A retrospective analysis of the complication rate after SARPE in 111 cases, and its relationship to patient age at surgery.

PURPOSE: Surgically assisted rapid palatal expansion (SARPE) is a well-known surgical intervention for treating maxillary transverse deficiencies (MTDs). This investigation aimed to evaluate the complication rate after SARPE, and its relationship to patient age. MATERIALS AND METHODS: Based on multivariate analyses, the complication rate after SARPE and its association with increasing age in 111 patients with MTD was evaluated. In every case the following variables were evaluated: age, gender, concomitant surgery, expander appliance, perioperative and dental complications, pain score, neurosensory disturbances (NSDs), postoperative excessive haemorrhage, length of hospital stay, infection, oronasal communication, palatal ulceration, asymmetrical maxillary expansion, mal- or non-union of the bone, lacrimation, and mechanical failure. RESULTS: Overall, 58 (52.25%) patients had minor-to-severe complications. The most common complications were NSDs (27.03%) and postoperative pain (13.51%). Multivariate analysis showed that the frequency of dental complications (mean age 35.9; SD = 10.5140; p = 0.0021∗), NSDs in general (mean age 30; SD = 9.9827; p = 0.0157∗), NSDs lasting more than 4 weeks (mean age 30,9583; SD = 10.6260; p = 0.0105∗), and NSDs lasting more than 1 year (mean age 36.2; SD = 8.7579; p = 0.0201∗) increased significantly with patient age. CONCLUSION: Detailed data analysis revealed a limited number of severe, long-term complications after SARPE. However, careful patient selection is recommended in elderly cases.

In vivo quantification of mandibular bone remodeling and vascular changes in a Wistar rat model: A novel HR-MRI and micro-CT fusion technique

Purpose@#This study was performed to introduce an in vivo hybrid multimodality technique involving the coregistration of micro-computed tomography (micro-CT) and high-resolution magnetic resonance imaging (HR-MRI) to concomitantly visualize and quantify mineralization and vascularization at follow-up in a rat model. @*Materials and Methods@#Three adult female rats were randomly assigned as test subjects, with 1 rat serving as a control subject. For 20 weeks, the test rats received a weekly intravenous injection of 30 μg/kg zoledronic acid, and the control rat was administered a similar dose of normal saline. Bilateral extraction of the lower first and second molarswas performed after 10 weeks. All rats were scanned once every 4 weeks with both micro-CT and HR-MRI. Micro-CT and HR-MRI images were registered and fused in the same 3-dimensional region to quantify blood flow velocity and trabecular bone thickness at T0 (baseline), T4 (4 weeks), T8 (8 weeks), T12 (12 weeks), T16 (16 weeks), and T20 (20 weeks). Histological assessment was the gold standard with which the findings were compared. @*Results@#The histomorphometric images at T20 aligned with the HR-MRI findings, with both test and control rats demonstrating reduced trabecular bone vasculature and blood vessel density. The micro-CT findings were also consistent with the histomorphometric changes, which revealed that the test rats had thicker trabecular bone and smaller marrow spaces than the control rat. @*Conclusion@#The combination of micro-CT and HR-MRI may be considered a powerful non-invasive novel technique for the longitudinal quantification of localized mineralization and vascularization.

Accuracy and reliability of 2-dimensional photography versus 3-dimensional soft tissue imaging

PURPOSE: This study was conducted to objectively and subjectively compare the accuracy and reliability of 2-dimensional (2D) photography and 3-dimensional (3D) soft tissue imaging.MATERIALS AND METHODS: Facial images of 50 volunteers (25 males, 25 females) were captured with a Nikon D800 2D camera (Nikon Corporation, Tokyo, Japan), 3D stereophotogrammetry (SPG), and laser scanning (LS). All subjects were imaged in a relaxed, closed-mouth position with a normal smile. The 2D images were then exported to Mirror® Software (Canfield Scientific, Inc, NJ, USA) and the 3D images into Proplan CMF® software (version 2.1, Materialise HQ, Leuven, Belgium) for further evaluation. For an objective evaluation, 2 observers identified soft tissue landmarks and performed linear measurements on subjects' faces (direct measurements) and both linear and angular measurements on all images (indirect measurements). For a qualitative analysis, 10 dental observers and an expert in facial imaging (subjective gold standard) completed a questionnaire regarding facial characteristics. The reliability of the quantitative data was evaluated using intraclass correlation coefficients, whereas the Fleiss kappa was calculated for qualitative data.RESULTS: Linear and angular measurements carried out on 2D and 3D images showed excellent inter-observer and intra-observer reliability. The 2D photographs displayed the highest combined total error for linear measurements. SPG performed better than LS, with borderline significance (P=0.052). The qualitative assessment showed no significant differences among the 2D and 3D imaging modalities.CONCLUSION: SPG was found to a reliable and accurate tool for the morphological evaluation of soft tissue in comparison to 2D imaging and laser scanning.