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Τρίτη 16 Αυγούστου 2022

Effect of cut‐out rescan procedures on the accuracy of an intraoral scanner used for digitizing an ear model: An in vitro study

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Abstract

Purpose

The purpose of this study was to evaluate the impact of the rescanning of mesh holes of different diameters on the accuracy of an intraoral scanner (IOS) used to digitize an ear model.

Materials and methods

An ear model was digitized using an intraoral scanner (Medit i500) to obtain a reference mesh. A baseline experimental scan was created by editing a duplicate of the reference mesh using the cut-out tool of the IOS software. Three equal groups were created based on the diameter of the cut-out areas: 2-mm (G1), 5mm (G2), and 8-mm (G3) (n = 15). The cut-out areas were rescanned and a total of 45 digital files were exported. The discrepancy between the reference and the experimental digital scans was measured using the root mean square calculation (RMS). The data were analyzed by a Kruskal–Wallis test followed by a post hoc Dunn's test with Bonferroni correction.

Results

The trueness values ranged from 19.53 to 27.13 μm. There were significant differences in the RMS error values among the groups tested (p<.001) and post hoc multiple comparisons showed significant differences between the G1 and G2 groups (p = .04), G1 and G3 groups (p<.001), and G2 and G3 groups (p = .004). Overall, the precision values ranged from 4.93 to 7.73 μm and significant differences in the RMS values were only found between the G1 and G2 groups (p = .014).

Conclusions

Mesh hole rescanning affected the scanning accuracy (trueness and precision) of the IOS tested. The larger the diameter of the mesh holes, the less the trueness of the IOS tested. The precision values seemed to be less affected compared with the trueness by the cut-out and rescanning procedures.

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Influence of geometric dimensions on early failures of adhesively retained composite resin core build‐ups

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Abstract

Objective

To determine the influence of the geometric dimensions of core build-ups on early core build-up failure, that is, loss before definitive prosthesis cementation.

Materials and Methods

Adhesive core build-ups of exclusively vital teeth in 114 participants were evaluated (n materials: 40 Rebilda DC, 38 Multicore Flow, 36 Clearfil DC Core; n teeth: 8 incisors, 54 premolars, 52 molars). Impressions of the abutment teeth were made (1) after removal of insufficient restorations/caries and (2) after core build-up and preparation for a fixed prosthesis. Digitized model surfaces of both situations were aligned (Geomagic Design X) and core build-up volume (V CBU), remaining hard tissue volume (V Abut), and size of the adhesive surface (A adh) were assessed. The derived measure d CBU = V CBU/A adh can be interpreted as mean arithmetic core build-up thickness. Associations between participant or core build-up design characteristics and the occurrence of early failures were statistically evaluated (SPSS v27, α = 0.05).

Results

A total of six (5.3%) core build-up failures were registered. Higher participant age, greater core build-up volume V CBU and greater arithmetic uniform thickness d CBU were associated with a greater incidence of failure in bivariate and univariate, however, not in multivariate statistics.

Conclusions

Core build-up volume and thickness were associated with early success or failure.

Clinical Significance

In the case of voluminous/thick core build-ups in relation to the adhesive surface, additional measures, such as the preparation of retentive elements to increase the bonding area, might be considered to reduce the risk of early core build-up failure.

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An overview of three‐dimensional imaging devices in dentistry

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Abstract

Objective

To review four types of three-dimensional imaging devices: intraoral scanners, extraoral scanners, cone-beam computed tomography (CBCT), and facial scanners, in terms of their development, technologies, advantages, disadvantages, accuracy, influencing factors, and applications in dentistry.

Methods

PubMed (National Library of Medicine) and Google Scholar databases were searched. Additionally, the scanner manufacturers' websites were accessed to obtain relevant data. Four authors independently selected the articles, books, and websites. To exclude duplicates and scrutinize the data, they were uploaded to Mendeley Data. In total, 135 articles, two books, and 17 websites were included.

Results

Research and clinical practice have shown that oral and facial scanners and CBCT can be used widely in various areas of dentistry with high accuracy.

Conclusion

Although further advancement of these devices is desirable, there is no doubt that digital technology represents the future of dentistry. Furthermore, the combined use of different devices may bring dentistry into a new era. These four devices will play a significant role in clinical utility with high accuracy. The combined use of these devices should be explored further.

Clinical significance

The four devices will play a significant role in clinical use with high accuracy. The combined use of these devices should be explored further.

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Clinical features, treatment outcomes and prognostic factors of allopurinol‐induced DRESS

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Clinical features, treatment outcomes and prognostic factors of allopurinol-induced DRESS in 52 patients

This study included 52 patients. The average age of the patients was 56.1 ± 17.1 years. The ratio of men to women was 3.7 to 1. The mean of latency periods was 24.6 ± 15.0 days. Most patients presented with fever and skin rash in association with facial edema, lymphadenopathy, leukocytosis, eosinophilia, and atypical lymphocytosis. Liver and kidney injury were the most common visceral manifestation. Pulmonary involvement, cardiac involvement and gastrointestinal involvement were relatively less known but severe complications. Two patients showed nervous system involved. HLA-B*5801 allele was tested in 18 patients. 88.9% (16/18) of cases were positive. 92.3% (48/52) of patients were treated with oral glucocorticoids. 25.0% of patients were died. Advanced age, underlying cardiovascular disease, chronic kidney disease and high dose of allopurinol, infection and internal organ involvement (including kidney, heart, lung and gastrointestinal tract) were risk factors for death.


Abstract

What is Known and Objective

Allopurinol-induced drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but serious and potentially life-threatening drug hypersensitivity syndrome. In this study, we aimed to investigate the clinical features, treatment outcomes, and prognostic factors of allopurinol-induced DRESS.

Methods

Case reports of allopurinol-induced DRESS published by China from January 2000 to August 2021 were retrieved from CNKI, Wan Fang, VIP, and PubMed databases for analysis.

Results and Discussion

This study included 52 patients, consisting of 41 (78.8%) males and 11 (21.2%) females (M:F = 3.7:1). The mean of age was 56.1 ± 17.1 years (range: 18–86 years). The mean of latency periods was 24.6 ± 15.0 days (range:1-63 days). Most patients presented with fever, cutaneous eruption, eosinophilia, lymphadenopathy, and facial edema. 36/52 (69.2%) patients showed two or more internal organs involved. Liver and kidney injuries were the most common visceral manifestation. Pulmonary involvement (34.6%), cardiac involvement (25.0%) and gastrointestinal involvement (21.2%) were relatively less known but severe complications. 2/52 (3.8%) patients showed nervous system involved, presenting as leukoencephalopathy or peripheral neuropathy. 2/52 (3.8%) patients presented with secondary hemophagocytic lymphohistiocytosis.1/52 (1.9%) patient developed pure red cell aplasia and 1/52 (1.9%) patient developed painless thyroiditis. HLA*B 58:01 allele was tested in 18/ 52 (34.6%) patients. 16/18 (88.9%) cases were positive. 48/52 (92.3%) patients were treated with systemic corticosteroids. 16/52 (30.8%) patients were cured, 23/52 (44.2%) patients received partial recovery, and 13/52 (25.0%) patients were died. Septic shock, gastrointestinal bleeding and multiple organ failure were the leading causes of death. Advanced age, underlying cardiovascular disease, chronic kidney disease and high dose of allopurinol, infection and internal organ involvement (including kidney, heart, lung and gastrointestinal tract) were risk factors for death.

What is New and Conclusion

We explored clinical features, treatment outcomes and prognostic factors of 52 allopurinol-induced DRESS cases in China. Ethnicity, especially Han Chinese, and positive HLA-B*58:01 allele are the clearest risk factors so far. Advanced age, underlying cardiovascular disease, chronic kidney disease and high dose of allopurinol, infection and internal organ involvement (including kidney, heart, lung and gastrointestinal tract) were associated with poorer outcomes. Early identification and discontinuation of the causative drug are crucial to the management of DRESS. For patients with severe disease, corticosteroids are recommended as the first-line therapy. However, further studies are needed to address diagnostic criteria of DRESS for early diagnosis, as well as to develop standardized corticosteroid treatment regimens.

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Stability of nasal symmetry following primary cleft lip and nasal repair: five years of follow-up

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Despite advances in cleft lip treatment, various levels of residual deformity remain after primary repair of cleft lip and palate. The aim of the current study was to compare the stability of short- and long-term postoperative nasal symmetry. This retrospective study included 100 consecutive non-syndromic patients with unilateral complete cleft lip who underwent primary cleft lip repair with follow-up of 5 years. Measurements taken from basal and frontal standard photograph views, obtained preoperatively (T1) and immediately (T2), 1 year (T3), and 5 years postoperative (T4), were analysed. (Source: International Journal of Oral and Maxillofacial Surgery)
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Periodontal ligament fibroblasts-derived exosomes induced by PGE2 inhibit human periodontal ligament stem cells osteogenic differentiation via activating miR-34c-5p/SATB2/ERK

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Publication date: Available online 15 August 2022

Source: Experimental Cell Research

Author(s): Chen Lin, Yingying Yang, Yingxue Wang, Heng Jing, Xinyi Bai, Zheng Hong, Chunxiang Zhang, Hui Gao, Linkun Zhang

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Prognostic validation of a new classification system for extent of resection in glioblastoma: a report of the RANO resect group

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Abstract
Background
Terminology to describe extent of resection in glioblastoma is inconsistent across clinical trials. A surgical classification system was previously proposed based upon residual contrast-enhancing (CE) tumor. We aimed to (I) explore the prognostic utility of the classification system and (II) define how much removed non-CE tumor translates into a survival benefit.
Methods
The international RANO resect group retrospectively searched previously compiled databases from seven neuro-oncological centers in the USA and Europe for patients with newly diagnosed glioblastoma per WHO 2021 classification. Clinical and volumetric information from pre- and post-operative MRI were collected.
Results
We collected 1008 patients with newly diagnosed IDHwt glioblastoma. 744 IDHwt glioblastomas were treated wit h radiochemotherapy per EORTC 26981/22981 (TMZ/RT→TMZ) following surgery. Among these homogenously treated patients, lower absolute residual tumor volumes (in cm 3) were favorably associated with outcome: patients with 'maximal CE resection' (class 2) had superior outcome compared to patients with 'submaximal CE resection' (class 3) or 'biopsy' (class 4). Extensive resection of non-CE tumor (≤5 cm 3 residual non-CE tumor) was associated with better survival among patients with complete CE resection, thus defining class 1 ('supramaximal CE resection'). The prognostic value of the resection classes was retained on multivariate analysis when adjusting for molecular and clinical markers.
Conclusions
The proposed "RANO categories for extent of resection in glioblastoma" are highly prognostic and may serve for stratification within clinical trials. Removal of non-CE tumor beyond the CE tumo r borders may translate into additional survival benefit, providing a rationale to explicitly denominate such 'supramaximal CE resection'.
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IDH1/2 wildtype gliomas grade 2 and 3 with molecular glioblastoma-like profile have a distinct course of epilepsy compared to IDH1/2 wildtype glioblastomas

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Abstract
Background
IDH1/2 wildtype (IDHwt) glioma WHO grade 2 and 3 patients with pTERT mutation and/or EGFR amplification and/or +7/−10 chromosome gain/loss have a similar overall survival time as IDHwt glioblastoma patients, and are both considered glioblastoma IDHwt according to the WHO 2021 classification. However, differences in seizure onset have been observed. This study aimed to compare the course of epilepsy in the two glioblastoma subtypes.
Methods
We analyzed epilepsy data of an existing cohort including IDHwt histologically lower-grade glioma WHO grade 2 and 3 with molecular glioblastoma-like profile (IDHwt hLGG) and IDHwt glioblastoma patients. Primary outcome was the incidence proportion of epilepsy during the disease course. Secondary outcomes included, among others, onset of epilepsy, number of seizure days and antiepileptic drug (AED) polytherapy.
Results
Out of 254 pa tients, 78% (50/64) IDHwt hLGG and 68% (129/190) IDHwt glioblastoma patients developed epilepsy during the disease (p=0.121). Epilepsy onset before histopathological diagnosis occurred more frequently in IDHwt hLGG compared to IDHwt glioblastoma patients (90% versus 60%, p<0.001), with a significantly longer median time to diagnosis (3.5 versus 1.3 months, p<0.001). Median total seizure days was also longer for IDHwt hLGG patients (7.0 versus 3.0, p=0.005), and they received more often AED polytherapy (32% versus 17%, p=0.028).
Conclusions
Although the incidence proportion of epilepsy during the entire disease course is similar, IDHwt hLGG patients show a significantly higher incidence of epilepsy before diagnosis and a significantly longer median time between first seizure and diagnosis compared to IDHwt glioblastoma patients, indicating a distinct clinical course.
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Translational Significance of CDKN2A/B Homozygous Deletion in IDH-Mutant Astrocytoma

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Abstract
Isocitrate dehydrogenase (IDH) 1 or 2 mutations confer a favorable prognosis compared to IDH-wildtype in astrocytoma, frequently denoting a lower grade malignancy. However, recent molecular profiling has identified specific aggressive tumor subgroups with clear clinical prognostic implications that are independent of histologic grading. The homozygous deletion of CDKN2A/B is the strongest implicated independent indicator of poor prognosis within IDH-mutant astrocytoma, and the identification of this alteration in these lower histologic grade tumors transforms their biology toward an aggressive grade 4 phenotype clinically. CDKN2A/B homozygous deletion is now sufficient to define a grade 4 tumor in IDH-mutant astrocytomas regardless of histologic appearance, yet there are currently no effective molecularly informed targeted therapies for these tumors. The biologic impact of CDKN2A/B homozygous deletion in IDH-mutant tumors and the optimal treatmen t strategy for this molecular subgroup remains insufficiently explored. Here we review the current understanding of the translational significance of homozygous deletion of CDKN2A/B gene expression in IDH-mutant astrocytoma and associated diagnostic and therapeutic implications.
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