Objectives: A randomized clinical trial was conducted to compare all three known static guided surgery protocols (pilot, partial, and full) with each other and with freehand surgery in terms of accuracy, under the same conditions.Material and Methods: A total of 207 implants of the same brand and type were placed in 101 partially edentulous volunteers in need of implantation in the mandible or maxilla or both. All cases were digitally planned, and the comparison of the planned and actual implant positions was performed using a medical image analysis software with dedicated algorithms. The primary outcome variable was angular deviation (AD, degrees). The secondary outcome variables were coronal global deviation (CGD, mm), apical global deviation (AGD, mm), and voxel overlap (VO, %).Results: AD showed stepwise improvement in significant steps as the amount of guidance increased. The highest mean AD (7.03° ± 3.44) was obtained by freehand surgery and the lowest by fully guided surgery (3.04° ± 1.51). As for the secondary outcome variables, all guided protocols turned out to be significantly superior to freehand surgery, but they were not always significantly different from each other.Conclusions: As for the comparison that this study sought to perform, it can be said that the static guided approach significantly improves the accuracy of dental implant surgery as compared to freehand surgery. Furthermore, the results suggest that any degree of guidance yields better results than freehand surgery and that increasing the level of guidance increases accuracy.
Objective: This study aimed to identify the key aspects of patients’ dental care experience that influenced their self-perceived satisfaction and loyalty. Also examined was the agreement between patients and dentists regarding these factors. Methods: Questionnaires were administered to 1121 patients and 77 dentists, focusing on demographic information and 15 selected items related to the patients’ last dental visit. Descriptive and linear regression analyses were conducted. Results: The study included participants from 41 practices. Factors significantly influencing satisfaction and loyalty included location convenience, treatment quality, trust in dentists’ decisions, visit frequency satisfaction, clear treatment explanations, dentist’s interest in symptoms, patient-dental personnel attachment, and dentist’s knowledge of the patient and their medical records. While overall agreement between patients and dentists was high, some areas exhibited notable disagreement. Conclusions: The findings mostly align with existing literature, underscoring the importance of communication, trust, and a personal patient-dentist relationship in promoting satisfaction and loyalty. However, they also show that local, generally not reported factors might be at play, which necessitates dentists’ awareness and consideration of the local context for optimal outcomes.
Introduction: Interictal deficits of elementary visuo-cognitive functions are well documented in patients with migraine and are mostly explained in terms of neocortical hyperexcitability. It has been suggested that the basal ganglia and the hippocampi might also be affected in migraine. If so, a deterioration of learning and memory processes related to these structures is expected. Methods: A visual learning paradigm thought to be capable of dissociating learning/memory processes mediated by the basal ganglia from processes mediated by the hippocampus (the Rutgers Acquired Equivalence Test) was applied to a group of patients with migraine without aura and to age- and sex-matched controls. Results: Patients with migraine showed a significantly poorer performance in both main phases of the test and the deficit in the phase considered to be dependent on the hippocampi was especially marked. Conclusions: These results can be interpreted as behavioural support for findings that have suggested the involvement of the basal ganglia and the hippocampi in migraine, but further research is needed to clarify these findings.
Motion perception is the process through which one gathers information on the dynamic visual world, in terms of the speed and movement direction of its elements. Motion sensation takes place from the retinal light sensitive elements, through the visual thalamus, the primary and higher visual cortices. In the present review we aim to focus on the extrageniculo-extrastriate cortical and subcortical visual structures of the feline and macaque brain and discuss their functional role in visual motion perception. Special attention is paid to the ascending tectofugal system that may serve for detection of the visual environment during self-motion.
17 April 2020 in The International Journal of Medical Robotics and Computer Assisted Surgery
Introduction: Apicoectomy is an endodontic surgical intervention that requires high precision. The computer‐assisted static guided approach has proven to increase the precision of dental implantation in a significant manner. The authors sought to transfer this precision to root‐end resection with the use of custom designed trephine burs manufactured specifically for use in targeted endodontic microsurgery.Methods: A set of custom bone trephines were designed and manufactured, then their digital models were integrated into an already existing implant surgical planning software, in cooperation with the software developer. Apicoectomy was performed in an actual case with the help of the new system.Results: It has become possible to plan root end removal in the virtual space and to manufacture 3D printed static surgical guides to help the execution of the surgery. A patient with persistent periapical lesion was successfully treated without complication. The 6‐month follow‐up found uneventful healing.Conclusion: The presented system is a step toward a standardized digital system and workflow dedicated to guided endodontic surgery.