Assessment of CT numbers in limited and medium field-of-view scans taken using Accuitomo 170 and Veraviewepocs 3De cone-beam computed tomography scanners

To assess the influence of anatomic location on the relationship between computed tomography (CT) number and X-ray attenuation in limited and medium field-of-view (FOV) scans. Materials and Methods Tubes containing solutions with different concentrations of K2HPO4 were placed in the tooth sockets of a human head phantom. Cone-beam computed tomography (CBCT) scans were acquired, and CT numbers of the K2HPO4 solutions were measured. The relationship between CT number and K2HPO4 concentration was examined by linear regression analyses. Then, the variation in CT number according to anatomic location was examined. Results The relationship between K2HPO4 concentration and CT number was strongly linear. The slopes of the linear regressions for the limited FOVs were almost 2-fold lower than those for the medium FOVs. The absolute CT number differed between imaging protocols and anatomic locations. Conclusion There is a strong linear relationship between X-ray attenuation and CT number. The specific imaging protocol and anatomic location of the object strongly influence this relationship.

Intravitreal injection versus sub-Tenon's infusion of triamcinolone acetonide for refractory diabetic macular edema: A randomized clinical trial

PURPOSE. To compare the effectiveness of posterior sub-Tenon's infusion (STi) and intravitreal injection (IVI) of triamcinolone acetonide (TA) for treatment of refractory diffuse diabetic macular edema.METHODS. Thirty-six phakic diabetic patients with refractory diffuse diabetic macular edema were prospectively enrolled. Patients randomly received either 40 mg STi or 4 mg IVI of TA. Comprehensive ophthalmic evaluation was performed at baseline and 1, 2, 4, 8 +/- 1, 12 +/- 2 and 24 +/- 2 weeks after treatment. Macular morphologic changes detected by optical coherence tomography and visual acuity, intraocular pressure, and lens status were evaluated.RESULTS. Twenty-eight patients (28 eyes) completed the 24-week study. Central macular thickness was significantly reduced in the IVI group when compared with the STi group at 2, 4, 8, 12, and 24 weeks after treatment (P < 0.01). Mean visual acuities (in logarithm of the minimum angle of resolution [logMAR]) at week-4, -8, and -12 follow-up examinations were significantly higher in the IVI group (0.74, 0.75, and 0.82, respectively) when compared with the STi group (0.88, 0.88, and 0.90, respectively; P < 0.01). A significant change from baseline in mean intraocular pressure (mm Hg) was seen at weeks 4 (+/- 3.21) and 8 (+/- 3.35) in STi the group (P < 0.01), and at week 8 (+/- 2.78) in the IVI group (P < 0.05). No patient had cataract progression during the study.CONCLUSIONS. Although the number of patients and length of follow-up in this preliminary study were limited, the changes in central macular thickness and visual acuity observed after treatment suggest that IVI TA may be more effective than STi for the management of refractory diffuse diabetic macular edema. Further studies are needed to confirm these preliminary findings.

A thermoporometry and small-angle x-ray scattering study of wet silica sonogels as the pore volume fraction is varied

Silica sonogels with different porosities were prepared by acid sono-hydrolysis of tetraethoxysilane. Wet sonogels were studied using small-angle x-ray scattering (SAXS) and differential scanning calorimetry (DSC). The DSC shows a broad thermal peak below the normal water melting point associated with the melting of confined ice nanocrystals, or nanoporosity. The nanopore size distribution was determined from the Gibbs-Thomson equation. As the porosity is increased, a second sharp DSC thermal peak with onset temperature at the water melting point is apparent, which was associated with the melting of ice macrocrystals, or macroporosity. The DSC result could be causing misinterpretation of the macroporosity because water may not be exactly confined in very feeble silica network regions in sonogels with high porosity. The structure of the wet gels can be described fairly well as mutually self-similar mass fractal structures with characteristic length. increasing from similar to 1.8 to similar to 5.4 nm and mass fractal dimension D diminishing discretely from similar to 2.6 to similar to 2.3 as the porosity increases in the range studied. More specifically, such a structure could be described using a two-parameter correlation function gamma(r) similar to r(D-3) exp(-r/xi), which is limited at larger scale by the cut-off distance xi but without a well-defined small scale cut-off distance, at least up to the maximum angular domain probed using SAXS in the present study.

Myositis ossificans traumatica of the medial pterygoid muscle: a case report.

In this report, we present a case of myositis ossificans traumatica (MOT) of the medial pterygoid muscle that had developed after mandibular block anesthesia administered for endodontic treatment of the lower right second molar, demonstrating typical features of this condition. MOT should be considered as a differential diagnosis when there is severe limitation of jaw opening and an associated trauma. Panoramic radiographs and axial and coronal computed tomography (CT) scans can effectively delineate the calcified mass. Other imaging studies that may be helpful include magnetic resonance imaging (MRI), bone scans, and ultrasound. As shown in our case, calcified masses were found in the right mandibular angle, which severely limited jaw opening. Some earlier reported cases of MOT were treated by extraoral surgical approaches with complete removal of the evolving muscle. The aim of this case report is to present only the diagnostic imaging aspects of myositis ossificans traumatica.

Mechanical behavior of dental implants in different positions in the rehabilitation of the anterior maxilla

Statement of problem. In dental rehabilitations that involve implants, the number of implants is sometimes smaller than the number of lost teeth. This fact can affect the biomechanical behavior and success of the implants.Purpose. The purpose of this study was to investigate the mechanical behavior of different implant positions in the rehabilitation of the anterior maxilla.Material and methods. Three-dimensional models of the maxilla were created based on computed tomography images for 3 different anterior prosthetic rehabilitations. In group IL, the implants were placed in the lateral incisor positions with pontics in the central incisor positions; in group IC, the implants were in the central incisor positions with cantilevers in the lateral incisor positions; and, in group ILIC, one implant was in a lateral incisor position and one was in a central incisor position, with a pontic and a cantilever in the remaining positions. A 150 N load was distributed and applied at the center of the palatal surface of each tooth at a 45-degree angle to the long axis of the tooth. The resulting stress-strain distribution was analyzed for each group.Results. The lowest displacement of the prosthetic structure was observed in group IC, although the same group exhibited the largest displacement of the bone tissue. In the bone tissue, the von Mises stress was mainly observed in the cortical bone in all groups. The maximum value of the von Mises stress shown in the cortical tissue was 35 MPa in the implant that neighbors the cantilever in group ILIC. The maximum von Mises stress in the trabecular bone was 3.5 MPa.Conclusion. The prosthetic configuration of group IC limited the displacement of the prosthetic structure but led to greater displacement of the bone structure. The use of a cantilever increased the stress concentration in the implant and in the bone structure adjacent to the cantilever under the conditions studied here.

Influence of cone-beam computed tomography image artifacts on the determination of dental arch measurements

Objective: To compare dental plaster model (DPM) and cone-beam computed tomography (CBCT) in the measurement of the dental arches, and investigate whether CBCT image artifacts compromise the reliability of such measurements.Materials and Methods: Twenty patients were divided into two groups based on the presence or absence of metallic restorations in the posterior teeth. Both dental arches of the patients were scanned with the CBCT unit i-CAT, and DPMs were obtained. Two examiners obtained eight arch measurements on the CBCT images and DPMs and repeated this procedure 15 days later. The arch measurements of each patient group were compared separately by the Wilcoxon rank sum (Mann-Whitney U) test, with a significance level of 5% (alpha = .05). Intraclass correlation measured the level of intraobserver agreement.Results: Patients with healthy teeth showed no significant difference between all DPM and CBCT arch measurements (P > .05). Patients with metallic restoration showed significant difference between DPM and CBCT for the majority of the arch measurements (P > .05). The two examiners showed excellent intraobserver agreement for both measuring methods with intraclass correlation coefficient higher than 0.95.Conclusion: CBCT provided the same accuracy as DPM in the measurement of the dental arches, and was negatively influenced by the presence of image artifacts.