Fitting 3D morphable models using implicit representations

We consider the problem of approximating the 3D scan of a real object through an affine combination of examples. Common approaches depend either on the explicit estimation of point-to-point correspondences or on 2-dimensional projections of the target mesh; both present drawbacks. We follow an approach similar to [IF03] by representing the target via an implicit function, whose values at the vertices of the approximation are used to define a robust cost function. The problem is approached in two steps, by approximating first a coarse implicit representation of the whole target, and then finer, local ones; the local approximations are then merged together with a Poisson-based method. We report the results of applying our method on a subset of 3D scans from the Face Recognition Grand Challenge v.1.0.

Statistical model-based segmentation of the proximal femur in digital antero-posterior (AP) pelvic radiographs.

PURPOSE    Segmentation of the proximal femur in digital antero-posterior (AP) pelvic radiographs is required to create a three-dimensional model of the hip joint for use in planning and treatment. However, manually extracting the femoral contour is tedious and prone to subjective bias, while automatic segmentation must accommodate poor image quality, anatomical structure overlap, and femur deformity. A new method was developed for femur segmentation in AP pelvic radiographs. METHODS    Using manual annotations on 100 AP pelvic radiographs, a statistical shape model (SSM) and a statistical appearance model (SAM) of the femur contour were constructed. The SSM and SAM were used to segment new AP pelvic radiographs with a three-stage approach. At initialization, the mean SSM model is coarsely registered to the femur in the AP radiograph through a scaled rigid registration. Mahalanobis distance defined on the SAM is employed as the search criteria for each annotated suggested landmark location. Dynamic programming was used to eliminate ambiguities. After all landmarks are assigned, a regularized non-rigid registration method deforms the current mean shape of SSM to produce a new segmentation of proximal femur. The second and third stages are iteratively executed to convergence. RESULTS    A set of 100 clinical AP pelvic radiographs (not used for training) were evaluated. The mean segmentation error was [Formula: see text], requiring [Formula: see text] s per case when implemented with Matlab. The influence of the initialization on segmentation results was tested by six clinicians, demonstrating no significance difference. CONCLUSIONS    A fast, robust and accurate method for femur segmentation in digital AP pelvic radiographs was developed by combining SSM and SAM with dynamic programming. This method can be extended to segmentation of other bony structures such as the pelvis.

Combined effect of heterogeneity, anisotropy and saturation on steady state flow and transport: Structure recognition and numerical simulation

1 Natural soil profiles may be interpreted as an arrangement of parts which are characterized by properties like hydraulic conductivity and water retention function. These parts form a complicated structure. Characterizing the soil structure is fundamental in subsurface hydrology because it has a crucial influence on flow and transport and defines the patterns of many ecological processes. We applied an image analysis method for recognition and classification of visual soil attributes in order to model flow and transport through a man-made soil profile. Modeled and measured saturation-dependent effective parameters were compared. We found that characterizing and describing conductivity patterns in soils with sharp conductivity contrasts is feasible. Differently, solving flow and transport on the basis of these conductivity maps is difficult and, in general, requires special care for representation of small-scale processes.

Mejoras en el procesamiento de imágenes de TC para el tratamiento con radioterapia adaptativa del cáncer de próstata

El cáncer de próstata es el tipo de cáncer con mayor prevalencia entre los hombres del mundo occidental y, pese a tener una alta tasa de supervivencia relativa, es la segunda mayor causa de muerte por cáncer en este sector de la población. El tratamiento de elección frente al cáncer de próstata es, en la mayoría de los casos, la radioterapia externa. Las técnicas más modernas de radioterapia externa, como la radioterapia modulada en intensidad, permiten incrementar la dosis en el tumor mientras se reduce la dosis en el tejido sano. Sin embargo, la localización del volumen objetivo varía con el día de tratamiento, y se requieren movimientos muy pequeños de los órganos para sacar partes del volumen objetivo fuera de la región terapéutica, o para introducir tejidos sanos críticos dentro. Para evitar esto se han desarrollado técnicas más avanzadas, como la radioterapia guiada por imagen, que se define por un manejo más preciso de los movimientos internos mediante una adaptación de la planificación del tratamiento basada en la información anatómica obtenida de imágenes de tomografía computarizada (TC) previas a la sesión terapéutica. Además, la radioterapia adaptativa añade la información dosimétrica de las fracciones previas a la información anatómica. Uno de los fundamentos de la radioterapia adaptativa es el registro deformable de imágenes, de gran utilidad a la hora de modelar los desplazamientos y deformaciones de los órganos internos. Sin embargo, su utilización conlleva nuevos retos científico-tecnológicos en el procesamiento de imágenes, principalmente asociados a la variabilidad de los órganos, tanto en localización como en apariencia. El objetivo de esta tesis doctoral es mejorar los procesos clínicos de delineación automática de contornos y de cálculo de dosis acumulada para la planificación y monitorización de tratamientos con radioterapia adaptativa, a partir de nuevos métodos de procesamiento de imágenes de TC (1) en presencia de contrastes variables, y (2) cambios de apariencia del recto. Además, se pretende (3) proveer de herramientas para la evaluación de la calidad de los contornos obtenidos en el caso del gross tumor volumen (GTV). Las principales contribuciones de esta tesis doctoral son las siguientes: _ 1. La adaptación, implementación y evaluación de un algoritmo de registro basado en el flujo óptico de la fase de la imagen como herramienta para el cálculo de transformaciones no-rígidas en presencia de cambios de intensidad, y su aplicabilidad a tratamientos de radioterapia adaptativa en cáncer de próstata con uso de agentes de contraste radiológico. Los resultados demuestran que el algoritmo seleccionado presenta mejores resultados cualitativos en presencia de contraste radiológico en la vejiga, y no distorsiona la imagen forzando deformaciones poco realistas. 2. La definición, desarrollo y validación de un nuevo método de enmascaramiento de los contenidos del recto (MER), y la evaluación de su influencia en el procedimiento de radioterapia adaptativa en cáncer de próstata. Las segmentaciones obtenidas mediante el MER para la creación de máscaras homogéneas en las imágenes de sesión permiten mejorar sensiblemente los resultados de los algoritmos de registro en la región rectal. Así, el uso de la metodología propuesta incrementa el índice de volumen solapado entre los contornos manuales y automáticos del recto hasta un valor del 89%, cercano a los resultados obtenidos usando máscaras manuales para el registro de las dos imágenes. De esta manera se pueden corregir tanto el cálculo de los nuevos contornos como el cálculo de la dosis acumulada. 3. La definición de una metodología de evaluación de la calidad de los contornos del GTV, que permite la representación de la distribución espacial del error, adaptándola a volúmenes no-convexos como el formado por la próstata y las vesículas seminales. Dicha metodología de evaluación, basada en un nuevo algoritmo de reconstrucción tridimensional y una nueva métrica de cuantificación, presenta resultados precisos con una gran resolución espacial en un tiempo despreciable frente al tiempo de registro. Esta nueva metodología puede ser una herramienta útil para la comparación de distintos algoritmos de registro deformable orientados a la radioterapia adaptativa en cáncer de próstata. En conclusión, el trabajo realizado en esta tesis doctoral corrobora las hipótesis de investigación postuladas, y pretende servir como cimiento de futuros avances en el procesamiento de imagen médica en los tratamientos de radioterapia adaptativa en cáncer de próstata. Asimismo, se siguen abriendo nuevas líneas de aplicación futura de métodos de procesamiento de imágenes médicas con el fin de mejorar los procesos de radioterapia adaptativa en presencia de cambios de apariencia de los órganos, e incrementar la seguridad del paciente. I.2 Inglés Prostate cancer is the most prevalent cancer amongst men in the Western world and, despite having a relatively high survival rate, is the second leading cause of cancer death in this sector of the population. The treatment of choice against prostate cancer is, in most cases, external beam radiation therapy. The most modern techniques of external radiotherapy, as intensity modulated radiotherapy, allow increasing the dose to the tumor whilst reducing the dose to healthy tissue. However, the location of the target volume varies with the day of treatment, and very small movements of the organs are required to pull out parts of the target volume outside the therapeutic region, or to introduce critical healthy tissues inside. Advanced techniques, such as the image-guided radiotherapy (IGRT), have been developed to avoid this. IGRT is defined by more precise handling of internal movements by adapting treatment planning based on the anatomical information obtained from computed tomography (CT) images prior to the therapy session. Moreover, the adaptive radiotherapy adds dosimetric information of previous fractions to the anatomical information. One of the fundamentals of adaptive radiotherapy is deformable image registration, very useful when modeling the displacements and deformations of the internal organs. However, its use brings new scientific and technological challenges in image processing, mainly associated to the variability of the organs, both in location and appearance. The aim of this thesis is to improve clinical processes of automatic contour delineation and cumulative dose calculation for planning and monitoring of adaptive radiotherapy treatments, based on new methods of CT image processing (1) in the presence of varying contrasts, and (2) rectum appearance changes. It also aims (3) to provide tools for assessing the quality of contours obtained in the case of gross tumor volume (GTV). The main contributions of this PhD thesis are as follows: 1. The adaptation, implementation and evaluation of a registration algorithm based on the optical flow of the image phase as a tool for the calculation of non-rigid transformations in the presence of intensity changes, and its applicability to adaptive radiotherapy treatment in prostate cancer with use of radiological contrast agents. The results demonstrate that the selected algorithm shows better qualitative results in the presence of radiological contrast agents in the urinary bladder, and does not distort the image forcing unrealistic deformations. 2. The definition, development and validation of a new method for masking the contents of the rectum (MER, Spanish acronym), and assessing their impact on the process of adaptive radiotherapy in prostate cancer. The segmentations obtained by the MER for the creation of homogenous masks in the session CT images can improve significantly the results of registration algorithms in the rectal region. Thus, the use of the proposed methodology increases the volume overlap index between manual and automatic contours of the rectum to a value of 89%, close to the results obtained using manual masks for both images. In this way, both the calculation of new contours and the calculation of the accumulated dose can be corrected. 3. The definition of a methodology for assessing the quality of the contours of the GTV, which allows the representation of the spatial distribution of the error, adapting it to non-convex volumes such as that formed by the prostate and seminal vesicles. Said evaluation methodology, based on a new three-dimensional reconstruction algorithm and a new quantification metric, presents accurate results with high spatial resolution in a time negligible compared to the registration time. This new approach may be a useful tool to compare different deformable registration algorithms oriented to adaptive radiotherapy in prostate cancer In conclusion, this PhD thesis corroborates the postulated research hypotheses, and is intended to serve as a foundation for future advances in medical image processing in adaptive radiotherapy treatment in prostate cancer. In addition, it opens new future applications for medical image processing methods aimed at improving the adaptive radiotherapy processes in the presence of organ’s appearance changes, and increase the patient safety.

Aplicación de técnicas de inteligencia artificial para contribuir en la detección de microcalcificaciones en mamografía digitalizada

A nivel mundial, el cáncer de mama es el tipo de cáncer más frecuente además de una de las principales causas de muerte entre la población femenina. Actualmente, el método más eficaz para detectar lesiones mamarias en una etapa temprana es la mamografía. Ésta contribuye decisivamente al diagnóstico precoz de esta enfermedad que, si se detecta a tiempo, tiene una probabilidad de curación muy alta. Uno de los principales y más frecuentes hallazgos en una mamografía, son las microcalcificaciones, las cuales son consideradas como un indicador importante de cáncer de mama. En el momento de analizar las mamografías, factores como la capacidad de visualización, la fatiga o la experiencia profesional del especialista radiólogo hacen que el riesgo de omitir ciertas lesiones presentes se vea incrementado. Para disminuir dicho riesgo es importante contar con diferentes alternativas como por ejemplo, una segunda opinión por otro especialista o un doble análisis por el mismo. En la primera opción se eleva el coste y en ambas se prolonga el tiempo del diagnóstico. Esto supone una gran motivación para el desarrollo de sistemas de apoyo o asistencia en la toma de decisiones. En este trabajo de tesis se propone, se desarrolla y se justifica un sistema capaz de detectar microcalcificaciones en regiones de interés extraídas de mamografías digitalizadas, para contribuir a la detección temprana del cáncer demama. Dicho sistema estará basado en técnicas de procesamiento de imagen digital, de reconocimiento de patrones y de inteligencia artificial. Para su desarrollo, se tienen en cuenta las siguientes consideraciones: 1. Con el objetivo de entrenar y probar el sistema propuesto, se creará una base de datos de imágenes, las cuales pertenecen a regiones de interés extraídas de mamografías digitalizadas. 2. Se propone la aplicación de la transformada Top-Hat, una técnica de procesamiento digital de imagen basada en operaciones de morfología matemática. La finalidad de aplicar esta técnica es la de mejorar el contraste entre las microcalcificaciones y el tejido presente en la imagen. 3. Se propone un algoritmo novel llamado sub-segmentación, el cual está basado en técnicas de reconocimiento de patrones aplicando un algoritmo de agrupamiento no supervisado, el PFCM (Possibilistic Fuzzy c-Means). El objetivo es encontrar las regiones correspondientes a las microcalcificaciones y diferenciarlas del tejido sano. Además, con la finalidad de mostrar las ventajas y desventajas del algoritmo propuesto, éste es comparado con dos algoritmos del mismo tipo: el k-means y el FCM (Fuzzy c-Means). Por otro lado, es importante destacar que en este trabajo por primera vez la sub-segmentación es utilizada para detectar regiones pertenecientes a microcalcificaciones en imágenes de mamografía. 4. Finalmente, se propone el uso de un clasificador basado en una red neuronal artificial, específicamente un MLP (Multi-layer Perceptron). El propósito del clasificador es discriminar de manera binaria los patrones creados a partir de la intensidad de niveles de gris de la imagen original. Dicha clasificación distingue entre microcalcificación y tejido sano. ABSTRACT Breast cancer is one of the leading causes of women mortality in the world and its early detection continues being a key piece to improve the prognosis and survival. Currently, the most reliable and practical method for early detection of breast cancer is mammography.The presence of microcalcifications has been considered as a very important indicator ofmalignant types of breast cancer and its detection and classification are important to prevent and treat the disease. However, the detection and classification of microcalcifications continue being a hard work due to that, in mammograms there is a poor contrast between microcalcifications and the tissue around them. Factors such as visualization, tiredness or insufficient experience of the specialist increase the risk of omit some present lesions. To reduce this risk, is important to have alternatives such as a second opinion or a double analysis for the same specialist. In the first option, the cost increases and diagnosis time also increases for both of them. This is the reason why there is a great motivation for development of help systems or assistance in the decision making process. This work presents, develops and justifies a system for the detection of microcalcifications in regions of interest extracted fromdigitizedmammographies to contribute to the early detection of breast cancer. This systemis based on image processing techniques, pattern recognition and artificial intelligence. For system development the following features are considered: With the aim of training and testing the system, an images database is created, belonging to a region of interest extracted from digitized mammograms. The application of the top-hat transformis proposed. This image processing technique is based on mathematical morphology operations. The aim of this technique is to improve the contrast betweenmicrocalcifications and tissue present in the image. A novel algorithm called sub-segmentation is proposed. The sub-segmentation is based on pattern recognition techniques applying a non-supervised clustering algorithm known as Possibilistic Fuzzy c-Means (PFCM). The aim is to find regions corresponding to the microcalcifications and distinguish them from the healthy tissue. Furthermore,with the aim of showing themain advantages and disadvantages this is compared with two algorithms of same type: the k-means and the fuzzy c-means (FCM). On the other hand, it is important to highlight in this work for the first time the sub-segmentation is used for microcalcifications detection. Finally, a classifier based on an artificial neural network such as Multi-layer Perceptron is used. The purpose of this classifier is to discriminate froma binary perspective the patterns built from gray level intensity of the original image. This classification distinguishes between microcalcifications and healthy tissue.

Non uniform embedding based on relevance analysis with reduced computational complexity: application to the detection of pathologies from biosignal recordings

Nonlinear analysis tools for studying and characterizing the dynamics of physiological signals have gained popularity, mainly because tracking sudden alterations of the inherent complexity of biological processes might be an indicator of altered physiological states. Typically, in order to perform an analysis with such tools, the physiological variables that describe the biological process under study are used to reconstruct the underlying dynamics of the biological processes. For that goal, a procedure called time-delay or uniform embedding is usually employed. Nonetheless, there is evidence of its inability for dealing with non-stationary signals, as those recorded from many physiological processes. To handle with such a drawback, this paper evaluates the utility of non-conventional time series reconstruction procedures based on non uniform embedding, applying them to automatic pattern recognition tasks. The paper compares a state of the art non uniform approach with a novel scheme which fuses embedding and feature selection at once, searching for better reconstructions of the dynamics of the system. Moreover, results are also compared with two classic uniform embedding techniques. Thus, the goal is comparing uniform and non uniform reconstruction techniques, including the one proposed in this work, for pattern recognition in biomedical signal processing tasks. Once the state space is reconstructed, the scheme followed characterizes with three classic nonlinear dynamic features (Largest Lyapunov Exponent, Correlation Dimension and Recurrence Period Density Entropy), while classification is carried out by means of a simple k-nn classifier. In order to test its generalization capabilities, the approach was tested with three different physiological databases (Speech Pathologies, Epilepsy and Heart Murmurs). In terms of the accuracy obtained to automatically detect the presence of pathologies, and for the three types of biosignals analyzed, the non uniform techniques used in this work lightly outperformed the results obtained using the uniform methods, suggesting their usefulness to characterize non-stationary biomedical signals in pattern recognition applications. On the other hand, in view of the results obtained and its low computational load, the proposed technique suggests its applicability for the applications under study.

Detección automática con snakes y representación 3D sobre imágenes cerebrales

Comunicación presentada en la VI Conferencia de la Asociación Española para la Inteligencia Artificial (CAEPIA'95), Alicante, 15-17 noviembre 1995.

Methodology based on registration techniques for representing subjects and their deformations acquired from general purpose 3D sensors

In this thesis a methodology for representing 3D subjects and their deformations in adverse situations is studied. The study is focused in providing methods based on registration techniques to improve the data in situations where the sensor is working in the limit of its sensitivity. In order to do this, it is proposed two methods to overcome the problems which can difficult the process in these conditions. First a rigid registration based on model registration is presented, where the model of 3D planar markers is used. This model is estimated using a proposed method which improves its quality by taking into account prior knowledge of the marker. To study the deformations, it is proposed a framework to combine multiple spaces in a non-rigid registration technique. This proposal improves the quality of the alignment with a more robust matching process that makes use of all available input data. Moreover, this framework allows the registration of multiple spaces simultaneously providing a more general technique. Concretely, it is instantiated using colour and location in the matching process for 3D location registration.

Recognition on Finite Set of Events: Bayesian Analysis of Generalization Ability and Classification Tree Pruning

The problem of recognition on finite set of events is considered. The generalization ability of classifiers for this problem is studied within the Bayesian approach. The method for non-uniform prior distribution specification on recognition tasks is suggested. It takes into account the assumed degree of intersection between classes. The results of the analysis are applied for pruning of classification trees.

Annotated record of the detailed examination of Mn deposits from COCOTOW Expedition stations in the intersection of the Siqueiros Transform Fault and the East Pacific Rise

A near-bottom geological and geophysical survey was conducted at the western intersection of the Siqueiros Transform Fault and the East Pacific Rise. Transform-fault shear appears to distort the east flank of the rise crest in an area north of the fracture zone. In ward-facing scarps trend 335° and do not parallel the regional axis of spreading. Small-scale scarps reveal a hummocky bathymetry. The center of spreading is not a central peak but rather a 20-40 m deep, 1 km wide valley superimposed upon an 8 km wide ridge-crest horst. Small-scale topography indicates widespread volcanic flows within the valley. Two 0.75 km wide blocks flank the central valley. Fault scarps are more dominant on the western flank. Their alignment shifts from directions intermediate to parallel to the regional axis of spreading (355°). A median ridge within the fracture zone has a fault-block topography similar to that of the East Pacific Rise to the north. Dominant eastward-facing scarps trending 335° are on the west flank. A central depression, 1 km wide and 30 m deep, separates the dominantly fault-block regime of the west from the smoother topography of the east flank. This ridge originated by uplift due to faulting as well as by volcanism. Detailed mapping was concentrated in a perched basin (Dante's Hole) at the intersection of the rise crest and the fracture zone. Structural features suggest that Dante's Hole is an area subject to extreme shear and tensional drag resulting from transition between non-rigid and rigid crustal behavior. Normal E-W crustal spreading is probably taking place well within the northern confines of the basin. Possible residual spreading of this isolated rise crest coupled with shear drag within the transform fault could explain the structural isolation of Dante's Hole from the remainder of the Siqueiros Transform Fault.

Fast 2D/3D object representation with growing neural gas

This work presents the design of a real-time system to model visual objects with the use of self-organising networks. The architecture of the system addresses multiple computer vision tasks such as image segmentation, optimal parameter estimation and object representation. We first develop a framework for building non-rigid shapes using the growth mechanism of the self-organising maps, and then we define an optimal number of nodes without overfitting or underfitting the network based on the knowledge obtained from information-theoretic considerations. We present experimental results for hands and faces, and we quantitatively evaluate the matching capabilities of the proposed method with the topographic product. The proposed method is easily extensible to 3D objects, as it offers similar features for efficient mesh reconstruction.

Integrated visual perception architecture for robotic clothes perception and manipulation

This thesis proposes a generic visual perception architecture for robotic clothes perception and manipulation. This proposed architecture is fully integrated with a stereo vision system and a dual-arm robot and is able to perform a number of autonomous laundering tasks. Clothes perception and manipulation is a novel research topic in robotics and has experienced rapid development in recent years. Compared to the task of perceiving and manipulating rigid objects, clothes perception and manipulation poses a greater challenge. This can be attributed to two reasons: firstly, deformable clothing requires precise (high-acuity) visual perception and dexterous manipulation; secondly, as clothing approximates a non-rigid 2-manifold in 3-space, that can adopt a quasi-infinite configuration space, the potential variability in the appearance of clothing items makes them difficult to understand, identify uniquely, and interact with by machine. From an applications perspective, and as part of EU CloPeMa project, the integrated visual perception architecture refines a pre-existing clothing manipulation pipeline by completing pre-wash clothes (category) sorting (using single-shot or interactive perception for garment categorisation and manipulation) and post-wash dual-arm flattening. To the best of the author’s knowledge, as investigated in this thesis, the autonomous clothing perception and manipulation solutions presented here were first proposed and reported by the author. All of the reported robot demonstrations in this work follow a perception-manipulation method- ology where visual and tactile feedback (in the form of surface wrinkledness captured by the high accuracy depth sensor i.e. CloPeMa stereo head or the predictive confidence modelled by Gaussian Processing) serve as the halting criteria in the flattening and sorting tasks, respectively. From scientific perspective, the proposed visual perception architecture addresses the above challenges by parsing and grouping 3D clothing configurations hierarchically from low-level curvatures, through mid-level surface shape representations (providing topological descriptions and 3D texture representations), to high-level semantic structures and statistical descriptions. A range of visual features such as Shape Index, Surface Topologies Analysis and Local Binary Patterns have been adapted within this work to parse clothing surfaces and textures and several novel features have been devised, including B-Spline Patches with Locality-Constrained Linear coding, and Topology Spatial Distance to describe and quantify generic landmarks (wrinkles and folds). The essence of this proposed architecture comprises 3D generic surface parsing and interpretation, which is critical to underpinning a number of laundering tasks and has the potential to be extended to other rigid and non-rigid object perception and manipulation tasks. The experimental results presented in this thesis demonstrate that: firstly, the proposed grasp- ing approach achieves on-average 84.7% accuracy; secondly, the proposed flattening approach is able to flatten towels, t-shirts and pants (shorts) within 9 iterations on-average; thirdly, the proposed clothes recognition pipeline can recognise clothes categories from highly wrinkled configurations and advances the state-of-the-art by 36% in terms of classification accuracy, achieving an 83.2% true-positive classification rate when discriminating between five categories of clothes; finally the Gaussian Process based interactive perception approach exhibits a substantial improvement over single-shot perception. Accordingly, this thesis has advanced the state-of-the-art of robot clothes perception and manipulation.

A framework for selecting appropriate remotely sensed data dimensions for environmental monitoring and management

Two major factors are likely to impact the utilisation of remotely sensed data in the near future: (1)an increase in the number and availability of commercial and non-commercial image data sets with a range of spatial, spectral and temporal dimensions, and (2) increased access to image display and analysis software through GIS. A framework was developed to provide an objective approach to selecting remotely sensed data sets for specific environmental monitoring problems. Preliminary applications of the framework have provided successful approaches for monitoring disturbed and restored wetlands in southern California.

Use of resin-bonded extracoronal attachments with removable partial denture: case report

Introduction: Resin-bonded extracoronal attachments may be indicated for the abutment teeth of removable partial dentures, especially for anterior teeth when a cingulum rest must be provided. This type of treatment has a series of advantages such as minimal tooth reduction, supragingival margins, favourable stress distribution, and improved aesthetic appearance. Objective: To report a clinical case of oral rehabilitation using a combination of resin-bonded extracoronal attachments joined by a Dolder bar with a removable partial denture. Case report: A 60-year-old male patient with only the canines in the maxillary arch was restored with a combination of resin-bonded extracoronal attachments joined by a Dolder bar and a removable partial denture. Conclusion: Dentures with resin-bonded extracoronal attachments can have a number of advantages over traditional clasp-retained removable partial dentures.