Quality assessment of instructions for authors in dental, oral and maxillofacial journals

Objective: to develop and test inter-observer reproducibility of instructions for authors quality rating (IAQR) tool measuring the quality of instructions for authors at journal level for a possible improvement of editorial guidelines.Material and methods: instructions for authors of 75 dental and maxillofacial surgery journals were assessed by two independent observers using assessment tool inspired from AGREE with 16 questions and 1 to 4 points scale per answer. Two observers evaluated the instructions of authors independently and blind to impact factor of a given journal. Scores obtained from our tool were compared with “journal impact factor 2013”. Results: IAQR presented with an excellent interobserver reproducibility (κ= 0.81) despite a difference in data distribution between observers. There existed a weak positive correlation between IAQR and “journal impact factor 2013”. Conclusions: The IAQR is a reproducible quality assessment tool at the journal level. The IAQR assess the quality of instruction for authors and it is a goodstarting point for possible improvements of the instructions for authors, especially when it comes to their completeness. Nemesis relevance: 28% of dental and maxillofacial journals might revise their instructions for authors to provide more up-to-date version.Objective: to develop and test inter-observer reproducibility of instructions for authors quality rating (IAQR) tool measuring the quality of instructions for authors at journal level for a possible improvement of editorial guidelines.Material and methods: instructions for authors of 75 dental and maxillofacial surgery journals were assessed by two independent observers using assessment tool inspired from AGREE with 16 questions and 1 to 4 points scale per answer. Two observers evaluated the instructions of authors independently and blind to impact factor of a given journal. Scores obtained from our tool were compared with “journal impact factor 2013”. Results: IAQR presented with an excellent interobserver reproducibility (κ= 0.81) despite a difference in data distribution between observers. There existed a weak positive correlation between IAQR and “journal impact factor 2013”. Conclusions: The IAQR is a reproducible quality assessment tool at the journal level. The IAQR assess the quality of instruction for authors and it is a goodstarting point for possible improvements of the instructions for authors, especially when it comes to their completeness. Nemesis relevance: 28% of dental and maxillofacial journals might revise their instructions for authors to provide more up-to-date version

Three-dimensional analysis of airway space and mandibular morphology in Pierre Robin sequence using cone beam computed tomography.

Objectives: The Pierre Robin sequence (PRS) is defined by retromicrognathia, glossoptosis, and sleep apnea and can also be associated with cleft palate. Diagnosis, management and mandibular catch-up growth are still controversial issues in PRS patients. The aim of our retrospective study was to evaluate in three dimensions (3D) the airway space and mandibular morphology in PRS compared to a normal control group patients in the pre-orthodontic period of life. The null hypothesis was that we would not find a significant difference between the PRS and control group patients in oropharyngeal airway volume measurements. Material and methods: We analyzed 9 PRS patients (mean age: 8 years-old) who underwent cleft palate surgery in the first four months of life, performed by the same surgeon using the same technique. Cone-beam computed tomography (CBCT) was performed in these patients after local ethical committee approval. The control group consisted of 15 patients (mean age: 9 years-old) with CBCT already performed for other reasons. 3D Slicer was used in both groups for semi-automatic segmentation of the airway space. Two independent observers performed semi-automatic segmentations twice in each patient with a one- week interval between the two series of measurements. Airway volume was automatically measured using 3D Slicer. We also developed a 3D cephalometric analysis with Maxilim software in order to define a 3D mandibular morphology which consisted of 25 landmarks, 4 planes, and 23 distances. Two independent observers performed the 3D cephalometric analysis twice for each patient, with a one- week interval between the two series of measurements. Results: There was no significant difference in the intra- and inter-observer measurements between the PRS and control groups for airway space volume (p<0.05). However, there was a significant difference in the shape of the mandible between the PRS group and the control group (p<0.05). Conclusions: Vertical ramus width and mandibular global anteroposterior length were significantly lower in the PRS group. Mandibular hypoplasia could be found in PRS patients not only in the horizontal dimension. Nemesis relevance: the null hypothesis was confirmed. Moreover we failed to find exactly the same control group under 9 years-old due to radioprotection restrictions of application of cone beam CT in children.Objectives: The Pierre Robin sequence (PRS) is defined by retromicrognathia, glossoptosis, and sleep apnea and can also be associated with cleft palate. Diagnosis, management and mandibular catch-up growth are still controversial issues in PRS patients. The aim of our retrospective study was to evaluate in three dimensions (3D) the airway space and mandibular morphology in PRS compared to a normal control group patients in the pre-orthodontic period of life. The null hypothesis was that we would not find a significant difference between the PRS and control group patients in oropharyngeal airway volume measurements. Material and methods: We analyzed 9 PRS patients (mean age: 8 years-old) who underwent cleft palate surgery in the first four months of life, performed by the same surgeon using the same technique. Cone-beam computed tomography (CBCT) was performed in these patients after local ethical committee approval. The control group consisted of 15 patients (mean age: 9 years-old) with CBCT already performed for other reasons. 3D Slicer was used in both groups for semi-automatic segmentation of the airway space. Two independent observers performed semi-automatic segmentations twice in each patient with a one- week interval between the two series of measurements. Airway volume was automatically measured using 3D Slicer. We also developed a 3D cephalometric analysis with Maxilim software in order to define a 3D mandibular morphology which consisted of 25 landmarks, 4 planes, and 23 distances. Two independent observers performed the 3D cephalometric analysis twice for each patient, with a one- week interval between the two series of measurements. Results: There was no significant difference in the intra- and inter-observer measurements between the PRS and control groups for airway space volume (p<0.05). However, there was a significant difference in the shape of the mandible between the PRS group and the control group (p<0.05). Conclusions: Vertical ramus width and mandibular global anteroposterior length were significantly lower in the PRS group. Mandibular hypoplasia could be found in PRS patients not only in the horizontal dimension. Nemesis relevance: the null hypothesis was confirmed. Moreover we failed to find exactly the same control group under 9 years-old due to radioprotection restrictions of application of cone beam CT in children

Drugs targeting the bone microenvironment: new therapeutic tools in Ewing's sarcoma?

Introduction: Ewing's sarcoma (ES) is the second most frequent malignant primary bone tumour in children, adolescents and young adults. The overall survival is 60 – 70% at 5 years but still very poor for patients with metastases, disease relapse or for those not responding to chemotherapy. For these high risk patients, new therapeutic approaches are needed beyond conventional therapies (chemotherapy, surgery and radiation) such as targeted therapies. Areas covered: Transcriptomic and genomic analyses in ES have revealed alterations in genes that control signalling pathways involved in many other cancer types. To set up more specific approaches, it is reasonable to think that the particular microenvironment of these bone tumours is essential for their initiation and progression, including in ES. To support this hypothesis, preclinical studies using drugs targeting bone cells (bisphosphonate zoledronate, anti-receptor activator of NF-κB ligand strategies) showed promising results in animal models. This review will discuss the new targeted therapeutic options in ES, focusing more particularly on the ones modulating the bone microenvironment. Expert opinion: Targeting the microenvironment represents a new option for patients with ES. The proof-of-concept has been demonstrated in preclinical studies using relevant animal models, especially for zoledronate, which induced a strong inhibition of tumour progression in an orthotopic bone model

Three-Dimensional Evaluation of Implant Positioning in the Maxillary Sinus Septum: A Retrospective Study.

BACKGROUND The aim of this study was to simulate implant placement in the maxillary sinus septum, as a potential alternative site to avoid sinus grafting. MATERIAL AND METHODS One hundred partially or completely edentulous patients, with their maxillary sinus septum present in the edentulous region, were selected from the database of the Department of Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Bruxelles, Belgium. Three-dimensional (3D) reconstructions were created using 3D planning software. 3D reconstructions were performed for each maxillary sinus. Using the software implant library, the implants that presented the best fit with the maxillary sinus septum and that followed the established inclusion criteria were selected. RESULTS All of the implants were inserted in premolar and molar regions. Most implants were inserted in the position of the second molar (21 of 55) or in the position of the first molar (17 of 55). In all sites the most frequently used implant was 4 mm in diameter and 7 mm in height. The mean coronal angle for the implant was 80.19±17.13 degrees and the mean sagittal angle was 94.83±9.94 degrees. The septal height represents 38.13% of the total available bone height (ABH). The mean percentage of the septum used to insert the implants was 47.33±2.47%. The septum increased the available bone height by a mean value of 2.18±1.47 mm. In 45 cases, the septa did not permit implant placement. CONCLUSIONS In completely edentulous patients, inserting implants in sinus septa does not exclude the need for sinus grafting, but in partially edentulous patients, this minimally invasive technique is an alternative to subantral augmentation

Three-Dimensional Evaluation of Maxillary Sinus Septa for Implant Placement.

BACKGROUND: The aim of our study was to investigate, in 3 dimensions, the maxillary sinus septa as an alternative site for dental implant placement to avoid sinus lift procedures. MATERIAL AND METHODS: We selected 100 dentate and 100 edentate patients with the presence of a maxillary sinus septum by reviewing a larger cone beam computer tomography (CBCT) database from the Department of Oral and Maxillofacial Surgery at Cliniques Universitaires Saint Luc in Bruxelles, Belgium. Three-dimensional reconstructions of 200 maxillary sinus septa were performed using Maxilim software. Ten measurements (length, lateral height, and thickness of the middle and medial region of the septum) were performed by 1 observer, 2 times, with an interval of 1 week between measurements. The angle between the septum and the maxillary plane was also measured. Finally, localization and orientation were assessed for each septum. RESULTS: There was no statistically significant difference between the 2 intraobserver measurements (p>0.05). Student's t-test was used to compare means. Middle height was the only measurement for which there was a difference between edentate and dentate patients (p=0.0095, edentate mean < dentate mean). The location of the septa observed in our study groups demonstrated greater prevalence in the posterior region than in the anterior and middle regions. For the spatial orientation of the septum, we found that most septa (81.2% in dentate patients, 53% in edentate patients) were oblique. CONCLUSIONS: Three-dimensional evaluation of maxillary sinus septa using 3D CBCT imaging showed that the sinus septum could offer an alternative site for implant placement in the maxillary sinus

Reproducibility of the sella turcica landmark in three dimensions using a sella turcica-specific reference system.

This study was performed to assess the reproducibility of identifying the sella turcica landmark in a three-dimensional (3D) model by using a new sella-specific landmark reference system

Reproducibility of the sella turcica landmark in three dimensions using a sella turcica-specific reference system

PURPOSE: This study was performed to assess the reproducibility of identifying the sella turcica landmark in a three-dimensional (3D) model by using a new sella-specific landmark reference system. MATERIALS AND METHODS: Thirty-two cone-beam computed tomographic scans (3D Accuitomo® 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim® software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p<0.005, interobserver precision: p<0.0011). RESULTS: The intraobserver mean precision of all landmarks was 50% precision in locating the landmark within 1 mm. CONCLUSION: A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data.status: publishe

Three-dimensional Frankfort horizontal plane for 3D cephalometry: a comparative assessment of conventional versus novel landmarks and horizontal planes

Background: To assess the reproducibility of landmarks in three dimensions that determine the Frankfort horizontal plane (FH) as well as two new landmarks, and to evaluate the angular differences of newly introduced planes to the FH. Methods: Three-dimensional (3D) surface models were created from CBCT scans of 26 dry human skulls. Porion (Po), orbitale (Or), internal acoustic foramen (IAF), and zygomatico-maxillary suture (ZyMS) were indicated in the software by three observers twice with a 4-week interval. Angles between two FHs (FH 1: Or-R, Or-L, mid-Po; FH 2: Po-R, Po-L, mid-Or) and between FHs and new planes (Plane 1–6) were measured. Coordinates were exported to a spreadsheet. A statistical analysis was performed to define the landmark reproducibility and 3D angles. Results: Intra- and inter-observer landmark reproducibility showed mean difference more than 1 mm for x-coordinates of all landmarks except IAF. IAF showed significantly better reproducibility than other landmarks (P < 0.0018). The mean angular difference between FH 1 and FH 2 was 0.7 degrees. Plane 3, connecting Or-R, Or-L and mid-IAF, and Plane 4, connecting Po-R, Po-L and mid-ZyMS, both showed an angular difference of less than 1 degree when compared to FHs. Conclusions: This study revealed poor reproducibility of the traditional FH landmarks on the x-axis and good reproducibility of a new landmark tested to replace Po, the IAF. Yet, Or showed superior results compared to ZyMS. The potential of using new horizontal planes was demonstrated. Future studies should focus on identification of a valid alternative for Or and ZyMS and on clinical implementation of the findings.status: publishe

A new mandible-specific landmark reference system for three-dimensional cephalometry using cone-beam computed tomography

OBJECTIVES: To develop a novel 3D landmark reference system that is specific for mandibular midline cephalometric landmarks and to assess its repeatability and reproducibility. METHODS: Cone-beam computed tomography (CBCT) scans (3D Accuitomo® 170) were performed on 26 dry human skulls. The CBCT data were exported into DICOM files and imported to Maxilim® software to create 3D surface models. Two observers identified five landmarks to create a specific mid-sagittal mandibular plane: two mandibular foramina, two molar landmarks and one interincisive landmark. On this mid-sagittal mandibular plane, four mandibular cephalometric landmarks were marked: Point B, Pogonion, Gnathion and Menton. All observations were repeated by the two observers after an interval of 4 weeks. The coordinates (x, y, z) of each landmark were exported, and statistical analyses were performed to evaluate inter- and intra-rater precision. RESULTS: The intra-observer median precision in locating all landmarks ranged between 0.17 and 0.61mm. The intra-observer repeatability was generally good with a precision under 1mm in more than 50 per cent. The overall median inter-observer precision was 0.26-2.30mm. The mandibular foramina showed the best inter-observer reproducibility. The general inter-observer reproducibility was moderate to good, except for Pogonion and Point B. LIMITATIONS: Dry human skulls may not represent anatomical conditions found in living patients, thus the system should be validated using patients' data. CONCLUSION: The novel reference system offered good precision and generally good to moderate repeatability and reproducibility for mandibular midline cephalometric landmark identification in three dimensions. These findings will be useful for further improvement of 3D cephalometric systems.status: publishe