Artificial intelligence-based cephalometric landmark annotation and measurements according to Arnett’s analysis: can we trust a bot to do that?

Objective: To assess the reliability of CEFBOT, an artificial intelligence (AI)-based cephalometry software, for cephalometric landmark annotation and linear and angular measurement according to Arnett’s analysis. Methods: Thirty lateral cephalometric radiographs acquired with a Carestream CS 9000 3D unit (Carestream Health Inc., Rochester/NY) were used in this study. The 66 landmarks and the ten selected linear and angular measurements of Arnett’s analysis were identified on each radiograph by a trained human examiner (control) and by CEFBOT (RadioMemory Ltd., Belo Horizonte, Brazil). For both methods, landmark annotations and measurements were duplicated with an interval of 15 days between measurements and the intraclass correlation coefficient (ICC) was calculated to determine reliability. The numerical values obtained with the two methods were compared by a t-test for independent variables. Results: CEFBOT was able to perform all but one of the ten measurements. ICC values > 0.94 were found for the remaining eight measurements, while the Frankfurt horizontal plane - true horizontal line (THL) angular measurement showed the lowest reproducibility (human, ICC = 0.876; CEFBOT, ICC = 0.768). Measurements performed by the human examiner and by CEFBOT were not statistically different. Conclusion: Within the limitations of our methodology, we concluded that the AI contained in the CEFBOT software can be considered a promising tool for enhancing the capacities of human Radiologists.

Intranasal corticosteroids: patient administration angles and impact of education

INTRODUCTION: Intranasal corticosteroids sprays (INCS) are first line treatment for allergic rhinitis and are frequently used for chronic rhinosinusitis. Improperly aiming INCS increases the risk of epistaxis and may decrease the efficacy of the medication. The goal of this study was to determine how patients position INCS for drug delivery and if verbal or written instructions improve their positioning. METHODS: Patients in rhinology clinics were photographed while administering a generic spray bottle. The angle of the spray bot- tle relative to the patients’ head and a fixed background was determined. RESULTS: A total of 46 participants were included. The average spray angle for the right naris was 10.1o towards the septum and 67.2o below the Frankfurt Horizontal plane. The average spray angle for the left naris was 4.5o towards the septum and 62.2o below the Frankfurt horizontal plane. The angle of the spray bottle ranged from 50o toward the septum to 43o away from the sep- tum. Only 8 patients aimed away from the septum for both nares. Patients who recalled receiving verbal and written instructions aimed the INCS bottle at the lateral wall and inferior turbinate in contrast to patients who only received one form of instruction or no instructions. CONCLUSIONS: Most patients (83%) incorrectly aim INCS when compared to current guidelines. There was statistically significant improvement in the positioning of patients who reported receiving both verbal and written instruction; however, this study high- lights a greater need for patient education.

Correlation of Bite Force Interpretation in Maximal Intercuspal Position among Patient, Clinician, and T-Scan III System

Objective The main purpose of this article was to determine the correlation of bite force in maximal intercuspal position (MIP) among patient’s perceptions, clinician subjective interpretation, and T-Scan III system. Materials and Methods Forty-three dental students at Naresuan University (Phitsanulok, Thailand) participated in the study. Subjects were positioned by Frankfurt horizontal plane paralleled to the horizontal plane and asked to bilaterally clenched in MIP. Patient’s perception was evaluated by asking which side of the jaw had heavier bite force (right, left, or equally on both sides). Then, the clinician subjective interpretation was assessed using traditional occlusal indicators. Furthermore, patient’s bite force was analyzed using T-Scan III. Statistical Analysis Cohen’s weighted kappa test was used to evaluate the correlation of bite force. Results The best correlation between patient’s perception and T-Scan III was at the ± 7.5% cutoff range with 15 subject agreements. While the best correlation between clinician subjective interpretation and T-Scan III was at ± 5.0% cutoff range with 23 subject agreements. Cohen’s weighted kappa indicated slight agreement between T-Scan III and patient’s perception and fair agreement between T-Scan III and clinician. Conclusions Clinician subjective interpretation is more clinically reliable than patient’s perception when T-Scan III is used as a gold standard.

A Comparative Study on Measurement of Maxillary Occlusal Cant Obtained through Facebow Transfer and Using Lateral CEPH.: An in vivo Study

Purpose: The purpose of the study was to compare measurements of maxillary occlusal cant obtained through facebow transfer and through lateral cephalogram. Method: 40 subjects were included in this study according to inclusion and exclusion criteria and divided into two groups: dentulous and edentulous. For edentulous subjects, all the steps of complete denture fabrication were carried out and finished dentures were delivered. Alginate impressions were now made for all the subjects (with complete denture worn in edentulous cases) for both upper and lower arches. The study was conducted in two parts. Facebow transfer was done next and casts were mounted. In first part of the study, sagittal inclination was measured after facebow transfer. After mounting of the casts, four points were marked to measure the inclination of the occlusal plane. In second part, cephalometric evaluation of occlusal plane and Frankfurt horizontal plane was carried out. Angle between Frankfurt horizontal plane and the occlusal plane was maxillary occlusal cant. which was evaluated by tracing. Paired t test was used to compare mean facebow values and lateral ceph values in edentulous subjects. Intergroup comparison between lateral ceph and mean facebow values between dentulous and edentulous subjects was evaluated using independent t test. Results: Facebow measurements gave comparatively higher values in both dentulous and edentulous patients and are subjected to less variation as compared to the lateral cephalogram values p<0.0001. Conclusion: The occlusal plane angle of lateral cephalogram was found to be significantly different from angle obtained through facebow transfer.