Using 21st-Century Technologies to Determine the Cognitive Capabilities of a 11,000-Year-Old Perak Man Who Had Brachymesophalangia Type A2.

Perak Man, named after the state where the skeleton was found, was the most complete skeleton found in Southeast Asia. The funerary artefacts indicate that Perak Man was highly respected, as he was buried at the centre of the highest cave in Lenggong, and he was the only person buried there. A copy of the original skull was made using computed tomography (CT) and 3D printing. Based on the internal structure of the reconstructed skull, the estimated intracranial volume (ICV) is 1,204.91 mL. The hypothetical face of Perak Man was reconstructed according to established forensic methods. Based on his presumed status, Perak Man was likely a respected person in the group and, perhaps, a shaman and the most knowledgeable person in the group regarding survival, hunting, gathering and other aspects of Palaeolithic daily life.

Designing 3D prosthetic templates for maxillofacial defect rehabilitation: A comparative analysis of different virtual workflows.

OBJECTIVE: To design and compare the outcome of commercial (CS) and open source (OS) software-based 3D prosthetic templates for rehabilitation of maxillofacial defects using a low powered personal computer setup. METHOD: Medical image data for five types of defects were selected, segmented, converted and decimated to 3D polygon models on a personal computer. The models were transferred to a computer aided design (CAD) software which aided in designing the prosthesis according to the virtual models. Two templates were designed for each defect, one by an OS (free) system and one by CS. The parameters for analyses were the virtual volume, Dice similarity coefficient (DSC) and Hausdorff's distance (HD) and were executed by the OS point cloud comparison tool. RESULT: There was no significant difference (p > 0.05) between CS and OS when comparing the volume of the template outputs. While HD was within 0.05-4.33 mm, evaluation of the percentage similarity and spatial overlap following the DSC showed an average similarity of 67.7% between the two groups. The highest similarity was with orbito-facial prostheses (88.5%) and the lowest with facial plate prosthetics (28.7%). CONCLUSION: Although CS and OS pipelines are capable of producing templates which are aesthetically and volumetrically similar, there are slight comparative discrepancies in the landmark position and spatial overlap. This is dependent on the software, associated commands and experienced decision-making. CAD-based templates can be planned on current personal computers following appropriate decimation.

Ultraviolet A and Ultraviolet C Light-Induced Reduction of Surface Hydrocarbons on Titanium Implants.

OBJECTIVE: The carbon, titanium, and oxygen levels on titanium implant surfaces with or without ultraviolet (UV) pretreatment were evaluated at different wavelengths through X-ray photoelectron spectroscopy (XPS). MATERIALS AND METHODS: This interventional experimental study was conducted on nine Dio UFII implants with hybrid sandblasted and acid-etched (SLA) surface treatments, divided equally into three groups. Control group A samples were not given UV irradiation, while groups B and C samples were given UVA (382 nm, 25 mWcm2) and UVC (260 nm, 15 mWcm2) irradiation, respectively. The atomic ratio of carbon, titanium, and oxygen was compared through XPS. RESULTS: Mean carbon-to-titanium ratio and C1 peaks considerably increased in Group A compared to those in experimental Groups B and C. The intensity of Ti2p and O1s peaks was more pronounced for group C compared to that for groups A and B. CONCLUSIONS: Although the decrease in surface hydrocarbons was the same in both UV-treated groups, the peak intensity of oxygen increased in the UVC-treated group. Thus, it can be concluded that compared with UVA irradiation, UVC irradiation has the potential to induce more hydrophilicity on SLA-coated implants.

Enhancement of thermal, mechanical and physical properties of polyamide 12 composites via hybridization of ceramics for bone replacement.

This study reports the influence of ZrO2/ß-TCP hybridization on the thermal, mechanical, and physical properties of polyamide 12 composites to be suited for bone replacement. Amount of 15 wt% of nano-ZrO2 along with 5,10,15,20 and 25 wt% of micro-ß-TCP was compounded with polyamide 12 via a twin-screw extruder. The hybrid ZrO2/ß-TCP filled polyamide 12 exhibited higher thermal, mechanical and physical properties in comparison to unfilled polyamide 12 at certain filler loading; which is attributed to the homogenous dispersion of ZrO2/ß-TCP fillers particle in polyamide 12 matrix. The hybrid ZrO2/ß-TCP filled PA 12 demonstrated an increment of tensile strength by up to 1%, tensile modulus of 38%, flexural strength of 15%, flexural modulus of 45%, and surface roughness value of 93%, as compared to unfilled PA 12. With enhanced thermal, mechanical and physical properties, the newly developed hybrid ZrO2/ß-TCP filled PA 12 could be potentially utilized for bone replacement.

Shape-based interpolation method in measuring intracranial volume for pre- and post-operative decompressive craniectomy using open source software.

INTRODUCTION: Intracranial volume (ICV) is an important tool in the management of patients undergoing decompressive craniectomy (DC) surgery. The aim of this study was to validate ICV measurement applying the shape-based interpolation (SBI) method using open source software on computed tomography (CT) images. METHODS: The pre- and post-operative CT images of 55 patients undergoing DC surgery were analyzed. The ICV was measured by segmenting every slice of the CT images, and compared with estimated ICV calculated using the 1-in-10 sampling strategy and processed using the SBI method. An independent t test was conducted to compare the ICV measurements between the two different methods. The calculation using this method was repeated three times for reliability analysis using the intraclass correlations coefficient (ICC). The Bland-Altman plot was used to measure agreement between the methods for both pre- and post-operative ICV measurements. RESULTS: The mean ICV (±SD) were 1341.1±122.1ml (manual) and 1344.11±122.6ml (SBI) for the preoperative CT data. The mean ICV (±SD) were 1396.4±132.4ml (manual) and 1400.53±132.1ml (SBI) for the post-operative CT data. No significant difference was found in ICV measurements using the manual and the SBI methods (p=.983 for pre-op, and p=.960 for post-op). The intrarater ICC showed a significant correlation; ICC=1.00. The Bland-Altman plot showed good agreement between the manual and the SBI method. CONCLUSION: The shape-based interpolation method with 1-in-10 sampling strategy gave comparable results in estimating ICV compared to manual segmentation. Thus, this method could be used in clinical settings for rapid, reliable and repeatable ICV estimations.

Density estimation based on the Hounsfield unit value of cone beam computed tomography imaging of the jawbone system.

The aim of this study is to investigate the estimation of density from the Hounsfield unit of cone beam computed tomography data in dental imaging, especially for dental implant application. A jaw phantom with various known densities of anatomical parts (e.g. soft tissue, cortical bone, trabecular bone, tooth enamel, tooth dentin, sinus cavity, spinal cord and spinal disc) has been used to test the accuracy of the Hounsfield unit of cone beam computed tomography in estimating the mechanical density (true density). The Hounsfield unit of cone beam computed tomography data was evaluated via the MIMICS software using both two-dimensional and three-dimensional methods, and the results showed correlation with the true density of the object. In addition, the results revealed that the Hounsfield unit of cone beam computed tomography and bone density had a logarithmic relation, rather than a linear one. To this end, the correlation coefficient of logarithmic correlation (R2 = 0.95) is higher than the linear one (R2 = 0.77).

Mechanical and cytotoxicity properties of hybrid ceramics filled polyamide 12 filament feedstock for craniofacial bone reconstruction via fused deposition modelling.

OBJECTIVE: To compare the mechanical and biological properties of newly developed hybrid ceramics filled and unfilled polyamide 12 (PA 12) for craniofacial reconstruction via a fused deposition modelling (FDM) framework. METHODS: 15wt% of zirconia (ZrO2) as well as 30, 35, and 40wt% of beta-tricalcium phosphate (ß-TCP) were compounded with PA 12, followed by the fabrication of filament feedstocks using a single screw extruder. The fabricated filament feedstocks were used to print the impact specimens. The melt flow rate, tensile properties of fabricated filament feedstocks, and 3D printed impact properties of the specimens were assessed using melt flow indexer, universal testing machine, and Izod pendulum tester, respectively. The microstructure of selected filament feedstocks and broken impact specimens were analysed using a field emission scanning electron microscope and universal testing machine. Human periodontal ligament fibroblast cells (HPdLF) were used to evaluate the cytotoxicity of the materials by (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromid) (MTT) assay. RESULTS: Hybrid ceramics filled PA 12 indicated sufficient flowability for FDM 3D printing. The tensile strength of hybrid ceramics filled PA 12 filament feedstocks slightly reduced as compared to unfilled PA 12. However, the tensile modulus and impact strength of hybrid ceramics filled PA 12 increased by 8%-31% and 98%-181%, respectively. A significant increase was also detected in the cell viability of the developed composites at concentrations of 12.5, 25, 50 and 100mg/ml. SIGNIFICANCE: The newly developed hybrid ceramics filled PA 12 filament feedstock with improved properties is suitable for an FDM-based 3D printer, which enables the creation of patient-specific craniofacial implant at a lower cost to serve low-income patients.

A functional pipeline framework for landmark identification on 3D surface extracted from volumetric data.

Landmarks, also known as feature points, are one of the important geometry primitives that describe the predominant characteristics of a surface. In this study we proposed a self-contained framework to generate landmarks on surfaces extracted from volumetric data. The framework is designed to be a three-fold pipeline structure. The pipeline comprises three phases which are surface construction, crest line extraction and landmark identification. With input as a volumetric data and output as landmarks, the pipeline takes in 3D raw data and produces a 0D geometry feature. In each phase we investigate existing methods, extend and tailor the methods to fit the pipeline design. The pipeline is designed to be functional as it is modularised to have a dedicated function in each phase. We extended the implicit surface polygonizer for surface construction in first phase, developed an alternative way to compute the gradient of maximal curvature for crest line extraction in second phase and finally we combine curvature information and K-means clustering method to identify the landmarks in the third phase. The implementations are firstly carried on a controlled environment, i.e. synthetic data, for proof of concept. Then the method is tested on a small scale data set and subsequently on huge data set. Issues and justifications are addressed accordingly for each phase.

Orbital Morphometry: A Computed Tomography Analysis.

INTRODUCTION: The human orbit is a complex anatomic region, which plays predominant role in the evaluation of craniofacial complex. A thorough understanding of the relationship of the distance from orbital rim to the important vital structures of the orbital apex is required for the surgeon to perform safe and effective surgery. OBJECTIVES: To evaluate and compare the depth and distances from various points of the orbital rim to the fissures and foramina of the orbital apex between genders in the local population. METHODOLOGY: Linear measurements were conducted on 60 orbits from 30 patients who had undergone head computed tomography scan. These measurements were done utilizing the multiplanar reconstruction modes on computed tomography images with minimum slice thickness of 1 mm. RESULTS: Males have statistically significant larger orbits than females with higher mean measurements in all parameters, except for the distance from posterior ethmoidal foramen to the optic canal which was the same. However, there were no significant differences in all parameters between the right and left orbits. CONCLUSION: This study provides the absolute limit of safe internal orbital dissection in respect to the local population. Despite males having larger orbits than females, it is clinically negligible.

Genetics of cleft lip and palate : a review.

Orofacial clefts, particularly non-syndromic cleft lip with or without cleft palate (CL/P) are the most common craniofacial deformities, affecting one in every 700 to 1000 newborns worldwide. Numerous efforts have been made to understand the etiology of CL/P so as to predict its occurrence and to prevent it from occurring in the future. In the recent years, advances in genetics and molecular biology have begun to reveal the basis of craniofacial development. Various genetic approaches, including genome-wide and candidate gene association studies as well as linkage analysis, have been undertaken to identify aetiologic factors, but results have often been inconclusive or contradictory. These results may support the presence of aetiologic heterogeneity among populations and the presence of multiple genes involved in the aetiology of CL/P. Despite these difficulties, several different genes have been implicated in harbouring genes that contribute to the aetiology of CL/P. In conclusion, the genetic basis of CL/P is still controversial because of genetic complexity of clefting.