OBJECTIVE: To develop a clinical automated diagnostic system for temporomandibular disorders (TMD) based on the diagnostic criteria for TMD (DC/TMD) to assist dentists in making rapid and accurate clinical diagnosis of TMD. METHODS: Clinical and imaging data of 354 patients, who visited the Center for TMD & Orofacial Pain at Peking University Hospital of Stomatology from September 2023 to January 2024, were retrospectively collected. The study developed a clinical automated diagnostic system for TMD using the DC/TMD, built on the. NET Framework platform with branching statements as its internal structure. Further validation of the system on consistency and diagnostic efficacy compared with DC/TMD were also explored. Diagnostic efficacy of the TMD clinical automated diagnostic system for degenerative joint diseases, disc displacement with reduction, disc displacements without reduction with limited mouth opening and disc displacement without reduction without limited mouth opening was evaluated and compared with a specialist in the field of TMD. Accuracy, precision, specificity and the Kappa value were assessed between the TMD clinical automated diagnostic system and the specialist. RESULTS: Diagnoses for various TMD subtypes, including pain-related TMD (arthralgia, myalgia, headache attributed to TMD) and intra-articular TMD (disc displacement with reduction, disc displacement with reduction with intermittent locking, disc displacement without reduction with limited opening, disc displacement without reduction without limited opening, degenerative joint disease and subluxation), using the TMD clinical automated diagnostic system were completely identical to those obtained by the TMD specialist based on DC/TMD. Both the system and the expert showed low sensitivity for diagnosing degenerative joint disease (0.24 and 0.37, respectively), but high specificity (0.96). Both methods achieved high accuracy (> 0.9) for diagnosing disc displacements with reduction and disc displacements without reduction with limited mouth opening. The sensitivity for diagnosing disc displacement without reduction without limited mouth opening was only 0.59 using the automated system, lower than the expert (0.87), while both had high specificity (0.92). The Kappa values for most TMD subtypes were close to 1, except the disc displacement without reduction without limited mouth opening, which had a Kappa value of 0.68. CONCLUSION This study developed and validated a reliable clinical automated diagnostic system for TMD based on DC/TMD. The system is designed to facilitate the rapid and accurate diagnosis and classification of TMD, and is expected to be an important tool in clinical scenarios.
Humans ; Temporomandibular Joint Disorders/diagnosis* ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Facial Pain/diagnosis* ; Diagnosis, Computer-Assisted/methods* ; Sensitivity and Specificity ; Young Adult

Objective To evaluate the clinical value of multi-slice spiral CT (MSCT)in the screening of coronary artery lesions in elderly patients with diabetes mellitus.Methods MSCT and coronary angiography(CAG)were performed in 136 elderly patients(68 patients with diabetes and 68 patients without diabetes).The number of diseased coronary segments and the plaque type (noncalcified,mixed and calcified)for each patient were determined.The characteristics of coronary lesions were compared between patients with and without diabetes.The sensitivity and specificity of MSCT were evaluated.Results More noncalcified and calcified plaques and few ermixed plaques were observed in patients with diabetes,compared with patients without diabetes(noncalcified plagues:10 cases or 14.7％ vs.4 cases or 5.9％;calcified plagues:47 cases or 69.1％ vs.39 cases or 57.4％)(P＜ 0.05).In addition,diabetic patients showed a significantly higher frequency of multivessel disease(P＜0.05).Furthermore,MSCT was able to clearly show stenosis and plaque type in the trunk and branches of the coronary artery,with a sensitivity of 91.0％,a specificity of 95.0％,a positive predictive value of 93％ and a negative predictive value of 96.0％.Conclusions Diabetes is associated with a higher risk of coronary artery disease.MSCT can effectively detect the characteristics of coronary artery disease in diabetic patients and is an effective,noninvasive,and safe screening method.

BACKGROUND:To decrease operation amount of finite element analysis and increase its clinical practice,previous studies explored the material properties and 10 kinds of material attributes were assigned,which met the requirements of finite element analysis.Moreover,it can be used to calculate bone density.OBJECTIVE:To explore a method for measurement of bone density based on three-dimensional reconstruction and finite element analysis.METHODS:A total of 11 specimens of femoral superior segment were selected.The mass of control group was firstly measured.The experimental groups were treated with thin-slice high resolution CT scan and three-dimensional reconstruction in Mimics 10.0,volume meshing in Ansys,assigned with 10,100 and 400 kinds of material attributes Mimics,exported to Ansys to calculat the volumes of the block elements of every types of material attributes.The mass and the density of the specimens was harvested according to the empirical formula concerning the gray value and the bone density.All results were treated with one-way ANOVA.RESULTS AND CONCLUSION:One-way ANOVA showed that there were no significant differences between control group and experimental groups assigned with 10,100 and 400 kinds of material attributes (P＞0.28),and there were no significantly among the experimental groups (P＞0.8).Results show that the method was able to measure the mass and the density of bone quantitatively,as well as the proportion between compact bone and cancellous bone;to assign 10 kinds of material attributes to three-dimensional model of femur could match the needs for measurements.The results can be used as an initial preparation for the unification of bone density and finite element analysis for osteoporosis.

BACKGROUND:Based on previously theoretical derivation,it thought that assignment with 10 kinds of material attributes to three-dimensional model of bone can match the needs of finite element analysis,however,whether the results is consistent with actual needs to be validated by experimental results.OBJECTIVE:Twelve specimens of femoral superior segment were used for finite element analysis,which were verified with results of biomechanical testing,to explore a reasonable method for material assignment of bone.METHODS:All 12 specimens of femoral superior segment were treated with CT scan,three-dimensional reconstruction in Mimics 10.0 and volume meshing in Ansys.The finite element analysis group was divided into 2 kinds (compact bone and cancellated bone),10,50,100,200,400 kinds of material attributes groups based on the gray value.All models were assigned with material attributes and tested in Ansys for mechanics data of nodes on surface of femoral neck.In biomechanical testing group,12 specimens of femoral superior segment were treated with compressed testing to harvest mechanics data of measuring point same as that of finite element analysis group.RESULTS AND CONCLUSION:The one-way analysis of variance showed that the differences between the biomechanical testing group and finite element analysis group of 2 kinds of material attributes had no obvious significance (P=0.082).Compared to the 10,50,100,200,400 kinds of material attributes group,the difference had no significance (P > 0.39).However,the differences between the 2 kinds of material attributes and the 10,50,100,200,400 kinds of material attributes in the finite element analysis group were obviously difference (P< 0.05),which was no difference in the 10,50,100,200,400 kinds of material attributes (P>0.9).The results demonstrated that to assign 10 kinds of material attributes to three-dimensional model of bone can match the needs of finite element analysis.