Effects of image enhancement on reliability of landmark identification in digital cephalometry.

Introduction: Although digital cephalometric radiography is gaining popularity in orthodontic practice, the most important source of error in its tracing is uncertainty in landmark identification. Therefore, efforts to improve accuracy in landmark identification were directed primarily toward the improvement in image quality. One of the more useful techniques of this process involves digital image enhancement which can increase overall visual quality of image, but this does not necessarily mean a better identification of landmarks. The purpose of this study was to evaluate the effectiveness of digital image enhancements on reliability of landmark identification. Materials and Methods: Fifteen common landmarks including 10 skeletal and 5 soft tissues were selected on the cephalograms of 20 randomly selected patients, prepared in Natural Head Position (NHP). Two observers (orthodontists) identified landmarks on the 20 original photostimulable phosphor (PSP) digital cephalogram images and 20 enhanced digital images twice with an intervening time interval of at least 4 weeks. The x and y coordinates were further analyzed to evaluate the pattern of recording differences in horizontal and vertical directions. Reliability of landmarks identification was analyzed by paired t test. Results: There was a significant difference between original and enhanced digital images in terms of reliability of points Ar and N in vertical and horizontal dimensions, and enhanced images were significantly more reliable than original images. Identification of A point, Pogonion and Pronasal points, in vertical dimension of enhanced images was significantly more reliable than original ones. Reliability of Menton point identification in horizontal dimension was significantly more in enhanced images than original ones. Conclusion: Direct digital image enhancement by altering brightness and contrast can increase reliability of some landmark identification and this may lead to more accurate cephalometric analysis.

Autoclaving and clinical recycling: Effects on mechanical properties of orthodontic wires.

Background: About half of the orthodontists recycle and reuse orthodontic wires because of their costs. So when talking about reuse and sterilization of wires, their effects on mechanical properties of wires should be clarified. The purpose of this study was to assess the effects of sterilization and clinical use on mechanical properties of stainless steel wires. Materials and Methods: Thirty stainless steel orthodontic wires were divided into three equal groups of control, autoclave (sterilized by autoclave), and recycle group (wires were used for orthodontic patients up to 4 weeks, cleaned by isopropyl alcohol and sterilized by autoclave). The mechanical properties (tensile test, three-point loading test for load-deflection curve) were determined. Results: Fracture force, yield strength, stiffness and modulus of elasticity in recycle groups were significantly lower than the other groups (P < 0.05). Conclusion: Although recycle wires were softer than those of control group, relatively small differences and also various properties of available wires have obscured the clinical predictability of their application. There is seemingly no problem in terms of mechanical properties to recycle orthodontic wires.

In vitro evaluation of force-expansion characteristics in a newly designed orthodontic expansion screw compared to conventional screws.

Objective : Expansion screws like Hyrax, Haas and other types, produce heavy interrupted forces which are unfavorable for dental movement and could be harmful to the tooth and periodontium. The other disadvantage of these screws is the need for patient cooperation for their regular activation. The purpose of this study was to design a screw and compare its force- expansion curve with other types. Materials and Methods : A new screw was designed and fabricated in the same dimension, with conventional types, with the ability of 8 mm expansion (Free wire length: 12 mm, initial compression: 4.5 mm, spring wire diameter: 0.4 mm, spring diameter: 3 mm, number of the coils: n0 ine, material: s0 tainless steel). In this in vitro study, the new screw was placed in an acrylic orthodontic appliance, and after mounting on a stone cast, the force-expansion curve was evaluated by a compression test machine and compared to other screws. Results : Force-expansion curve of designed screw had a flatter inclination compared to other screws. Generally it produced a light continuous force (two to 3.5 pounds) for every 4 mm of expansion. Conclusion : In comparison with heavy and interrupted forces of other screws, the newly designed screw created light and continuous forces.