Reproducibility of linear and angular cephalometric measurements obtained by an artificial-intelligence assisted software (WebCeph) in comparison with digital software (AutoCEPH) and manual tracing method

ABSTRACT Introduction: It has been suggested that human errors during manual tracing of linear/angular cephalometric parameters can be eliminated by using computer-aided analysis. The landmarks, however, are located manually and the computer system completes the analysis. With the advent of Artificial Intelligence in the field of Dentistry, automatic location of the landmarks has become a promising tool in digital Orthodontics. Methods: Fifty pretreatment lateral cephalograms obtained from the Orthodontic department of SRM dental college (India) were used. Analysis were done by the same investigator using the following methods: WebCeph™, AutoCEPH© for Windows or manual tracing. Landmark identification was carried out automatically by Artificial Intelligence in WebCeph™ and with a mouse driven cursor in AutoCEPH©, and manually using acetate sheet and 0.3-mm pencil, ruler and a protractor. The mean differences of the cephalometric parameters obtained between the three methods were calculated using ANOVA with statistical significance set at p<0.05. Intraclass correlation coefficient (ICC) was used to determine both reproducibility and agreement between linear and angular measurements obtained from the three methods and intrarater reliability of repeated measurements. ICC value of >0.75 indicated good agreement. Results: Intraclass correlation coefficient between the three groups was >0.830, showing good level of agreement, and the value within each group was >0.950, indicating high intrarater reliability. Conclusion: Artificial Intelligence assisted software showed good agreement with AutoCEPH© and manual tracing for all the cephalometric measurements.

RESUMO Introdução: Tem sido sugerido que os erros humanos durante o traçado manual das medidas cefalométricas lineares/angulares podem ser eliminados usando a análise guiada por computador. Os pontos de referência, no entanto, são localizados manualmente e o sistema computadorizado completa a análise. Com o advento da Inteligência Artificial na Odontologia, a localização automática dos pontos de referência tornou-se uma ferramenta promissora na Ortodontia digital. Métodos: Cinquenta cefalogramas laterais pré-tratamento obtidos do departamento de Ortodontia da Faculdade de Odontologia SRM (Índia) foram usados. Todas as análises foram feitas pelo mesmo investigador, usando os seguintes métodos: WebCeph™, AutoCEPH© para Windows ou traçado manual. A identificação dos pontos foi realizada automaticamente por Inteligência Artificial no WebCeph™; com o cursor do mouse, no AutoCEPH©; e manualmente, utilizando folha de acetato e lápis 0,3 mm, régua e transferidor. As diferenças médias dos parâmetros cefalométricos entre os três métodos foram calculadas por ANOVA com significância estatística fixada em p<0,05. O coeficiente de correlação intraclasse (ICC) foi usado para determinar a reprodutibilidade e a concordância entre as medidas lineares e angulares obtidas pelos três métodos e a confiabilidade intraexaminador para medidas repetidas. O valor de ICC > 0,75 indicou boa concordância. Resultados: O ICC entre os três grupos foi >0,830, mostrando bom nível de concordância, e o valor dentro de cada grupo foi >0,950, indicando alta confiabilidade intra-avaliador. Conclusão: O software assistido por Inteligência Artificial mostrou boa concordância com o AutoCEPH© e o traçado manual para todas as medidas cefalométricas.

Survival rate and stability of surface-treated and non-surface-treated orthodontic mini-implants: a randomized clinical trial

ABSTRACT Objectives: This clinical trial was conducted to evaluate the stability and failure rate of surface-treated orthodontic mini-implants and determine whether they differ from those of non-surface-treated orthodontic mini-implants. Trial Design: Randomized clinical trial with a split-mouth study design. Setting: Department of Orthodontics, SRM Dental College, Chennai. Participants: Patients who required orthodontic mini-implants for anterior retraction in both arches. Methods: Self-drilling, tapered, titanium orthodontic mini-implants with and without surface treatment were placed in each patient following a split-mouth design. The maximum insertion and removal torques were measured for each implant using a digital torque driver. The failure rates were calculated for each type of mini-implant. Results: The mean maximum insertion torque was 17.9 ± 5.6 Ncm for surface-treated mini-implants and 16.4 ± 9.0 Ncm for non-surface-treated mini-implants. The mean maximum removal torque was 8.1 ± 2.9 Ncm for surface-treated mini-implants and 3.3 ± 1.9 Ncm for non-surface-treated mini-implants. Among the failed implants, 71.4% were non-surface-treated mini-implants and 28.6% were surface-treated mini-implants. Conclusion: The insertion torque and failure rate did not differ significantly between the groups, whereas the removal torque was significantly higher in the surface-treated group. Thus, surface treatment using sandblasting and acid etching may improve the secondary stability of self-drilling orthodontic mini-implants. Trial registration: The trial was registered in the Clinical Trials Registry, India (ICMR NIMS). Registration number: CTRI/2019/10/021718

RESUMO Objetivos: Este ensaio clínico foi conduzido para avaliar a estabilidade e a taxa de falha de mini-implantes ortodônticos com superfície tratada, e determinar se elas diferem das dos mini-implantes ortodônticos sem superfície tratada. Desenho do estudo: Ensaio clínico randomizado com desenho de boca dividida. Instituição: Department of Orthodontics, SRM Dental College, Chennai/India. Participantes: Pacientes que necessitavam de mini-implantes ortodônticos para retração anterior em ambas as arcadas. Métodos: Mini-implantes ortodônticos autoperfurantes, cônicos, de titânio com ou sem tratamento de superfície, foram colocados em cada paciente, seguindo um desenho de boca dividida. Os torques máximos de inserção e de remoção foram medidos para cada mini-implante, usando um torquímetro digital. As taxas de falha foram calculadas para cada tipo de mini-implante. Resultados: O valor médio do torque máximo de inserção foi de 17,9 ± 5,6 Ncm para mini-implantes com superfície tratada e 16,4 ± 9,0 Ncm para mini-implantes sem superfície tratada. O valor médio do torque máximo de remoção foi de 8,1 ± 2,9 Ncm para mini-implantes com superfície tratada e 3,3 ± 1,9 Ncm para mini-implantes sem superfície tratada. Entre os implantes que falharam, 71,4% eram mini-implantes sem superfície tratada e 28,6% eram mini-implantes com superfície tratada. Conclusão: O torque de inserção e a taxa de falha não diferiram significativamente entre os grupos; porém, o torque de remoção foi significativamente maior no grupo com superfície tratada. Assim, o tratamento de superfície com jateamento e condicionamento ácido pode melhorar a estabilidade secundária dos mini-implantes ortodônticos autoperfurantes. Registro do estudo: Esse estudo foi registrado no Clinical Trials Registry, Índia (ICMR NIMS). Número de registro: CTRI/2019/10/021718

Validation of quality of life questionnaire for patients with cancer--Indian scenario.

BACKGROUND: Quality of Life (QOL) is an important health outcome measure in oncology. Given the underlying pressure of individual geo-political entities, a universal solution may not be applicable and hence there is a need to develop a regional tool and standardize the same to address the linguistic and socio-cultural factors. OBJECTIVE: To standardize a tool to assess the QOL of patients with cancer to suit the Indian scenario. MATERIALS AND METHODS: The samples were collected from the Cancer Institute (WIA), Chennai. Samples comprise of 400 patients with all sites and stages of cancer. Period: January 2001 to January 2002. Patients were in the age range of 41-60 years. Thirty-eight items were pooled from existing tools, reviews, and the field trial, by which face and factorial validity were established. Reliability of the tool was also tested. Correlation analysis was done to find out the relation between the domains of QOL. STATISTICS USED: Principal component method with varimax rotation was used. Spearmen product moment correlation and Cronbach alpha coefficient were used for reliability analysis. RESULTS: Ten factors emerged with Eigen values ranging from 8.55 to 1.10 and accounted for 62.6% of variance. The first factor contributed maximally, 22% of variance. The remaining nine factors contributed totally to 40% of the variance on QOL. The ten factors that emerged were psychological well being, self-adequacy, physical well being, confidence in self-ability, external support, pain, mobility, optimism and belief, interpersonal relationship and self-sufficiency and independence. The internal consistency using Cronbach alpha test was 0.90 and split-half reliability was 0.74. CONCLUSION: The tool was found to be highly reliable and valid. It was feasible to administer it at clinical settings.

Pelvic exenteration: a perspective from a regional cancer center in India.

BACKGROUND: Pelvic exenteration is an extensive surgical procedure performed for locally advanced cancers in the pelvis. AIMS: The twenty-year experience with this procedure at the Cancer Institute has been analyzed for morbidity, failure pattern and survival. SETTINGS AND DESIGN: The case records of all the patients who had undergone pelvic exenteration between 1981 and 2000 at Cancer Institute (WIA), Chennai were retrieved from Tumor Registry and were analyzed. METHODS AND MATERIAL: Forty-eight patients underwent Pelvic Exenteration from 1981 to 2000 at the institute. Twenty-nine of them had rectal cancer, 15 had cervical cancer, 3 had bladder cancer, and 1 had ovarian cancer. There were 43 women and 5 men with a median age of 45 years. STATISTICAL ANALYSIS: The survival rates were calculated by Kaplan-Meier method using EGRET statistical software package. RESULTS: The operative mortality and postoperative morbidity were 10.42% and 62.50% respectively. The 5-year overall survival for the patients with Ca rectum and Ca cervix were 54.2% and 77.6% respectively. All 4 patients with Ca bladder or Ca ovary survived for more than 5 years. On multivariate analysis, nodal involvement and number of positive nodes emerged as significant prognostic factors for patients with Ca rectum. Although no factor reached statistical significance for patients with Ca cervix, those with adjacent organ invasion had a trend towards poorer survival. CONCLUSIONS: For carefully selected locally advanced cancer in the pelvis, pelvic exenteration may provide the opportunity of long-term survival.