Purpose: Vertical root fractures (VRFs) remain a major diagnostic challenge in endodontics due to image noise and artifacts in cone-beam computed tomography (CBCT), particularly those caused by intracanal posts. This study evaluated the effect of an advanced noise reduction (ANR) algorithm on CBCT performance in detecting VRFs inmaxillary second premolars and examined how different post materials influenced diagnostic outcomes. Materials and Methods: Seventy extracted maxillary second premolars with single canals were divided into 5groups according to post material (cast, fiberglass, titanium, stainless steel, and brass). VRFs were induced in half of the specimens using a universal testing machine under standardized conditions. CBCT scans were obtainedusing a Carestream 9600 device with fixed parameters, both with and without ANR. Two experienced radiologists independently evaluated the images using a 5-point scale. Sensitivity, specificity, predictive values, and interobserveragreement were analyzed using SPSS version 21 (IBM Corp., Armonk, NY, USA). Results: The application of ANR increased overall sensitivity and interobserver agreement compared with conventional images. Specificity varied by post material: fiberglass posts demonstrated the highest diagnostic accuracy, while stainless steel and brass produced stronger artifacts and lower sensitivity. Conclusion Incorporating ANR into CBCT imaging improves VRF detection by improving sensitivity and observerconsistency, especially in cases with minimal metallic interference. These findings highlight the clinical benefits of ANR and support further research integrating noise and metal artifact reduction techniques with artificial intelligenceto optimize diagnostic precision.

Humans ; COVID-19/epidemiology* ; Environmental Pollution/statistics & numerical data*

OBJECTIVES: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. MATERIALS AND METHODS: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). RESULTS: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). CONCLUSION Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

OBJECTIVES: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO. MATERIALS AND METHODS: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01). RESULTS: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122). CONCLUSION Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.

OBJECTIVES: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO.MATERIALS AND METHODS: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01).RESULTS: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122).CONCLUSION: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.
Cone-Beam Computed Tomography ; Female ; Humans ; Jaw ; Mandible ; Mandibular Nerve ; Osteotomy, Sagittal Split Ramus ; Surgeons

BACKGROUND: Surgery on the lower thoracic and lumbosacral spine is possible with both general and spinal anesthesia, but most spine surgeons are reluctant to perform the surgery with spinal anesthesia. We aimed to conduct a survey on the short-term outcome of microlumbar discectomy in the patients who had been treated under general or spinal anesthesia. METHODS: In this prospective study, we performed a survey on 72 patients who underwent microlumbar discectomy under general anesthesia (group A) or spinal anesthesia (group B). Demographic characteristics, American Society of Anesthesiologists physical status, duration of operation, blood loss, and complications were all documented. Preoperative and early postoperative (at the time of discharge) disability and pain were assessed by using Japanese Orthopedic Association (JOA) scoring system and a visual analog scale questionnaire. RESULTS: The two groups were homogenous preoperatively. The mean intraoperative blood loss was less and the mean operating time was shorter in group A than in group B, but there was no statistically significant difference between groups. The rate of postoperative improvement in JOA score and improvement in pain were similar between groups. Anesthetic complications were unremarkable. CONCLUSIONS: Simple lumbar disc operations in the otherwise healthy patients can be safely performed under either spinal or general anesthesia. Both anesthetic methods led to comparable outcomes with minimal complications.
Anesthesia, General ; Anesthesia, Spinal ; Asian Continental Ancestry Group ; Diskectomy ; Humans ; Orthopedics ; Prospective Studies ; Spine ; Surgeons ; Visual Analog Scale

Studies on the trend of air pollution in Tehran, Iran, as one of the most polluted metropolis in the world are scant, and today Tehran is known for its high levels of air pollutants. In this study, the trend of air pollution concentration was evaluated over the past 10 years (2004-2015). The data were collected from 22 stations of the Air Quality Control Company. Daily concentrations of CO, NO₂, SO₂, O₃, PM₁₀ were analyzed using SPSS 16 based on the statistical method, repeated measures, and intra-group test to determine the pattern of each pollutant changes. As a result of the 22 air pollution monitoring stations, NO₂ and SO₂ concentrations have been increasing over the period of 10 years. The highest anomaly is related to SO₂. The CO concentrations represent a descending pattern over the period, although there was a slight increase in 2013 and 2014. The O₃ concentrations declined in the following years. The average concentration of PM₁₀ has been rising during the period. Also we evaluated changes of each pollutant in different months and calculated the number of clean, healthy, unhealthy days for sensitive, unhealthy, very unhealthy, and dangerous groups. The study findings illustrated the necessity for larger investment in air pollution abatement. Overall, trends have been progressed to worsening, the number of healthy days has been declined and the number of unhealthy days has been increased in recent years.
Air Pollutants ; Air Pollution ; Investments ; Iran* ; Methods ; Quality Control

Studies on the trend of air pollution in Tehran, Iran, as one of the most polluted metropolis in the world are scant, and today Tehran is known for its high levels of air pollutants. In this study, the trend of air pollution concentration was evaluated over the past 10 years (2004-2015). The data were collected from 22 stations of the Air Quality Control Company. Daily concentrations of CO, NO₂, SO₂, O₃, PM₁₀ were analyzed using SPSS 16 based on the statistical method, repeated measures, and intra-group test to determine the pattern of each pollutant changes. As a result of the 22 air pollution monitoring stations, NO₂ and SO₂ concentrations have been increasing over the period of 10 years. The highest anomaly is related to SO₂. The CO concentrations represent a descending pattern over the period, although there was a slight increase in 2013 and 2014. The O₃ concentrations declined in the following years. The average concentration of PM₁₀ has been rising during the period. Also we evaluated changes of each pollutant in different months and calculated the number of clean, healthy, unhealthy days for sensitive, unhealthy, very unhealthy, and dangerous groups. The study findings illustrated the necessity for larger investment in air pollution abatement. Overall, trends have been progressed to worsening, the number of healthy days has been declined and the number of unhealthy days has been increased in recent years.
Air Pollutants ; Air Pollution ; Investments ; Iran ; Methods ; Quality Control

To compare the safety, efficacy, predictability, stability and complications of wavefront-guided laser-assisted subepithelial keratectomy ( LASEK ) in low myopia, myopic astigmatism and high myopia correction.METHODS: A retrospective analysis of 416 eyes were assigned to 3 groups:159 eyes with low myopia ( LM) and mean refractive spherical equivalent (MRSE) of-3. 68±1. 33 dioptre ( D ); 161 eyes with myopic astigmatism ( MA ) and MRSE of -5. 99 ± 2. 24D and mean cylinder of 2. 41 ± 1. 07D;and 96 eyes with high myopia (HM) and MRSE of- 7. 41 ± 0. 80D. After an epithelial flap creation, a wavefront-based excimer laser ablation was performed. Safety, efficacy, predictability and stability were evaluated at day 10, 2, 6 and 12mo postoperatively.RESULTS:At 12mo, the MRSE was -0. 36 ± 0. 31D in LM group, 0. 15 ± 0. 41D in MA group and 0. 58 ± 0. 68D in HM group. The uncorrected visual acuity ( UCVA) was 20/20 in 90. 60% of patients in LM group, 78. 90% in MA group and 67% in HM group. Efficacy indices were 0. 98, 1. 04 and 0. 92 in LM, MA and HM groups, respectively. Safety indices were 1. 00, 1. 07 and 1. 05 in LM, MA and HM respectively. Five eyes (3. 1%) in the LM group gained 1 line. Forty-four eyes (27. 3%) in MA gained 1-3 lines and eighteen eyes (19. 2%) of HM group gained 1-2 lines of BSCVA. Only 2 eyes in LM group developed corneal haze. There were not statistically significant differences in efficacy and safety indices amongst three groups.CONCLUSlON:Wavefront-guided LASEK is an effective and safe procedure for the treatment of LM, MA, and HM. although in myopic astigmatism the predictability, efficacy and safety indices had been better.