bone. In this work, we propose an approach that allows three-material decomposition using a dual-layer flat panel detector in the presence of soft tissue motion. We assume the calcium signal (bone) remains stationary in the pre- and post-contrast images but allow soft tissues to move freely (e.g. cardiac motion). The dual-layer pre- and post-injection images form and ensemble of four measurements that permits material decomposition of four bases (pre- and post-injection soft tissue, calcium, and iodine). We apply two different processing techniques: 1) a modified lookup table and; 2) a model-based material estimation. These are compared with previously proposed DSA methods using temporal subtraction and hybrid (dual-energy) subtraction. Investigations were performed using an XCAT thorax phantom simulating a breath-hold. The pre- and post-contrast measurements were simulated at different time points within a cardiac cycle. Both the lookup table and model-based algorithms eliminate motion artifact as a result of soft tissue motion and allow good separation of iodine, bone, and soft tissue. While the lookup table algorithm contains high noise at the simulated dose level, the model-based algorithm produced iodine images that allow the visualization of major vessels around the heart. In contrast, traditional temporal DSA is susceptible to subtraction artifacts and hybrid DSA shows increased noise.

Three-Dimensional Modeling of Heart Soft Tissue Motion

The modeling and simulation of biological tissue is the core part of a virtual surgery system. In this study, the geometric and physical methods related to soft tissue modeling were investigated. Regarding geometric modeling, the problem of repeated inverse calculations of control points in the Bezier method was solved via re-parameterization, which improved the calculation speed. The base surface superposition method based on prior information was proposed to make the deformation model not only have the advantages of the Bezier method but also have the ability to fit local irregular deformation surfaces. Regarding physical modeling, the fitting ability of the particle spring model to the anisotropy of soft tissue was improved by optimizing the topological structure of the particle spring model. Then, the particle spring model had a more extensive nonlinear fitting ability through the dynamic elastic coefficient parameter. Finally, the secondary modeling of the elastic coefficient based on the virtual body spring enabled the model to fit the creep and relaxation characteristics of biological tissue according to the elongation of the virtual body spring.

Three-dimensional evaluation of orofacial movements during articulation in patients with skeletal Class III malocclusion with mandibular asymmetry

ABSTRACT Purpose This study aimed to compare the perioral soft tissue movements in patients with skeletal Class III malocclusion with and without mandibular asymmetry during sound articulation. Materials and Methods Patients with skeletal Class III facial deformity with mandibular asymmetry (asymmetric facial deformity; AFD, n = 21), without mandibular asymmetry (symmetric facial deformity; SFD, n = 27), and control skeletal Class I healthy individuals (n = 24) participated in this study. Perioral soft tissue movements were recorded during the articulation of /apa/, /ipi/, /upu/, /epe/, and /opo/ using a three-dimensional motion capture system. The asymmetry index (AI) of the range of movements of the commissure points on both sides was compared among the three groups by Kruskal–Wallis test and Dunn–Bonferroni test. Additionally, the correlation between the AI and the range of menton (Me) deviation was examined among patients in the SFD or AFD group by Spearman’s correlation test. Results AI on the vertical and sagittal dimensions during the /ipi/ sound articulation in the AFD group was significantly lower than in the other two groups (p < 0.05). In the AFD and SFD groups, AI on the vertical dimension was significantly correlated with Me deviation during /ipi/ sound articulation, as well as on the sagittal dimension during /apa/, /ipi/, /upu/, and /epe/ sound articulation (p < 0.05). Conclusion AFD patients displayed more asymmetric perioral soft tissue movements than SFD patients during bilabial sound production.

CONTEMPORARY OPINIONS ON THE PECULIARITIES OF ORAL MUCOSA WOUNDS HEALING: A LITERATURE REVIEW

The purpose of the study is to update data on the features of oral mucosa (OM) wound healing through a systematic assessment of sources of scientific and medical information. Materials and Methods. An analysis of the data obtained during the information search in the online databases “PubMed”, “SciELO”, “Medscape”, and “Science of Ukraine: access to knowledge” was performed using the key words (tags): “mucous membrane of the oral cavity”, “oral mucosa”, “wounds of the mucous membrane”, “healing”, “regeneration”. Publications in periodical scientific issues, methodological recommendations, and reports were included in the list of sources of information. Results. According to the results of clinical observations, experimental studies on laboratory animals and volunteer patients, it was established that the healing of the OM wounds is qualitatively different from a similar process on the skin. This fact was established for both humans and animal models. Wound healing in the human body is a well-defined typical process aimed at restoring tissues after damage. Unlike the skin, OM wounds heal relatively quickly and with little or no scar tissue. And all this happens against the background of constant movement of soft tissues, stress (tension), mechanical abrasion, and contact with a large number of microorganisms in oral fluid. The leading factors of higher-quality regeneration of OM can be considered a moist wound healing environment, direct contact with the protective and regenerative systems of oral fluid which contains a high concentration of commensal microorganisms with immunomodulatory properties and more than 1000 protective and regulatory factors of saliva. There are distinct differences in the properties of the germ layer cells between the skin and OM and the cytokine profile of wound healing is also significantly different. Most reactions that take place in the main phases of the wound process in the oral cavity are faster and more intense. The processes of accumulation of collagen and elastin fibers, remodeling of the intercellular matrix (amorphous substance) are more qualitative. Conclusions: the data from the literature and the results of a significant number of studies allow us to state that faster wound closure, presence of saliva, faster immune response, increased release of anti-inflammatory cytokines, matrix metalloproteinase-mediated cleavage of chemokines, and remodeling of the extracellular matrix contribute to better wound healing and reduced scar formation on the OM, which, unfortunately, does not relate to the skin.

Pengaruh Penerapan Oral Motor Untuk Anak Speech Delay Usia 2-4 Tahun

Speech is one aspect of child development that starts from birth. By talking, children can communicate to those around them about themselves, about their condition and about what they want to convey. A child is said to be late in speaking if at the age the ability to process vocals and communicate is not in accordance with the age of the development period or is below the average age of the child. The impact that will be very visible and clearly felt is when communicating with the environment and experiencing difficulties in adaptation and socialization. Oro motor is the movement of the mouth (oral). In newborns this ability is carried out reflexively, then through the learning process an automatic and skilled oromotor will be achieved. Oral motor training is the coordination and movement of hard tissue, soft tissue, vascular system, and control of the nerves in the face and mouth areas that form the function of oral motor. Coordination of these structures is essential for speech, chewing and swallowing with a wide variety of food textures. In general, this paper is to review the results of research that identifies oral motor stimulation increasing the function of orofacial muscles in speech delay children. Method; qualitative descriptive with SSR (Single Subject Research) technique. Literature Review: The oral motor stimulation program includes activities to improve tongue literacy, lip control and chewing power. Oral motor stimulation includes active exercises and passive exercises. Results: The oral motor stimulation program can improve the function of orofacial muscles in children such as pronouncing letters, swallowing food and breathing properly. Language and speech disorders are a type of communication disorder which is indicated by a disturbance in the symbolic process. Language and speech disorders can be caused by disorders of the nervous system or abnormalities in organs related to language and speech processes. Oral motor stimulation can improve the functional ability of the muscles in the mouth area. Good oral motor skills will support the child's speech process.

Pengaruh Penerapan Oral Motor Untuk Anak Speech Delay Usia 2-4 Tahun

Speech is one aspect of child development that starts from birth. By talking, children can communicate to those around them about themselves, about their condition and about what they want to convey. A child is said to be late in speaking if at the age the ability to process vocals and communicate is not in accordance with the age of the development period or is below the average age of the child. The impact that will be very visible and clearly felt is when communicating with the environment and experiencing difficulties in adaptation and socialization. Oro motor is the movement of the mouth (oral). In newborns this ability is carried out reflexively, then through the learning process an automatic and skilled oromotor will be achieved. Oral motor training is the coordination and movement of hard tissue, soft tissue, vascular system, and control of the nerves in the face and mouth areas that form the function of oral motor. Coordination of these structures is essential for speech, chewing and swallowing with a wide variety of food textures. In general, this paper is to review the results of research that identifies oral motor stimulation increasing the function of orofacial muscles in speech delay children. Method; qualitative descriptive with SSR (Single Subject Research) technique. Literature Review: The oral motor stimulation program includes activities to improve tongue literacy, lip control and chewing power. Oral motor stimulation includes active exercises and passive exercises. Results: The oral motor stimulation program can improve the function of orofacial muscles in children such as pronouncing letters, swallowing food and breathing properly. Language and speech disorders are a type of communication disorder which is indicated by a disturbance in the symbolic process. Language and speech disorders can be caused by disorders of the nervous system or abnormalities in organs related to language and speech processes. Oral motor stimulation can improve the functional ability of the muscles in the mouth area. Good oral motor skills will support the child's speech process.

In vivo quantification of 3D displacement in sacral soft tissues under compression: Relevance of 2D US-based measurements for pressure ulcer risk assessment

Objective2D Ultrasound (US) imaging has been recently investigated as a more accessible alternative to 3D Magnetic Resonance Imaging (MRI) for the estimation of soft issue motion under external mechanical loading. In the context of pressure ulcer prevention, the aim of this pilot MRI study was to design an experiment to characterize the sacral soft tissue motion under a controlled mechanical loading. Such an experiment targeted the estimation of the discrepancy between tissue motion assessed using a 2D imaging modality (echography) versus tissue motion assessed using a (reference) 3D imaging modality (MRI). MethodsOne healthy male volunteer participated in the study. An MRI-compatible custom-made setup was designed and used to load the top region of the sacrum with a 3D-printed copy of the US transducer. Five MR images were collected, one in the unloaded and four in the different loaded configurations (400–1200 [g]). Then, a 3D displacement field for each loading configuration was extracted based on the results of digital volume correlation. Tissue motion was separated into the X, Y, Z directions of the MRI coordinate system and the ratios between the out-of-plane and in-plane components were assessed for each voxel of the selected region of interest. ResultsRatios between the out-of-plane and in-plane displacement components were higher than 0.6 for more than half of the voxels in the region of interest for all load cases and higher than 1 for at least quarter of the voxels when loads of 400–800 [g] were used. ConclusionThe out-of-ultrasound-plane tissue displacement was not negligible, therefore 2D US imaging should be used with caution for the evaluation of the tissue motion in the sacrum region. The 3D US modality should be further investigated for this application.