Comparison of Inter and Intra-Operator Differences for Cephalometric Landmark Identification on Three-Dimensional CBCT Images using Pro Plan CMF

Objective: To establish reliability of cephalometric landmark identification in threedimensions using ProPlan CMF software. Methods: Two orthodontist identified a series of 33 cephalometric landmarks on 20 CBCT scans of Class I, pre-orthodontic patients and repeated the landmark identification about two months later. Intraclass correlations (ICC) were calculated by landmark in the X, Y, and Z dimensions and F-test were used to assess difference in landmark location in the X, Y, and Z dimensions. Results: The majority of landmarks had good to excellent ICC for both inter- and intraobserver reliability. F-test also showed the majority of landmarks had no significant difference between the observers. Conclusion: Most landmarks showed good to very good reliability and reproducibility using ProPlan CMF, with some landmarks proving more reliable than others and further research is needed to establish the utility and practicality of three-dimensional cephalometrics as a common diagnostic tool in orthodontics

The prevalence of caries and tooth loss among participants in the Hispanic Community Health Study/Study of Latinos

ABSTRACT: Background.: The Hispanic and Latino population is projected to increase from 16.7 percent to 30.0 percent by 2050. Previous U.S. national surveys had minimal representation of Hispanic and Latino participants other than Mexicans, despite evidence suggesting that Hispanic or Latino country of origin and degree of acculturation influence health outcomes in this population. In this article, the authors describe the prevalence and mean number of cavitated, decayed and filled surfaces, missing teeth and edentulism among Hispanics and Latinos of different national origins. Methods.: Investigators in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)—a multicenter epidemiologic study funded by the National Heart, Lung, and Blood Institute with funds transferred from six other institutes, including the National Institute of Dental and Craniofacial Research—conducted in-person examinations and interviews with more than 16,000 participants aged 18 to 74 years in four U.S. cities between March 2008 and June 2011. The investigators identified missing, filled and decayed teeth according to a modified version of methods used in the National Health and Nutrition Examination Survey. The authors computed prevalence estimates (weighted percentages), weighted means and standard errors for measures. Results.: The prevalence of decayed surfaces ranged from 20.2 percent to 35.5 percent, depending on Hispanic or Latino background, whereas the prevalence of decayed and filled surfaces ranged from 82.7 percent to 87.0 percent, indicating substantial amounts of dental treatment. The prevalence of missing teeth ranged from 49.8 percent to 63.8 percent and differed according to Hispanic or Latino background. Significant differences in the mean number of decayed surfaces, decayed or filled surfaces and missing teeth according to Hispanic and Latino background existed within each of the age groups and between women and men. Conclusions.: Oral health status differs according to Hispanic or Latino background, even with adjustment for age, sex and other characteristics. Practical Implications.: These data indicate that Hispanics and Latinos in the United States receive restorative dental treatment and that practitioners should consider the association between Hispanic or Latino origin and oral health status. This could mean that dental practices in areas dominated by patients from a single Hispanic or Latino background can anticipate a practice based on a specific pattern of treatment needs

Heterogeneity in periodontitis prevalence in the Hispanic Community Health Study/Study of Latinos

To examine acculturation and established risk factors in explaining variation in periodontitis prevalence among Hispanic/Latino subgroups

How strong is the evidence for the use of perioperative β blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials

Objective To determine the effect of perioperative β blocker treatment in patients having non-cardiac surgery. Design Systematic review and meta-analysis. Data sources Seven search strategies, including searching two bibliographic databases and hand searching seven medical journals. Study selection and outcomes We included randomised controlled trials that evaluated β blocker treatment in patients having non-cardiac surgery. Perioperative outcomes within 30 days of surgery included total mortality, cardiovascular mortality, non-fatal myocardial infarction, non-fatal cardiac arrest, non-fatal stroke, congestive heart failure, hypotension needing treatment, bradycardia needing treatment, and bronchospasm. Results Twenty two trials that randomised a total of 2437 patients met the eligibility criteria. Perioperative β blockers did not show any statistically significant beneficial effects on any of the individual outcomes and the only nominally statistically significant beneficial relative risk was 0.44 (95% confidence interval 0.20 to 0.97, 99% confidence interval 0.16 to 1.24) for the composite outcome of cardiovascular mortality, non-fatal myocardial infarction, and non-fatal cardiac arrest. Methods adapted from formal interim monitoring boundaries applied to cumulative meta-analysis showed that the evidence failed, by a considerable degree, to meet standards for forgoing additional studies. The individual safety outcomes in patients treated with perioperative β blockers showed a relative risk for bradycardia needing treatment of 2.27 (95% CI 1.53 to 3.36, 99% CI 1.36 to 3.80) and a nominally statistically significant relative risk for hypotension needing treatment of 1.27 (95% CI 1.04 to 1.56, 99% CI 0.97 to 1.66). Conclusion The evidence that perioperative β blockers reduce major cardiovascular events is encouraging but too unreliable to allow definitive conclusions to be drawn

Heterogeneity in periodontitis prevalence in the Hispanic Community Health Study/Study of Latinos

PURPOSE: To examine acculturation and established risk factors in explaining variation in periodontitis prevalence among Hispanic/Latino subgroups. METHODS: Participants were 12,730 dentate adults aged 18–74 years recruited into the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four U.S. field centers between 2008 and 2011. A standardized periodontal assessment measured probing pocket depth and gingival recession at six sites per tooth for up to 28 teeth. Periodontitis was defined according to the CDC/AAP case classifications developed for population surveillance. Covariates included acculturation indicators and established periodontitis risk factors. Survey estimation procedures took account of the complex sampling design. Adjusted multivariate binomial regression estimated prevalence ratios (PR) and 95% confidence limits (95% CL). RESULTS: Unadjusted prevalence of moderate/severe periodontitis was 38.5% and ranged from 24.7% among Dominicans to 52.1% among Cubans. Adjusted prevalence ratios for subgroups relative to Dominicans were: 1.34 (95% CL: 1.13, 1.58) among South Americans; 1.37 (95% CL: 1.17, 1.61) among Puerto Ricans; 1.43 (95% CL: 1.25, 1.64) among Mexicans; 1.53 (95% CL: 1.32, 1.76) among Cubans; and 1.55 (95% CL: 1.35, 1.78) among Central Americans. CONCLUSION: Heterogeneity in prevalence of moderate/severe periodontitis among Hispanic/Latino subpopulations was not explained by acculturation or periodontitis risk factors

Genome Scan Meta-Analysis of Schizophrenia and Bipolar Disorder, Part III: Bipolar Disorder

Genome scans of bipolar disorder (BPD) have not produced consistent evidence for linkage. The rank-based genome scan meta-analysis (GSMA) method was applied to 18 BPD genome scan data sets in an effort to identify regions with significant support for linkage in the combined data. The two primary analyses considered available linkage data for “very narrow” (i.e., BP-I and schizoaffective disorder–BP) and “narrow” (i.e., adding BP-II disorder) disease models, with the ranks weighted for sample size. A “broad” model (i.e., adding recurrent major depression) and unweighted analyses were also performed. No region achieved genomewide statistical significance by several simulation-based criteria. The most significant P values (<.01) were observed on chromosomes 9p22.3-21.1 (very narrow), 10q11.21-22.1 (very narrow), and 14q24.1-32.12 (narrow). Nominally significant P values were observed in adjacent bins on chromosomes 9p and 18p-q, across all three disease models on chromosomes 14q and 18p-q, and across two models on chromosome 8q. Relatively few BPD pedigrees have been studied under narrow disease models relative to the schizophrenia GSMA data set, which produced more significant results. There was no overlap of the highest-ranked regions for the two disorders. The present results for the very narrow model are promising but suggest that more and larger data sets are needed. Alternatively, linkage might be detected in certain populations or subsets of pedigrees. The narrow and broad data sets had considerable power, according to simulation studies, but did not produce more highly significant evidence for linkage. We note that meta-analysis can sometimes provide support for linkage but cannot disprove linkage in any candidate region