Search Results (87)

Background/Objectives: The brain serves as the central command center for the nervous system in the human body and is made up of nerve cells known as neurons. When these nerve cells grow rapidly and abnormally, it can lead to the development of a brain tumor. Brain tumors are severe conditions that can significantly reduce a person’s lifespan. Failure to detect or delayed diagnosis of brain tumors can have fatal consequences. Accurately identifying and classifying brain tumors poses a considerable challenge for medical professionals, especially in terms of diagnosing and treating them using medical imaging analysis. Errors in diagnosing brain tumors can significantly impact a person’s life expectancy. Magnetic Resonance Imaging (MRI) is highly effective in early detection, diagnosis, and classification of brain cancers due to its advanced imaging abilities for soft tissues. However, manual examination of brain MRI scans is prone to errors and heavily depends on radiologists’ experience and fatigue levels. Swift detection of brain tumors is crucial for ensuring patient safety. Methods: In recent years, computer-aided diagnosis (CAD) systems incorporating deep learning (DL) and machine learning (ML) technologies have gained popularity as they offer precise predictive outcomes based on MRI images using advanced computer vision techniques. This article introduces a novel hybrid CAD approach named ViT-PCA-RF, which integrates Vision Transformer (ViT) and Principal Component Analysis (PCA) with Random Forest (RF) for brain tumor classification, providing a new method in the field. ViT was employed for feature extraction, PCA for feature dimension reduction, and RF for brain tumor classification. The proposed ViT-PCA-RF model helps detect early brain tumors, enabling timely intervention, better patient outcomes, and streamlining the diagnostic process, reducing patient time and costs. Our research trained and tested on the Brain Tumor MRI (BTM) dataset for multi-classification of brain tumors. The BTM dataset was preprocessed using resizing and normalization methods to ensure consistent input. Subsequently, our innovative model was compared against traditional classifiers, showcasing impressive performance metrics. Results: It exhibited outstanding accuracy, specificity, precision, recall, and F1 score with rates of 99%, 99.4%, 98.1%, 98.1%, and 98.1%, respectively. Conclusions: Our innovative classifier’s evaluation underlined our model’s potential, which leverages ViT, PCA, and RF techniques, showing promise in the precise and effective detection of brain tumors. Full article

The mineralized cover of chiton (Polyplacophora) soft tissue consists of aragonite, developed as shell-plates, girdle-scales, and girdle-spicules. This study characterizes crystallographic aspects of the girdle-spicules of the species Ischnochiton rissoi, Rhyssoplax olivacea, Acanthopleura vaillantii, and Acanthopleura spinosa. Spicule crystal arrangements and texture variations are described. Different misorientations between the spicule crystals are shown and are discussed with respect to the physical properties of the biomaterial. Characterization was performed with electron backscattered diffraction (EBSD), as well as with laser confocal and Field emission scanning electron microscopy (FE-SEM) imaging. All investigated species had porous spicules and distinct structural characteristics. Spicule crystal co-orientation strength was strongly increased for R. olivacea and I. rissoi, and it was almost random for A. vaillantii. R. olivacea, I. rissoi. A. spinosa spicule crystal texture was axial, whereas A. vaillantii spicule crystals were almost untextured. For all species investigated, spicule aragonite was twinned, as demonstrated with the strong 63°/64° peak in the misorientation angle distribution diagram, indicating a {110}-twin relationship. R. olivacea and I. rissoi spicules consisted of few twinned crystals and twin boundaries; A. vaillantii and A. spinosa spicules showed an abundance of twinned crystals and twin boundaries. We observed a difference in spicule dimension, morphology, arrangement on the girdle, and crystal organization for the investigated species, but always the generation of twinned aragonite. 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: Childhood obesity and overweight conditions impact systemic health and craniofacial development. Objectives: This review assessed the influence of elevated body mass index (BMI) on craniofacial morphology, considering age, sex, and ethnicity. Methods: A comprehensive search of Scopus, Web of Science, Embase, Cochrane, PubMed, and OpenGrey was conducted following PRISMA guidelines. Ten cross-sectional studies involving 1383 individuals aged 6 to 18 years were included. The sample comprised 812 females and 571 males, with most studies focusing on adolescents aged 12–18 years of different ethnicities depending on the study. Craniofacial structures were compared between overweight/obese and normal weight groups through cephalometric analysis. Study quality was assessed using the Newcastle–Ottawa Scale (NOS). Results: Overweight and obese individuals showed significant craniofacial changes, including increased anterior cranial base length, maxillary and mandibular dimensions, bimaxillary prognathism, and greater soft tissue thickness. These alterations may be influenced by differences in tissue composition, hormonal fluctuations, fat-to-bone ratio, and metabolic disorders. Variations in skeletal divergence, dental alignment, and airway space were also observed. The methodological quality ranged from moderate to high. Conclusions: Excess weight during growth is linked to distinct craniofacial alterations. Orthodontic diagnostics should integrate metabolic and hormonal considerations to optimize treatment outcomes. These changes should be carefully considered by orthodontists and pediatric dentists. Longitudinal studies are needed to understand the long-term effects of obesity on craniofacial development. Full article

Resorbable microparticles can be added to hydrogel-based biocompatible scaffolds to improve their mechanical characteristics and allow localised drug delivery, which will aid in tissue repair and regeneration. It is well-known that bioprinting is important for producing scaffolds personalised to patients by loading them with their own cells and printing them with specified shapes and dimensions. The question is how the addition of such particles affects the rheological responsiveness of the hydrogels (which is critical during the printing process) as well as mechanical parameters like the elastic modulus. This study tries to answer this question using a specific system: an alginate-gelatine hydrogel containing polyhydroxybutyrate-co-hydroxyvalerate (PHBV) microparticles. Scaffolds were made by bioprinting and moulding incorporating PHBV microspheres (7–12 μm in diameter) into alginate–gelatine inks (4.5 to 9.0% w/v). The microparticles (MP) were predominantly located within the polymeric matrix at concentrations up to 10 mg MP/mL ink. Higher particle concentrations disrupted their spatial distribution. Inks pre-crosslinked with 15 mM calcium and containingMPat concentrations ranging from 0 to 10 mg/mL demonstrated rheological characteristics appropriate for bioprinting, such as solid-like behaviour (G′ = 1060–1300 Pa, G″ = 720–930 Pa), yield stresses of 320–400 Pa, and pseudoplastic behaviour (static viscosities of 4000–5600 Pa·s and ~100 Pa·s at bioprinting shear rates). Furthermore, these inks allow high printing quality, assessed through scaffold dimensions, filament widths, and printability (Pr > 0.94). The modulus of elasticity in compression (E) of the scaffolds varied according to the content of MP and the manufacturing technique, with values resembling those of soft tissues (200–600 kPa) and exhibiting a maximum reinforcement effect with 3 mg MP/mL ink (bioprinted E = 273 ± 28 kPa; moulded E = 541 ± 66 kPa). Over the course of six days, the sample’s mass and shape remained stable during degradation in simulated body fluid (SBF). Thus, the alginate–gelatine hydrogel loaded with PHBV microspheres inks shows promise for targeted drug delivery in soft tissue bioengineering applications. Full article

Background/Objectives: Emerging hybrid imaging modalities, like Positron Emission Tomography/Computed Tomography (PET/CT) and Positron Emission Tomography/Magnetic Resonance Imaging (PET/MRI), are useful for assessing head and neck cancer (HNC) and its prognosis during follow-up. PET/MRI systems enable simultaneous PET and MRI scans within a single session. These combined PET/MRI scanners merge MRI’s better soft tissue contrast and the molecular metabolic information offered by PET. Aim: To review scientific articles on the use of hybrid PET/MRI techniques in diagnosing dentomaxillofacial malignancies. Method: The available literature on the use of PET/MRI for the diagnosis of dentomaxillofacial malignancies in four online databases (Scopus, PubMed, Web of Science, and the Cochrane Library) was searched. Eligible for this review were original full-text articles on PET/MRI imaging, published between January 2010 and November 2024, based on experimental or clinical research involving humans. Results: Out of the 783 articles retrieved, only twelve articles were included in this systematic review. Nearly half of the articles (5 out of 12) concluded that PET/MRI is superior to PET, MRI, and PET/CT imaging in relation to defining malignancies’ size. Six articles found no statistically significant results and the diagnostic accuracy presented was similar in PET/MRI versus MRI and PET/CT images. Regarding the overall risk of bias, most articles had a moderate risk. Conclusions: The use of PET/MRI in HNC cases provides a more accurate diagnosis regarding dimensions of the tumor and thus a more accurate surgical approach if needed. Further prospective studies on a larger cohort of patients are required to obtain more accurate results on the application of hybrid PET/MRI. 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

Aim: The purpose of this study was to evaluate the accuracy and efficacy of a new wireframe template methodology in analyzing three-dimensional facial soft tissue asymmetry. Materials and methods: Three-dimensional facial soft tissue data were obtained for 24 patients. The wireframe template was established by identifying 34 facial landmarks and then forming a template on the face with the MeshLab 2020 software. The angle asymmetry index was automatically scored using the template. The mirroring and overlapping technique is accepted as the golden standard method to diagnose facial asymmetry by acquiring deviation values of one’s face. Consistency rates between the two methodologies were determined through a statistical comparison of the angle asymmetry index and deviation values. Results: Overall consistency rates in the labial, mandibular angle, cheek, chin, and articular regions were 87.5%, 95.8%, 87.5%, 91.7%, and 100%, respectively. Regions with consistency rates in three dimensions of more than 85% are the x-axis and the z-axis of all regions and the y-axis of the mandibular angle, chin, and articular region. Conclusions: Soft tissue facial asymmetry can be diagnosed accurately and effectively by using a three-dimensional soft tissue spatial angle wireframe template. Precise localization of asymmetry can be offered, and indiscernible tiny asymmetry can be identified. Full article

Background and Objectives: The palate’s morphological characteristics are of great importance, especially in periodontology, where the palatine tissue represents a source of tissue graft for multiple mucogingival surgeries. This study aimed to estimate the amount of donor tissue available through the average palatal height and average location of the greater palatine artery in the Saudi population according to age and gender. Materials and Methods: Digital casts for adult Saudi patients at the age of 18–60 years old with a mean age of 37.76 ± 12.68 years were collected and analyzed using EXOCAD software. The digital casts were evaluated, and measurements of arch width at molars and canines, palatal vault height (PVH), palatal height index (PHI), and extension of the palatal rugae were registered. Finally, the amount available for soft tissue graft harvesting was calculated. Results: Overall, 109 maxillary casts for Saudi patients, 52 (47.7%) males and 57 (52.3%) females, were analyzed. The maxillary inter-molar arch width, inter-canine width, and palatal vault height significantly differed between males and females (p < 0.05). The mean PHI was 45.51% ± 8.12%, and 27.5% were classified as orthostaphyline, while 72.5% were categorized as hypsistaphyline, with no significant difference between the genders. The mean maximum graft width was 11.45 mm, and the graft width was significantly different between males and females (p < 0.005), while the mean maximum graft length was 17.78 mm, and the graft length showed no significant difference. Conclusions: The results of this study provide specific clinical guidelines for periodontal procedures by emphasizing the importance of gender-specific anatomical considerations. Data on graft dimensions and palatal measurements will enable the exact planning of soft tissue harvesting to minimize surgical risks and optimize mucogingival surgery outcomes in the Saudi population. Full article

Background: Osteosarcomas are rare malignancies (<1% of all cancers) that produce an osteoid matrix. Osteosarcomas are the second most frequent type of primary bone tumor after multiple myeloma and the most prevalent primary bone tumor in children. The spectrum of imaging findings of these malignancies varies significantly, reflecting different histological subtypes. For instance, conventional osteosarcoma typically presents with a mixed radiological pattern (lytic and bone mineralization) or with a completely eburneous one; aggressive periosteal reactions such as sunburst, Codman triangle, and soft-tissue components are frequently displayed. On the other hand, telangiectatic osteosarcoma usually presents as a purely lytic lesion with multiple fluid–fluid levels on MRI fluid-sensitive sequences. Other typical and atypical radiological patterns of presentation in other subtypes of osteosarcomas are described in this review. In addition to the characteristics associated with osteosarcoma subtyping, this review article also focuses on imaging features that have been associated with patient outcomes, namely response to chemotherapy and event-free and overall survivals. This includes simple semantic radiological features (such as tumor dimensions, anatomical location with difficulty of radical surgery, occurrence of pathological fractures, and presence of distant metastases), but also quantitative imaging parameters from diffusion-weighted imaging, dynamic contrast-enhanced MRI, and 18F-FDG positron emission tomography and radiomics approaches. Other particular features are described in the text. Overall, this comprehensive literature review aims to be a practical tool for oncologists, pathologists, surgeons, and radiologists involved in these patients’ care. Full article

The dynamics of tissue wound healing associated with dental implants placed in fresh extraction sockets or in healed alveolar ridges are not fully understood. Therefore, the aim of this preclinical in vivo investigation was to evaluate soft tissue healing and osseointegration after immediate implant placement, compared with delayed implant placement, using histomorphometric and immunohistochemical analyses. Methods: In 8 dogs, immediate postextraction implants and delayed implants were evaluated. After 2 and 8 weeks of healing, dissected tissue blocks were processed for calcified and decalcified histological analysis. Histometric measurements for soft tissue height and width were performed. Immunohistochemical analysis for the evaluation of bone metabolism, immune response and angiogenesis was performed. Results: At 2 weeks, histometric analysis showed that peri-implant soft tissue height was significantly greater in the immediate implant group (4.47 mm ± 0.78) compared to the delayed implant group (2.92 mm ± 0.51, p = 0.028), primarily due to the connective tissue height. Immunohistochemical analysis indicated significantly higher alkaline phosphatase (ALP) (6.85 ± 5.17 vs. 3.56 ± 2.31, p < 0.05) and matrix metalloproteinase (MMP2) activity (1.59 ± 1.64 vs. 0.58 ± 0.48, p < 0.05) in immediate implants, suggesting increased osteogenic and matrix metalloproteinase activity. At 8 weeks, the peri-implant soft tissue height remained higher in the immediate implant group (3.43 mm ± 0.83) compared to the delayed implant group (2.4 mm ± 0.37, p = 0.088), although the difference was less pronounced. Immunohistochemical differences between groups diminished in late healing stages. Conclusions: Soft tissue dimensions around immediate implants differ from those established around staged implants placed on healed alveolar ridges. Moreover, osseointegration dynamics around immediate implants may occur at a different rate compared with staged implants. Full article

Background/Objectives: Perineal reconstruction after abdominoperineal excision often requires complex closures and is fraught with wound healing complications. Flap-based approaches introduce non-irradiated vascularized tissue to the area of resection to fill a large soft-tissue defect and dead space, reduce the risk of infection, and facilitate wound healing. Employing perforator flaps with their beneficial donor site properties, the authors have developed a concept of bilateral superior gluteal artery perforator (SGAP) flaps to restore extensive perineal defects. Methods: This retrospective case series was conducted between September 2015 and December 2019. We included three patients who received bilateral SGAP flap reconstruction after oncological resection. One deepithelialized SGAP flap was used for obliteration of dead space, combined with the contralateral SGAP flap for superficial defect reconstruction and wound closure. Results: Within this patient population, two male and one female patient, with a median age of 62 years (range, 52–76 years), were included. Six pedicled SGAP flaps were performed with average flap dimensions of 9 × 20 cm (range 7–9 × 19 × 21). No flap loss or no local recurrence were documented. In one case, partial tip necrosis with prolonged serous drainage was observed, which was managed by surgical debridement. No further complications were detected. Conclusions: The combination of two SGAP flaps provides maximal soft tissue for defect reconstruction and obliteration of dead space, while maintaining a very inconspicuous donor site, even with bilateral harvesting. Given these advantages, the authors recommend this promising approach for successful reconstruction of perineal defects. Full article

Background/Objectives: Implant treatment in patients who require teeth extraction due to periodontitis presents a significant challenge. The consideration of peri-implantitis is crucial when planning the placement of dental implants. The predictability of implant treatment relies on the suitability of both hard and soft tissue quality. The aim of this article is to present a case report demonstrating a secure treatment protocol for implant procedures in patients with periodontitis requiring the extraction of all teeth, soft tissue management targeted at increasing the keratinized mucosa zone, and the provision of a reliable prosthetic solution. The secondary objective is to review the relevant literature regarding the significance of keratinized mucosa surrounding dental implants and its association with the occurrence of peri-implantitis. Case presentation: A 65-year-old female with generalized periodontitis, stage IV grade C and very poor oral hygiene came for treatment and rehabilitation of the lower jaw. CBCT revealed periodontal lesions and labio-lingual ridge dimensions in the region of teeth 34–44 from 8.0 to 10.2 mm. The first surgery included teeth extraction and periodontal lesions enucleation with simultaneous placement of four implants in the positions of teeth 32, 34, 42, 44. The second-stage surgery involved increasing the keratinized mucosa using two free gingival grafts. Conclusions: The present case report described the treatment process of the patient with periodontitis, including immediate implantation in the infected region, soft tissue augmentation using free gingival grafts and the ultimate placement of a bar-retained overdenture for final restoration. After two years of observation, despite questionable hygiene, no symptoms of gingival inflammation were detected. Furthermore, there is limited information in the literature regarding the correlation between inadequate keratinized gingiva and the occurrence of peri-implantitis. Full article

Background and Objectives: Two of the most exciting new technologies are biotechnology and nanotechnology. The science of nanostructures, or nanotechnology, is concerned with the development, testing, and use of structures and molecules with nanoscale dimensions ranging from 1 to 100 nm. The development of materials and tools with high specificity that interact directly at the subcellular level is what makes nanotechnology valuable in the medical sciences. At the cellular or tissue level, this might be converted into focused clinical applications with the greatest possible therapeutic benefits and the fewest possible side effects. The purpose of the present study was to review the literature and explore the applicability of the nanostructured materials in the process of the regeneration of the soft and hard tissues of the oral cavity. Materials and Methods: An electronic search of articles was conducted in several databases, such as PubMed, Embase, and Web of Science, to conduct this study, and the 183 articles that were discovered were chosen and examined, and only 22 articles met the inclusion criteria in this review. Results: The findings of this study demonstrate that using nanoparticles can improve the mechanical properties, biocompatibility, and osteoinductivity of biomaterials. Conclusions: Most recently, breakthroughs in tissue engineering and nanotechnology have led to significant advancements in the design and production of bone graft substitutes and hold tremendous promise for the treatment of bone abnormalities. The creation of intelligent nanostructured materials is essential for various applications and therapies, as it allows for the precise and long-term delivery of medication, which yields better results. Full article

Background: Bone-anchored maxillary protraction (BAMP) aims to correct midfacial deficiencies, with proven positive skeletal changes without potential unwanted side effects. However, the influence of BAMP treatment on facial soft tissues, particularly in subjects with complete unilateral cleft lip, alveolus, and palate (CUCLAP), remains unclear. Methods: This single-center longitudinal cohort study examined the effects of 1.5 years of BAMP treatment on facial soft tissues in growing subjects with complete unilateral cleft lip, alveolus, and palate. The sample consisted of 25 patients, age range 9.7 to 12.6 years. Three-dimensional surface models derived from CBCT scans were superimposed on stable structures of the anterior cranial base and on the occipital area posterior of the foramen magnum to assess three-dimensional changes due to growth and BAMP therapy. Results: The results revealed a moderate positive correlation (Pearson’s correlation coefficient from 0.203 to 0.560) between changes in hard tissue and soft tissue; some correlations were found to be weak (<0.300). Linear changes in soft tissue following BAMP were in the same direction as skeletal changes, showing downward, forward, and outward displacement. The only exception was in the vertical dimension. The lower facial third showed a slight but significant reduction, mainly in lip length (−1.2 mm), whereas the middle facial third showed a small increase (1.1 mm). Conclusions: It was concluded that during BAMP, soft tissue changes occur in the same direction as skeletal changes, although with a larger variability and less pronounced effects. Full article