Objective: To describe the techniques used for automatic landmarking of cephalograms, highlighting the strengths and weaknesses of each one and reviewing the percentage of success in locating each cephalometric point. Materials and Methods: The literature survey was performed by searching the Medline, the Institute of Electrical and Electronics Engineers, and the ISI Web of Science Citation Index databases. The survey covered the period from January 1966 to August 2006. Abstracts that appeared to fulfill the initial selection criteria were selected by consensus. The original articles were then retrieved. Their references were also hand-searched for possible missing articles. The search strategy resulted in 118 articles of which eight met the inclusion criteria. Many articles were rejected for different reasons; among these, the most frequent was that results of accuracy for automatic landmark recognition were presented as a percentage of success. Results: A marked difference in results was found between the included studies consisting of heterogeneity in the performance of techniques to detect the same landmark. All in all, hybrid approaches detected cephalometric points with a higher accuracy in contrast to the results for the same points obtained by the model-based, image filtering plus knowledge-based landmark search and “soft-computing” approaches. Conclusions: The systems described in the literature are not accurate enough to allow their use for clinical purposes. Errors in landmark detection were greater than those expected with manual tracing and, therefore, the scientific evidence supporting the use of automatic landmarking is low.

Calcification of the interclinoid ligament (ICL) of the sella turcica, or sella turcica bridging, has been associated with severe craniofacial deviations. Despite no comprehensive study on the sella turcica bridge, a relationship with tooth and eruption disturbances has been reported. In order to investigate whether congenital absence of the second mandibular premolar, or the presence of a palatally displaced canine (PDC), is associated with sella bridging, a retrospective study was performed. Lateral cephalometric radiographs from 20 males and 14 females, aged between 8 and 16 years, with a PDC and second mandibular premolar aplasia were reviewed and compared with a control group. A standardized scoring scale was established to quantify the extent of a sella turcica bridge from each radiograph (no calcification, partially calcified, and completely calcified). The prevalence of complete calcification of the ICL in adolescents with dental anomalies was equal to 17.6 per cent, while an incidence 9.9 per cent was found in the control group. A partially calcified sella turcica was observed in 58.8 per cent of adolescents with dental anomalies compared with 33.7 per cent in the control group. The association between the degree of calcification of the ICL and the presence of dental anomalies in the studied adolescents was statistically significant according to chi-square statistics (P = 0.004). This was confirmed by Fisher's exact test (P = 0.003). According to these findings, the prevalence of a sella turcica bridge in adolescents with dental anomalies is increased, while age and gender do not greatly influence ossification of the ICL. The very early appearance during development of a sella turcica bridge should alert clinicians to possible tooth anomalies in life later.

Objective: To quantify the amount of perioral tissue changes following the extraction of four premolars in patients with bimaxillary protrusion who had nearly completed active growth. Materials and Methods: A literature search was conducted to identify clinical trials that assessed cephalometric perioral soft tissue changes in patients affected by biprotrusion and treated with extractions. Electronic databases (PubMed, ISI WoS Science Citation Index Expanded, and HubMed) were searched. Abstracts that appeared to fulfill the initial selection criteria were selected, and the full-text original articles were retrieved and analyzed. Only articles that fulfilled the final selection criteria were finally considered. Their references were also hand-searched for possible missing articles from the database searches. Results: Nine abstracts met the initial inclusion criteria and these articles were retrieved. From these, five were later rejected mostly because the sample dealt with growing subjects. Four articles remained and they showed that the upper and lower lips retracted and the nasolabial angle increased following premolar extraction. Upper lip retraction ranged from 2 mm to 3.2 mm, lower lip retraction ranged from 2 mm to 4.5 mm. Conclusions: The lip procumbency improves following the extraction of four premolars and this improvement is predictable. However, the changes are small and do not dramatically modify the profile. A “dished in” profile is not to be expected. Individual variation in response is large.

Vitamin C and antioxidants play a crucial role in endothelial function and may be a link for the known interaction of periodontitis and ischemic heart disease (CAD). This pilot study evaluates the association of gingival health, periodontitis, CAD, or both conditions with salivary and serum vitamin C and antioxidant levels. The clinical and periodontal characteristics, serum, and saliva samples were collected from 36 patients with periodontitis, 35 patients with CAD, 36 patients with periodontitis plus CAD, and 36 healthy controls. Levels of vitamin C, antioxidants, and C-reactive protein (hs-CRP) were assessed with a commercially available kit. The median concentrations of salivary and serum vitamin C and antioxidants (α-tocopherol, β-carotene, lutein, and lycopene) were significantly lower in the CAD group (p < 0.001) and in the periodontitis plus CAD group (p < 0.001) compared to periodontitis patients and controls. In univariate models, periodontitis (p = 0.034), CAD (p < 0.001), and hs-CRP (p < 0.001) were significantly negatively associated with serum vitamin C; whereas, in a multivariate model, only hs-CRP remained a significant predictor of serum vitamin C (p < 0.001). In a multivariate model, the significant predictors of salivary vitamin C levels were triglycerides (p = 0.028) and hs-CRP (p < 0.001). Patients with CAD and periodontitis plus CAD presented lower levels of salivary and serum vitamin C compared to healthy subjects and periodontitis patients. hs-CRP was a significant predictor of decreased salivary and serum vitamin C levels.

Osteoarthritis is the most common human arthritis characterized by degeneration of articular cartilage. Several studies reported that levels of human cartilage glycoprotein chitinase 3-like-1 (CHI3L1) are known as a potential marker for the activation of chondrocytes and the progression of Osteoarthritis (OA), whereas lubricin appears to be chondroprotective. The aim of this study was to investigate the co-expression and co-localization of CHI3L1 and lubricin in normal and osteoarthritic rat articular cartilage to correlate their modified expression to a specific grade of OA. Samples of normal and osteoarthritic rat articular cartilage were analyzed by the Kellgren–Lawrence OA severity scores, the Kraus’ modified Mankin score and the Histopathology Osteoarthritis Research Society International (OARSI) system for histomorphometric evaluations, and through CHI3L1 and lubricin gene expression, immunohistochemistry and double immuno-staining analysis. The immunoexpression and the mRNA levels of lubricin increased in normal cartilage and decreased in OA cartilage (normal vs. OA, p < 0.01). By contrast, the immunoexpression and the mRNA levels of CHI3L1 increased in OA cartilage and decreased in normal cartilage (normal vs. OA, p < 0.01). Our findings are consistent with reports suggesting that these two glycoproteins are functionally associated with the development of OA and in particular with grade 2/3 of OA, suggesting that in the future they could be helpful to stage the severity and progression of the disease.