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In this study, the imaging performance of electronic portal imaging devices (EPIDs) is evaluated, comparing measurements collected from EPID images captured at 115 cm, with a field size of 15 × 15 cm2, monitor units (MUs) in the range of 2 MU-100 MU and dose rates (DRs) of 200 MU/min, 400 MU/min and 600 MU/min, using a 6 MV LINAC system and the QC-3V image quality phantom. The analysis includes the normalized contrast transfer function (CTFnorm), the noise power spectrum (NPS) and the information capacity (IC), as well as the signal-to-noise frequency response (SNFR), which can be used as a comprehensive quality index. The results of our study are compared with previously published data captured at 100 cm under similar exposure conditions. They show similar CTF curves with different source-to-phantom distances, with the lowest values observed at specific MU and DR combinations. Moreover, NPS graphs are found to decrease with respect to spatial frequency. SNFR values also display a reduction with increasing spatial frequency. In addition, irradiation with the phantom placed closer to the EPID, 115 cm from the LINAC, yields better SNFR and IC performance characteristics, indicating better delineation of the organs closer to the EPID. The testing of EPID performance may potentially benefit from our results, which may lead to improvements in the quality of radiotherapy treatments. [ABSTRACT FROM AUTHOR]

Due to its inherent technical challenges, craniospinal irradiation (CSI) entails crucial considerations regarding plan complexity and robustness. The scope of this work was to establish and validate methods suitable for the evaluation of robustness, as well as for dose verification in CSI with VMAT. Five patients previously treated with CSI were retrospectively selected. For each patient, two technically different treatment plans were generated, based on the conventional (static overlap) and staggered (dynamic overlap) configuration. These techniques served as a benchmark to evaluate the potential of a metric proposed in this work, aimed at quantifying robustness, the Overlap Robustness Index (ORI). Furthermore, they were utilized to assess the suitability of two experimental methods relying on film dosimetry, as well as on Delta4 phantom for identifying sources of uncertainties in CSI applications. In accordance with the positional error simulation performed, the staggered approach yielded a statistically significant superior ORI value compared to the conventional one. Additionally, the strong correlation observed between the positional shift induced dose distribution changes and ORI results (Spearman's r = -0.941, p-value < 0.001) demonstrated the sensitivity of ORI in detecting areas of steep dose gradients within the overlapping regions that could potentially compromise the quality of treatment. Concerning dose verification, analysis in terms of dose profiles revealed a superior dosimetric accuracy for the staggered technique relative to conventional for both film and Delta4 measurements. Film-based gamma index results showed that staggered technique outperformed the conventional for the majority of passing criteria considered, with differences in passing rates up to 8.1%. The two treatment techniques however, exhibited equivalent dose delivery accuracy for the clinically relevant passing criteria when Delta4 was employed, with passing rate differences less than 0.6%. Findings of this study revealed that ORI is suitable for quantifying robustness in CSI with VMAT, while radiochromic films appeared to be the best candidate for CSI dose verification in this work. [ABSTRACT FROM AUTHOR]

To evaluate and compare the efficiency of orthodontic treatment and surgical uprighting of first and second mandibular molars. An electronic literature search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, and Google Scholar, as well as a hand search was conducted by two independent researchers to identify relevant articles up to January 2022. In addition, a manual search was done that included article reference lists, grey literature, and dissertations. The risk of bias of the included prospective and retrospective studies was assessed with the Risk Of Bias Tool In Non-randomized Studies of Interventions (ROBINS-I) assessment tool. A total of six nonrandomized clinical trials (non-RCT) evaluating the efficiency of mandibular molar orthodontic and/or surgical uprighting were included. The quality analysis showed certain defects of the Non-RCTs included and, according to the criteria used, the majority of the articles were judged to be of moderate quality. Based on the evidence, orthodontic and surgical uprighting appear to be effective treatment methods for mandibular molars. Surgical uprighting may be associated with more complications than orthodontic uprighting. However, the existing literature on the subject is limited, heterogeneous, and methodologically limited. Therefore, the outcomes should be interpreted carefully. [ABSTRACT FROM AUTHOR]

Background: The present study aims to define through questionnaires the frequency and the variety of accidental incidents occurring in orthodontic clinical practice among Greek practicing orthodontists. Methods: A questionnaire survey was conducted among orthodontists from the registry of orthodontists in Greece. The questionnaire was divided into two parts. The first part involved three questions relating to the socio-demographic status and the background of the orthodontist, and the second part concerned exclusively the frequency of accidental incidents that have occurred during clinical practice with three possible answers: never, once, more than once. Results: From the 200 initially distributed questionnaires, 124 were finally completed and sent back (response rate: 62%). The results showed that orthodontists with more years of clinical practice had faced more accidental incidents. Among the ingestion incidents caused by foreign objects, the most frequently occurring was the ingestion of elastic separators, followed by the ingestion of elastic ligatures and ingestion of hooks. The most commonly reported traumatic incidents were the trauma-lesion of the mucosa by the orthodontic wire or part of it, followed by trauma-lesion by hooks and wire ligatures. The reported number of incidents with further complications and with patients referred to an emergency room was very low. Conclusions: The results of the present study determined a high frequency of accidental incidents among Greek orthodontists. The longer clinical experience was accompanied by more accidental incidents. Orthodontists, like other health professionals, must learn and continuously update their knowledge regarding the management protocols of medical emergencies. [ABSTRACT FROM AUTHOR]

Simple Summary: Mandibular deficiency is a very common orthodontic problem. Many different types of appliances have been utilized to correct such malocclusions. Most are appliances that alter the function of the mandible resulting in a more forward positioning of the lower jaw. Many researchers state that such an alteration results in a different rate of mandibular growth, due to condyle endochondral ossification, thus correcting the orthodontic anomaly. Their effect though remains controversial. The aim of the present study was to investigate the effect of such functional appliances in the mandible of growing rats by reviewing the existing literature up to March of 2022. Most of them stated that true condylar growth is observed, although there are many limitations due to the nature of such experiments. Skeletal Class II malocclusion is the most common skeletal anomaly in orthodontics. Growth in the body of the deficient mandible is induced by periosteal apposition and endochondral ossification in the condyle. Functional appliances have been used in the correction of Class II malocclusions by inducing mandibular growth. Despite their utilization though, their effect still remains controversial. The aim of the present study is to review the existing literature regarding the effects of mandibular protrusion in mandibular growth of growing rats. A protocol was followed according to the guidelines of the Cohrane Handbook for Systematic Reviews. Databases were searched using a specific algorithm. From the ten studies finally analyzed, we conclude that the use of a functional appliance in growing rats induces cell proliferation and bone formation in their condyles, resulting in mandibular growth. [ABSTRACT FROM AUTHOR]

Mandibular protrusion and its treatment is challenging for the orthodontist. The aim of the present research was to identify macroscopic changes in the mandible, based on three-dimensional Cone Beam Computed Tomography analysis. Seventy-two male Wistar rats were divided into two equal groups, experimental (group A) and control (group B). Each consisted of three equal subgroups of 12 rats (A1, A2, A3, B1, B2, B3). Full-cast orthodontic intraoral devices were attached to the maxillary incisors of the experimental animals, and effected functional posterior mandibular displacement. Throughout the experimental period, all animals were fed with mashed food. Animals were sacrificed at 30 days (A1, B1), 60 days (A2, B2) and 90 days (A3, B3). At the 60th day of the experiment, the orthodontic devices were removed from the remaining experimental subgroup A3. Measurements revealed significant differences in the anteroposterior dimensions between experimental and control subgroups. However, the observed changes in the vertical dimensions, Condylion/Go'–Menton and the Intercondylar distance proved insignificant. Posterior mandibular displacement of the mandible in growing rats affects the morphology of the mandible and culminates in the development of a smaller mandible at a grown age. [ABSTRACT FROM AUTHOR]

Simple Summary: Cell killing and tumor response in cancer patients depends not only on the absorbed radiation dose but also on the dose rate and delivery time. In this study, a biodosimetry assay based on the frequency of dicentrics chromosomes scored in peripheral blood lymphocytes from prostate cancer patients and PC3 human prostate cancer cell line was used to investigate the radiobiological impact of the relative prolonged dose delivery time and/or decreased dose rate met in advanced modulated radiotherapy techniques (VMAT and IMRT) compared to conventional non-modulated (3D-CRT) in prostate patient plan irradiations. The results showed a small but statistically significant decrease in the number of dicentrics following radiation with the modulated techniques, suggesting a corresponding decrease on the radiation dose efficiency. The biodosimetry assay could be used as an alternative to the laborious conventional clonogenic assay, while both lymphocytes and cancer cell line could effectively be used for estimation of the biological absorbed dose. While rapid technological advances in radiotherapy techniques have led to a more precise delivery of radiation dose and to a decreased risk of side effects, there is still a need to evaluate the efficacy of the new techniques estimating the biological dose and to investigate the radiobiological impact of the protracted radiotherapy treatment duration. The aim of this study is to compare, at a cytogenetic level, advanced radiotherapy techniques VMAT and IMRT with the conventional 3D-CRT, using biological dosimetry. A dicentric biodosimetry assay based on the frequency of dicentrics chromosomes scored in peripheral blood lymphocytes from prostate cancer patients and PC3 human prostate cancer cell line was used. For each patient blood sample and each subpopulation of the cultured cell line, three different irradiations were performed using the 3D-CRT, IMRT, and VMAT technique. The absorbed dose was estimated with the biodosimetry method based on the induced dicentric chromosomes. The results showed a statistically significant underestimation of the biological absorbed dose of ~6% for the IMRT and VMAT compared to 3D-CRT irradiations for peripheral blood lymphocytes, whereas IMRT and VMAT results were comparable without a statistically significant difference, although slightly lower values were observed for VMAT compared to IMRT irradiation. Similar results were obtained using the PC3 cell line. The observed biological dose underestimation could be associated with the relative decreased dose rate and increase irradiation time met in modulated techniques compared to the conventional 3D-CRT irradiations. [ABSTRACT FROM AUTHOR]