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OBJECTIVE The purpose of this study was to compare the root position accuracy of the use of panoramic radiography and cone-beam computed tomography (CBCT) in the indirect digital bracket placement. METHODS Two hundred and eighty-six maxillary and 300 mandibular teeth of 27 patients who have digital model, panoramic image and CBCT scan were included to the study. Indirect digital bonding was performed by using digital models and panoramic images in Group 1 and by superimposing the CBCT on the digital models with the OrthoAnalyzer™ 2020 (3Shape, Copenhagen, Denmark) software in Group 2. Angular measurements were calculated with 3-dimensional superimposition of the positions of the brackets placed with the Gom Inspect 2020 software. In the statistical analysis, One-way Analysis of Variance (ANOVA) and the Paired t test were used. RESULTS Maxillary canines had the highest angular deviation at 5.56°± 4.01° in comparison with the maxillary teeth (P

Background Direct and 3D-assisted methods are an available alternative when inserting temporary anchorage devices (TADs) in the anterior palate for orthodontic anchorage. This study aimed to evaluate the differences between a planned insertion versus a direct method on digital models. Settings and sample population Seventy TADs were inserted by the direct insertion method in 35 patients who needed palatal TADs for orthodontic anchorage. For each patient, placement was independently planned by the superimposition of lateral cephalograms and corresponding plaster models. After mini-implant placement, impressions were taken with scanbodies. For the measurement of both linear and angle deviations, virtual planning models and postoperative oral scans were compared using 3D software for automatic surface registration and calculations. Results Comparing TADs positioned by the direct method and the digitally planned method, a mean linear distance was found of 2.54 ± 1.51 mm in the occlusal view and 2.41 ± 1.33 mm in the sagittal view. No significant difference has been found between TADs positioned in the right and left palatal sides. A mean distance of 7.65 ± 2.16 mm was found between the tip of the digitally planned TAD and the central incisors root apex. Conclusions Both direct and 3D-assisted TAD insertion methods are safe and accurate in the anterior palate. However, the use of insertion guides facilitates TAD insertion, allowing less-experienced clinicians to use palatal implants.

Background Few studies have focused on the dimensional accuracy of customized bone grafting by means of guided bone regeneration (GBR) with 3D-Printed Individual Titanium Mesh (3D-PITM). Purpose Digital technologies were applied to evaluate the dimensional accuracy of customized bone augmentation with 3D-PITM with a two-stage technique. Materials and methods Sixteen patients were included in this study. The CBCT data of post-GBR (immediate post-GBR) and post-implantation (immediate post-implant placement) were 3D reconstructed and compared with the pre-surgical planned bone augmentation. The dimensional differences were evaluated by superimposition using the Materialize 3-matic software. Results The superimposition analysis showed that the maximum deviations of contour between were 3.4 mm, and the average differences of the augmentation contour were 0.5 ± 0.4 and 0.6 ± 0.5 mm respectively. The planned volume of bone regeneration was approximately equal to the amount of regenerated bone present 6 to 9 months after the surgical procedure. On average, the vertical gain in bone height was about 0.5 mm less than planned. And, the horizontal bone gain on the straight buccal of the dental implants and 2 to 4 mm apical of the platform fell also about a 0.5 mm short on average. Statistically significant differences were observed between the augmented volume of virtual and post-GBR, and the horizontal bone gain of post-implantation on the level of 4 mm apical to the implant platform (P Conclusions The dimensional accuracy of customized bone augmentation with the 3D-PITM approach needs further improvement and compared to other surgical approaches of bone augmentation.

Purpose To present an open‐source software (https://github.com/CHUSRadOncPhys/FluoMV) for monitoring intrafraction motion that is based on the visualization of superimposed contours of projected region‐of‐interests from DICOM RTSTRUCT files on cine‐MV images acquired and displayed in real‐time during radiation therapy delivery. Clinical use with prostate gold fiducial markers is presented. Methods Projections of regions of interest (ROI) in the reference frame of the electronic portal imaging device are computed offline for different gantry angles before the first treatment fraction. During treatment delivery, the contrast of portal images is automatically adjusted using a histogram equalization algorithm. The projections associated with the current gantry angle are then superimposed on the images in real time. This allows the therapist to evaluate if the imaged structures of interest remain within their respective contours during treatment delivery and to potentially interrupt the treatment if deemed necessary. The spatial accuracy of the method was evaluated by imaging a ball bearing phantom in a set‐up where the position of the projected ROI is highly sensitive to gantry angle errors. The visibility of fiducial markers during one fraction of seven different volumetric modulated arc therapy (VMAT) prostate treatments is characterized. Results The geometric validation showed a negligible systematic error μ

OBJECTIVE To use morphometric methods to investigate the size and shape of the sella turcica in children with unilateral cleft lip and palate (UCLP). SETTING AND SAMPLE POPULATION Fifty-six healthy children with non-syndromic UCLP, from a major paediatric teaching hospital, with lateral cephalograms taken prior to alveolar bone grafting, were compared with an age- and sex-matched control group of healthy children without orofacial clefts, with lateral cephalograms taken prior to orthodontic treatment. MATERIALS AND METHODS In this cross-sectional study, conventional measurements were performed on the sella turcica to measure width, height and area on lateral cephalograms. Sella shape was also analysed using 11 points defining the sella turcica contours, using geometric morphometrics. Procrustes superimposition was used to register all sella contour tracings to calculate average sella shape. Principal component analysis was applied to the residuals of the point coordinates, and principal components (PCs) of shape were extracted. RESULTS Statistically significant differences between the UCLP and control groups were found for sella posterior height, midpoint height, maximum height and area, where all of these were smaller in children with UCLP. Principal component analysis revealed that the first two PCs accounted for 84.7% of total shape variance. There was a statistically significant difference in sella shape between children with UCLP and control children. CONCLUSIONS In children with UCLP, the sella turcica is shorter and with a smaller surface area when compared to matched non-cleft children. Moreover, sella turcica shape, when disregarding size, seems to differ to that of non-cleft children.

The articulator is a prerequisite device for the analysis of occlusion and prosthodontic treatment, and it is required to simulate patient jaw movements. This article describes the technique to obtain sagittal condylar inclination (SCI) using cone beam computed tomography (CBCT) data and intraoral scan of the protrusive interocclusal position. The SCI can be used on a virtual articulator in a computer-aided design software, and it can assist in the fabrication of prosthesis which is harmonious with the mandibular movement of individual patient.

OBJECTIVES To test the reliability and reproducibility of a fast and user-friendly voxel-based 3D superimposition method and the effect of bone segmentation on its outcomes. SETTING AND SAMPLE POPULATION This prospective methodological study assessed 15 pairs of pre-existing serial CBCT images (interval: 1.69 ± 0.37 years) obtained from growing patients (initial age: 11.75 ± 0.59 years). MATERIALS AND METHODS Volumes were superimposed on the anterior cranial base using Dolphin 3D software. Reliability was assessed visually, by inspecting the overlap of the superimposition reference structures. Reproducibility was tested with intra- and inter-operator comparisons of superimposition outcomes. RESULTS The method presented good reliability in all cases. The median differences between intra- and inter-operator comparisons at various tested areas ranged from 0.06 to 0.16 mm and from 0.15 to 0.24 mm, respectively. In few individual cases, differences exceeded 0.5 mm. There was no evidence that the error increased upon increase in the magnitude of the detected T0-T1 changes. However, the superimposition error increased when the distance between the measurement area and the superimposition reference also increased. For a single image, the median error of bone surface segmentation ranged in different areas between 0.05 and 0.12 mm, with few exceptions where it slightly exceeded 0.25 mm. CONCLUSIONS The tested voxel-based superimposition method presented good efficiency, cranial base matching and reproducibility in a growing patient sample. Segmentation error was considered minimal. The total error reached clinically relevant levels in very few cases. Thus, this technique is considered appropriate for clinical use, when 3D assessment of craniofacial changes is required.

Standards for estimating mouth width and Cupid's bow width in craniofacial approximation and superimposition are limited. Currently, the only guideline for mouth width, using direct skeletal references, is a general rule indicating a 75% inter-canine to mouth width ratio. The philtrum, which closely corresponds to the Cupid's bow, is said to be equal to the inter-superior prominences of the maxillary central incisors. This study tested these guidelines against newly generated regression models and mean values. Cone-beam CT scans of 120 black and 39 white southern African adults were used. Comparative hard and soft tissue measurements were taken using a 3D DICOM viewer. Regression equations accounting population, sex, and approximate age variables (20-39 and 40+ years), utilizing maxillary inter-canine width to estimate mouth width and maxillary central-lateral incisor junction width to estimate Cupid's bow width, performed statistically best. The regression models were more reliable than existing standards in validation tests.

Background Postsurgical evaluation of sinus floor elevation regularly involves linear measurements of the elevated volumes in the cone beam computed tomography (CBCT) images. The accuracy of measurements could be compromised due to ill-defined sinus floor outline if implants are placed simultaneously. Purpose The aim was to examine a CBCT superimposition method to improve the measurement accuracy. Materials and methods Twenty patients who received transalveolar sinus floor elevation with immediate implantation were enrolled. CBCTs before and after surgery were transformed into digital imaging and communications in medicine format and imported into the Dolphin Imaging software. Voxel-based superimposition was automated to merge the files. In the superimposed image, parameters including alveolar bone height, protruded implant length, and total elevated height were measured. The superimposition and measurements were performed independently by two examiners and in two timepoints with 1-week time interval. We used intraclass correlation coefficient (ICC) to analyze the interexaminer and intraexaminer agreements. Results Of measured parameters, the mean of difference between two timepoints ranged from 0.18 to 0.26 mm by examiner 1, and from 0.16 to 0.20 mm by examiner 2. ICCs were equal or greater than 0.98, indicating perfect intraexaminer agreement. For interexaminer reliability, the largest mean of difference was 0.27 mm in measuring alveolar bone height between two examiners. ICCs were greater than 0.98, showing perfect interexaminer agreement. Conclusions The voxel-based superimposition of pre- and post-surgical CBCT images with Dolphin Imaging is an effective and reliable way for linear measurements so as to assess the surgical outcome. There is minimal effect on reproducibility of measured data by different timepoints or performers.

Objective: (a) To evaluate intra- and inter-observer reliability in landmarks placement along the three planes of space on cone-beam computed tomography (CBCT) data sets; (b) To evaluate whether the reliability of each landmark differs in CBCT scans characterized by two different voxel dimension and quality. Setting and Sample Population: A total of 84 scans were used in this study: 49 scans were taken with the NewTom 3G, and 35 scans were taken with the NewTom 5G. The scans were characterized by an isotropic voxel dimension of 0.36 and 0.30 mm for the NewTom 3G and the NewTom 5G, respectively. Methods: A total of 13 landmarks were placed according to the corresponding definitions in 3D, also presented in this study: Foramen Spinosum (R/L), Nasion, Sella, Gonion (R/L), Pogonion, Menton, A point, Anterior nasal spine, Posterior nasal spine, Basion, Cribriform Plate (CR). Intra- and inter-observer reliability and Intra-class correlation coefficients (ICC) ICC for landmarks identification were assessed. Five reference and registration planes based on the above-mentioned landmarks were also presented. Results: ICC both for the intra- and inter-observer measurements had a score larger than 0.9 in all directions, except in the sagittal direction for CR. Regarding intra- and inter-observer reliability, only N, S, and Ba scored well in all directions. Conclusions: Most of the landmarks analysed displayed a high reliability along at least 2 directions. The choice of landmarks to define registration and superimposition planes must be carefully selected, as the reliability of these planes is inherited from the one of the landmarks defining them.

Objective To assess validity and reliability of palatal superimposition of holograms of 3D digital dental models using a customized software, (Ortho Mechanics Sequential Analyzer OMSA), installed on Microsoft HoloLens device as compared to the OMSA application running on a regular computer screen. Methods The sample consisted of pre- and post-treatment digital maxillary dental models of 20 orthodontic cases (12.3 ± 1.9 years) treated by rapid maxillary expansion (two turns per day). For each case, the pre- and post-treatment digital models were superimposed using hand gestures for marking the dental models holograms in mixed reality using the Microsoft HoloLens. The same models were then superimposed using the conventional landmark-based method with OMSA software running on a regular computer screen. The same set of dental arch parameters was measured on the superimposed 3D data by the two software versions for comparison. Agreement in the superimposition outcomes among the two superimposition methods was assessed using Dahlberg error (DE), concordance correlation coefficients (CCCs) using two-way ANOVA mixed model for absolute agreement and Bland-Altman analysis. Results Repeatability was acceptable for all variables based on the high values of CCCs over 0.99 with a lower 95% confidence limit over 0.95 for any variable. The DE ranged from 0.14 mm to 0.36 mm. The absolute error did not exceed 0.5 mm for any variable. Conclusion Using the depth vision capabilities of the Microsoft HoloLens, 3D digital dental models can be reliably superimposed allowing virtual assessment of orthodontic treatment outcomes.

Mounting casts accurately on an articulator is a prerequisite for the treatment planning/execution of complex dental cases that require occlusal rehabilitation. A full digital approach to transfer the position of maxillary dentition to a virtual articulator, by using intraoral scans and cone beam computed tomography (CBCT) files is presented. This technique offers reduced chairside time and the flexibility of choosing the orientation plane. It can be used in orthognathic surgeries, complex interdisciplinary treatments requiring a CBCT scan with a large field of view, or treatments that already have the head CT or CBCT scans from previous diagnosis/treatment.

The aim of this clinical report is to describe a complete digital workflow protocol for mandibular full-arch implant rehabilitation from guided surgery to definitive prosthesis in only 3 appointments. This expedited protocol allows for guided implant placement with a system of stackable surgical templates and CAD/CAM prosthodontic rehabilitation using a digital workflow. At the first appointment, a guided implant placement protocol with the stackable template concept was done followed by immediate loading with a prefabricated interim prosthesis. At the same appointment, the Double Digital Scanning (DDS) technique was used for scanning, maxillomandibular relationship registration and virtual articulation. The anchor pins from guided surgery were used as fiducial markers for DDS data superimposition. At the second appointment, the prosthesis prototype was tried-in and adjustments were made. At the third appointment, the definitive monolithic zirconia full-arch prosthesis was delivered.

OBJECTIVES To investigate the anteroposterior and vertical changes of the median rugae area, which is commonly used as dental model superimposition reference, relevant to its underlying skeletal structures. SETTINGS AND SAMPLE POPULATION Retrospectively collected pre- and post-treatment cephalometric radiographs and 3D digital dental models of 24 orthodontic patients (age at treatment start: 12.26 ± 0.83 years; assessment period: 2.13 ± 0.68 years) were analysed. All had mild to moderate malocclusions that were treated non-extraction with full fixed appliances. MATERIAL AND METHODS The incisive papilla and rugae points were placed on the dental models that were then registered to the cephalometric radiographs. Afterwards, the radiographs were superimposed on Sella, ANS-PNS, and through a maxillary structural method. The vertical and horizontal movements of the papilla and the rugae points, as well as of a central incisor, were measured (Viewbox 4 software). RESULTS The incisive papilla and the three rugae points remained stable anteroposteriorly, but moved downwards in the vertical dimension (approximately 1-2 mm), in a similar manner (P>0.05). However, the anteroposterior position of the papilla and the first rugae points were affected by changes in anterior tooth position and inclination (p

Objectives This study aimed to (a) evaluate the stability of the parietal bone of 6-9 months old beagles and (b) examine whether parietal regional superimposition can provide an atraumatic and effective solution for further maxillary expansion study. Materials and methods Six prepubertal 6-month-old male beagles were included. Six miniscrew markers were inserted into the left and right sides of the parietal bone, and two of them were placed bilaterally near the palatal suture. The subjects were scanned with cone beam computed tomography (CBCT) at three time points of T0 (6 months old), T1 (7.5 months old) and T2 (9 months old), respectively. All skull models were analyzed by both the miniscrew superimposition and the parietal regional superimposition. Results The two superimposition methods had no significant difference (p > 0.05) in displacements of miniscrew markers between left and right first premolars (PM1). The maxillary superimposition between T0 and T2 indicated that the length and width of the maxillary as well as the width of the zygoma root increased significantly (p 0.05) over the 3 months. Conclusions The parietal bone is relatively stable for beagles from 6 months old to 9 months old and thus can be used as a reference region for 3D skull model superimposition of the beagle dog.

The computational design of novel nested proteins-in which the primary structure of one protein domain (insert) is flanked by the primary structure segments of another (parent)-would enable the generation of multifunctional proteins. Here we present a new algorithm, called Loop-Directed Domain Insertion (LooDo), implemented within the Rosetta software suite, for the purpose of designing nested protein domain combinations connected by flexible linker regions. Conformational space for the insert domain is sampled using large libraries of linker fragments for linker-to-parent domain superimposition followed by insert-to-linker superimposition. The relative positioning of the two domains (treated as rigid bodies) is sampled efficiently by a grid-based, mutual placement compatibility search. The conformations of the loop residues, and the identities of loop as well as interface residues, are simultaneously optimized using a generalized kinematic loop closure algorithm and Rosetta EnzymeDesign, respectively, to minimize interface energy. The algorithm was found to consistently sample near-native conformations and interface sequences for a benchmark set of structurally similar but functionally divergent domain-inserted enzymes from the α/β hydrolase superfamily, and discriminates well between native and nonnative conformations and sequences, although loop conformations tended to deviate from the native conformations. Furthermore, in cross-domain placement tests, native insert-parent domain combinations were ranked as the best-scoring structures compared to nonnative domain combinations. This algorithm should be broadly applicable to the design of multi-domain protein complexes with any combination of inserted or tandem domain connections.

Purpose To evaluate the 3D static articulation accuracy of 3 model scanner-CAD systems (Ceramill Map400 [AG], inEos X5 [SIR], Scanner S600 Arti [ZKN]) using a coordinate measuring machine (CMM). Trueness and precision for each system will be reported in Part I. Materials and methods The master model simulated a single crown opposing a 3-unit fixed dental prosthesis. Five mounted stone cast sets were prepared, and one set was randomly selected. Reference values were obtained by measuring interarch and interocclusal reference features with the CMM. The stone cast set was scanned 5 times consecutively and articulated virtually with each system (3 test groups, n = 5). STL files of the virtual models were measured with CMM software. dRR , dRC , and dRL , represented interarch global distortions at right, central, and left sides, respectively, while dRM , dXM , dYM , and dZM represented interocclusal global and linear distortions between preparations. Results For trueness values, mean interarch global distortions ranged from 13.1 to 40.3 μm for dRR , -199.0 to -48.1 μm for dRC , and -114.1 to -47.7 μm for dRL . Mean percentage error of interarch distortion did not exceed 0.6%. Mean interocclusal distortions ranged from 16.0 to 117.0 μm for dRM , -33.1 to 101.3 μm for dXM , 32.9 to 49.9 μm for dYM and -32.0 to 133.1 μm for dZM. ANOVA of trueness found statistically significant differences for dRC , dRL , dRM , dXM , and dZM . For precision values, absolute mean difference between the 10 superimposition combinations ranged from 25.3 to 91.0 μm for dRR , 21.5 to 85.5 μm for dRC , 24.8 to 70.0 μm for dRL . Absolute mean difference ranged from 49.9 to 66.1 μm for dRM , 20.7 to 92.1 μm for dXM , 86.8 to 96.0 μm for dYM , and 36.5 to 100.0 μm for dZM . ANOVA of precision of all test groups found statistically significant differences for dRR , dRC , dRL , dXM and dZM , and the SIR group was the least precise. Conclusion The overall interarch global distortion of all three model scanner-CAD systems was low and did not exceed 0.6%. Variations in scanner technology, virtual articulation algorithm, and use of physical articulators contributed to the differences in distortion observed among all three groups.

Objectives To evaluate the reliability of CT measurement of canine elbow axial radioulnar congruence using a duplicated circle superimposition technique. Materials and Methods CT of six cadaveric canine elbows was performed following either: (1) placement of an external fixator on the radius with ostectomy and radial shortening of 1 to 5 mm; (2) radial lengthening of 1 to 5 mm using a radial lengthening system; or, (3) no axial length adjustment. Four observers, on two occasions, blinded to the amount of radial adjustment, placed a circle of best fit of the ulnar trochlear notch on a sagittal image that was duplicated and transposed to the articular contour of the radial head; then the axial distance between circles relative to the dorsal radius was measured. Statistical analysis assessed differences between actual and observer-assessed radial length adjustment; inter−/intra-observer interclass correlation coefficients and sensitivity/specificity were calculated to evaluate measurement reliability. Results There was not a significant difference between actual and observer measures of radioulnar congruence. Inter- (intraclass correlation coefficient=0.98) and intra-observer reliability (intraclass correlation coefficient=0.94 to 0.99) were almost perfect for measurement of radioulnar incongruence when compared to the actual radial adjustment. A Bland–Altman plot revealed a 95% confidence interval range of −1.31 to 1.16 mm. Sensitivity and specificity were high for correct identification of congruent elbows and elbows with 1 or 2 mm incongruency. Clinical Significance The duplicated circle superimposition technique provides a simple and accurate means of assessing radioulnar axial incongruence.

The use of the physical appearance of the deceased has become more important because the available antemortem information for comparisons may consist only of a physical description and photographs. Twenty-one articles dealing with the identification based on the physiognomic features of the human body were selected for review and were divided into four sections: (i) visual recognition, (ii) specific facial/body areas, (iii) biometrics, and (iv) dental superimposition. While opinions about the reliability of the visual recognition differ, the search showed that it has been used in mass disasters, even without testing its objectivity and reliability. Specific facial areas being explored for the identification of dead; however, their practical use is questioned, similarly to soft biometrics. The emerging dental superimposition seems to be the only standardized and successfully applied method for identification so far. More research is needed into a potential use of the individualizing features, considering that postmortem changes and technical difficulties may affect the identification.

Objectives To evaluate and compare the accuracy and reliability of 3 different methods of three-dimensional cone-beam computed tomography scans (3D CBCTs) superimpositions: landmark-based, surface-based and voxel-based. Materials and methods Pre- and post-orthodontic treatment CBCTs (T1 and T2) of 20 subjects with a mean age of 11 years were obtained. Seven points on the zygomatic arch and supraorbital region were selected to perform landmark-based superimposition. Surface-based and voxel-based superimpositions were performed using the anterior cranial base as a reference. Each superimposition method of T1 and T2 scans was repeated twice to assess the reliability. Accuracy of each technique was tested by superimposing duplicated sets of T1 scans. A total of 11 landmarks on the anterior cranial base, maxilla and mandible were located, and deviations of these landmarks on superimposed data were quantified to assess reliability and accuracy of all superimpositions. Results There were no significant differences from zero when duplicated sets of T1 scans were superimposed using surface-based and voxel-based methods. Statistical significant differences were detected in several parameters when evaluating the accuracy of the landmark superimposition. Superimposition of T1 and T2 scans for testing the reliability revealed intraclass correlation coefficients greater than 0.90 for all measurements except for ACP-x and PNS-y of landmark-based method as well as ANS-x of voxel-based method. Conclusions Surface-based and voxel-based superimposition methods using the anterior cranial base as a reference structure were accurate and reliable in detecting changes in landmark positions when superimposing. Landmark-based superimposition method was reliable but less accurate than the other methods.

Essential and continuous spectrum of symmetric difference equations have been investigated. It has been shown that the deficiency indices and the existence of these components of the spectrum are determined by the growth conditions of the coefficients. In particular, the deficiency indices are superimposition of those clusters determined by the coefficient growth. Finally, we have proved the neccessary and sufficient conditions for the existence of essential spectrum of selfadjoint subspace extensions using subspace theory and asymtotic summation.

Objective When using a completely digital workflow on larger prosthetic cases it is often difficult to communicate to the laboratory or chairside Computer Aided Design and Computer Aided Manufacturing system the provisional prosthetic information. The problem arises when common hard tissue data points are limited or non-existent such as in complete arch cases in which the 3D model of the complete arch provisional restorations must be aligned perfectly with the 3D model of the complete arch preparations. In these instances, soft tissue is not enough to ensure an accurate automatic or manual alignment due to a lack of well-defined reference points. A new technique is proposed for the proper digital alignment of the 3D virtual model of the provisional prosthetic to the 3D virtual model of the prepared teeth in cases where common and coincident hard tissue data points are limited. Clinical considerations: A technique is described in which fiducial composite resin dots are temporarily placed on the intraoral keratinized tissue in strategic locations prior to final impressions. These fiducial dots provide coincident and clear 3D data points that when scanned into a digital impression allow superimposition of the 3D models. Conclusions Composite resin dots on keratinized tissue were successful at allowing accurate merging of provisional restoration and post-preparation 3D models for the purpose of using the provisional restorations as a guide for final CLINICAL SIGNIFICANCE Composite resin dots placed temporarily on attached tissue were successful at allowing accurate merging of the provisional restoration 3D models to the preparation 3D models for the purposes of using the provisional restorations as a guide for final restoration design and manufacturing. In this case, they allowed precise superimposition of the 3D models made in the absence of any other hard tissue reference points, resulting in the fabrication of ideal final restorations.

The overlay of a skull and a face image for identification purposes requires similar subject-to-camera distances (SCD) to be used at both photographic sessions so that differences in perspective do not compromise the anatomical comparisons. As the facial photograph is the reference standard, it is crucial to determine its SCD first and apply this value to photography of the skull. So far, such a method for estimating the SCD has been elusive (some say impossible), compromising the technical validity of the superimposition procedure. This paper tests the feasibility of using the palpebral fissure length and a well-established photographic algorithm to accurately estimate the SCD from the facial photograph. Recordings at known SCD across a 1-10 m range (repeated under two test conditions) demonstrate that the newly formulated method works: a mean SCD estimation error of 7% that translates into

Techniques of 2D–3D superimposition are widely used in cases of personal identification from video surveillance systems. However, the progressive improvement of 3D image acquisition technology will enable operators to perform also 3D–3D facial superimposition. This study aims at analyzing the possible applications of 3D–3D superimposition to personal identification, although from a theoretical point of view. Twenty subjects underwent a facial 3D scan by stereophotogrammetry twice at different time periods. Scans were superimposed two by two according to nine landmarks, and root-mean-square (RMS) value of point-to-point distances was calculated. When the two superimposed models belonged to the same individual, RMS value was 2.10 mm, while it was 4.47 mm in mismatches with a statistically significant difference (p < 0.0001). This experiment shows the potential of 3D–3D superimposition: Further studies are needed to ascertain technical limits which may occur in practice and to improve methods useful in the forensic practice.

In cases of disputed CCTV identification, expert testimony based on the results of analysis by facial image comparison may be presented to the Jury. However, many of the techniques lack empirical data to support their use. Using a within-participants design, we compared the accuracy of face-matching decisions when images were presented using a ‘facial wipe’ technique (where one image is superimposed on another and the display gradually ‘wipes’ between the two) with decisions based on static images. Experiment 1 used high-quality image pairs; Experiment 2 used disguised target images; and Experiment 3 used degraded target images. Across all three experiments, rather than optimising performance, facial wipes reduced accuracy relative to static presentations. Further, there is evidence that video wipes increase false positives and therefore may increase the likelihood that images of two different people will be incorrectly judged to show the same individual.

The difficulty of retrieving the abutment screw is a major disadvantage of cement-retained implant restorations. Conventional methods for locating the screw-access hole are based largely on radiography or manual labor, which limits accuracy and clinical feasibility. This clinical report describes a non-radiological method for fabricating an accurate drilling guide for location of the screw channel using intraoral optical scanning, 3D superimposition, and computer-aided design and computer-aided manufacturing (CAD/CAM) technologies. The present technique not only improves the guide fabrication process and the accuracy of screw-channel drilling, but also has wide indications for implant restorations.

Maximizing the scientific impact of NMR-based structure determination requires robust and statistically sound methods for assessing the precision of NMR-derived structures. In particular, a method to define a core atom set for calculating superimpositions and validating structure predictions is critical to the use of NMR-derived structures as targets in the CASP competition. FindCore (Snyder and Montelione, Proteins 2005;59:673-686) is a superimposition independent method for identifying a core atom set and partitioning that set into domains. However, as FindCore optimizes superimposition by sensitively excluding not-well-defined atoms, the FindCore core may not comprise all atoms suitable for use in certain applications of NMR structures, including the CASP assessment process. Adapting the FindCore approach to assess predicted models against experimental NMR structures in CASP10 required modification of the FindCore method. This paper describes conventions and a standard protocol to calculate an "Expanded FindCore" atom set suitable for validation and application in biological and biophysical contexts. A key application of the Expanded FindCore method is to identify a core set of atoms in the experimental NMR structure for which it makes sense to validate predicted protein structure models. We demonstrate the application of this Expanded FindCore method in characterizing well-defined regions of 18 NMR-derived CASP10 target structures. The Expanded FindCore protocol defines "expanded core atom sets" that match an expert's intuition of which parts of the structure are sufficiently well defined to use in assessing CASP model predictions. We also illustrate the impact of this analysis on the CASP GDT assessment scores.

Change in perspective between antemortem and postmortem imaging sessions (radiograph to radiograph and surface scan to radiograph) may cause different 2D renderings of the same osseous element complicating comparisons for identification. In this study, clavicle shape changes due to radiographic positioning and 3D laser scanning were examined in 20 right-side specimens, as pertinent to chest radiograph comparisons. Results indicate substantial changes in clavicle form with short source-to-image receptor distance, elevation of the element from the image receptor, and movement of the element away from the center beam (10% mean square for shape). Although quantitative shape differences were small when the clavicle was in close opposition to the image receptor (3% mean square), important qualitative differences remained with large distances from the center beam (e.g., conoid tubercle presence/absence). The significance of these results for image superimposition and computer-automated-shape-based searches of radiographic libraries to find matching candidates is discussed.

Objective To assess the precision of a novel protocol for determination of femoral varus angle (FVA) using computed tomography (CT) in dogs, and to quantify the effect of femoral rotational and sagittal plane malpositioning on measured FVA. Study Design Cross-sectional study. Sample Population Femora (n = 66) from dogs that had pelvic limb CT examination for patellar instability (26) or other reasons (10). Methods Three observers measured FVA of each of 66 femora on three separate occasions. Standardized orientation of a volume rendered image was achieved by superimposition of the caudal and distal aspects of the femoral condyles on a lateral projection, definition of a sagittal plane axis, and finally rotation through 90° to yield a cranial projection. Intra- and inter-observer variability were estimated using the intra-class correlation coefficient. The effect of variation in rotational and sagittal plane orientation on measured FVA was subsequently quantified using 6 femora with FVAs between −0.4° and 19°. Results Intra-class correlation coefficients for the 3 observers, indicating intra-observer variation, were 0.982, 0.937, and 0.974. The intra-class correlation coefficient of the means of the results from each observer, indicating inter-observer variation, was 0.976. Consistent linear variations in measured FVA occurred as a result of rotational malpositioning in all 6 tested femora, and as a result of sagittal plane malpositioning in femora with FVAs ≥ 7.9°. Conclusions The reported protocol for the measurement of FVA in dogs is repeatable and reproducible. Small variations in femoral orientation, as might be expected with conventional radiography, lead to clinically significant alterations in measured FVA.

Summary 1. Many ecological and evolutionary studies seek to explain patterns of shape variation and its covariation with other variables. Geometric morphometrics is often used for this purpose, where a set of shape variables are obtained from landmark coordinates following a Procrustes superimposition. 2. We introduce geomorph: a software package for performing geometric morphometric shape analysis in the R statistical computing environment. 3. Geomorph provides routines for all stages of landmark-based geometric morphometric analyses in two and three-dimensions. It is an open source package to read, manipulate, and digitize landmark data, generate shape variables via Procrustes analysis for points, curves and surfaces, perform statistical analyses of shape variation and covariation, and to provide graphical depictions of shapes and patterns of shape variation. An important contribution of geomorph is the ability to perform Procrustes superimposition on landmark points, as well as semilandmarks from curves and surfaces. 4. A wide range of statistical methods germane to testing ecological and evolutionary hypotheses of shape variation are provided. These include standard multivariate methods such as principal components analysis, and approaches for multivariate regression and group comparison. Methods for more specialized analyses, such as for assessing shape allometry, comparing shape trajectories, examining morphological integration, and for assessing phylogenetic signal, are also included. 5. Several functions are provided to graphically visualize results, including routines for examining variation in shape space, visualizing allometric trajectories, comparing specific shapes to one another and for plotting phylogenetic changes in morphospace. 6. Finally, geomorph participates to make available advanced geometric morphometric analyses through the R statistical computing platform.

Introduction: Muscle weakness can be caused by decreases in either the maximum force-generating ability of a muscle (MFGA) or neural drive from the nervous system (e.g., after a stroke). Presently, there is no agreed-upon practical method for calculating the MFGA in individuals with central nervous system pathology. The purpose of this study was to identify the best method for determining MFGA. Methods: The predicted and estimated MFGA of the muscles of 23 non-neurologically impaired subjects (13 males, 21.9 ± 1.9 years) were compared using the burst superimposition, twitch interpolation, doublet interpolation, twitch-to-tetanus ratio, and the adjusted burst superimposition methods. Results: The adjusted burst superimposition test was the most accurate predictor of MFGA. Conclusions: Further testing is needed to validate the use of the adjusted burst superimposition test in a neurologically impaired population. Muscle Nerve 45: 849–858, 2012

The bony labyrinth in the temporal bone houses the sensory systems of balance and hearing. While the overall structure of the semicircular canals and cochlea is similar across therian mammals, their detailed morphology varies even among closely related groups. As such, the shape of the labyrinth carries valuable functional and phylogenetic information. Here we introduce a new, semilandmark-based three-dimensional geometric morphometric approach to shape analysis of the labyrinth, as a major improvement upon previous metric studies based on linear measurements and angles. We first provide a detailed, step-by-step description of the measurement protocol. Subsequently, we test our approach using a geographically diverse sample of 50 recent modern humans and 30 chimpanzee specimens belonging to Pan troglodytes troglodytes and P. t. verus. Our measurement protocol can be applied to CT scans of different spatial resolutions because it primarily quantifies the midline skeleton of the bony labyrinth. Accurately locating the lumen centre of the semicircular canals and the cochlea is not affected by the partial volume and thresholding effects that can make the comparison of the outer border problematic. After virtually extracting the bony labyrinth from CT scans of the temporal bone, we computed its midline skeleton by thinning the encased volume. On the resulting medial axes of the semicircular canals and cochlea we placed a sequence of semilandmarks. After Procrustes superimposition, the shape coordinates were analysed using multivariate statistics. We found statistically significant shape differences between humans and chimpanzees which corroborate previous analyses of the labyrinth based on traditional measurements. As the geometric relationship among the semilandmark coordinates was preserved throughout the analysis, we were able to quantify and visualize even small-scale shape differences. Notably, our approach made it possible to detect and visualize subtle, yet statistically significant (P = 0.009), differences between two chimpanzee subspecies in the shape of their semicircular canals. The ability to discriminate labyrinth shape at the subspecies level demonstrates that the approach presented here has great potential in future taxonomic studies of fossil specimens.

Accuracy of forensic facial approximation and superimposition techniques relies on the knowledge of anatomical correlations between soft and hard tissues. Recent studies by Stephan and collaborators (6,8,10) reviewed traditional guidelines leading to a wrong placement of the eyeball in the orbit. As those statements are based on a small cadaver sample, we propose a validation of these findings on a large database (n = 375) of living people. Computed tomography scans of known age and sex subjects were used to collect landmarks on three-dimensional surfaces and DICOM with TIVMI. Results confirmed a more superior and lateral position of the eyeball relatively to the orbital rims. Orbital height and breadth were used to compute regression formulae and proportional placement using percentages to find the most probable position of the eyeball in the orbit. A size-related sexual dimorphism was present but did not impact on the prediction accuracy.

To be able to determine if endodontic treatment of apical pathosis is successful or not, healing of lesions is followed up by radiographic imaging. This can be done by observing changes in apical radiolucencies. Recently, cone beam computed tomography (CBCT) has been introduced as a method of gaining an unabridged view of dental anatomy, thus eliminating some of the most prevalent problems, such as superimposition and distortion. CBCT reduces false diagnosis and is rapidly replacing other radiographic techniques in diagnosis, quality control of treatment methods and techniques, and outcome assessment. Healing assessment using conventional and newer three-dimensional imaging includes, but is not limited to, periapical osseous lesions, conditions of the maxillary sinus, status after endodontic surgery, hard tissue deposition in regeneration procedures, and horizontal root fractures. Due to a low predictive value of two-dimensional periapical radiographs to distinguish between periapical disease and health, future assessment of endodontic treatment efficacy may include 3D imaging from small field-of-view CBCT units.

Radiographic examination is essential for the diagnosis and management of temporomandibular joint (TMJ) disorders. The goals of TMJ radiography are to evaluate cortical and trabecular architecture of the bony structures and confirm their integrity, to assess the extent and monitor progression of osseous changes, and to evaluate the response to treatment. Accurate evaluation of the TMJ by conventional radiography is limited by structure superimposition. Cone beam computed tomography (CBCT) provides high-resolution multiplanar images and delivers substantially lower radiation dose, compared with multislice CT. CBCT allows examination of TMJ anatomy without superimposition and distortion to facilitate analysis of bone morphology, joint space and dynamic function in all three dimensions. This article will describe the role of CBCT imaging for the assessment of the TMJ osseous structures and present typical appearances of common pathological conditions of the TMJ.

The relationship between redd superimposition and spawning habitat availability was investigated in the brown trout (Salmo trutta L.) population inhabiting the river Castril (Granada, Spain). Redd surveys were conducted in 24 river sections to estimate the rate of redd superimposition. Used and available microhabitat was evaluated to compute the suitable spawning habitat (SSH) for brown trout. After analysing the microhabitat characteristics positively selected by females, SSH was defined as an area that met all the following five requirements: water depth between 10 and 50 cm, mean water velocity between 30 and 60 cm s )1 , bottom water velocity between 15 and 60 cm s )1 , substrate size between 4 and 30 mm and no embeddedness. Simple regression analyses showed that redd superimposition was not correlated with redd numbers, SSH or redd density. A simulation-based analysis was performed to estimate the superimposition rate if redds were randomly placed inside the SSH. This analysis revealed that the observed superimposition rate was higher than expected in 23 of 24 instances, this difference being significant (P < 0.05) in eight instances and right at the limit of statistical significance (P = 0.05) in another eight instances. Redd superimposition was high in sections with high redd density. High superimposition however was not exclusive to sections with high redd density and was found in moderate- and low-redd-density sections. This suggests that factors other than habitat availability are also responsible for redd superimposition. We argue that female preference for spawning over previously excavated redds may be the most likely explanation for high superimposition at lower densities.

The sphenopalatine (SP) sinuses communicate with the caudal maxillary sinuses and are in close apposition to the ethmoturbinates and cranium. Multiple pathologies of the SP sinus are reported, but pathology in this location can be challenging to diagnose. Radiographs of the region are difficult to interpret due to the superimposition of multiple structures. Recently, computed tomography (CT) has become preferable for detailed diagnosis of sinus disorders. Surgical access to the SP sinuses is limited and therefore accurate diagnosis can influence treatment options and improve outcomes.

Magnetic susceptibility artifacts as a result of metal debris from shoeing are a common problem in magnetic resonance imaging of the equine foot. Our purpose was to determine the suitability of radiography as a screening tool for the presence and location of metallic particles in the equine foot and to predict the size of the resultant magnetic susceptibility artifact. Radiography had 100% sensitivity for detection of metal particles > or = 1 mm diameter. Metal particles of known diameter were placed within the hoof wall of 22 cadaver feet and scanned with a low-field strength MR imaging unit (0.21 T). Magnetic resonance images were characterized by a signal void with a hyperintense rim and adjacent image distortion at the level of the known metal location. T2* weighted sequences were the most and fast spin echo (FSE) sequences the least affected. For all four sequences (T1 gradient echo [GRE]; T2*W GRE; T2 FSE; and short tau inversion recovery FSE), linear relationships were observed between particle and resultant artifact size. Magnetic susceptibility artifact size, location and superimposition on clinically relevant anatomic structures can be predicted radiographically for particles larger than 1 mm. If metal debris cannot be removed, the least artifact-prone FSE sequences should be selected.

Mild facial asymmetries are common in typical growth patterns. Therefore, detection of disordered facial growth patterns in individuals characterized by asymmetries is preferably accomplished by reference to the typical variation found in the general population rather than to some ideal of perfect symmetry, which rarely exists. This presents a challenge in developing an asymmetry assessment tool that is applicable, without modification, to detect both mild and severe facial asymmetries. In this paper we use concepts from geometric morphometrics to obtain robust and spatially-dense asymmetry assessments using a superimposition protocol for comparison of a face with its mirror image. Spatially-dense localization of asymmetries was achieved using an anthropometric mask consisting of uniformly sampled quasi-landmarks that were automatically indicated on 3D facial images. Robustness, in the sense of an unbiased analysis under increasing asymmetry, was ensured by an adaptive, robust, least-squares superimposition. The degree of overall asymmetry in an individual was scored using a root-mean-squared-error, and the proportion was scored using a novel relative significant asymmetry percentage. This protocol was applied to a database of 3D facial images from 359 young healthy individuals and three individuals with disordered facial growth. Typical asymmetry statistics were derived and were mainly located on, but not limited to, the lower two-thirds of the face in males and females. The asymmetry in males was more extensive and of a greater magnitude than in females. This protocol and proposed scoring of asymmetry with accompanying reference statistics will be useful for the detection and quantification of facial asymmetry in future studies.

Cortical bone histology has been the subject of scientific inquiry since the advent of the earliest microscopes. Histology – literally the study of tissue – is a field nearly synonymous with 2D thin sections. That said, progressive developments in high-resolution X-ray imaging are enabling 3D visualization to reach ever smaller structures. Micro-computed tomography (micro-CT), employing conventional X-ray sources, has become the gold standard for 3D analysis of trabecular bone and is capable of detecting the structure of vascular (osteonal) porosity in cortical bone. To date, however, direct 3D visualization of secondary osteons has eluded micro-CT based upon absorption-derived contrast. Synchrotron radiation micro-CT, through greater image quality, resolution and alternative contrast mechanisms (e.g. phase contrast), holds great potential for non-destructive 3D visualization of secondary osteons. Our objective was to demonstrate this potential and to discuss areas of bone research that can be advanced through the application of this approach. We imaged human mid-femoral cortical bone specimens derived from a 20-year-old male (Melbourne Femur Collection) at the Advanced Photon Source synchrotron (Chicago, IL, USA) using the 2BM beam line. A 60-mm distance between the target and the detector was employed to enhance visualization of internal structures through propagation phase contrast. Scan times were 1 h and images were acquired with 1.4-μm nominal isotropic resolution. Computer-aided manual segmentation and volumetric 3D rendering were employed to visualize secondary osteons and porous structures, respectively. Osteonal borders were evident via two contrast mechanisms. First, relatively new (hypomineralized) osteons were evident due to differences in X-ray attenuation relative to the surrounding bone. Second, osteon boundaries (cement lines) were delineated by phase contrast. Phase contrast also enabled the detection of soft tissue remnants within the vascular pores. The ability to discern osteon boundaries in conjunction with vascular and cellular porosity revealed a number of secondary osteon morphologies and provided a unique 3D perspective of the superimposition of secondary osteons on existing structures. Improvements in resolution and optimization of the propagation phase contrast promise to provide further improvements in structural detail in the future.

The Case Report discussed in this commentary (Beccati et al. 2011) described a colt with a comminuted basilar skull fracture diagnosed using computed tomography (CT), the fracture having not been evident on survey radiography. It is well established that radiography of the equine head enables limited interpretation due to the superimposition of the complex anatomy. Computed tomography is currently the gold standard imaging modality for bone pathology having multiple advantages over radiography. Computed tomography has superior contrast resolution and enables evaluation of the cross-sectional anatomy without superimposition (Morrow et al. 2000) and its clinical value in the horse has been extensively described (Ramirez et al. 1998; Puchalski 2007; Kinns and Pease 2009). Computed tomography image acquisition is faster, less expensive than MRI and is very sensitive in the detection of acute haemorrhage, in addition to providing excellent bone detail (Chalela et al. 2007). Computed tomography has been used to detect intra-cranial haemorrhage in horses but is limited in detecting lesions of the parenchyma of the brain (Lacombe et al. 2010). Despite being inferior to MRI, soft tissue evaluation using CT is superior to that of radiography. The complex 3D anatomy of the equine skull is a prime example whereby superimposition of structures visualised radiographically results in the potential for pathology to be unrecognised, as demonstrated in this clinical case where the comminuted basilar fracture was not evident radiographically. The ability to perform post processing CT reconstruction facilitates the precise localisation and evaluation of pathology.

Superimposition has been applied to skulls of unidentified skeletonized corpses as a personal identification method. The current method involves layering of a skull and a facial image of a suspected person and thus requires a real skeletonized skull. In this study, we scanned skulls of skeletonized corpses by computed tomography (CT), reconstructed three-dimensional (3D) images of skulls from the CT images, and superimposed the 3D images with facial images of the corresponding persons taken in their lives. Superimposition using 3D-reconstructed skull images demonstrated, as did superimposition using real skulls, an adequate degree of morphological consistency between the 3D-reconstructed skulls and persons in the facial images. Three-dimensional skull images reconstructed from CT images can be saved as data files and the use of these images in superimposition is effective for personal identification of unidentified bodies.

Background Segmental mandibular resection represents a challenge to maxillofacial surgeons in terms of accurate contouring of reconstruction plates, restoration of mandibular symmetry and maintaining accurate condylar position in the glenoid fossae. Methods We propose a CAD/CAM technique for fabricating patient-specific templates to symmetrically prebend reconstruction plates, guide osteotomies and reposition the condylar process in the proximal edentulous segment in its preoperative position. We operated on two patients using this new technique. Results The custom-made templates showed excellent passive fit on the respective mandibles and accurately guided the reciprocating saw blade along the resection margins. The template was also capable of maintaining the spatial relation of the resected mandibles and the patients experienced excellent repeatable occlusion. Superimposition of pre- and postoperative cone-beam CT scans showed restoration of mandibular symmetry and maximum deviation of 0.4–1.4 (mean of 0.9) mm from the preoperative condylar position. The achieved resection margins using the template showed a mean distance of 1.17 mm from the virtually planned ones. Conclusion We present an innovative computer-guided template that allowed for accurate guidance of mandibular resection margins and condylar positioning. The technique needs to be applied in a larger cohort of patients to verify the results. Further modifications of the design and rigidity of the template might proof beneficial. Copyright © 2011 John Wiley & Sons, Ltd.

Increasingly, data on shape are analysed in combination with molecular genetic or ecological information, so that tools for geometric morphometric analysis are required. Morphometric studies most often use the arrangements of morphological landmarks as the data source and extract shape information from them by Procrustes superimposition. The MorphoJ software combines this approach with a wide range of methods for shape analysis in different biological contexts. The program offers an integrated and user-friendly environment for standard multivariate analyses such as principal components, discriminant analysis and multivariate regression as well as specialized applications including phylogenetics, quantitative genetics and analyses of modularity in shape data. MorphoJ is written in Java and versions for the Windows, Macintosh and Unix/Linux platforms are freely available from http://www.flywings.org.uk/MorphoJ_page.htm.

PURPOSE: The purpose of this study is to evaluate a novel approach for treatment planning using digital fundus image fusion in EYEPLAN for proton beam radiation therapy (PBRT) planning for ocular melanoma. The authors used a prototype version of EYEPLAN software, which allows for digital registration of high-resolution fundus photographs. The authors examined the improvement in tumor localization by replanning with the addition of fundus photo superimposition in patients with macular area tumors. METHODS: The new version of EYEPLAN (v3.05) software allows for the registration of fundus photographs as a background image. This is then used in conjunction with clinical examination, tantalum marker clips, surgeon's mapping, and ultrasound to draw the tumor contour accurately. In order to determine if the fundus image superimposition helps in tumor delineation and treatment planning, the authors identified 79 patients with choroidal melanoma in the macular location that were treated with PBRT. All patients were treated to a dose of 56 GyE in four fractions. The authors reviewed and replanned all 79 macular melanoma cases with superimposition of pretreatment and post-treatment fundus imaging in the new EYEPLAN software. For patients with no local failure, the authors analyzed whether fundus photograph fusion accurately depicted and confirmed tumor volumes as outlined in the original treatment plan. For patients with local failure, the authors determined whether the addition of the fundus photograph might have benefited in terms of more accurate tumor volume delineation. RESULTS: The mean follow-up of patients was 33.6 +/- 23 months. Tumor growth was seen in six eyes of the 79 macular lesions. All six patients were marginal failures or tumor miss in the region of dose fall-off, including one patient with both in-field recurrence as well as marginal. Among the six recurrences, three were managed by enucleation and one underwent retreatment with proton therapy. Three patients developed distant metastasis and all three patients have since died. The replanning of six patients with their original fundus photograph superimposed showed that in four cases, the treatment field adequately covered the tumor volume. In the other two patients, the overlaid fundus photographs indicated the area of marginal miss. The replanning with the fundus photograph showed improved tumor coverage in these two macular lesions. For the remaining patients without local failure, replanning with fundus photograph superimposition confirmed the tumor volume as drawn in the original treatment plan. CONCLUSIONS: Local control was excellent in patients receiving 56 GyE of PBRT for uveal melanomas in the macular region, which traditionally can be more difficult to control. Posterior lesions are better defined with the additional use of fundus image since they can be difficult to mark surgically. In one-third of treatment failing patients, the superposition of the fundus photograph would have clearly allowed improved localization of tumor. The current practice standard is to use the superimposition of the fundus photograph in addition to the surgeon's clinical and clip mapping of the tumor and ultrasound measurement to draw the tumor volume.

Postmortem computed tomography (CT) images can show internal findings related to the cause of death, and it can be a useful method for forensic diagnosis. In this study, we scanned a ready-made box by helical CT on 2-mm slices in a mobile CT scanner and measured each side of the box to assess whether reconstructed images are useful for superimposition. The mean difference between the actual measurements and the measurements on the three-dimensional (3D) reconstructed images (3D-CT images) is 0.9 mm; we regarded it as having no effect on reconstruction for the superimposition method. Furthermore, we could get 3D-CT images of the skull, which were consistent with the actual skull, indicating that CT images can be applied to superimposition for identification. This study suggested that postmortem CT images can be applied as superimpositions for unidentified cases, and thinner slices or cone beam CT can be a more precise tool.

Summary Interpretation of cervical radiographs can be challenging due to the complex anatomy and superimposition of osseous structures on either side of the vertebrae. This report describes the investigation of neck pain in a Thoroughbred gelding following a traumatic fall. Several imaging modalities were used to demonstrate the presence of a fracture of the left cranial articular process of the fourth cervical vertebra (C4), including nuclear scintigraphy, ultrasonography, oblique radiographic projections and a novel cineradiographic technique. Oblique radiographs were superior to standard lateral-lateral radiographs in both the diagnosis and for monitoring the progression of healing of the articular process fracture in this case.