Concurrent validity and reliability of cephalometric analysis using smartphone apps and computer software

Objectives:To assess the diagnostic accuracy of two smartphone cephalometric analysis apps compared with Viewbox software.Materials and Methods:Pretreatment digital lateral cephalograms of 50 consecutive orthodontic patients (20 males, 30 females; mean age, 19.1 years; SD, 11.7) were traced twice using two apps (ie, CephNinja and OneCeph), with Viewbox used as the gold standard computer software program. Seven angular and two linear measurements, originally derived from Steiner cephalometric analysis, were performed.Results:Regarding validity, intraclass correlation coefficients (ICCs) ranged from .903–.983 and .786–.978 for OneCeph vs Viewbox and CephNinja vs Viewbox, respectively. The ICC values for intratool reliability ranged from .647–.993. None of the CephNinja measurements was below the recommended cutoff values of ICCs for reliability.Conclusions:OneCeph has a high validity compared with Viewbox, while CephNinja is the best alternative to Viewbox regarding reliability. Smartphone apps may have a great potential in supplementing traditional cephalometric analysis.     

Reliability and validity of measurements of facial swelling with a stereophotogrammetry optical three-dimensional scanner

Volume changes in facial morphology can be assessed using the 3dMD DSP400® stereo-optical 3-dimensional scanner, which uses visible light and has a short scanning time. Its reliability and validity have not to our knowledge been investigated for the assessment of facial swelling. Our aim therefore was to assess them for measuring changes in facial contour, in vivo and in vitro. Twenty-four healthy volunteers with and without an artificial swelling of the cheek were scanned, twice in the morning and twice in the afternoon (in vivo measurements). A mannequin head was scanned 4 times with and without various externally applied artificial swellings (in vitro measurements). The changes in facial contour caused by the artificial swelling were measured as the change in volume of the cheek (with and without artificial swelling in place) using 3dMD Vultus® software. In vivo and in vitro reliability expressed in intraclass correlations were 0.89 and 0.99, respectively. In vivo and in vitro repeatability coefficients were 5.9 and 1.3 ml, respectively. The scanner underestimated the volume by 1.2 ml (95% CI -0.9 to 3.4) in vivo and 0.2 ml (95% CI 0.02 to 0.4) in vitro.     

Maxillary implant‐supported overdentures opposed by (partial) natural dentitions: a 5‐year prospective case series study

The aim of this study was to assess the 5‐year treatment outcome of maxillary implant‐retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone was present (n = 25 patients) Implant were placed in the posterior region if implant placement in the anterior region was not possible (n = 25 patients). Variables assessed included survival of implants, condition of hard and soft peri‐implant tissues and patients' satisfaction. The five‐year implant survival rate was 97·0% and 99·3%, and mean radiographic bone loss was 0·23 and 0·69 mm in the anterior and posterior group, respectively. Median scores for plaque, calculus, gingiva, bleeding and mean scores for pocket probing depth were low and stayed low. Patients' satisfaction after treatment was high in both groups. Within the limits of this 5‐year study, it is concluded that six dental implants (placed in the anterior or posterior region) connected with a bar and opposed to natural antagonistic teeth result in acceptable results for clinical parameters and good outcomes for marginal bone level changes and patient satisfaction.     

DEGRANULATION OF RAT SALIVARY GLANDS FOLLOWING TREATMENT WITH RECEPTOR-SELECTIVE AGONISTS

1. The aim of this study was to find a drug that induces an almost complete degranulation of secretory cells in rat parotid and submandibular glands. 2. Phenylephrine (α-adrenergic), isoproterenol (β-adrenergic) and mecholine (muscarinic cholinergic) were tested. Time and degree of maximal depletion of acinar and granular convoluted tubule cells were determined morphologically. 3. Following phenylephrine-injection (5 mg/kg or 10.2 mg/kg, i.p.), no effect on the acinar granulation level was observed in either of the glands, while about 50–60% granular convoluted tubules were degranulated for at least 120–180 min post-injection. 4. With isoproterenol (5, 10, 40, 70 or 100 mg/kg, i.p.), degranulation of 100% of the acinar cells in the parotid and 80% of the acinar cells in the submandibular gland was observed 90 min post-injection. Granular convoluted tubule cells did not respond to this β-adrenergic drug. 5. Mecholine (3.75 or 7.5 mg/kg, i.p.) induced mainly degranulation of granular convoluted tubule cells (about 50% after 120 min). Numbers of granulated acinar cells decreased only slightly in both glands (about 10%, 90–120 min). 6. From this study it appears that with a relatively low dosage (5 mg/kg, i.p.) of isoproterenol, a high level of degranulation can be induced in acinar cells of rat parotid and submandibular glands without toxic side effects. Concerning granular convoluted tubules, only moderate degranulation was observed with phenylephrine and mecholine, respectively.     

Variability of flow rate when collecting stimulated human parotid saliva

The aim of this study was to estimate the accuracy and reproducibility of citric‐acid‐stimulated parotid saliva sampling. In healthy volunteers a strong correlation (r² = 0.79) between flow rates from the left and right parotid gland was observed. In patients with Sjögren's syndrome this correlation (r² = 0.90) was even stronger. The intraindividual variation in healthy volunteers was 23.3 ± 5.9%. Increasing the number of collections did not reduce this variation significantly. In head and neck cancer patients, to estimate whether repeated measurements result in more reliable baseline values for use in clinical studies, repeated collections did not result in a significant reduction of intrapatient variation, similar to the results with the healthy volunteers. Thus, notwithstanding the good agreement between left and right flow rates, a high variation in parotid flow rates has to be considered when planning clinical trials evaluating the effects of treatment on salivary gland functioning.     

A cystic lesion in the mandibular angle

A 27-year-old male patient was referred by his dentist to a department of Oral and Maxillofacial Surgery, because of a radiolucent lesion in the mandibular angle. There were no clinical signs or symptoms. The orthopantomogram showed a sharp, demarcated, oval (1.5 x 2.5 cm), unilocular radiolucency caudal of the mandibular canal. Additional radiographic evaluation (CT scan, sialogram) revealed an oval depression in the lingual cortex of the mandible filled with salivary gland tissue. The diagnosis Stafne defect was made. At radiographic follow-up after 1 year, no progression of the lesion was seen. Treatment is not needed.     

Research methods in dentistry 2. Methods for determining the flow rate of saliva

For patients with complaints of either hyposalivation or hypersalivation, or saliva with altered properties, the secretory flow rate can be determined in an easy way to study whether abnormalities are detectable. It is most simple to measure the flow rate of whole saliva. After collection of saliva the oral fluid can be analyzed on rheological properties, such as viscosity and elasticity and also on pH and its chemical composition. Oral fluid is the combined fluid in the oral cavity mainly composed of glandular salivas, and in addition crevicular fluid and serum exsudate. For collection of oral fluid it is of crucial importance to standardize the conditions. The diverse collection methods and their application for patient research with oral complaints are described.     

Reconstructive preprosthetic surgery 2. Pre-implantologic surgery

Reconstructive preprosthetic surgery is, amongst others, aimed at the creation of an environment which is favourable to the construction of an implant supported prosthesis. Not in all cases the pre-existent volume of bone is sufficient to place an implant in the planned position. In this paper various techniques to augment local bone defects for reliable implant placement are described.     

Dentoalveolar traumatology

The dentist will be confronted unexpectedly with a dentoalveolar trauma patient. This patient has to be seen immediately and has to be treated adequately. The risk of overlooking trauma-related signs when examining these patients, can be minimized by following a strict protocol. This article describes a protocol for examination and treatment of a patient with a dentoalveolar trauma. The prognosis after treatment of the trauma is discussed. Also some recommendations regarding aftercare and prevention are presented.     

Mandibulotomy and implant insertion

BACKGROUND: A mandibulotomy can be necessary to approach a tumor in the oral cavity or oropharynx. The aim of this study was to develop and prospectively evaluate a technique enabling simultaneous performance of a mandibulotomy and insertion of endosseous implants in the same area. METHODS: In five edentulous patients such a procedure was performed. The pilot drilling of the implants was done before performing the mandibulotomy. After tumor resection, reconstruction, and restoration of the continuity of the mandible, the final drilling and insertion of the implants were completed. In total, 20 implants were inserted. All patients received radiation therapy within 6 weeks after surgery. Implant-supported overdentures were fabricated 6 months after irradiation. At regular time intervals, a standardized clinical and radiographic evaluation was performed. RESULTS: No complications with respect to the combination of implant insertion and mandibulotomy were observed either during or after surgery. In addition, no adverse mucosal reactions were observed during the course of radiotherapy, no cases of osteoradionecrosis developed, and no implants were lost. Clinical and radiographic evaluation revealed healthy peri-implant parameters. CONCLUSION: From this study it is concluded that, when following the technique described, a mandibulotomy can be combined safely with the insertion of implants in the ventral part of the edentulous mandible.