• Archives of Plastic Surgery
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• 제45권3호
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• pp.284-288
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• 2018

Dynamic infrared thermography (DIRT) has been used for the preoperative mapping of cutaneous perforators. This technique has shown a positive correlation with intraoperative findings. Our aim was to evaluate the accuracy of perforator mapping with DIRT and augmented reality using a portable projector. For this purpose, three volunteers had both of their anterolateral thighs assessed for the presence and location of cutaneous perforators using DIRT. The obtained image of these "hotspots" was projected back onto the thigh and the presence of Doppler signals within a 10-cm diameter from the midpoint between the lateral patella and the anterior superior iliac spine was assessed using a handheld Doppler device. Hotspots were identified in all six anterolateral thighs and were successfully projected onto the skin. The median number of perforators identified within the area of interest was 5 (range, 3-8) and the median time needed to identify them was 3.5 minutes (range, 3.3-4.0 minutes). Every hotspot was correlated to a Doppler sound signal. In conclusion, augmented reality can be a reliable method for transferring the location of perforators identified by DIRT onto the thigh, facilitating its assessment and yielding a reliable map of potential perforators for flap raising.

• Archives of Plastic Surgery
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• 제50권4호
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• pp.340-347
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• 2023

Background Though in facial plastic surgery, the ideal nasal characteristics are defined by average European-American facial features known as neoclassical cannons, many ethnicities do not perceive these characteristics as suitable. Methods To investigate the preferences for nasofrontal angle, nasolabial angle, dorsal height, alar width, and nasal tip projection, manipulated pictures of one male and one female model were shown to 203 volunteer patients from a tertiary university hospital's facial plastic clinic. Results The most aesthetically preferred nasofrontal angles were 137.64 ± 4.20 degrees for males and 133.55 ± 4.53 degrees for females. Acute nasofrontal angles were more desirable in participants aged 25 to 44. The most preferred nasolabial angles were 107.56 ± 5.20 degrees and 98.92 ± 4.88 degrees, respectively. Volunteers aged 19 to 24 preferred more acute male nasolabial angles. A straight dorsum was the most desirable in both genders (0.03 ± 0.78 and 0.26 ± 0.75 mm, respectively). The ideal male and female alar widths were -0.51 ± 2.26 and -1.09 ± 2.18 mm, respectively. More 45- to 64-year-old volunteers preferred alar widths equal to intercanthal distance. The ideal female and male tip projections were 0.57 ± 0.01 and 0.56 ± 0.01, respectively. Conclusion Results indicate that the general Iranian patients prefer thinner female noses with wider nasofrontal angles for both genders. However, the ideal nasolabial angles, dorsal heights, and tip projections were consistent with the neoclassical cannons. Besides ethnic differences, the trend of nasal beauty is also affected by gender, age, and prior history of aesthetic surgery.

• 대한치과보철학회지
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• 제57권3호
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• pp.219-224
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• 2019

목적:컴퓨터 가이드 임플란트 수술에서 방사선 영상과 디지털 영상과의 정합은 필수적인 과정이다. 본 연구의 목적은 마이크로스크류의 사용이 가이드 수술을 위한 영상정합 과정에서 작업시간과 술자편의성에 미치는 영향을 조사하는 것이다. 재료 및 방법: 연구모형의 제작을 위해 Kennedy class I 하악 덴티폼에 마이크로스크류 2개를 후구치 삼각 부위에 식립 후 컴퓨터 단층촬영과 디지털 스캔을 통해 방사선 영상과 스캔 영상을 획득하였다. 영상들은 잔존 치아 부위만을 이용하는 방법과 치아와 마이크로스크류를 이용하는 방법을 이용하여 12명의 술자에 의해 중첩되었다. 이 중첩된 영상에 대하여 작업시간, 술자편의성, 만족도의 자료가 수집되고, Mann-Whitney U test을 통해 분석되었다. 결과: 작업시간은 영상정합 조건 사이에 통계학적인 차이가 없었다 (P > .05). 술자편의성과 만족도는 치아와 마이크로스크류를 이용하는 방법에서 잔존 치아 부위만을 이용하는 방법보다 높았다 (P < .001). 결론: 영상정합에서 마이크로스크류의 이용은 작업시간의 단축에는 영향을 미치지 않지만 술자편의성과 만족도는 향상시킨다.

• The Journal of Advanced Prosthodontics
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• 제10권4호
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• pp.279-285
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• 2018

PURPOSE. The aim of this clinical study was to assess the accuracy of the implants placed using a universal digital surgical guide. MATERIALS AND METHODS. Among 17 patients, 28 posterior implants were included in this study. The digital image of the soft tissue acquired from cast scan and hard tissue from CBCT have been superimposed and planned the location, length, diameter of the implant fixture. Then digital surgical guides were created using 3D printer. Each of angle deviations, coronal, apical, depth deviations of planned and actually placed implants were calculated using CBCT scans and casts. To compare implant positioning errors by CBCT scans and plaster casts, data were analyzed with independent samples t-test. RESULTS. The results of the implant positioning errors calculated by CBCT and casts were as follows. The means for CBCT analyses were: angle deviation: $4.74{\pm}2.06^{\circ}$, coronal deviation: $1.37{\pm}0.80mm$, and apical deviation: $1.77{\pm}0.86mm$. The means for cast analyses were: angle deviation: $2.43{\pm}1.13^{\circ}$, coronal deviation: $0.82{\pm}0.44mm$, apical deviation: $1.19{\pm}0.46mm$, and depth deviation: $0.03{\pm}0.65mm$. There were statistically significant differences between the deviations of CBCT scans and cast. CONCLUSION. The model analysis showed lower deviation value comparing the CBCT analysis. The angle and length deviation value of the universal digital guide stent were accepted clinically.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.36-42
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• 2011

Introduction: The current study examined the morphological characteristics of maxillary sinus septum by computed tomography (CT). Materials and Methods: Two hundred and four patients (408 maxillary sinuses) who visited dental clinic were evaluated. CT were examined. The height of the septum measured from the sinus floor to the apex of the septum more than 3 mm was defined as "sinus septum". Results: The prevalence of sinus septa was 21.3% (87/408), and 31.4% (64/204) of patients had more than 1 sinus septum. Females showed higher and thinner sinus septa than males. The anatomic location of the septa were distributed in the 2nd molar region (43.7%), 1st molar region (31.0%), 2nd premolar region (21.8%) and 1st premolar region (3.5%). In 57 patients with chronic disease, there was no significant difference between sinus disease and the presence of sinus septa. The loss of remaining teeth and teeth adjacent to the sinus septum area was not related to the presence of sinus septa. Older subjects showed a reduced height and length of the septum, and a thicker septum. Conclusion: These results show that the maxillary sinus septum undergoes atrophy with age.

• Imaging Science in Dentistry
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• 제46권2호
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• pp.77-85
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• 2016

Purpose: To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. Materials and Methods: Computed tomography (CT) images were collected from 85 patients. The vertical lengths of each anatomic point from the five horizontal planes passing through the MnF were measured at the coronoid process, sigmoid notch, condyle, and the gonion. The distance from the anterior ramus point to the posterior ramus point on the five horizontal planes was designated the anteroposterior horizontal distance of the ramus for each plane. The perpendicular distance from each anterior ramus point to each vertical plane through the MnF was designated the horizontal distance from the anterior ramus to the MnF. The horizontal and vertical positions were examined by regression analysis. Results: Regression analysis showed the heights of the coronoid process, sigmoid notch, and condyle for the five horizontal planes were significantly related to the height of the MnF, with the highest significance associated with the MnF-mandibular plane (coefficients of determination ($R^2$): 0.424, 0.597, and 0.604, respectively). The horizontal anteroposterior length of the ramus and the distance from the anterior ramus point to the MnF were significant by regression analysis. Conclusion: The relative position of the MnF was significantly related to the vertical heights of the sigmoid notch, coronoid process, and condyle as well as to the horizontal anteroposterior length of the ascending ramus. These findings should be clinically useful for patients with skeletal class III mandibular prognathism.

• Imaging Science in Dentistry
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• 제42권4호
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• pp.225-229
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• 2012

Purpose: This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. Materials and Methods: The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either "non-cleft side" or "cleft side". The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. Results: The pixel area showed a significant difference between the "non-cleft side" and "cleft side" in group 0 ($404.27{\pm}103.72/117.73{\pm}92.25$; p=0.00), group 1 ($434.29{\pm}86.70/388.31{\pm}109.51$; p=0.01), and group 4 ($430.98{\pm}98.11/366.71{\pm}154.59$; p=0.02). No significant differences were found in group 2 ($423.57{\pm}98.12/383.47{\pm}135.88$; p=0.06) or group 3 ($433.02{\pm}116.07/384.16{\pm}146.55$; p=0.19). Conclusion: Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.540-545
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• 2012

Background Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. Methods This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 ${\mu}g/mL$ remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 ${\mu}g/mL$ and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. Results Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. Conclusions Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.

• Imaging Science in Dentistry
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• 제53권1호
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• pp.43-51
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• 2023

Purpose: This study aimed to assess texture analysis(TA) of cone-beam computed tomography (CBCT) images as a quantitative tool for the differential diagnosis of odontogenic and non-odontogenic maxillary sinusitis(OS and NOS, respectively). Materials and Methods: CBCT images of 40 patients diagnosed with OS (N=20) and NOS (N=20) were evaluated. The gray level co-occurrence (GLCM) matrix parameters, and gray level run length matrix texture (GLRLM) parameters were extracted using manually placed regions of interest on lesion images. Seven texture parameters were calculated using GLCM and 4 parameters using GLRLM. The Mann-Whitney test was used for comparisons between the groups, and the Levene test was performed to confirm the homogeneity of variance (α=5%). Results: The results showed statistically significant differences(P<0.05) between the OS and NOS patients regarding 3 TA parameters. NOS patients presented higher values for contrast, while OS patients presented higher values for correlation and inverse difference moment. Greater textural homogeneity was observed in the OS patients than in the NOS patients, with statistically significant differences in standard deviations between the groups for correlation, sum of squares, sum of entropy, and entropy. Conclusion: TA enabled quantitative differentiation between OS and NOS on CBCT images by using the parameters of contrast, correlation, and inverse difference moment.

• The Journal of Advanced Prosthodontics
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• 제15권5호
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• pp.259-270
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• 2023

PURPOSE. This study evaluated the reliability of the chair-side CAD-CAM surgical guide (CSG) in the anterior maxilla by comparing its accuracy with the laboratory 3D-printed surgical guide (3DSG) and manual surgical guide (MSG) concerning different levels of dentists' surgical experience. MATERIALS AND METHODS. Ten surgical guides of each type (MSG, 3DSG, and CSG) were fabricated on a control study model with missing right and left central incisors. Sixty implants were placed in 30 study models by two dentists (one inexperienced and one experienced) using three different types of surgical guides. Horizontal deviations at shoulder and at apex, vertical, and angular deviations were measured after superimposing the planned and placed implant positions in the software. Kruskal-Wallis and Mann-Whitney U tests were used to compare the accuracy of three types of surgical guides in each dentist group and the accuracy of each surgical guide between two dentists (α = .05). RESULTS. There were no significant differences in any deviations between CSG and 3DSG, apart from angular deviation, for both dentists' groups. Moreover, both CSG and 3DSG showed no significant differences in accuracy between the two dentists (P > .05). In contrast, MSG demonstrated significant differences from CSG and 3DSG and a significant difference in accuracy between the two dentists (P < .05). CONCLUSION. CSG provides superior accuracy to MSG in implant placement in the maxillary anterior region and is comparable to 3DSG at different levels of surgical experience, while offering the benefits of shorter manufacturing time and reduced patient visits.