Purpose: The aim of this study was to compare the accuracy of AI-based AudaxCeph software, Dolphin software, and the manual technique for identifying orthodontic landmarks and tracing lateral cephalograms. Materials and Methods: In this cross-sectional study, 23 anatomical landmarks were identified on 60 randomlyselected lateral cephalograms, and 5 dental indices, 4 skeletal indices, and 1 soft tissue index were measured. Each cephalogram was traced using 4 different methods: manually, with the Dolphin software, with the AudaxCeph software automatically, and with the AudaxCeph software in semi-automatic mode. The intra-class correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between methods. Inter-observer and intra-observer agreements, calculated using the ICC, confirmed the accuracy, reliability, and reproducibility of the results: . Results: There was strong agreement among the AudexCeph (semi-automated or automated) AudaxCeph, Dolphin, and manual methods in measuring orthodontic indices, with ICC values consistently above 0.90. Bland-Altman plots confirmed satisfactory agreement between both versions of AudaxCeph (semi-automated and automated) with the manual method, with mean differences close to 0 and about 95% of data points within the limits of agreement.However, the semi-automated AudaxCeph showed greater agreement and precision than the automated version, as indicated by narrower limits of agreement. The ICC values for inter-observer and intra-observer agreements exceeded 0.98 and 0.99, respectively. Conclusion The semi-automated AudaxCeph software offers a robust and cost-effective solution for cephalometric analysis. Its high accuracy and affordability make it a compelling alternative to Dolphin software and the manual method.

Purpose: The aim of this study was to compare the accuracy of AI-based AudaxCeph software, Dolphin software, and the manual technique for identifying orthodontic landmarks and tracing lateral cephalograms. Materials and Methods: In this cross-sectional study, 23 anatomical landmarks were identified on 60 randomlyselected lateral cephalograms, and 5 dental indices, 4 skeletal indices, and 1 soft tissue index were measured. Each cephalogram was traced using 4 different methods: manually, with the Dolphin software, with the AudaxCeph software automatically, and with the AudaxCeph software in semi-automatic mode. The intra-class correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between methods. Inter-observer and intra-observer agreements, calculated using the ICC, confirmed the accuracy, reliability, and reproducibility of the results: . Results: There was strong agreement among the AudexCeph (semi-automated or automated) AudaxCeph, Dolphin, and manual methods in measuring orthodontic indices, with ICC values consistently above 0.90. Bland-Altman plots confirmed satisfactory agreement between both versions of AudaxCeph (semi-automated and automated) with the manual method, with mean differences close to 0 and about 95% of data points within the limits of agreement.However, the semi-automated AudaxCeph showed greater agreement and precision than the automated version, as indicated by narrower limits of agreement. The ICC values for inter-observer and intra-observer agreements exceeded 0.98 and 0.99, respectively. Conclusion The semi-automated AudaxCeph software offers a robust and cost-effective solution for cephalometric analysis. Its high accuracy and affordability make it a compelling alternative to Dolphin software and the manual method.

Purpose: The aim of this study was to compare the accuracy of AI-based AudaxCeph software, Dolphin software, and the manual technique for identifying orthodontic landmarks and tracing lateral cephalograms. Materials and Methods: In this cross-sectional study, 23 anatomical landmarks were identified on 60 randomlyselected lateral cephalograms, and 5 dental indices, 4 skeletal indices, and 1 soft tissue index were measured. Each cephalogram was traced using 4 different methods: manually, with the Dolphin software, with the AudaxCeph software automatically, and with the AudaxCeph software in semi-automatic mode. The intra-class correlation coefficient (ICC) and Bland-Altman plots were used to evaluate the agreement between methods. Inter-observer and intra-observer agreements, calculated using the ICC, confirmed the accuracy, reliability, and reproducibility of the results: . Results: There was strong agreement among the AudexCeph (semi-automated or automated) AudaxCeph, Dolphin, and manual methods in measuring orthodontic indices, with ICC values consistently above 0.90. Bland-Altman plots confirmed satisfactory agreement between both versions of AudaxCeph (semi-automated and automated) with the manual method, with mean differences close to 0 and about 95% of data points within the limits of agreement.However, the semi-automated AudaxCeph showed greater agreement and precision than the automated version, as indicated by narrower limits of agreement. The ICC values for inter-observer and intra-observer agreements exceeded 0.98 and 0.99, respectively. Conclusion The semi-automated AudaxCeph software offers a robust and cost-effective solution for cephalometric analysis. Its high accuracy and affordability make it a compelling alternative to Dolphin software and the manual method.

Purpose: This study aimed to assess incidental abnormal findings in the paranasal sinuses and anatomical variations of the ostiomeatal complex (OMC) on magnetic resonance imaging (MRI) scans. Materials and Methods: MRI scans of 616 patients (mean age, 44.0±19.4 years) were evaluated. Prior to obtaining the MRI scans, a checklist of patients’ clinical symptoms was filled out after obtaining their consent. The Lund-Mackay classification was used to assess the paranasal sinuses and OMC. The prevalence of abnormal findings and their associations with patients’ age, sex, and subjective symptoms were analyzed by the chi-square test, independent-sample t-test, and analysis of variance. The level of significance was set at 0.05. Results: Abnormal findings in the paranasal sinuses were detected in 32.0% of patients, with a significantly higher prevalence in males (P<0.05), but no significant association with age (P>0.05). Epithelial thickening and retention cyst were the most common abnormal findings in the paranasal sinuses. According to the Lund-Mackay classification, 93% of the study population had normal sinuses (score<4). Concha bullosa and paradoxical concha were detected in 15.3% and 3.4%, respectively, with no significant association with the presence of septal deviation or Lund-Mackay classification (P>0.05). Conclusion Considering the relatively high prevalence of abnormal findings in the paranasal sinuses, it appears that clinical symptoms alone are not sufficient to diagnose sinusitis. A more accurate strategy would be to assess radiographic images of the paranasal sinuses and use a classification system. Sinusitis should be suspected in patients receiving a high score in this classification.

Objective: In humans, polycystic ovary syndrome (PCOS) is an androgen-dependent ovarian disorder. Aberrant gene expression in folliculogenesis can arrest the transition of preantral to antral follicles, leading to PCOS. We explored the possible role of altered gene expression in preantral follicles of estradiol valerate (EV) induced polycystic ovaries (PCO) in a mouse model. Methods: Twenty female balb/c mice (8 weeks, 20.0±1.5 g) were grouped into control and PCO groups. PCO was induced by intramuscular EV injection. After 8 weeks, the animals were killed by cervical dislocation. Blood serum (for hormonal assessments using the enzyme-linked immunosorbent assay technique) was aspirated, and ovaries (the right ovary for histological examinations and the left for quantitative real-time polymerase) were dissected. Results: Compared to the control group, the PCO group showed significantly lower values for the mean body weight, number of preantral and antral follicles, serum levels of estradiol, luteinizing hormone, testosterone, and follicle-stimulating hormone, and gene expression of TGFB1, GDF-9 and BMPR2 (p<0.05). Serum progesterone levels were significantly higher in the PCO animals than in the control group (p<0.05). No significant between-group differences (p>0.05) were found in BMP6 or BMP15 expression. Conclusions In animals with EV-induced PCO, the preantral follicles did not develop into antral follicles. In this mouse model, the gene expression of TGFB1, GDF9, and BMPR2 was lower in preantral follicles, which is probably related to the pathologic conditions of PCO. Hypoandrogenism was also detected in this EV-induced murine PCO model.

Purpose: This study investigated the accuracy of laser-scanned models and 3-dimensional (3D) rendered cone-beam computed tomography (CBCT) compared to the gold standard (plaster casts) for linear measurements on dental arches. Materials and Methods: CBCT scans and plaster models from 30 patients were retrieved. Plaster models were scanned by an Emerald laser scanner (Planmeca, Helsinki, Finland). Sixteen different measurements, encompassing the mesiodistal width of teeth and both arches’ length and width, were calculated using various landmarks. Linear measurements were made on laser-scanned models using Autodesk Meshmixer software v. 3.0 (Autodesk, Mill Valley, CA, USA), on 3D-rendered CBCT models using OnDemand 3D v. 1.0 (Cybermed, Seoul, Korea) and on plaster casts by a digital caliper. Descriptive statistics, the paired t-test, and intra- and inter-class correlation coefficients were used to analyze the data. Results: There were statistically significant differences between some measurements on plaster casts and laser-scanned or 3D-rendered CBCT models (P<0.05). Molar mesiodistal width and mandibular anterior arch width deviated significantly different from the gold standard in both methods. The largest mean differences of laser-scanned and 3D-rendered CBCT models compared to the gold standard were 0.12±0.23 mm and 0.42±0.53 mm, respectively. Most of the mean differences were not clinically significant. The intra- and inter-class correlation results were acceptable for all measurements (>0.830) and between observers (>0.801). Conclusion The 3D-rendered CBCT images and laser-scanned models were useful and accurate alternatives to conventional plaster models. They could be used for clinical purposes in orthodontics and prostheses.

Purpose: This study aimed to compare the accuracy of 3-dimensional (3D) printed models derived from multidetector computed tomography (MDCT) and cone-beam computed tomography (CBCT) systems with different fields of view (FOVs). Materials and Methods: Five human dry mandibles were used to assess the accuracy of reconstructions of anatomical landmarks, bone defects, and intra-socket dimensions by 3D printers. The measurements were made on dry mandibles using a digital caliper (gold standard). The mandibles then underwent MDCT imaging. In addition, CBCT images were obtained using Cranex 3D and NewTom 3G scanners with 2 different FOVs. The images were transferred to two 3D printers, and the digital light processing (DLP) and fused deposition modeling (FDM) techniques were used to fabricate the 3D models, respectively. The same measurements were also made on the fabricated prototypes. The values measured on the 3D models were compared with the actual values, and the differences were analyzed using the paired t-test. Results: The landmarks measured on prototypes fabricated using the FDM and DLP techniques based on all 4 imaging systems showed differences from the gold standard. No significant differences were noted between the FDM and DLP techniques. Conclusion The 3D printers were reliable systems for maxillofacial reconstruction. In this study, scanners with smaller voxels had the highest precision, and the DLP printer showed higher accuracy in reconstructing the maxillofacial landmarks. It seemed that 3D reconstructions of the anterior region were overestimated, while the reconstructions of intra-socket dimensions and implant holes were slightly underestimated.

Objective: In humans, polycystic ovary syndrome (PCOS) is an androgen-dependent ovarian disorder. Aberrant gene expression in folliculogenesis can arrest the transition of preantral to antral follicles, leading to PCOS. We explored the possible role of altered gene expression in preantral follicles of estradiol valerate (EV) induced polycystic ovaries (PCO) in a mouse model. Methods: Twenty female balb/c mice (8 weeks, 20.0±1.5 g) were grouped into control and PCO groups. PCO was induced by intramuscular EV injection. After 8 weeks, the animals were killed by cervical dislocation. Blood serum (for hormonal assessments using the enzyme-linked immunosorbent assay technique) was aspirated, and ovaries (the right ovary for histological examinations and the left for quantitative real-time polymerase) were dissected. Results: Compared to the control group, the PCO group showed significantly lower values for the mean body weight, number of preantral and antral follicles, serum levels of estradiol, luteinizing hormone, testosterone, and follicle-stimulating hormone, and gene expression of TGFB1, GDF-9 and BMPR2 (p<0.05). Serum progesterone levels were significantly higher in the PCO animals than in the control group (p<0.05). No significant between-group differences (p>0.05) were found in BMP6 or BMP15 expression. Conclusions In animals with EV-induced PCO, the preantral follicles did not develop into antral follicles. In this mouse model, the gene expression of TGFB1, GDF9, and BMPR2 was lower in preantral follicles, which is probably related to the pathologic conditions of PCO. Hypoandrogenism was also detected in this EV-induced murine PCO model.

Purpose: The mastoid region is ideal for studying sexual dimorphism due to its anatomical position at the base of the skull. This study aimed to determine sex in the Iranian population based on measurements of the mastoid process using different data mining algorithms. Materials and Methods: This retrospective study was conducted on 190 3-dimensional cone-beam computed tomographic (CBCT) images of 105 women and 85 men between the ages of 18 and 70 years. On each CBCT scan, the following 9 landmarks were measured: the distance between the porion and the mastoidale; the mastoid length, height, and width; the distance between the mastoidale and the mastoid incision; the intermastoid distance (IMD); the distance between the lowest point of the mastoid triangle and the most prominent convex surface of the mastoid (MF); the distance between the most prominent convex mastoid point (IMSLD); and the intersecting angle drawn from the most prominent right and left mastoid point (MMCA). Several predictive models were constructed and their accuracy was compared using cross-validation. Results: The results of the t-test revealed a statistically significant difference between the sexes in all variables except MF and MMCA. The random forest model, with an accuracy of 97.0%, had the best performance in predicting sex. The IMSLD and IMD made the largest contributions to predicting sex, while the MMCA variable had the least significant role. Conclusion These results show the possibility of developing an accurate tool using data mining algorithms for sex determination in the forensic framework.

Purpose: This study investigated the position of the hyoid bone and its relationship with airway dimensions in different skeletal malocclusion classes using cone-beam computed tomography (CBCT). Materials and Methods: CBCT scans of 180 participants were categorized based on the A point-nasion-B point angle into class I, class Ⅱ, and class Ⅲ malocclusions. Eight linear and 2 angular hyoid parameters (H-C3, H-EB, H-PNS, H-Me, H-X, H-Y, H-[C3-Me], C3-Me, H-S-Ba, and H-N-S) were measured. A 3-dimensional airway model was designed to measure the minimum cross-sectional area, volume, and total and upper airway length. The mean cross-sectional area, morphology, and location of the airway were also evaluated. Data were analyzed using analysis of variance and the Pearson correlation test, with p values <0.05 indicating statistical significance. Results: The mean airway volume differed significantly among the malocclusion classes (p<0.05). The smallest and largest volumes were noted in class Ⅱ (2107.8±844.7 mm3) and class Ⅲ (2826.6±2505.3 mm3), respectively. The means of most hyoid parameters (C3-Me, C3-H, H-Eb, H-Me, H-S-Ba, H-N-S, and H-PNS) differed significantly among the malocclusion classes. In all classes, H-Eb was correlated with the minimum cross-sectional area and airway morphology, and H-PNS was correlated with total airway length. A significant correlation was also noted between H-Y and total airway length in class Ⅱ and Ⅲ malocclusions and between H-Y and upper airway length in class I malocclusions. Conclusion The position of the hyoid bone was associated with airway dimensions and should be considered during orthognathic surgery due to the risk of airway obstruction.