Accuracy of linear measurement using cone-beam computed tomography at different reconstruction angles

Purpose: This study was performed to evaluate the effect of changing the orientation of a reconstructed image on the accuracy of linear measurements using cone-beam computed tomography (CBCT). Materials and Methods: Forty-two titanium pins were inserted in seven dry sheep mandibles. The length of these pins was measured using a digital caliper with readability of 0.01 mm. Mandibles were radiographed using a CBCT device. When the CBCT images were reconstructed, the orientation of slices was adjusted to parallel (i.e., 0°), +10°, +12°, -12°, and -10° with respect to the occlusal plane. The length of the pins was measured by three radiologists, and the accuracy of these measurements was reported using descriptive statistics and one-way analysis of variance (ANOVA); p<0.05 was considered statistically significant. Results: The differences in radiographic measurements ranged from -0.64 to +0.06 at the orientation of -12°, -0.66 to -0.11 at -10°, -0.51 to +0.19 at 0°, -0.64 to +0.08 at +10°, and -0.64 to +0.1 at +12°. The mean absolute values of the errors were greater at negative orientations than at the parallel position or at positive orientations. The observers underestimated most of the variables by 0.5-0.1 mm (83.6%). In the second set of observations, the reproducibility at all orientations was greater than 0.9. Conclusion: Changing the slice orientation in the range of -12°to +12°reduced the accuracy of linear measurements obtained using CBCT. However, the error value was smaller than 0.5 mm and was, therefore, clinically acceptable. © 2014 by Korean Academy of Oral and Maxillofacial Radiology

Design, synthesis, and antimicrobial evaluation of a novel bone-targeting bisphosphonate-ciprofloxacin conjugate for the treatment of osteomyelitis biofilms

Osteomyelitis is a major problem worldwide and is devastating due to the potential for limb-threatening sequelae and mortality. Osteomyelitis pathogens are bone-attached biofilms, making antibiotic delivery challenging. Here we describe a novel osteoadsorptive bisphosphonate-ciprofloxacin conjugate (BV600022), utilizing a “target and release” chemical strategy, which demonstrated a significantly enhanced therapeutic index versus ciprofloxacin for the treatment of osteomyelitis in vivo. In vitro antimicrobial susceptibility testing of the conjugate against common osteomyelitis pathogens revealed an effective bactericidal profile and sustained release of the parent antibiotic over time. Efficacy and safety were demonstrated in an animal model of periprosthetic osteomyelitis, where a single dose of 10 mg/kg (15.6 μmol/kg) conjugate reduced the bacterial load by 99% and demonstrated nearly an order of magnitude greater activity than the parent antibiotic ciprofloxacin (30 mg/kg, 90.6 μmol/kg) given in multiple doses. Conjugates incorporating a bisphosphonate and an antibiotic for bone-targeted delivery to treat osteomyelitis biofilm pathogens constitute a promising approach to providing high bone-antimicrobial potency while minimizing systemic exposure