The topology of the dentofacial system obtained by network analysis could allow orthodontists to visually evaluate and anticipate the co-occurrence of auxological anomalies during individual craniofacial growth and possibly localize reactive sites for a therapeutic approach to malocclusion.
Fuzzy clustering repartition can be usefully used to estimate an individualized risk of unsuccessful treatment outcome in Class III patients.
The combination of Fuzzy clustering and Network algorithms allowed the development of principles for combining multiple auxological cephalometric features into a joint global model and to predict the individual risk of the facial pattern imbalance during growth.
In this paper we use Bayesian networks to determine and visualise the interactions among various Class III malocclusion maxillofacial features during growth and treatment. We start from a sample of 143 patients characterised through a series of a maximum of 21 different craniofacial features. We estimate a network model from these data and we test its consistency by verifying some commonly accepted hypotheses on the evolution of these disharmonies by means of Bayesian statistics. We show that untreated subjects develop different Class III craniofacial growth patterns as compared to patients submitted to orthodontic treatment with rapid maxillary expansion and facemask therapy. Among treated patients the CoA segment (the maxillary length) and the ANB angle (the antero-posterior relation of the maxilla to the mandible) seem to be the skeletal subspaces that receive the main effect of the treatment.
A system of elements that interact or regulate each other can be represented by a mathematical object called a network. While network analysis has been successfully applied to high-throughput biological systems, less has been done regarding their application in more applied fields of medicine; here we show an application based on standard medical diagnostic data. We apply network analysis to Class III malocclusion, one of the most difficult to understand and treat orofacial anomaly. We hypothesize that different interactions of the skeletal components can contribute to pathological disequilibrium; in order to test this hypothesis, we apply network analysis to 532 Class III young female patients. The topology of the Class III malocclusion obtained by network analysis shows a strong co-occurrence of abnormal skeletal features. The pattern of these occurrences influences the vertical and horizontal balance of disharmony in skeletal form and position. Patients with more unbalanced orthodontic phenotypes show preponderance of the pathological skeletal nodes and minor relevance of adaptive dentoalveolar equilibrating nodes. Furthermore, by applying Power Graphs analysis we identify some functional modules among orthodontic nodes. These modules correspond to groups of tightly inter-related features and presumably constitute the key regulators of plasticity and the sites of unbalance of the growing dentofacial Class III system. The data of the present study show that, in their most basic abstraction level, the orofacial characteristics can be represented as graphs using nodes to represent orthodontic characteristics, and edges to represent their various types of interactions. The applications of this mathematical model could improve the interpretation of the quantitative, patient-specific information, and help to better targeting therapy. Last but not least, the methodology we have applied in analyzing orthodontic features can be applied easily to other fields of the medical science.
SummaryGenetic typing of serum transferrin was performed in a group of 88 extremely premature infants (gestation age <32 wk) and in a control group of 351 full-term infants, using isoelectric focusing technique on ultrathin layer of polyacrilamide gel. A major incidence bf Cz type was found among the preterm infants when compared to full-term infants X2 = 22,86, (P < 0.001).In view of the previously reported higher incidence of this phenotype in women prone to spontaneous abortion, a selective mechanism associated with this serum transferrin type promoting spontaneous abortion and preterm delivery, seems to occur. The relative risk of preterm delivery were calculated to 1.4 and 8.3 for the Cz-l and Cz types, respectively. Supportive evidence in favour of this hv~othesis is offered bv the correlation existing between ".transferrin Cz allele and placeital alkaline phosphatase;ariant F, the latter being associated with increased risk of spontaneous abortion. SpeculationAssessment of the familial genetic pattern of serum transferrin may result to be a useful procedure for the evaluation of genetic risk of abortion and preterm delivery.The molecular polymorphism of transferrin (Tf), the iron-binding p globulin of the human serum, has been extensively studied by the use of starch gel electrophoresis (9); subsequently, the isoelectric focusing technique has brought evidence of a greater microheterogenity of the most commonly encountered C allele: two transferrin suballeles can be detected with this technique, C, (anodal) and C2 (cathodal) (7,13,14) (Fig. 1).Recently, the Tf suballele Cz was found to have a high incidence in women prone to spontaneous abortion: the relative risk of abortion was found to be 2.3, 1.4, 0.6 for the C2, C2-I, and C I subtypes, respectively (2). The aim of the present study was to investigate on the relationships existing between the transferrin C polymorphism and extremely premature delivery. MATERIALS AND METHODSWe have compared gene frequencies of the Tf C alleles in a group of 88 preterm infants (gestational age <32 wk) and a group of 35 1 term controls taken at random from population of healthy newborn delivered in the same period of time. About 40% of the infants of these two groups originated from the province of Rome, the remaining 60% from the province of Arezzo (Tuscany). It was ascertained that gene frequencies of the Tf alleles are identical in the two provinces and therefore computation was operated regardless of the place of origin.Cord serum samples were obtained at delivery and stored at -20°C before the determination. The informed consent was obtained from the parents.The gestational age was calculated on the basis of the date of the first day of the last menstrual period and on obstetric and neonatal objectivity (8). If discordance aroused between our estimation and that of the mother, the infant was excluded from the study.Four preterm infants were deliberately excluded from this study because preterm delivery was ascribed to specific causes, such as uterus malformation, ac...
CTs provided a valid measure of elucidating the effective contribution of craniofacial characteristics in predicting favourable/unfavourable growth in untreated Class III subjects.
In the last decade, the availability of innovative algorithms derived from complexity theory has inspired the development of highly detailed models in various fields, including physics, biology, ecology, economy, and medicine. Due to the availability of novel and ever more sophisticated diagnostic procedures, all biomedical disciplines face the problem of using the increasing amount of information concerning each patient to improve diagnosis and prevention. In particular, in the discipline of orthodontics the current diagnostic approach based on clinical and radiographic data is problematic due to the complexity of craniofacial features and to the numerous interacting co-dependent skeletal and dentoalveolar components. In this study, we demonstrate the capability of computational methods such as network analysis and module detection to extract organizing principles in 70 patients with excessive mandibular skeletal protrusion with underbite, a condition known in orthodontics as Class III
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