Search Results (75)

Background: Identifying the etiological factors of syringomyelia, which can cause progressive neurological deficits in the spinal cord, is critically important for both diagnosis and treatment. This study aimed to assess the cranial morphometric features of patients with idiopathic syringomyelia by conducting comparative analyses with individuals diagnosed with Chiari Type I, Chiari Type I accompanied by syringomyelia, and healthy controls, in order to elucidate the potential structural contributors to the pathogenesis of idiopathic syringomyelia. Methods: In this retrospective and comparative study, a total of 172 patients diagnosed with Chiari Type I and/or syringomyelia between 2016 and 2024, along with 156 radiologically normal individuals, were included. The participants were categorized into four groups: healthy controls, Chiari Type I, Chiari Type I with syringomyelia, and idiopathic syringomyelia (defined as syringomyelia without an identifiable cause). Midline sagittal T1-weighted MR images were used to obtain quantitative measurements of the posterior fossa, cerebellum, intracranial area, and foramen magnum. All measurements were stratified and statistically analyzed by sex. Results: In cases with idiopathic syringomyelia, both the posterior fossa area and the cerebellum/posterior fossa ratio differed significantly from those of healthy controls. In male patients, the foramen magnum diameter was significantly larger in the Chiari + syringomyelia group compared with the idiopathic group. A significant correlation was found between the degree of tonsillar descent and selected morphometric parameters in female subjects, whereas no such correlation was observed in males. Both Chiari groups exhibited significantly smaller posterior fossa dimensions compared with the healthy and idiopathic groups, indicating greater neural crowding. Additionally, in Chiari Type I patients, increasing degrees of tonsillar descent were associated with a decreased incidence of syringomyelia. Conclusions: Anatomical variations such as a reduced posterior fossa area or altered foramen magnum diameter may contribute to the pathogenesis of idiopathic syringomyelia. Cranial morphometric analysis appears to offer diagnostic value in these cases. Further prospective, multicenter studies incorporating advanced neuroimaging modalities, particularly those assessing cerebrospinal fluid dynamics, are warranted to better understand the mechanisms underlying syringomyelia of unknown etiology. Full article

Background: Adrenal glands are situated cranially and in close proximity to both kidneys. The rabbit is a preferred animal pet species and is also used as an experimental model in research. The aim of this study was to investigate the CT anatomical features of the rabbit adrenal glands, using the CT device SOMATOM. Methods: Ten sexually mature clinically healthy rabbits, with body weights from 2.5 to 3.0 kg were used. They were separated into two groups—five males and five females. CT algorithm: Transverse, sagittal, and dorsal CT studies were performed. The animals were positioned in supine recumbency. They were anesthetized with 15 mg/kg Zoletil^® 50. Helical CT was carried out. The body was scanned from the intrathoracic part of the abdominal cavity to the pelvic inlet. CCD, DVD, and MLD dimensions were measured. Results: Transverse CT scans at the Th12 and L1 level visualized the topography of the right and left adrenal glands. Sagittal CT scans of Regio abdominis, 10 mm to the right and to the left of the median plane, showed the right and left adrenal glands as findings with intermediate attenuation. The dorsal CT investigation of Regio abdominis 30 mm and 45 mm ventral to the spine demonstrated both glands in the vicinity of abdominal organs and large blood vessels. CCD of the right adrenal gland was 6.9 ± 0.5 mm, DVD of the same gland was 5.7 ± 0.7 mm, and MLD was—3.9 ± 0.3 mm. CCD of the left adrenal gland was 5.4 ± 0.6 mm, DVD was—4.0 ± 1.1 mm, and MLD was—4.1 ± 0.9 mm. Conclusions: CCD and DVD of the right adrenal gland were greater than the same parameters of the left gland. MLD of the right adrenal gland was lower than the same parameter measured for the left one. Full article

The rapid maxillary expander is one of the most widely used devices in orthodontics, and this study analyzes the skeletal and dental effects of a two-band rapid maxillary expander (RME) and a splint resin palatal expander (SRPE) in growing children with skeletal maxillary contraction. Seventy-four subjects with palatal skeletal contraction and unilateral or bilateral posterior crossbite were treated using maxillary expander devices. The sample was made up of two different randomly assigned groups: RME (21 females, 17 males; mean age ± SD 7.7 ± 1.1 years) and SRPE (24 females, 15 males; mean age ± SD 7.6 ± 1.0 years). The effects of these two different devices were evaluated based on lateral cephalograms and measurements of digital models before and after treatment (7.0 ± 1.0 months). Longitudinal changes in the different groups were evaluated statistically using Student’s t-test (p < 0.05). No significant differences in treatment effects were found for any vertical or sagittal skeletal variables in the groups. However, there was a significantly increased maxillary intercanine distance in the SRPE group (36 patients; mean ± SD = 6.0 ± 4.8 mm) compared to the RME group (38 patients; mean ± SD = 3.1 ± 2.9 mm). The results of this study showed an increase in vertical skeletal dimensions in more patients treated using SRPE than RME. Moreover, the SRPE device was shown to be better at increasing the intercanine distance, and it could therefore be preferred in children with anterior dental crowding. An evaluation of long-term treatment stability would be useful to confirm the study results. Full article

Background/Objectives: This cross-sectional analytical study investigated the relationship between the craniofacial morphology, condylar displacement, and degenerative changes in the temporomandibular joints (TMJs) in adult patients with class II skeletal malocclusion. To compare cephalometric variables, joint space dimensions, and centric slide measurements between patients with and without CBCT-confirmed TMJ degenerative alterations. Methods: Sixty adults with class II malocclusion were divided into two equal groups (n = 30) based on the presence or absence of TMJ degenerative changes on CBCT. Joint spaces were measured, condylar displacement was evaluated using a condylar position indicator (CPI), and cephalometric analysis was performed in both maximal intercuspation and centric relation. Statistical comparisons were performed using t-tests, chi-squared tests, and Pearson’s correlation analysis. Significance was set at p < 0.05. Results: Patients with degenerative TMJ changes exhibited significantly greater overjet (p = 0.0001) and a trend toward increased ANB angles (p = 0.055). The superior joint space was reduced on the right side (p = 0.031). Condylar displacements ≥ 2 mm were more frequent in the affected group and correlated with sagittal cephalometric discrepancies (45% vs. 24% in controls). Conclusions: Aggravated skeletal class II malocclusion with increased overjet could be associated with TMJ degenerative changes. CR-based cephalometry and CBCT evaluation may aid in diagnostic assessment, but longitudinal studies are needed to confirm the clinical relevance. Full article

The aim of this study was to assess the maxillary arch asymmetry in paediatric subjects with functional posterior crossbite. Linear widths and depths of maxillary hemi-arches were measured in crossbite patients (29 girls, 14 boys; mean age: 9.49 ± 1.22 years) and in a control group (26 girls, 18 boys; mean age: 9.35 ± 0.70 years) without crossbite. Differences in the linear widths and depths between the two maxillary sides were analysed and compared between groups. Additionally, a 3D superimposition of the mirrored maxillary models was performed for each subject to evaluate dental–alveolar and palatal vault-matching percentages and compare between groups. The Mann–Whitney U test was used for the statistical analysis. The differences in the maxillary hemi-arch linear distances between the two sides of the maxilla were significantly greater in the study group than in the control group (p = 0.000). Matching percentages of the upper arch were lower in the crossbite group (p = 0.000), particularly in the dental–alveolar region of the molars. These findings indicate that maxillary asymmetry in both the transverse and sagittal dimensions is more pronounced in crossbite patients, and the deviations between the two maxillary halves are more evident at the dental–alveolar level and in the molar region. Full article

Background: The aim of this work is to compare the size of the frontal sinus and the different skeletal classes and divergence patterns of the subjects. Methods: This study retrospectively includes lateral radiographs performed on a total of 200 adults (78 M, 122 F; mean age 29.2 ± 8.0 years). Subject inclusion criteria were an age of 18–45 years, presence of both frontal sinuses, and good general health with no hormonal system disorders that may affect the growth and pneumatization of the frontal sinuses. Four different parameters of the frontal sinus were evaluated: length, width, perimeter, and area. In order to calculate the variables inherent to the sagittal and vertical skeletal pattern, two independent nominal variables were considered: skeletal class (ANB°) and mandibular divergence (SN^MP°). Results: The statistical analysis showed that there is a statistically significant difference between the frontal sinus dimension and the three skeletal classes. Subjects in group 3 presented significantly higher mean dimensional values. In the analysis of sinus size variables with skeletal divergence, significant results were found for the width value, which resulted in higher average values in group c. Conclusions: The present study shows a statistically significant difference in frontal sinus size among different skeletal classes and divergence patterns. This result suggests that, in future studies, it should be analyzed whether the dimensional analysis of the frontal sinus could be associated with skeletal class III malocclusion. Full article

Background: This study investigated the effects of preoperative maxillary plates on cleft width reduction in infants with unilateral cleft lip and palate and their control group. The study also aimed to compare the digital and manual methods in measurement of changes in maxillary segment positioning in sagittal and transverse dimensions using digital 3D models and conventional plaster casts. Methods: Twenty infants with unilateral cleft lip and palate and their control group of eleven infants with isolated cleft palate were enrolled in a prospective interventional study (2020 to 2024). Participants were treated with either active or passive maxillary plates. Sagittal, transversal and angular measurements were taken both manually as well as digitally at three time points: 24–48 h postnatal (T0), approximately at six months old (T1, immediately before surgery), and one year postoperatively (T2). Results: Significant reductions in cleft width were observed across all patients over the treatment period, regardless of the type of plate used (p < 0.001). The mean cleft width reduction was 5.050 mm. Infants treated with active plates had a larger reduction in cleft width than those with passive plates (p = 0.024), averaging 5.846 mm compared to 3.571 mm. Neither the side of the cleft nor the patient’s gender influenced the degree of cleft reduction (p = 0.884 and p = 0.245, respectively). The study found significant modifications in the maxilla’s transverse, sagittal, and angular dimensions (p < 0.001). When comparing sagittal growth, the study group differed from the control group (p = 0.004), with isolated cleft palate patients showing more substantial sagittal expansion. Additionally, the overall change in the ITT’ distance differed significantly between the study and control groups over time (p < 0.001). Cleft size at baseline did not affect the extent of changes within the cleft area. No significant discrepancies were found between digital and manual measurement methods, confirming the reliability of both. Conclusions: Active plates demonstrated greater efficacy in cleft reduction for wider and more divergent clefts, while passive plates were suitable for smaller clefts. Full article

Background/Objectives: Implant placement in cases of severe bone atrophy or compromised alveolar bone requires careful planning, especially in the anterior maxilla. The nasopalatine canal (NPC) and its cortical walls offer potential anchorage sites. This study evaluates the NPC’s anatomical characteristics using cone beam computed tomography (CBCT) to assess its suitability for implant anchorage. Methods: A retrospective analysis of 150 CBCT scans from three dental clinics in Poland was conducted. NPC measurements—including length, width, number of canals, and distances to adjacent anatomical structures—were taken in the sagittal, coronal, and axial planes. Statistical tests included Pearson correlation and Student’s t-test to explore relationships between NPC dimensions and gender. Results: The mean NPC length was 10.27 mm and mean width 3.55 mm. Significant gender differences were observed in the canal length, width, and distances to the labial and palatal plates (p < 0.05). Strong positive correlations were found between the canal width at the palate base and other parameters, such as the midpoint width (r = 0.58) and diameter (r = 0.44). The distance from the palatal opening to the labial plate showed the strongest correlation (r = 0.67), indicating enhanced cortical anchorage potential with increased canal dimensions. Discussion: NPC morphology varied (cylindrical, funnel-like, hourglass), aligning with prior studies. Larger diameters were linked to single-canal configurations. Implant placement strategies—such as direct canal insertion or lateralization—can be effective, especially with polished, single-piece implants that reduce soft tissue ingrowth and improve primary stability. Conclusions: Understanding NPC anatomy is crucial for implant planning in atrophic maxillae. With the proper technique, NPC use for cortical anchorage is a viable treatment option. Full article

Background: Assessment of functional occlusion is crucial in orthodontics and prosthodontics. With scientific advancements, optical jaw tracking systems are increasingly used to evaluate mandibular kinematics. Objectives: To compare the performance of an optical jaw tracking system (Modjaw^®) and a traditional condylar position indicator (CPI) in identifying condylar position discrepancies within an orthodontic population. A secondary objective was to explore the association between condylar discrepancies and temporomandibular disorders (TMD). Methods: Measurements were collected from 132 patients consecutively recruited from the private practice of a coauthor, using Modjaw and CPI, analyzing discrepancies in the sagittal, vertical, and transverse planes. TMD presence was determined clinically and using the DC-TMD questionnaire. Receiver operating characteristic (ROC) curves and diagnostic metrics were used to evaluate the tools’ performance. Results: No correlation was found between CPI and Modjaw measurements. CPI did not effectively discriminate between patients with and without TMD, with areas under the curve (AUC) not statistically significant. In contrast, the AUCs for Modjaw were 0.683 for the vertical plane (p = 0.001), 0.654 for the sagittal plane (p = 0.004), and 0.777 for the transverse plane (p < 0.001). The cut-off values for TMD screening using Modjaw were established at 2 mm (vertical), 1 mm (sagittal), and 0.5 mm (transverse), exhibiting some specificity, especially in the transverse dimension, but very low sensitivity. Conclusions: No correlation was found between Modjaw and CPI for assessing condylar position discrepancies. While these discrepancies may aid orthodontic treatment planning, they lack sufficient sensitivity for reliable TMD diagnosis. Modjaw’s cut-off points may help exclude TMD risk in orthodontic patients. Full article

Introduction: Cephalometric analysis is an essential tool used in orthodontic diagnosis and treatment planning. Aim: The aim of this study was to compare the measurement reliabilities (repeatability and reproducibility) of the Tau and Yen angles and compare them to the results obtained for the ANB angle. Methods: Repeatability and reliability assessments for the seven points (N, A, B, S, W, M, G) used in the analysis of ANB, Yen and Tau angles were performed twice with an interval of 7 days by 22 orthodontists. The measurement results for ANB, Yen and Tau angles were assessed using the Bland–Altman formula, Dahlberg formula, intraclass correlation coefficients (ICCs), R² coefficients and R&R. In order to assess the number of individual skeletal classes of sagittal discrepancy, the Pearson chi-squared test was used. With common parameters of df = 4, p < 0001, for the ANB angle, the result was χ² = 9104; for the Tau angle, χ² = 4556; and for the Yen angle, χ² = 4207. In order to determine the inter-rater reliability based on two-way ANOVA analysis without repetitions, the ICC (2,2) was used. The ICC (2,2) index at the 95% confidence level was 0.998 for the ANB angle, 0.997 for Tau and 0.998 for Yen. High values of the ICC index close to 1 indicate the agreement of the measurements and their high reliability. Results: The orthodontists in the study measured sagittal discrepancy significantly more accurately using the ANB angle compared to the Yen and Tau angles. Using a Bland–Altman plot, the bias and range of agreement within which 95% of the differences between measurements were accounted for were determined. For the ANB angle, the mean difference between measurements was 0.07 with a confidence interval of −1.55 to +1.69; for the Tau angle, the mean difference between measurements was 0.19 with a confidence interval of −2.92 to 3.30; and for the Yen angle, the mean difference was 0.09 with a confidence interval of −2.71 to +2.89. Using regression analysis, the measurements were assessed using the R2 index, which for the ANB angle was 0.952 (p < 0.001); for the Tau angle, R2 = 0.928 (p < 0.001), and for the Yen angle, R2 = 0.942 (p < 0.001). Conclusions: The obtained results of the assessment of the ANB, Tau and Yen angles confirm the thesis of the highest reliability, including repeatability and reproducibility, in the assessment of sagittal discrepancy in orthodontic diagnostics using the ANB angle, previously considered the gold standard. One of the basic factors attributed to the poorer repeatability and reproducibility of Tau and Yen measurements is human error related to the precision of determining new anthropometric points. Further studies to assess the usefulness of using the new Tau and Yen angle measurements in orthodontic diagnostics for sagittal discrepancy should be correlated with other measurements used so far, depending on the type of defects in the vertical dimension. It is necessary to consider enlarging the study group and performing longitudinal studies. Full article

Background and Objectives: The main objectives of our study were to assess sexual dimorphism and to compare the facial height, as well as the anteroposterior width of the upper airway, within adult Caucasians diagnosed with skeletal Class I and skeletal Class III malocclusion, based on a number of angular and linear cephalometric parameters. Materials and Methods: One hundred lateral cephalograms were selected from orthodontic adult Caucasian patients from western Romania. Several angular parameters (SNA, SNB, ANB, FMA, Y–FH, Ba–S–PNS and NL–ML angles) and linear parameters (total, upper and lower anterior facial height—TAFH, UAFH, LAFH; total posterior facial height—TPFH) were analysed for each case. The upper airway width parameters included the width of the nasopharynx, as well as the upper, middle and lower pharyngeal airway width (UPAW, MPAW and LPAW). Results: Distinct sexual dimorphism was observed regarding the vertical cephalometric parameters within both Class I and Class III groups, with males exhibiting significantly larger facial height parameters, while females demonstrated larger nasopharyngeal depth angles (Ba–S–PNS). The Y–FH angle had significantly higher values in Class I than in Class III subjects, regardless of sex. Upper airway dimensions showed sexual dimorphism specifically in Class III subjects, with females exhibiting larger UPAW values than males. The inter-class comparisons showed larger values for LPAW, especially in females. Correlation analyses revealed no statistically significant relationships between the vertical and the upper airway parameters in Class I subjects. UPAW showed a tendency to decrease in Class III subjects as TAFH and LAFH increased. Ba–S–PNS showed consistent negative correlations with the vertical dimensions in both groups. Conclusions: These findings suggest that skeletal Class I and Class III malocclusions exhibit not only different sagittal relationships, but also distinctive, sex-related vertical skeletal patterns within each group, and therefore it would be advised that male and female patients should be diagnosed and treated according to separate protocols. In our population, Class III males are more likely to require orthognathic surgery, in addition to orthodontic treatment, with a more reserved prognosis and they might have a higher risk of OSA or other respiratory disorders in comparison with Class III females. Full article

Background/Objectives: To correlate size changes in undifferentiated pleomorphic sarcoma (UPS) on magnetic resonance imaging (MRI) after neoadjuvant chemoradiation therapy (nCRT) with pathological response, risk of local recurrence, and therapeutic regimens. Methods: This retrospective study analyzed clinical, pathological, and imaging data from 39 biopsy-proven UPS subjects. Four readers measured the tumor dimensions before and after nCRT, including two perpendicular axial diameters and the longest coronal/sagittal diameter. Three cross-sectional areas and bounding volume were also calculated. Responders (pR) were defined as having ≤10% viable cells and non-responders (pNR) as having more. Inter-reader agreement was evaluated using Kendall’s concordance coefficient. Changes in tumor size were compared between pR and pNR using one-way ANOVA and Tukey’s HSD test for multiple comparisons of means. Results: pR showed a greater increase in size across all measurements compared to pNR. For the longest axial diameter, the mean increase was 30% ± 35% for pR and 14% ± 31% for pNR, with a mean difference (pR-pNR) of 16% (95% CI: 6–27%, p = 0.003). In tumors treated with radiotherapy alone, pR exhibited larger size increases in all dimensions compared to pNR. In contrast, in the chemoradiation group, pR showed a slight increase, while pNR generally shrank, although these differences did not reach statistical significance. Notably, pNR with local recurrence exhibited a reduction in all tumor dimensions compared to pNR without local recurrence. Conclusions: This exploratory study suggests that tumor size changes may predict pathological response and local recurrence after nCRT in UPS; however, the small sample size limits the generalizability of these findings. Full article

Class III patients have classically been managed through monomaxillary techniques, mainly involving mandibular setback movements. More recently, according to the upper incisor to soft tissue plane (UI-STP) or Barcelona Line (BL) planning protocol, bimaxillary procedures for upper maxilla advancement and reduced mandibular setback have been recommended in order to secure better aesthetic outcomes and avoid upper airway constriction. The present study describes the jaw movements in the sagittal plane performed in class III patients subjected to bimaxillary surgery following the BL protocol. A retrospective evaluation was performed on 124 class III patients subjected to bimaxillary surgery. All subjects underwent upper maxilla advancement. A total of 112 patients received mandible advancement movement (90.3%), nine received mandibular setback (7.25%), and the mandible underwent no movement along the sagittal dimension in the three remaining patients (2.4%). Mandibular advancement was significantly the most frequent treatment option. The presented results suggest that when the BL planning protocol is used as an aesthetic and functional reference, class III occlusion appears mostly related to maxillary sagittal hypoplasia instead of mandible hyperplasia, so bimaxillary advancement surgery should be considered as one of the first-choice procedures for the treatment of these patients. Full article

This paper focuses on the experimental testing and characterisation of two designed and constructed prototypes of a human knee joint mechanism. The aim of the mechanical systems, presented as kinematic diagrams and 3D CAD drawings, is to reproduce the knee joint’s complex movement, in particular the flexion/extension in the sagittal plane, within a given range and constraints, while taking into account the trajectory of the joint’s instantaneous centre of rotation. The first prototype can simulate different movements by modifying its dimensions in real time using a linearly adjustable crossed four-bar mechanism. The second prototype has interchangeable cooperating components, with cam profiles that can be adapted to specific requirements. Both devices are built from 3D-printed parts and their characteristics are determined experimentally. Although many types of tests have been carried out, this research mainly aims to conduct experiments with volunteers. To this end, the IMU sensors measure the mechanisms’ movements, but the main source of the data is video analysis of the colour markers. For the purposes of postprocessing, the results in the form of numerical values and figures were computed by Matlab 2019b. To illustrate the prototypes’ capabilities, the results are shown as motion trajectories of selected tibia/femur points and the calculated knee joint’s flexion/extension angle. Full article

The timely reintegration into their daily routine of patients suffering from work-related musculoskeletal disorders is a priority in medical rehabilitation. This can be accomplished by means of certain procedures and adequate medical rehabilitation equipment. Starting from these considerations this paper proposes an original constructive solution of a rehabilitation device designed for the passive mobilization of the neck joint in the sagittal and frontal plane. The constructive solution that is put forward uses a pneumatic muscle as the actuation element, ensuring the adaptability of the equipment to the particular pain tolerance of each patient. The construction and dimensioning calculations of the equipment are presented, followed by the determination of the torsional rigidity and compliance permitted by the system. Based on the results the paper concludes with recommendations for the optimum deployment of the rehabilitation equipment. Full article