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To explore the mandibular retromolar space length (MRSL), initial root‐inner cortex contact percentage (IRCCP), and the various factors that influence mandibular molar distalization. Searches were undertaken in PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, and grey literature (Google Scholar and OpenGrey) for eligible cross‐sectional observational studies measuring the MRSL and IRCCP in healthy adult patients. The risk of bias and evidence quality were evaluated using the Joanna Briggs Institute's checklist and GRADE framework. Thirteen studies involving 1169 patients were included for qualitative synthesis. Seven of these studies were eligible for quantitative analysis. Meta‐analysis showed that the mean MRSL at the subfurcation‐6 mm plane in Asian normodivergent cases was 3.78 mm (95% confidence interval [CI]: 2.81–4.35; I2 = 79.7%) for skeletal Class‐I malocclusions, 3.02 mm (95% CI: 2.10–3.94; I2 = 62.5%) for Class‐II, and 4.43 mm (95% CI: 3.14–5.73; I2 = 75.1%) for Class‐III. The mean MRSL at the sub‐cementoenamel junction (CEJ)‐10 mm plane for Asian, Class‐I, normodivergent cases was 3.28 mm (95% CI: 2.44–4.12; I2 = 68.9%). The mean IRCCP for Asian, Class‐I, normodivergent cases was 27.2% (95% CI: 0.22–0.32; I2 = 0%). In Asian normodivergent cases, MRSL ranges from 3.28 to 4.43 mm with a 27.2% IRCCP for Class‐I. Cone‐beam computed tomography imaging is recommended for measuring the MRSL in the apex region particularly before molar distalization. Factors influencing MRSL and IRCCP include different races, skeletal patterns, facial types, and third‐molar status. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the relative growth rates (RGRs) of the maxilla and mandible at varying fusion stages of the spheno‐occipital synchondrosis (SOS), thereby elucidating the potential of SOS stages in predicting maxillomandibular growth. Materials and Methods: A total of 320 subjects (171 boys and 149 girls), aged 6 to 18 years, were retrospectively included. Each subject had a minimum of two longitudinal cone‐beam computed tomography (CBCT) images, with no more than one interval of SOS fusion stage change between the two scans. Subjects were categorized based on their SOS fusion stages and genders. The RGRs of the maxilla and mandible at various SOS fusion stages were measured and compared using longitudinal CBCT images. Results: Significant statistical differences were observed in maxillomandibular RGRs across various SOS fusion stages. In girls, the sagittal growth of the maxilla remained stable and active until SOS 3, subsequently exhibited deceleration in SOS 4–5 (compared to SOS 3–4, P <.05) and continued to decrease in SOS 5–6. Whereas in boys, the sagittal growth of the maxilla remained stable until SOS 4, and a deceleration trend emerged starting from SOS 5 to 6 (P <.01 compared to SOS 4–5). Mandibular growth patterns in both genders exhibited a progression of increasing‐accelerating‐decelerating rates from SOS 2 to 6. The highest RGRs for total mandibular length were observed in SOS 3–4 and SOS 4–5. Conclusion: Spheno‐occipital synchondrosis fusion stages can serve as a valid indicator of maxillomandibular growth maturation. [ABSTRACT FROM AUTHOR]

Controlling root movement is one of the greatest challenges in orthodontic treatment with aligners, like Invisalign® aligners. Cone Beam Computed Tomography (CBCT) integration into ClinCheck®, enabling bone and root visualisation, allows a more accurate follow-up of the teeth position. This study aims to compare torque measurements of the upper central incisors with and without CBCT and relate them to the upper incisor inclination and facial biotype. In a sample of 70 teeth, torque measurements were obtained by importing images into AutoCAD® software (version 2024). The angle between the tooth's long axis with CBCT duplicate and the tooth's long axis without CBCT was obtained to assess the difference. Statistically significant differences between torque measurements with and without CBCT were found, as well as between these measurements and the inclination of the upper incisors. No statistically significant differences were found among the facial biotypes. The average values of 27.8° ± 3.4° and 21.5° ± 3.2° were obtained for the angle between the axes. Torque without CBCT was lower than torque with CBCT, for the same tooth. The angle between the axes had a similar mean for both teeth. CBCT integration into ClinCheck® allows for a more correct torque measurement. [ABSTRACT FROM AUTHOR]

Objective: The primary goal of this investigation was to ascertain the efficacy of the CALM® motion artifact reduction algorithm in diminishing motion-induced blurriness in Cone Beam Computed Tomography [CBCT] images. The assessment was conducted through Fractal Dimension [FD] analysis of the trabecular bone. Methods and Materials: A desiccated human mandible was subjected to Planmeca ProMax 3D® scanning under eight distinct protocols, marked by variations in motion presence [at 5, 10, and 15 degrees] and the deployment of CALM®. In every scan, five distinct regions of interest [ROIs] were designated for FD analysis, meticulously avoiding tooth roots or cortical bone. The FD was computed employing the box-counting method with Image-J 1.53 software. Results: Our findings reveal that a 5-degree motion does not significantly disrupt FD analysis, while a 10-degree motion and beyond exhibit statistical differences and volatility among the sites and groups. A decreased FD value, signifying a less intricate or "rough" bone structure, correlated with amplified motion blurriness. The utilization of CALM® software seemed to counteract this effect in some instances, reconciling FD values to those akin to the control groups. Nonetheless, CALM®'s efficacy differed across sites and motion degrees. Interestingly, at one site, CALM® application in the absence of motion resulted in FD values considerably higher than all other groups. Conclusion: The study indicates that motion, particularly at 10 degrees or more, can considerably impact the FD analysis of trabecular bone in CBCT images. In some situations, the CALM® motion artifact reduction algorithm can alleviate this impact, though its effectiveness fluctuates depending on the site and degree of motion. This underscores the necessity of factoring in motion and the employment of artifact reduction algorithms during the interpretation of FD analysis outcomes in CBCT imaging. More research is necessary to refine the application of such algorithms and to comprehend their influence on different sites under varying motion degrees. [ABSTRACT FROM AUTHOR]

Objective. This study examined the potential use of computed tomography panoramic mandibular indices on cone beam CT (CBCT) for assessing bone density in postmenopausal women with low bone mass. Study design. The study enrolled 104 postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) using a DXA scanner and mental foramen region CBCT alongside the NewTom VGi EVO Cone Beam 3D system. We assessed the relationship between the following DXA parameters: lumbar, femoral neck, and total hip T score, bone mineral density (BMD), and lumbar trabecular bone score (TBS). The following panoramic mandibular indices were also considered: the computed tomography mandibular index superior (CTI(S)), computed tomography mandibular index inferior (CTI(I)), and computed tomography mental index (CTMI). Results. The study revealed moderate correlations between CBCT indices and BMD/TBS scores: CTMI showed the highest correlation with the femoral neck T-score (r = 0.551, p < 0.0001). TBS scores were also moderately correlated with CBCT indices: CTMI showed a moderate positive correlation with TBS (r = 0.431, p < 0.0001); CTI(S) had a similar moderate positive correlation with TBS (r = 0.421, p < 0.0001). AUC values ranged from 0.697 to 0.733 for osteoporosis versus the osteopenia/normal group and from 0.734 to 0.744 for low versus normal bone quality groups, p < 0.0001. The comparison of the values of the studied indices between low versus normal bone quality (quantified with TBS) groups showed high sensitivity but low specificity. Conclusions. CBCT-measured indices CTI(S), CTI(I), and CTMI are useful in assessing patients with low bone mass to improve, by specific treatment, the prognosis of dental implants. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the relationship between osteoarthritic bony alterations in the temporomandibular joint (TMJ) and general bone mineral density (BMD) in postmenopausal edentulous females. Cone beam computed tomography (CBCT) scans for both TMJs were acquired for 80 clinically asymptomatic patients (mean age 72 ± 8.8 y). Both lumbar spine and femoral neck measurements of BMD were performed using dual-energy X-ray absorptiometry (DXA). The most frequently observed bony alterations were flattening of the articular surface (47.5%), sclerosis (41.5%), subcortical cysts (10%), and erosions (5%). Osteophytes were not observed. No statistical differences were observed between those who had or did not have radiological signs of bony alterations according to age or DXA scores. The prevalence of radiological findings of degenerative TMJ bony alterations in clinically asymptomatic postmenopausal females did not confirm a connection with a generally low BMD. [ABSTRACT FROM AUTHOR]

Teaching root canal anatomy has traditionally been reliant on static methods, but recent studies have explored the potential of advanced technologies like augmented reality (AR) to enhance learning and address the limitations of traditional training methods, such as the requirement for spatial imagination and the inability to simulate clinical scenarios fully. This study evaluated the potential of AR as a tool for teaching root canal anatomy in preclinical training in endodontics for predoctoral dental students. Six cone beam computed tomography (CBCT) images of teeth were selected. Board-certified endodontist and radiologist recorded the tooth type and classification of root canals. Then, STereoLithography (STL) files of the same images were imported into a virtual reality (VR) application and viewed through a VR head-mounted display. Forty-three third-year dental students were asked questions about root canal anatomy based on the CBCT images, and then, after the AR model. The time to respond to each question and feedback was recorded. Student responses were paired, and the difference between CBCT and AR scores was examined using a paired-sample t-test and set to p = 0.05. Students demonstrated a significant improvement in their ability to answer questions about root canal anatomy after utilizing the AR model (p < 0.05). Female participants demonstrated significantly higher AR scores compared to male participants. However, gender did not significantly influence overall test scores. Furthermore, students required significantly less time to answer questions after using the AR model (M = 4.09, SD = 3.55) compared to the CBCT method (M = 15.21, SD = 8.01) (p < 0.05). This indicates that AR may improve learning efficiency alongside comprehension. In a positive feedback survey, 93% of students reported that the AR simulation led to a better understanding of root canal anatomy than traditional CBCT interpretation. While this study highlights the potential of AR in learning root canal anatomy, further research is needed to explore its long-term impact and efficacy in clinical settings. [ABSTRACT FROM AUTHOR]

Featured Application: Systematic assessment of diagnostic imaging records should be applied to eliminate the risk of overlooking clinically significant incidental findings and facilitate successful interdisciplinary treatment planning (especially in cleft lip and/or palate cases). Incidental findings (IFs) depicted in imaging tests during the diagnostic evaluation of patients with cleft lip and/or palate (CL/P) can guide clinicians during treatment planning procedures for effective, comprehensive cleft care. Evidence regarding IFs in different anatomical regions distant from the dentition is scarce. The aim of this study was to compare the prevalence of IFs in various anatomical areas between patients with non-syndromic CL/P and unaffected subjects. Orthopantomographs (OPTs), lateral cephalometric (LC) radiographs, and cone beam computed tomography (CBCT) scans of 120 subjects (case group: n = 40, 18 females, age 14.5 ± 5.0 years; control group: n = 80, 36 females, age 14.6 ± 4.9 years) were examined, and IFs were assessed by four observers. A significantly higher prevalence of IFs (p < 0.001) was reported in the case group (97.5%) compared with the control group (62.5%). The most prevalent location of IFs in the case group was the maxilla (92.5%), followed by the nasal cavity (75.8%) and the mandible (63.2%), while in the control group, the highest rates of IFs occurred in the maxilla (43.8%), mandible (41.3%), and temporomandibular joint (TMJ) (14.7%). No gender-dependent pattern for IF occurrence was detected overall. Orofacial clefts may affect the mandible. However, the reported IFs were limited compared to those in the maxilla. In conclusion, individuals with CL/P are more likely to present with a range of IFs than their unaffected peers. Understanding the association between CL/P and IFs is critical for successful interdisciplinary treatment, raising awareness of the potential need for future dental care for cleft patients, and managing extra-dental aberrations. A systematic assessment of diagnostic records is required to eliminate the risk of overlooking clinically significant IFs. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the retreatment efficacy of premixed bioceramic sealer using a reciprocating system, comparing single-cone and carrier-based obturation techniques. Materials and Methods: Twenty-three monoradicular teeth with oval canals were divided into two groups: NeoSealer Flo with single cone (SC) and NeoSealer Flo with Guttafusion (GF). Retreatment was performed using Reciproc Blue (RB) with a crown-down technique. X-ray and CBCT images were taken to measure the remnant areas and volumes. Results: Apical patency was achieved in all the samples. The remnants were mostly distributed in the middle third in the GF group, while an equal distribution in both the middle and apical thirds was observed in the SC group. The GF group had a lower remnant area and volume after RB 50.05, respectively (0.18 ± 0.33 mm2 vs. 0.39 ± 0.80 mm2 and 0.36 ± 0.59 mm3 vs. 0.51 ± 1.16 mm3). The use of RB 50.05 led to an additional reduction in the remnant areas in the SC (14.89%) and GF (69.49%) groups, while in terms of the volume, the reductions were 20.63% and 36.36%. Conclusions: Reciprocating instruments are effective in removing remnants from root canals filled with both single-cone and carrier-based techniques. The blooming effect in CBCT imaging suggests further in vivo studies for validation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Sciences / Sağlık Bilimleri Dergisi is the property of Erciyes Universitesi Saglik Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this report is to demonstrate the guided tooth autotransplantation of a palatally impacted maxillary canine into the site of a failed maxillary canine dental implant. A 47‐year‐old woman visited a dental clinic complaining of loose dental implant in the left maxillary canine site, tooth #11, as well as pain and swelling of the gum around the implant. The clinical examination revealed a mobile implant along with swollen soft tissues with bleeding on probing. A periapical radiograph demonstrated peri‐implant marginal bone loss. Cone beam computed tomography sections revealed that tooth #11 was impacted palatally. The implant was removed and replaced with the impacted canine via guided autotransplantation and posterior orthodontic alignment. The patient was recalled at 1, 3, 6, 9, 12, 24 and 48 months after the procedure. During this period, the patient was symptom‐free and radiographic examination at 2 years revealed no periapical pathosis or root resorption. [ABSTRACT FROM AUTHOR]

This report presents the detection, characterisation, instrumentation and filling of complex canal configurations in the mesiobuccal (MB) root of maxillary first molars. Three patients were referred for root canal treatment in first maxillary molars. Medical history, age, sex and clinical findings were recorded. Intraoral periapical radiographs and cone beam computed tomography (CBCT) were used for diagnosis and pre‐operative assessment. Using Ahmed et al. (2017) classification system, codes 3MaxM MB3‐5‐4‐2 DB1‐2‐1 P1 (case 1), 3MaxM MB2‐5‐3‐2 DB1 P1 (case 2) and 3MaxM MB1‐4‐2‐1‐2 DB1 P1 (case 3) were identified. Using the dental operating microscope, CBCT (if indicated) and troughing up to 3 mm allowed identification of more than three canals in the MB root of maxillary first molars. The coding system proposed by Ahmed et al. (2017) allows the classification of MB roots with highly complex canal configurations. [ABSTRACT FROM AUTHOR]

In the case of any pathologies arising in the hard palate, it is always important to exclude their possible odontogenic origins. Cone-beam computed tomography is mandatory. In cases where a possible non-teeth-related pathology is confirmed, each clinician should remember possible differential diagnostics. Many small salivary glands between the mucosa and bone are present in this palatal area. Both benign and malignant tumors arising from the small glands, and mucosa of the hard palate, might occur. The case presented here mimics a solid tumor because of the nodule consistency. Because of a healthy palatal mucosa without any erosions or irritations with firm attachment to the submucosal nodule, a possible malignant tumor of small salivary gland origins was suspected in this case. When the tumor diameter is small, an excisional biopsy is required to collect good and representative material for further histopathological evaluation. In most cases, bulky nodules present on the palate are hard on palpation, non-movable, and covered with healthy mucosa. Possible bone infiltrations with mucous membrane ulcerations could manifest a more expansive character of the lesion. In the presented case, an unusual occurrence of a traumatic neuroma without any past traumatic etiology of the palate was first differentiated from the occurrence of adenoid-cystic carcinoma (ACC), pleomorphic adenoma, other benign/malignant small gland tumors, or atypical, fibroma/schwannoma of the palate. This paper presents treatment options for this rare oral neural tumor occurrence in the palate and differential diagnosis between hard palate tumors in a 42-year-old male patient, furthermore highlighting the role of an excisional biopsy as a good source for a tissue sample. [ABSTRACT FROM AUTHOR]

PURPOSE. This cone-beam computed tomography (CBCT) study aimed to analyze the anatomical characteristics of alveolar bone at mandibular first molar (MFM) and their implications for immediate implant placement surgery. MATERIALS AND METHODS. 100 patients with 140 MFMs were reviewed retrospectively. We first performed a 3D reconstruction of the patient's CBCT data to determine a reference plane with ideal implant placement and orientation. The following parameters of MFM region were analyzed: mesial-distal socket size (MDSS), buccal-lingual socket size (BL-SS), root furcation fornix to inferior alveolar nerve (IAN) distance (RF-I), interradicular bone thickness (IRB), mesial/distal root apex to the IAN distance (MRA-I/DRA-I), thickness of the buccal/lingual bone of the mesial root (MR-B/MR-L), thickness of the buccal/lingual bone of the distal root (DR-B/DR-L). RESULTS. The MD-SS of MFM was 8.74 ± 0.76 mm, and the BLSS was 8.26 ± 0.72 mm. The MR-B, DR-B was 1.01 ± 0.40 mm and 1.14 ± 0.50 mm, and the difference was statistically significant ( P = .001). The values of the MR-L, DR-L were 2.71 ± 0.78 mm and 3.09 ± 0.73 mm, and the difference was also statistically significant ( P < .001). The mean distance of RF-I was 15.68 ± 2.13 mm, and the MRA-I was 7.06 ± 2.22 mm, which was greater than that of DRA-I (6.48 ± 2.30 mm, P < .001). The IRB at 2 mm, 4 mm apical from the furcation fornix, and at apex level was 2.81 ± 0.50 mm, 3.30 ± 0.62 mm, and 4.44 ± 1.02 mm, respectively. CONCLUSION. There is relatively sufficient bone mass in interradicular bone in height, but an adequate width is lacking for the bone between the mesial and distal root after the extraction of the MFM for immediate implantation. The thickness of the MFM buccal bone is relative thin, especially for the mesial root. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate the intra‐fractional tumor motion in lung stereotactic body radiotherapy (SBRT) with deep inspiration breath‐hold (DIBH), and to investigate the adequacy of the current planning target volume (PTV) margins. Methods: Twenty‐eight lung SBRT patients with DIBH were selected in this study. Among the lesions, twenty‐three were at right or left lower lobe, two at right middle lobe, and three at right or left upper lobe. Post‐treatment gated cone‐beam computed tomography (CBCT) was acquired to quantify the intra‐fractional tumor shift at each treatment. These obtained shifts were then used to calculate the required PTV margin, which was compared with the current applied margin of 5 mm margin in anterior‐posterior (AP) and right‐left (RL) directions and 8 mm in superior‐inferior (SI) direction. The beam delivery time was prolonged with DIBH. The actual beam delivery time with DIBH (Tbeam_DIBH) was compared with the beam delivery time without DIBH (Tbeam_wo_DIBH) for the corresponding SBRT plan. Results: A total of 113 treatments were analyzed. At six treatments (5.3%), the shifts exceeded the tolerance defined by the current PTV margin. The average shifts were 0.0 ± 1.9 mm, 0.1±1.5 mm, and ‐0.5 ± 3.7 mm in AP, RL, and SI directions, respectively. The required PTV margins were determined to be 4.5, 3.9, and 7.4 mm in AP, RL, and SI directions, respectively. The average Tbeam_wo_DIBH and Tbeam_DIBH were 2.4 ± 0.4 min and 3.6 ± 1.5 min, respectively. The average treatment slot for lung SBRT with DIBH was 25.3 ± 7.9 min. Conclusion: Intra‐fractional tumor motion is the predominant source of treatment uncertainties in CBCT‐guided lung SBRT with DIBH. The required PTV margin should be determined based on data specific to each institute, considering different techniques and populations. Our data indicate that our current applied PTV margin is adequate, and it is possible to reduce further in the RL direction. The time increase of Tbeam_DIBH, relative to the treatment slot, is not clinically significant. [ABSTRACT FROM AUTHOR]

Background: Surface‐guided radiotherapy (SGRT) is adopted by several institutions; however, reports on the phantoms used to assess the precision of the SGRT setup are limited. Purpose: The purpose of this study was to develop a phantom to verify the accuracy of the irradiation position during skin mark‐less SGRT. Methods: An acrylonitrile butadiene styrene (ABS) plastic cube phantom with a diameter of 150 mm on each side containing a dummy target of 15 mm and two types of body surface‐shaped phantoms (breast/face shape) that could be attached to the cube phantom were fabricated. Films can be inserted on four sides of the cubic phantom (left, right, anterior and posterior), and the center of radiation can be calculated by irradiating the dummy target with orthogonal MV beams. Three types of SGRT using a VOXELAN‐HEV600M (Electronics Research&Development Corporation, Okayama, Japan) were evaluated using this phantom: (i) SGRTCT—a SGRT set‐up based solely on a computed tomography (CT)‐reference image. (ii) SGRTCT + CBCT—a method where cone beam computed tomography (CBCT) matching was performed after SGRTCT. (iii) SGRTScan—a resetup technique using a scan reference image obtained after completing the (ii) step. Results: Both the breast and face phantoms were recognized in the SGRT system without problems. SGRTScan ensure precision within 1 mm/1° for breast and face verification, respectively. All SGRT methods showed comparable rotational accuracies with no significant disparities. Conclusions: The developed phantom was useful for verifying the accuracy of skin mark‐less SGRT position matching. The SGRTScan demonstrated the feasibility of achieving skin‐mark less SGRT with high accuracy, with deviations of less than 1 mm. Additional research is necessary to evaluate the suitability of the developed phantoms for use in various facilities and systems. This phantom could be used for postal surveys in the future. [ABSTRACT FROM AUTHOR]

Purpose: Online adaptive radiotherapy relies on a high degree of automation to enable rapid planning procedures. The Varian Ethos intelligent optimization engine (IOE) was originally designed for conventional treatments so it is crucial to provide clear guidance for lung SAbR plans. This study investigates using the Ethos IOE together with adaptive‐specific optimization tuning structures we designed and templated within Ethos to mitigate inter‐planner variability in meeting RTOG metrics for both online‐adaptive and offline SAbR plans. Methods: We developed a planning strategy to automate the generation of tuning structures and optimization. This was validated by retrospective analysis of 35 lung SAbR cases (total 105 fractions) treated on Ethos. The effectiveness of our planning strategy was evaluated by comparing plan quality with‐and‐without auto‐generated tuning structures. Internal target volume (ITV) contour was compared between that drawn from CT simulation and from cone‐beam CT (CBCT) at time of treatment to verify CBCT image quality and treatment effectiveness. Planning strategy robustness for lung SAbR was quantified by frequency of plans meeting reference plan RTOG constraints. Results: Our planning strategy creates a gradient within the ITV with maximum dose in the core and improves intermediate dose conformality on average by 2%. ITV size showed no significant difference between those contoured from CT simulation and first fraction, and also trended towards decreasing over course of treatment. Compared to non‐adaptive plans, adaptive plans better meet reference plan goals (37% vs. 100% PTV coverage compliance, for scheduled and adapted plans) while improving plan quality (improved GI (gradient index) by 3.8%, CI (conformity index) by 1.7%). Conclusion: We developed a robust and readily shareable planning strategy for the treatment of adaptive lung SAbR on the Ethos system. We validated that automatic online plan re‐optimization along with the formulated adaptive tuning structures can ensure consistent plan quality. With the proposed planning strategy, highly ablative treatments are feasible on Ethos. [ABSTRACT FROM AUTHOR]

The importance of the transverse tarsal arch (TTA) has recently been extensively reevaluated and has even been considered to play a greater role in foot stability than the medial longitudinal arch (MLA). However, the relevance of this observation in the context of common clinical foot disorders, such as progressive collapsing foot deformity (PCFD), has not yet been fully clarified. In this biomechanical study, we examined ten pairs of human cadaveric feet by serial weight‐bearing cone‐beam computed tomography under controlled loading using a custom‐designed testing machine. The MLA and TTA were transected separately, alternating the order in two study groups. A semiautomated three‐dimensional evaluation of their influence on three components of PCFD, namely collapse of the longitudinal arch (sagittal Meary's angle), hindfoot alignment (sagittal talocalcaneal angle), and forefoot abduction (axial Meary's angle), was performed. Both arches had a relevant effect on collapse of the longitudinal arch, however the effect of transecting the MLA was stronger compared to the TTA (sagittal Meary's angle, 7.4° (95%CI 3.8° to 11.0°) vs. 3.2° (95%CI 0.5° to 5.9°); p = 0.021). Both arches had an equally pronounced effect on forefoot abduction (axial Meary's angle, 4.6° (95%CI 2.0° to 7.1°) vs. 3.0° (95%CI 0.6° to 5.3°); p = 0.239). Neither arch showed a consistent effect on hindfoot alignment. In conclusion, weakness of the TTA has a decisive influence on radiological components of PCFD, but not greater than that of the MLA. Our findings contribute to a deeper understanding and further development of treatment concepts for flatfoot disorders. [ABSTRACT FROM AUTHOR]

Objectives Materials and Methods Results Conclusion To investigate long‐term alveolar ridge bone changes in patients treated with the split‐crest technique (SCT) with simultaneous implant placement.Alveolar ridge width (ARW) was measured with a caliper immediately before (ARW1) and after SCT (ARW2) with a caliper. Existing CBCT scans taken at least 5 years postoperatively were used to assess the healed ARW (ARWF), buccal bone thickness (BBT), and lingual/palatal bone thickness (L/PBT) at 0, 3, and 5 mm apically from implant platform level (IPL). The distance between IPL and buccal bone crest (IPL‐BBC) was also measured. Findings were compared with Wilcoxon and Student's t tests (p < .05).Records of thirty patients with 85 implants were included. Eleven patients (31 implants) presented CBCT scans taken in two separate occasions, resulting in 116 measurements. Tomographic follow‐up ranged from 5 to 18 years (11.5 ± 4.18 years). Mean ARW increased from 3.2 ± 0.6 to 6.6 ± 0.48 mm after SCT, but significantly reduced overtime to 4.46 ± 0.83 mm (ARWF) (p < .0001). Mean BBT was 0.5 ± 0.9, 1.3 ± 0.9, and 2.0 ± 1.2 mm, while mean L/PBT was 0.9 ± 0.7, 1.6 ± 0.9, and 2.1 ± 1.0 mm at 0, 3, and 5 mm from IPL, respectively. IPL‐BBC distance varied up to 8.7 mm (1.4 ± 2.0 mm), with 56/116 measurements (51/85 implants) showing IPL‐BBC = 0 mm.Although SCT with simultaneous implant placement can predictably increase ARW postoperatively, ARW tended to significantly reduce over time, due to reductions in BBT and L/PBT, especially coronally. Nonetheless, 60% of the implants still presented some buccal bone at IPL. [ABSTRACT FROM AUTHOR]

Objectives Materials and Methods Results Conclusions To evaluate the influence of multiplanar reconstruction thickness on the detection of peri‐implant bone defects with a standalone zirconia implant and compare it to when another implant is in the vicinity using cone‐beam computed tomography (CBCT).Five dry human mandibles were used to create twenty implant sites in the second premolar and first molar regions. The OP300 Maxio was used to acquire CBCT images (90 kVp, 6.3 mA, 5 × 5 cm FOV, and 0.125 mm3 voxel size) before and after creating 3 mm peri‐implant bone defects in the buccal aspect of the premolar region. Half of the scans featured a single zirconia implant in the premolar region, while the others had two implants in the premolar and molar regions. Three reconstruction thicknesses (0.125 mm, 1 mm, and 2 mm) were considered for the multiplanar reconstruction analyses. Five oral and maxillofacial radiologists assessed the detection of peri‐implant bone defects using a 5‐point scale. Diagnostic parameters were calculated and compared using Two‐way ANOVA (α = .05).The studied factors showed no significant influence on the diagnosis of peri‐implant bone defects (p > .05). Diagnostic performance was notably higher with a single implant, especially with a 2‐mm reconstruction thickness (AUC = 0.88, sensitivity = 0.68, specificity = 0.94). Although the differences were not statistically significant, the results were more modest when two implants were present (AUC = 0.80, sensitivity = 0.58, specificity = 0.82).The presence of an adjacent zirconia implant and variations in reconstruction thickness did not influence the detection of 3 mm buccal peri‐implant bone defects on CBCT images. [ABSTRACT FROM AUTHOR]

Objective: Rare coexistence of disease or pathology Background: Odontogenic keratocyst (OKC) is a common odontogenic cyst, and it occurs more frequently in the mandible, with the posterior region of the dental arch, the angle, or the ramus being the most commonly affected sites. Odontogenic keratocyst occurring within the maxillary sinus is extremely rare, accounting for only about 1% of cases. Case Report: A 20-year-old female patient without any clinical symptoms underwent an oral examination, during which a dense dental shadow was identified within the maxillary sinus, surrounded by a low-density shadow. Physical examination revealed absence of the left maxillary third molar, with intact mucosa. The patient reported no history of tooth extraction. X-ray and cone-beam computed tomography revealed a high-density image within the left maxillary sinus, resembling a tooth and surrounded by a soft-tissue shadow, which exhibited a greater density in comparison to conventional odontogenic cysts. The initial diagnosis was odontogenic keratocyst in the maxillary sinus with an ectopic maxillary third molar. Surgical enucleation of the cyst and extraction of the impacted tooth were carried out utilizing the Caldwell-Luc approach. Histopathological analysis confirmed the presence of OKC. No significant recurrence was noted during the 6 months of follow-up. Conclusions: Odontogenic keratocysts in the maxillary sinus with ectopic third molar are rare and may not have any symptoms in the early stage. Surgery can be performed using the Caroler-Luke approach to achieve ideal treatment results. In view of the high recurrence rate of OKC, close follow-up should be conducted after surgery. [ABSTRACT FROM AUTHOR]

Objectives. In recent years, new endodontic access techniques have been proposed with the aim of preserving as much dental tissue as possible for subsequent prosthetic rehabilitation. It has indeed been demonstrated that the success of this therapy is essential and dependent on the proper execution of endodontic cavity access. The main objective is to provide a comprehensive and up‐to‐date overview of the new access techniques in endodontics in order to guide clinical practice toward a more precise and qualitative approach. As of today, there is still no universally standardized and recognized taxonomy for the different access cavity designs described in the literature. It has been observed that there are various nomenclatures in the literature. The cavity access designs described mainly in the literature can be categorized into six groups: Traditional Access Cavity (TradAC), Conservative Access Cavity (ConsAC), Ultra‐Conservative Access Cavity (UltraAC), Truss Access Cavity (TrussAC), Caries‐Guided Access Cavity (CariesAC), and Restoration‐Guided Access Cavity (RestoAC). Materials and Methods. The drafting of this narrative review followed the indications of the SANRA (Scale for the Assessment of Narrative Review Articles). A search for scientific articles was conducted on the PubMed and SCOPUS databases, using the following search query: ((truss) OR (conservative) OR (ninja) OR (traditional)) AND access AND endodontic. Results. The initial search yielded a total of 941 articles. After removing duplicates using EndNote X8 software, the number of articles decreased to 785. By applying the inclusion and exclusion criteria, a total of 64 articles were obtained. Among these, 20 articles were finally selected for the purposes of this review, 11 literature reviews and 9 ex‐vivo studies. Conclusion. Studies on fracture resistance have yielded heterogeneous results. For anterior teeth, studies do not find a significant relationship between different endodontic access cavities and fracture resistance. However, in the posterior sector, there is more discrepancy and many positive results for minimally invasive access cavities seem to relate to molars. Therefore, it can be concluded that the evidence supporting the influence of endodontic preparations on dental fracture resistance is still limited. Research on new endodontic access techniques holds significant clinical relevance in contemporary endodontics. The evolution of dental technologies, including cone beam computed tomography (CBCT) and computer‐guided cavity preparation, has ushered in the era of minimally invasive endodontics. This shift aims to enhance the precision and quality of endodontic treatments while preserving maximum healthy dental tissue for subsequent prosthetic rehabilitation. The success of endodontic therapy is closely tied to the proper execution of access to the endodontium, influencing all phases of endodontic treatment and playing a role in determining fracture resistance for subsequent rehabilitation phases. The dichotomy between traditional and minimally invasive approaches has spurred clinical investigations. Specifically, within the scientific community, doubts have been raised about the potential limitations of minimally invasive access cavities. Concerns include their impact on canal orifice localization and raise questions about their influence on the overall success of endodontic treatment. This review holds clinical significance as it sheds light on the evolving landscape of endodontic access techniques, analyzing the anatomical trajectory, carefully examines the transition to minimally invasive approaches, and critically assesses existing scientific evidence and concerns surrounding these developments, contributing to an informed decision‐making process in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Repeated cone-beam CT (CBCT) scans for image-guided radiotherapy (IGRT) increase the health risk of radiation-induced malignancies. Patientenrolled studies to optimize scan protocols are inadequate. We proposed a virtual clinical trial-based approach to evaluate projection-reduced low-dose CBCT for IGRT. Materials and Methods: A total of 71 patients were virtually enrolled with 26 head, 23 thorax and 22 pelvis scans. Projection numbers of full-dose CBCT scans were reduced to 1/2, 1/4, and 1/8 of the original to simulate low-dose scans. Contrast-to-noise ratio (CNR) values in fat and muscle were measured in the fulldose and low-dose images. CBCT images were registered to planning CT to derive 6-degree-of-freedom couch shifts. Registration errors were statistically analyzed with the Wilcoxon paired signed-rank test. Results: As projection numbers were reduced, CNR values descended and the magnitude of registration errors increased. The mean CNR values of full-dose and half-dose CBCT were >3.0. For full-dose and low-dose CBCT (i.e. 1/2, 1/4 and 1/8 full-dose), the mean registration errors were< ± 0.4 mm in translational directions (LAT, LNG, VRT) and ±0.2 degree in rotational directions (Pitch, Roll, Yaw); the mean magnitude of registration errors were< 1 mm in translation and< 0.5 degree in rotation. The couch shift differences between full-dose and lowdose CBCT were not statistically significant (p>0.05) in all the directions. Conclusion: The results indicate that while the impact of dose-reduction on CBCT couch shifts is not significant, the impact on CNR values is significant. Further validation on optimizing CBCT imaging dose is required. [ABSTRACT FROM AUTHOR]

Background: Understanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation. Method: This cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761–70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05. Results: The distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females. Conclusion: This study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the distance between the maxillary central incisor root and the incisive canal based on skeletal malocclusion classification and to analyze the morphology of the incisive canal using cone-beam computed tomography (CBCT). Skeletal malocclusion was categorized into Class I, II, and III using lateral cephalometric analysis. Measurements of the distance between the maxillary central incisor root and the incisive canal were taken at two levels: 2 mm (L1) and 4 mm (L2) superior to the labial cementoenamel junction of the maxillary central incisor. At L1, the distance was found to be closer in the Class II group compared to the Class I or Class III groups. Similarly, at L2, the Class II group exhibited a closer distance than the Class III group. Interestingly, females showed a closer distance compared to males at both L1 and L2. Further analysis revealed a significant gender difference in the Class I and III groups, but not in the Class II group. These findings emphasize the significance of evaluating the distance between the maxillary central incisor root and the incisive canal in patients with skeletal Class II malocclusion, regardless of gender. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions To assess the relative position of mini‐implants to retain a mandibular overdenture, according to the surgical protocol, technical and anatomical factors.Mandibular cone‐beam computed tomography (CBCT) scans were analyzed for 73 patients who received four one‐piece titanium‐zirconium mini‐implants. Drilling was performed using a 1.6 mm needle drill and a 2.2 mm Pilot Drill, according to the bone density with a surgical stent. Post‐insertion CBCT images in DICOM format were analyzed using the E‐Vol‐DX software with BAR filters. Divergence angle between implants and between implants and the overdenture path of insertion was measured using CliniView 10.2.6 software.Divergence between implants ranged from 0° to 22.3° (mean = 4.2; SD = 3.7) in the lateral and from 0° to 26.2° (mean = 5.3; SD = 4.1) in the frontal projections (p < .001). Only 1 (0.2%) and 3 (0.7%) of the measurements were higher than 20° in the lateral and frontal views, respectively. The mean angulations between the implant and the path of insertion for the overdenture were 9.3° (SD = 7.5) and 4.0° (SD = 2.9) for the lateral and frontal views, respectively (p < .001). Regression analyses showed a significant association between the divergence of implants and the frontal view projection (p < .001), greater distance between the paired implants (p = .017), the flapped surgical protocol (p = .002), higher final insertion torque (p = .011), and deeper preparation with the needle drill (p < .001).The mini‐implants were placed with low divergence angles and satisfactory parallelism. Factors including shorter distances between the implants, higher density bone, and a flapless surgical approach all contributed positively to improved parallelism of the mini‐implants. [ABSTRACT FROM AUTHOR]

Objective Materials and Methods Results Conclusions To compare bone volume and height changes of two types of deproteinized bovine bone mineral (DBBM) for lateral window sinus floor elevation (LSFE) with simultaneous implant placement.This retrospective cohort study involved 72 patients who underwent LSFE using low‐temperature sintered cancellous bone‐derived DBBM (C‐DBBM) or high‐temperature two‐step sintered epiphyseal‐derived DBBM (E‐DBBM). Cone‐beam computed tomography (CBCT) was acquired preoperatively, immediately postoperatively, 6 months and 1–4 years post‐surgery. Bone volume (BV), apical bone height (ABH), endo‐sinus bone gain (ESBG), and crestal bone level (CBL) were evaluated through three‐dimensional fitting and superimposition. Linear mixed models (LMM) were employed to analyze factors influencing the reduction of BV (ΔBV) and ESBG (ΔESBG).The E‐DBBM group showed no significant change in BV 1–4 years post‐surgery, while the C‐DBBM group demonstrated a significant reduction (p = .006) with volume stability of 85.86%. Bone height in the E‐DBBM group increased at 6 months and subsequently decreased at 1–4 years (p = .003). In the C‐DBBM group, it decreased at 6 months (p = .014), then further decreased at 1–4 years (p = .001). ΔESBG was lower in the E‐DBBM group than the C‐DBBM group from immediate postoperative to 1–4 years (p = .009). LMM showed graft material type was the primary factor influencing ΔBV (p = .026) and ΔESBG (p = .003).Within the limitations of this study, both types of DBBM could achieve favorable clinical outcomes. E‐DBBM demonstrated enhanced stability in maintaining bone volume and height. [ABSTRACT FROM AUTHOR]

Objective: Using pediatric anthropomorphic phantoms (APs), we aimed to determine the scanning tube voltage/current combinations that could achieve optimal image quality and avoid excessive radiation exposure in pediatric patients. Materials and methods: A 64-slice scanner was used to scan a standard test phantom to determine the volume CT dose indices (CTDIvol), and three pediatric anthropomorphic phantoms (APs) with highly accurate anatomy and tissue-equivalent materials were studied. These specialized APs represented the average 1-year-old, 5-year-old, and 10-year-old children, respectively. The physical phantoms were constructed with brain tissue-equivalent materials having a density of ρ = 1.07 g/cm3, comprising 22 numbered 2.54-cm-thick sections for the 1-year-old, 26 sections for the 5-year-old, and 32 sections for the 10-year-old. They were scanned to acquire brain CT images and determine the standard deviations (SDs), effective doses (EDs), and contrast-to noise ratios (CNRs). The APs were scanned by 21 combinations of tube voltages/currents (80, 100, or 120 kVp/10, 40, 80, 120, 150, 200, or 250 mA) and rotation time/pitch settings of 1 s/0.984:1. Results: The optimal tube voltage/current combinations yielding optimal image quality were 80 kVp/80 mA for the 1-year-old AP; 80 kVp/120 mA for the 5-year-old AP; and 80 kVp/150 mA for the 10-year-old AP. Because these scanning tube voltages/currents yielded SDs, respectively, of 12.81, 13.09, and 12.26 HU, along with small EDs of 0.31, 0.34, and 0.31 mSv, these parameters and the induced values were expediently defined as optimal. Conclusions: The optimal tube voltages/currents that yielded optimal brain image quality, SDs, CNRs, and EDs herein are novel and essentially important. Clinical translation of these optimal values may allow CT diagnosis with low radiation doses to children's heads. [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusions The requirement for precise and effective delivery of the actual dose to the patient grows along with the complexity of breast cancer radiotherapy. Dosimetry during treatment has become a crucial component of guaranteeing the efficacy and security.To propose a dosimetry method during breast cancer radiotherapy based on body surface changes.A total of 29 left breast cancer radiotherapy cases were retroactively retrieved from an earlier database for analysis. Non‐rigid image registration and dose recalculation of the planning computed tomography (CT) referring to the Cone‐beam computed tomography were performed to obtain dose changes. The study used 3D point cloud feature extraction to characterize body surface changes. Based on the correlation proof, a mapping model is developed between body surface changes and dose changes using neural network framework. The MSE metrics, the Euclidean distances of feature points and the 3D gamma pass rate metric were used to assess the prediction accuracy.A strong correlation exist between body surface changes and dose changes (first canonical correlation coefficient = 0.950). For the dose deformation field and dose amplitude difference in the test set, the MSE of the predicted and actual values were 0.136 pixels and 0.229 cGy, respectively. After deforming the planning dose into a deformed one, the feature points’ Euclidean distance between it and the recalculated dose changes from 9.267 ± 1.879 mm to 0.456 ± 0.374 mm. The 3D gamma pass rate of 90% or higher for the 2 mm/2% criteria were achieved by 80.8% of all cases, with a minimum pass rate of 75.9% and a maximum pass rate of 99.6%. Pass rate for the 3 mm/2% criteria ranged from 87.8% to 99.8%, with 92.3% of the cases having a pass rate of 90% or higher.This study provides a dosimetry method that is non‐invasive, real‐time, and requires no additional dose for breast cancer radiotherapy. [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusions Cardiac applications in radiation therapy are rapidly expanding including magnetic resonance guided radiation therapy (MRgRT) for real‐time gating for targeting and avoidance near the heart or treating ventricular tachycardia (VT).This work describes the development and implementation of a novel multi‐modality and magnetic resonance (MR)‐compatible cardiac phantom.The patient‐informed 3D model was derived from manual contouring of a contrast‐enhanced Coronary Computed Tomography Angiography scan, exported as a Stereolithography model, then post‐processed to simulate female heart with an average volume. The model was 3D‐printed using Elastic50A to provide MR contrast to water background. Two rigid acrylic modules containing cardiac structures were designed and assembled, retrofitting to an MR‐safe programmable motor to supply cardiac and respiratory motion in superior‐inferior directions. One module contained a cavity for an ion chamber (IC), and the other was equipped with multiple interchangeable cavities for plastic scintillation detectors (PSDs). Images were acquired on a 0.35 T MR‐linac for validation of phantom geometry, motion, and simulated online treatment planning and delivery. Three motion profiles were prescribed: patient‐derived cardiac (sine waveform, 4.3 mm peak‐to‐peak, 60 beats/min), respiratory (cos4 waveform, 30 mm peak‐to‐peak, 12 breaths/min), and a superposition of cardiac (sine waveform, 4 mm peak‐to‐peak, 70 beats/min) and respiratory (cos4 waveform, 24 mm peak‐to‐peak, 12 breaths/min). The amplitude of the motion profiles was evaluated from sagittal cine images at eight frames/s with a resolution of 2.4 mm × 2.4 mm. Gated dosimetry experiments were performed using the two module configurations for calculating dose relative to stationary. A CT‐based VT treatment plan was delivered twice under cone‐beam CT guidance and cumulative stationary doses to multi‐point PSDs were evaluated.No artifacts were observed on any images acquired during phantom operation. Phantom excursions measured 49.3 ± 25.8%/66.9 ± 14.0%, 97.0 ± 2.2%/96.4 ± 1.7%, and 90.4 ± 4.8%/89.3 ± 3.5% of prescription for cardiac, respiratory, and cardio‐respiratory motion profiles for the 2‐chamber (PSD) and 12‐substructure (IC) phantom modules respectively. In the gated experiments, the cumulative dose was <2% from expected using the IC module. Real‐time dose measured for the PSDs at 10 Hz acquisition rate demonstrated the ability to detect the dosimetric consequences of cardiac, respiratory, and cardio‐respiratory motion when sampling of different locations during a single delivery, and the stability of our phantom dosimetric results over repeated cycles for the high dose and high gradient regions. For the VT delivery, high dose PSD was <1% from expected (5–6 cGy deviation of 5.9 Gy/fraction) and high gradient/low dose regions had deviations <3.6% (6.3 cGy less than expected 1.73 Gy/fraction).A novel multi‐modality modular heart phantom was designed, constructed, and used for gated radiotherapy experiments on a 0.35 T MR‐linac. Our phantom was capable of mimicking cardiac, cardio‐respiratory, and respiratory motion while performing dosimetric evaluations of gated procedures using IC and PSD configurations. Time‐resolved PSDs with small sensitive volumes appear promising for low‐amplitude/high‐frequency motion and multi‐point data acquisition for advanced dosimetric capabilities. Illustrating VT planning and delivery further expands our phantom to address the unmet needs of cardiac applications in radiotherapy. [ABSTRACT FROM AUTHOR]

Aim Materials and Methods Results Conclusions This study aimed to assess hard and soft tissue contour changes following micro crestal flap‐alveolar ridge preservation (MCF‐ARP) and natural healing (NH) in periodontally compromised molar extraction sites and to analyse the feasibility and need for bone augmentation during implant therapy.Fifty‐six patients with 70 sites were randomized into two groups at the site level (35 sites from 31 patients in the test group and 35 sites from 29 patients in the control group). Among whom, four patients contributed one tooth to the control group and one tooth to the test group. Hard tissue indicators were measured using cone beam computed tomography performed before tooth extraction and 6 months after surgery. Soft tissue contour changes were assessed using intraoral scanning performed before and immediately after surgery and also 2 weeks and 1, 3 and 6 months after surgery.Six months after surgery, the MCF‐ARP group showed less resorption in buccal bone height (p = .032) and greater augmentation in central bone height (p = .001) and ridge width (p = .009). The mean, vertical and horizontal collapse of buccal soft tissue contour in the MCF‐ARP group were 0.95 mm (p = .010), 0.61 mm (p = .019) and 0.56 mm (p = .013) less than that in the NH group, respectively. There were significantly (p = .007) fewer sites in the MCF‐ARP group than in the NH group (0% vs. 26.7%) for staged bone augmentation and more sites that could be treated with simple implant procedure in the MCF‐ARP group than in the NH group (71.9% vs. 56.6%).Compared with NH, MCF‐ARP reduced bone resorption in periodontally compromised molar extraction sites and maintained the buccal soft tissue contour. MCF‐ARP reduces the need for complex bone augmentation procedures in implant therapy. Trial registration: Chinese Clinical Trial Register (ChiCTR) ChiCTR2200056335. Registered on 4 February 2022, Version 1.0. [ABSTRACT FROM AUTHOR]

Background: The aim of this case was to understand and treat the intricate root canal anatomy observed in complex maxillary first premolars, particularly those exhibiting three root canals, emphasizing the significance of understanding root canal morphological variations in their treatment. Conclusions: This case reported the methods of treating three‐root canal maxillary first premolars, including warm vertical compression technique, root canal microsurgery, and the application of rubber dam. The utilization of dental operating microscopes, various surgical strategies, and key assessments of X‐rays and cone beam computed tomography (CBCT) scans were all essential steps for achieving accurate and safe root canal therapy. [ABSTRACT FROM AUTHOR]

Background: Spinal cord stimulation (SCS) has demonstrated multiple benefits in treating chronic pain and other clinical disorders related to sensorimotor dysfunctions. However, the underlying mechanisms are still not fully understood, including how electrode placement in relation to the spinal cord neuroanatomy influences epidural spinal recordings (ESRs). To characterize this relationship, this study utilized stimulation applied at various anatomical sections of the spinal column, including at levels of the intervertebral disc and regions correlating to the dorsal root entry zone. Method: Two electrode arrays were surgically implanted into the dorsal epidural space of the swine. The stimulation leads were positioned such that the caudal-most electrode contact was at the level of a thoracic intervertebral segment. Intraoperative cone beam computed tomography (CBCT) images were utilized to precisely determine the location of the epidural leads relative to the spinal column. High-resolution microCT imaging and 3D-model reconstructions of the explanted spinal cord illustrated precise positioning and dimensions of the epidural leads in relation to the surrounding neuroanatomy, including the spinal rootlets of the dorsal and ventral columns of the spinal cord. In a separate swine cohort, implanted epidural leads were used for SCS and recording evoked ESRs. Results: Reconstructed 3D-models of the swine spinal cord with epidural lead implants demonstrated considerable distinctions in the dimensions of a single electrode contact on a standard industry epidural stimulation lead compared to dorsal rootlets at the dorsal root entry zone (DREZ). At the intervertebral segment, it was observed that a single electrode contact may cover 20-25% of the DREZ if positioned laterally. Electrode contacts were estimated to be ~0.75 mm from the margins of the DREZ when placed at the midline. Furthermore, ventral rootlets were observed to travel in proximity and parallel to dorsal rootlets at this level prior to separation into their respective sides of the spinal cord. Cathodic stimulation at the level of the intervertebral disc, compared to an 'off-disc' stimulation (7 mm rostral), demonstrated considerable variations in the features of recorded ESRs, such as amplitude and shape, and evoked unintended motor activation at lower stimulation thresholds. This substantial change may be due to the influence of nearby ventral roots. To further illustrate the influence of rootlet activation vs. dorsal column activation, the stimulation lead was displaced laterally at ~2.88 mm from the midline, resulting in variances in both evoked compound action potential (ECAP) components and electromyography (EMG) components in ESRs at lower stimulation thresholds. Conclusion: The results of this study suggest that the ECAP and EMG components of recorded ESRs can vary depending on small differences in the location of the stimulating electrodes within the spinal anatomy, such as at the level of the intervertebral segment. Furthermore, the effects of sub-centimeter lateral displacement of the stimulation lead from the midline, leading to significant changes in electrophysiological metrics. The results of this pilot study reveal the importance of the small displacement of the electrodes that can cause significant changes to evoked responses SCS. These results may provide further valuable insights into the underlying mechanisms and assist in optimizing future SCS-related applications. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study is to identify a more reliable reference point in three-dimensional cephalometric analysis to replace the Porion point used in two-dimensional analysis, enhancing the accuracy of assessments. Methods: The methodology assessed potential alternative landmarks for three-dimensional cephalometric analysis. Utilizing a segmenting technique, anatomical landmarks were accurately pinpointed from the external acoustic meatus of 26 Cone Beam Computed Tomography (CBCT) scans. These landmarks were chosen for their clear and unambiguous detectability. To assess reproducibility, each landmark was replicated twice with a one-week interval by a master's student. Reproducibility was quantitatively evaluated by analyzing the absolute difference per axis. Results: Five possible candidate landmarks were identified: the most anterior, posterior, superior, and inferior points of the external acoustic meatus (EAM) and a notch delineating the epitympanic recess. The reproducibility of pinpointing these landmarks ranged from 0.56 mm to 2.2 mm. The absolute mean differences between measurements were 0.46 mm (SD 0.75) for the most anterior point, 0.36 mm (SD 0.44) for the most posterior point, 0.25 mm (SD 0.26) for the most superior point, 1.11 mm (SD 1.03) for the most inferior point, and 0.78 mm (SD 0.57) for the epitympanic notch. Conclusions: The most superior point of the EAM might successfully replace the Porion as an anatomical reference. [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this study was to assess the diagnostic accuracy of the AI-driven platform Diagnocat for evaluating endodontic treatment outcomes using cone beam computed tomography (CBCT) images. Methods: A total of 55 consecutive patients (15 males and 40 females, aged 12–70 years) referred for CBCT imaging were included. CBCT images were analyzed using Diagnocat's AI platform, which assessed parameters such as the probability of filling, adequate obturation, adequate density, overfilling, voids in filling, short filling, and root canal number. The images were also evaluated by two experienced human readers. Diagnostic accuracy metrics (accuracy, precision, recall, and F1 score) were assessed and compared to the readers' consensus, which served as the reference standard. Results: The AI platform demonstrated high diagnostic accuracy for most parameters, with perfect scores for the probability of filling (accuracy, precision, recall, F1 = 100%). Adequate obturation showed moderate performance (accuracy = 84.1%, precision = 66.7%, recall = 92.3%, and F1 = 77.4%). Adequate density (accuracy = 95.5%, precision, recall, and F1 = 97.2%), overfilling (accuracy = 95.5%, precision = 86.7%, recall = 100%, and F1 = 92.9%), and short fillings (accuracy = 95.5%, precision = 100%, recall = 86.7%, and F1 = 92.9%) also exhibited strong performance. The performance of AI for voids in filling detection (accuracy = 88.6%, precision = 88.9%, recall = 66.7%, and F1 = 76.2%) highlighted areas for improvement. Conclusions: The AI platform Diagnocat showed high diagnostic accuracy in evaluating endodontic treatment outcomes using CBCT images, indicating its potential as a valuable tool in dental radiology. [ABSTRACT FROM AUTHOR]

Metal artifacts notoriously pose significant challenge in computed tomography (CT), leading to inaccuracies in image formation and interpretation. Artifact reduction tools have been designed to improve cone beam computed tomography (CBCT) image quality by reducing artifacts caused by certain high-density materials. Metal artifact reduction (MAR) tools are specific algorithms that are applied during image reconstruction to minimize or eliminate artifacts degrading CBCT images. The purpose of the study is to evaluate the effect of a MAR algorithm on image quality in CBCT performed for evaluating patients before transarterial radioembolization (TARE). We retrospectively included 40 consecutive patients (aged 65 ± 13 years; 23 males) who underwent 45 CBCT examinations (Allura FD 20, XperCT Roll protocol, Philips Healthcare, Best, The Netherlands) in the setting of evaluation for TARE between January 2017 and December 2018. Artifacts caused by coils, catheters, and surgical clips were scored subjectively by four readers on a 5-point scale (1 = artifacts affecting diagnostic information to 5 = no artifacts) using a side-by-side display of uncorrected and MAR-corrected images. In addition, readers scored tumor visibility and vessel discrimination. MAR-corrected images were assigned higher scores, indicating better image quality. The differences between the measurements with and without MAR were most impressive for coils with a mean improvement of 1.6 points (95%CI [1.5 1.8]) on the 5-point likert scale, followed by catheters 1.4 points (95%CI [1.3 1.5]) and clips 0.7 points (95%CI [0.3 1.1]). Improvements for other artifact sources were consistent but relatively small (below 0.25 points on average). Interrater agreement was good to perfect (Kendall's W coefficient = 0.68–0.95) and was higher for MAR-corrected images, indicating that MAR improves diagnostic accuracy. A metal artifact reduction algorithm can improve diagnostic and interventional accuracy of cone beam CT in patients undergoing radioembolization by reducing artifacts caused by diagnostic catheters and coils, lowering interference of metal artifacts with adjacent major structures, and improving tumor visibility. [ABSTRACT FROM AUTHOR]

Studies during the past 9 years suggest that delivering radiation at dose rates exceeding 40 Gy/s, known as "FLASH" radiation therapy, enhances the therapeutic index of radiation therapy (RT) by decreasing normal tissue damage while maintaining tumor response compared with conventional (or standard) RT. This study demonstrates the cardioprotective benefits of FLASH proton RT (F-PRT) compared with standard (conventional) proton RT (S-PRT), as evidenced by reduced acute and chronic cardiac toxicities. Mice were imaged using cone beam computed tomography to precisely determine the heart's apex as the beam isocenter. Irradiation was conducted using a shoot-through technique with a 5-mm diameter circular collimator. Bulk RNA-sequencing was performed on nonirradiated samples, as well as apexes treated with F-PRT or S-PRT, at 2 weeks after a single 40 Gy dose. Inflammatory responses were assessed through multiplex cytokine/chemokine microbead assay and immunofluorescence analyses. Levels of perivascular fibrosis were quantified using Masson's Trichrome and Picrosirius red staining. Additionally, cardiac tissue functionality was evaluated by 2-dimensional echocardiograms at 8- and 30-weeks post-PRT. Radiation damage was specifically localized to the heart's apex. RNA profiling of cardiac tissues treated with PRT revealed that S-PRT uniquely upregulated pathways associated with DNA damage response, induction of tumor necrosis factor superfamily, and inflammatory response, and F-PRT primarily affected cytoplasmic translation, mitochondrion organization, and adenosine triphosphate synthesis. Notably, F-PRT led to a milder inflammatory response, accompanied by significantly attenuated changes in transforming growth factor β1 and α smooth muscle actin levels. Critically, F-PRT decreased collagen deposition and better preserved cardiac functionality compared with S-PRT. This study demonstrated that F-PRT reduces the induction of an inflammatory environment with lower expression of inflammatory cytokines and profibrotic factors. Importantly, the results indicate that F-PRT better preserves cardiac functionality, as confirmed by echocardiography analysis, while also mitigating the development of long-term fibrosis. [ABSTRACT FROM AUTHOR]

Cone beam computed tomography (CBCT)-based online adaptive radiation therapy (ART) is especially beneficial for patients with large interfractional anatomic changes. However, treatment planning and review decisions need to be made at the treatment console in real-time and may be delegated to clinical staff whose conventional scope of practice does not include making such decisions. Therefore, implementation can create new safety risks and inefficiencies. The objective of this work is to systematically analyze the safety and efficiency implications of human decision-making during the treatment session for CBCT-based online ART. The analysis was performed by applying the Systems-Theoretical Process Analysis technique and its extension for human decision-making. Four centers of different CBCT-based online ART practice models comprised the analysis team. The general radiation therapy control structure was refined to model the interactions between routine treatment delivery staff and in-person or remote support staff. The treatment delivery staff perform 6 key control actions. Eighteen undesirable states of those control actions were identified as affecting safety and/or efficiency. In turn, 97 hazardous clinical scenarios were identified, with the control action "prepare and position patient" having the least number of scenarios and "delineate/edit influencer and target structures" having the most. Five of these are specific to either in-person or remote support during the treatment session, and 12 arise from staff support in general. An optimally safe and efficient online ART program should require little to no support staff at the treatment console to reduce staff coordination. Uptraining of the staff already at the treatment console is needed to achieve this goal. Beyond the essential knowledge and skills such as contour editing and the selection of an optimal plan, uptraining should also target the specific cognitive biases identified in this work and the cognitive strategies to overcome these biases. Additionally, technological and organizational changes are necessary. [ABSTRACT FROM AUTHOR]

Significant improvements within radioembolization imaging and dosimetry permit the development of an accurate and personalized pretreatment plan with technetium 99 m –labeled macroaggregated albumin single-photon emission computed tomography (99m Tc-MAA SPECT/CT). Despite these potential advantages, the clinical transition to pretreatment protocols with SPECT/CT is hindered by its unknown safety constraints. This study aimed to address this issue by establishing novel dose limits for 99m Tc-MAA SPECT/CT to enable quantitative pretreatment planning. Stratification criteria to determine images most viable for dosimetry analysis were created from a cohort of 85 patients. SPECT/CT, cone beam CT, and activity calculations derived from the local deposition method were used to create an accurate pretreatment protocol. Planar and SPECT/CT images were compared using linear regression and modified Bland-Altman analyses to convert accepted planar dose limits to SPECT/CT. To validate these new dose limits, activity calculations based on SPECT/CT were compared with those calculated with the body surface area and planar methods for 3 treatment plans. A total of 38 of 85 patients were deemed viable for dosimetry analysis. SPECT lung shunt fractions (LSFs) yielded greater values than planar imaging when LSFs were <4.89%, whereas planar imaging was greater than SPECT when LSFs were >4.89. Planar to SPECT/CT dose safety conversions were 0.76 ×, 0.70 ×, and 0.55 × for the whole liver, normal liver, and lungs, respectively. Patients with SPECT LSFs <4.89% were safely treated with the direct application of planar lung dose limits. Activity calculations with SPECT/CT were greater than the body surface area method by a median of 33.1% to 61.9% and were lower than planar-based activity calculations by 12.5% to 13.7% for the whole liver and by 29.4% to 32.2% for the normal liver. A generalized method to establish safety dose limits between 2 modalities was used to translate safety dose limits from planar imaging to 99m Tc-MAA SPECT/CT. An accurate 99m Tc-MAA SPECT/CT treatment protocol was developed guided by the current knowledge in the field. Established SPECT/CT dose limits safely treated 97.5% of patients and permitted the application of independent pretreatment planning with 99m Tc-MAA SPECT/CT. [ABSTRACT FROM AUTHOR]

A study published in the journal Respirology discusses the use of a miniaturized videoendoscopy probe called Iriscope® for visualizing small peripheral lung nodules. The study included 23 patients who underwent the procedure, which involved using a navigational endoscopic technique and the probe to visualize the nodules. The probe provided clear images, allowing for accurate diagnosis and sampling. The study found that the probe was effective in identifying malignant nodules and had a high sampling diagnostic rate. However, the study did not test the probe's effectiveness on ground-glass opacities or differentiate between subsegmental atelectasis and lung cancer. Overall, the miniaturized videoendoscopy probe appears to be a useful tool for improving the diagnostic yield of procedures for peripheral lung nodules. The study was conducted ethically with informed consent from all participants. [Extracted from the article]

Implant surgery in individuals with atrophic maxilla presents challenges, particularly concerning nasal cavity complications such as perforations, implant migration, and airway obstruction. While panoramic radiographs offer diagnostic convenience, their two-dimensional nature limits the evaluation of anatomical structures. Cone beam computed tomography (CBCT) provides a three-dimensional assessment, enhancing surgical planning accuracy and potentially reducing complications. With the aim of understanding the measurement differences between panoramic radiographs and CBCT images, this retrospective study examined CBCT images of patients with severely atrophic maxilla taken between September 2021 and December 2023 at the Ahmet Keleşoğlu Faculty of Dentistry. Virtual implants were placed in various tooth regions using OnDemand3D software. The incidence of nasal cavity perforations and vertical bone height differences between panoramic radiographs and CBCT images were evaluated. For this purpose, vertical bone length measurements in panoramic and CBCT images were compared for the virtual implant placement areas. Statistical analyses, including t-tests and ANOVA, were performed to determine significant differences among quantitative measurements, and a chi square test with Bonferroni corrected z-tests were used for possible associations between ratios. CBCT data from 59 patients, totaling 1888 virtual implants, revealed significant differences in implant depths among tooth regions (F = 9.880, p < 0.001). Canine regions showed higher perforation risks, especially with 12 mm and 14 mm implants. Panoramic radiographs often overestimated vertical bone height in canine and first premolar regions compared to CBCT measurements, which could lead to increased perforation risks. Radiographic evaluations using CBCT prior to implant surgery in atrophic maxilla cases are crucial to prevent nasal cavity complications. Panoramic radiographs may inadequately represent three-dimensional anatomy, underscoring the importance of CBCT for accurate implant placement and surgical planning. Further studies should consider varying implant sizes and brands to generalize findings. [ABSTRACT FROM AUTHOR]

Background: This study aims to determine the position of impacted maxillary canines on cone beam computed tomography (CBCT) images, to determine the presence of resorption in adjacent teeth, and to investigate the position and type of resorption of impacted canines if resorption is present. Methods: Patients over 14 years of age with maxillary canine teeth who had CBCT images taken for any dental reason were included in the study. Resorption of teeth adjacent to maxillary canines was analyzed according to transversal, vertical, and buccopalatinal positions on the CBCT. The study evaluated 162 maxillary canine teeth on tomography images of 134 patients. Results: Of the affected adjacent teeth, 32.1% of the central incisor, 58.0% of the lateral incisor, and 19.1% of the first premolars showed mild-to-severe resorption. The relationships between transversal position and resorption in the central and lateral incisor, vertical position and resorption in the central incisor and buccopalatinal position and resorption in the first premolars were found to be significant. Maxillary canine teeth can cause mild-to-severe resorption of adjacent teeth, especially lateral incisors. Conclusion: For this reason, we think that a detailed examination with CBCT is essential in the early diagnosis of resorption of adjacent teeth. [ABSTRACT FROM AUTHOR]

Objective: To conduct a comprehensive and systematic review of the application of existing artificial intelligence for tooth segmentation in CBCT images. Materials and Methods: A literature search of the MEDLINE, Web of Science, and Scopus databases to find publications from inception through 21 August 2023, non-English publications excluded. The risk of bias and applicability of each article was assessed using QUADAS-2, and data on segmentation category, research model, sample size and groupings, and evaluation metrics were extracted from the articles. Results: A total of 34 articles were included. Artificial intelligence methods mainly involve deep learning-based techniques, including Convolutional Neural Networks (CNNs), Fully Convolutional Networks (FCNs), and CNN-based network structures, such as U-Net and V-Net. They utilize multi-stage strategies and combine other mechanisms and algorithms to further improve the semantic or instance segmentation performance of CBCT images, and most of the models have a Dice similarity coefficient greater than 90% and accuracy ranging from 83% to 99%. Conclusions: Artificial intelligence methods have shown excellent performance in tooth segmentation of CBCT images, but still face problems, such as the small size of training data and non-uniformity of evaluation metrics, which still need to be further improved and explored for their application and evaluation in clinical applications. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the amount of distortion using computer-guided implant surgery with 3D printed surgical guides in limited edentulous spaces. Materials and methods: 25 bone level self-tapping implants (Straumann® BL and BLT) were randomly inserted in either distal or intercalary posterior mandibular edentulism using a fully digital protocol and 3D printed surgical guides. Amount of inaccuracy was evaluated after superimposing the 3 coordinates of virtually planned and final implant images, which were obtained using intra-oral scans and scan bodies. Four evaluation parameters were considered: origo-displacement, error depth, apical displacement and angle between the planned and the placed implant. Results: The average of distortion was 0.71 mm for the origo-displacement, 0.36 mm for the error depth, 0.52 mm for the horizontal displacement and 3.34º for the error angle. Conclusion: The major reason of exclusion was CBCT artifacts. Results of this study were aligned with the results of previous studies concerning partially edentulous spaces. CAD/CAM manufacturing process did not result in significant distortion whilst the biggest part of distortions originated from the surgical process. The learning curve in computer-guided implant surgery presented an important source of inaccuracy. Trial registry: This trial is registered to the ClinicalTrials.gov Protocol Registration. Name of the registry: ClinicalTrials.gov Protocol Registration. Trial registration number: NCT06277076. Date of registration: February 17, 2024 Retrospectively registered. URL of trial registry record: https://register.clinicaltrials.gov/NCT06277076. [ABSTRACT FROM AUTHOR]

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Objective This study aimed to explore the relationship between the spontaneous changes of mesiodistal angulation of lower second molars (L2M) and individual clinical characteristics in patients with early permanent dentition correction. Methods A total of 44 patients with a total of 88 mandibular second molars were included in this study after screening. Based on the frequency distribution histogram of the initial angle of inclination (L2M initial angle) of the L2M crown before treatment, it was divided into three groups: Group A: small angle group, L2M initial angle is 0° ~ 17.5°; Group B: medium angle group, L2M initial angle is 17.5° ~ 42.5°; Group C: large angle group, L2M initial angle is 42.5° ~ 60°. According to whether L2M has erupted and exposed most of the crown, it was divided into erupted group and unerupted group. According to the mandibular plane angle, it can be divided into high angle, low angle, and average angle. CBCT reconstructed panoramic images were used to measure the mesiodistal inclination of L2M and analyze the relationship between each group and the change in mesiodistal inclination angles of L2M. Results After treatment, L2M mesiodistal angulation in the small angle, large angle, non-eruption, and high angle groups became more significant. The angle in the middle angle group was significantly smaller. The L2M mesiodistal angulation in the eruption and average angle group did not change significantly.The angles of ANB, Y-axis, and mandibular plane have no correlation with the initial angle of L2M. Conclusion The L2M in patients with large and high angles is more likely to topple during a correction. During the correction, the L2M tends to approach the normal axial inclination. [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusions Cone beam CT (CBCT) is widely utilized in clinics. However, the scatter artifact degrades the CBCT image quality, hampering the expansion of CBCT applications. Recently, beam‐blocker methods have been used for CBCT scatter correction and proved their high cost‐effectiveness.A rotating beam‐blocker (RBB) method for CBCT scatter correction was proposed to complete scatter correction and image reconstruction within a single scan in both full‐ and half‐fan scan scenarios.The RBB consisted of two open regions and two blocked regions, and was designed as a centrosymmetric structure. The open and blocked projections could be alternatively obtained within one single rotation. The open projections were corrected with the scatter signal calculated from the blocked projections, and then used to reconstruct the 3D image via the Feldkamp‐Davis‐Kress algorithm. The performance of the RBB method was evaluated on head and pelvis phantoms in scenarios with and without a bowtie filter. The images obtained from nine repeated scans in each scenario were used to calculate the evaluation metrics including the CT number error, spatial nonuniformity (SNU) and contrast‐to‐noise ratio (CNR).For the head phantom, the CT number error was decreased to <5 after scatter correction from >200 HU before correction when scanned without a bowtie filter, and to <4 from >160 HU when scanned with a full bowtie filter. For the pelvis phantom, the CT number error was reduced to <12 after scatter correction from >250 HU before correction when scanned without a bowtie filter, and to <10 from >190 HU when scanned with a half bowtie filter. After scatter correction, the uniformity and contrast were both improved, resulting in an SNU of >79% decrease and CNR of >2 times increase, respectively.High‐quality CBCT images could be obtained in a single scan after using the proposed RBB method for scatter correction, enabling more accurate image guidance for surgery and radiation therapy applications. With almost no time delay between the successive open and blocked projections, the RBB method could eliminate the motion‐induced anatomical mismatches between the corresponding open and blocked projections and could find particular usefulness in thoracic and abdominal imaging. [ABSTRACT FROM AUTHOR]

Background Objective Materials and Methods Results Conclusion Some orthodontic devices used in children share similar design principles to appliances used to treat obstructive sleep apnoea in adults. As well as treating malocclusion, orthodontic appliances used in children may therefore also have effects on the upper airway.A review of the literature to assess the effects of orthodontic treatment on the upper airway dimensions in children assessed on CBCT.Following registration of the protocol (PROSPERO CRD42023439056), a systematic electronic search of published studies was performed using several databases (PubMed; Scopus, Web of Science and Science Direct) in accordance with the PRISMA guidelines. Inclusion criteria were as follows: age under 18 years, orthodontic treatment with any appliance, a control group who received no treatment or a non‐active alternative treatment and airway measurement using CBCT. RoB‐2 and ROBINS‐I tools were used to assess risk of bias and quality of the evidence.In total, 341 studies were identified following the initial search. Title and abstract screening resulted in 45 studies for further full‐text analysis. On completion of the screening process, a total of 23 studies met the inclusion criteria. Study interventions included functional appliances (10 studies), rapid maxillary expansion (RME) (9 studies), reverse‐pull headgear (1 study) and 4 premolar dental extractions (3 studies). The included studies had moderate to high risk of bias, and the quality of evidence was low.The scientific evidence shows that functional appliances are associated with significant improvements in both upper airway volume and constriction when used in children however, the effects on the nasal cavity are limited. RME was associated with a significant increase in nasal cavity and nasopharyngeal dimensions, but not the upper pharyngeal airway. Neither reverse‐pull headgear nor dental extractions were associated with any change in airway dimensions; however, the evidence is limited. Functional appliances may reduce the severity of obstructive sleep apnoea (OSA) in children. [ABSTRACT FROM AUTHOR]

Background: Endodontic treatment is one of the main dental treatments to manage inflamed or infected root canal systems of teeth. The success of endodontic treatment principally depends on eradicating microorganisms in the root canal by chemo-mechanical debridement with irrigation solutions like sodium hypochlorite (NaOCl). NaOCl has been used in concentrations ranging from 0.5% to 5.25%. This study determined the antimicrobial effectiveness of selected concentrations (0.5%, 1.0%, 2.6%, and 5.2%) of NaOCl in endodontic treatment. Methods: The study sites were the University of Ghana Dental School (UGDS) and Noguchi Memorial Institute for Medical Research (NMIMR). Sixty infected single-rooted single-canal teeth were used. Before (S1) and after (S2), root canal samples during the endodontic treatment with the selected concentrations of NaOCl were examined via anaerobic and aerobic cultures. The isolates were identified using Matrix Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry (MALDI-TOF MS). Results: All S1 samples were positive for cultivable bacteria. Fifty-three (53) different microbial species belonging to 20 different microbial genera were isolated. Streptococcus viridans was the most frequently isolated microbe. There were zero isolates in the root canals irrigated with 2.6% and 5.2% NaOCl. Two teeth had isolates in the groups irrigated with the lower concentrations (0.5% and 1.0%) of NaOCl. The persistent bacteria were one species each of Streptococcus mitis and Streptococcus oralis, respectively. Conclusion: Root canal treatments using chemo-mechanical preparation with the selected concentrations (0.5%, 1.0%, 2.6%, and 5.2%) of NaOCl were effective in significantly reducing the microbial load, and for the 5.2% and 2.6% concentrations, in eliminating all the microorganisms. [ABSTRACT FROM AUTHOR]