Određivanje dužine korijenskog kanala: procjena CDR® intraoralnog radiografskog sustava in vivo

The Computed Dental Radiolography System® (CDR: Schick Technologies, Long Island City, NY) is a CCD-based digital intraoral radiographic device which possesses a measurement software algorithm that can be adjusted with respect to an object of known dimension. This “calibration ” algorithm was compared to the CDR® preset mode and analog film using 30 root canals in vivo. The three measurement methods differed significantly from each other for 40% o f the canals sampled. Two o f the three differed significantly for 50% o f canals. No difference existed between the methods for 10% o f the canals. Estimates of tooth length using the calibrated mode differed from those obtained using a conventional radiographic technique by an average o f 1.2 mm, while those using the calibrated mode differed by 1.9 mm. The 1.2 mm average for the calibrated CDR® was judged to be an acceptable degree o f clinical error for most root canal procedures and indicates that the calibration function of the CDR® system should be used when measuring endodontic working lengths. The results demonstrated that calibration to a 15 mm probe when using the Schick CDR® system is more consistent with a comparable measurement, if film is used as the “gold standard”, than are measurements of the tooth length using the CDR® without calibration.Sustav "Kompjuterizirane dentalne radiografije" (CDR: Schick Technologies. Long Island City. NY) je na CDD-u zasnovan uređaj za digitalnu intraoralnu radio grafiju koji posjeduje "Software-ski algoritam" za mjerenja koji se može prilagoditi prema objektu poznate veličine. Ovaj "kalibracijski" algoritam uspoređen je sa sustavom CDR (kompjutorizirane dentalne radiografije) bez mjernog algoritma i analognim filmom rabeći 30 korijenskih kanala in vivo. Tri postupka mjerenja značajno su se razlikovali u 40% mjerenih korijenskih kanala. Dva od tri postupka razlikovala su se u 50% mjerenih kanala. Nikakve razlike između postupaka nije bilo u 10% mjerenih korijenskih kanala. Procjena duljine zuba korištenjem kalibriranog načina razlikovala se od procjene dobivene konvencionalnom (analognom) radio grafskom tehnikom za otprilike 1,2 mm, dok se od digitalnog sustava bez mjernog algoritma razlikovala za prosječno 1,9 mm. Razlika od 1,2 mm za "kalibrirani CDR" se procjenjuje kao prihvatljiva klinička greška za većinu endodontskih postupaka i ukazuje da bi se "kalibracijski sustav CDRa" trebao rabiti pri mjerenju radne duljine korijenskog kanala. Rezultati ukazuju da je kalibracija sonde do 15 mm kad se rabi Schch-ov CDR sustav postojanija s usporednim mjerenjem ako se film koji se mjeri uzme kao "zlatni standard", nego je mjerenje duljine CDR sustavom bez kalibracije

Određivanje dužine korijenskog kanala: procjena CDR® intraoralnog radiografskog sustava in vivo

The Computed Dental Radiolography System® (CDR: Schick Technologies, Long Island City, NY) is a CCD-based digital intraoral radiographic device which possesses a measurement software algorithm that can be adjusted with respect to an object of known dimension. This “calibration ” algorithm was compared to the CDR® preset mode and analog film using 30 root canals in vivo. The three measurement methods differed significantly from each other for 40% o f the canals sampled. Two o f the three differed significantly for 50% o f canals. No difference existed between the methods for 10% o f the canals. Estimates of tooth length using the calibrated mode differed from those obtained using a conventional radiographic technique by an average o f 1.2 mm, while those using the calibrated mode differed by 1.9 mm. The 1.2 mm average for the calibrated CDR® was judged to be an acceptable degree o f clinical error for most root canal procedures and indicates that the calibration function of the CDR® system should be used when measuring endodontic working lengths. The results demonstrated that calibration to a 15 mm probe when using the Schick CDR® system is more consistent with a comparable measurement, if film is used as the “gold standard”, than are measurements of the tooth length using the CDR® without calibration.Sustav "Kompjuterizirane dentalne radiografije" (CDR: Schick Technologies. Long Island City. NY) je na CDD-u zasnovan uređaj za digitalnu intraoralnu radio grafiju koji posjeduje "Software-ski algoritam" za mjerenja koji se može prilagoditi prema objektu poznate veličine. Ovaj "kalibracijski" algoritam uspoređen je sa sustavom CDR (kompjutorizirane dentalne radiografije) bez mjernog algoritma i analognim filmom rabeći 30 korijenskih kanala in vivo. Tri postupka mjerenja značajno su se razlikovali u 40% mjerenih korijenskih kanala. Dva od tri postupka razlikovala su se u 50% mjerenih kanala. Nikakve razlike između postupaka nije bilo u 10% mjerenih korijenskih kanala. Procjena duljine zuba korištenjem kalibriranog načina razlikovala se od procjene dobivene konvencionalnom (analognom) radio grafskom tehnikom za otprilike 1,2 mm, dok se od digitalnog sustava bez mjernog algoritma razlikovala za prosječno 1,9 mm. Razlika od 1,2 mm za "kalibrirani CDR" se procjenjuje kao prihvatljiva klinička greška za većinu endodontskih postupaka i ukazuje da bi se "kalibracijski sustav CDRa" trebao rabiti pri mjerenju radne duljine korijenskog kanala. Rezultati ukazuju da je kalibracija sonde do 15 mm kad se rabi Schch-ov CDR sustav postojanija s usporednim mjerenjem ako se film koji se mjeri uzme kao "zlatni standard", nego je mjerenje duljine CDR sustavom bez kalibracije

<i>De Novo</i> and Rare Variants at Multiple Loci Support the Oligogenic Origins of Atrioventricular Septal Heart Defects

Congenital heart disease (CHD) has a complex genetic etiology, and recent studies suggest that high penetrance de novo mutations may account for only a small fraction of disease. In a multi-institutional cohort surveyed by exome sequencing, combining analysis of 987 individuals (discovery cohort of 59 affected trios and 59 control trios, and a replication cohort of 100 affected singletons and 533 unaffected singletons) we observe variation at novel and known loci related to a specific cardiac malformation the atrioventricular septal defect (AVSD). In a primary analysis, by combining developmental coexpression networks with inheritance modeling, we identify a de novo mutation in the DNA binding domain of NR1D2 (p.R175W). We show that p.R175W changes the transcriptional activity of Nr1d2 using an in vitro transactivation model in HUVEC cells. Finally, we demonstrate previously unrecognized cardiovascular malformations in the Nr1d2tm1-Dgen knockout mouse. In secondary analyses we map genetic variation to protein-interaction networks suggesting a role for two collagen genes in AVSD, which we corroborate by burden testing in a second replication cohort of 100 AVSDs and 533 controls (p = 8.37e-08). Finally, we apply a rare-disease inheritance model to identify variation in genes previously associated with CHD (ZFPM2, NSD1, NOTCH1, VCAN, and MYH6), cardiac malformations in mouse models (ADAM17, CHRD, IFT140, PTPRJ, RYR1 and ATE1), and hypomorphic alleles of genes causing syndromic CHD (EHMT1, SRCAP, BBS2, NOTCH2, and KMT2D) in 14 of 59 trios, greatly exceeding variation in control trios without CHD (p = 9.60e-06). In total, 32% of trios carried at least one putatively disease-associated variant across 19 loci,suggesting that inherited and de novo variation across a heterogeneous group of loci may contribute to disease risk