Browsing by Author "Ghoneima, Ahmed"
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Item Accuracy of 3D Reconstructed Orthodontic Models(2014) Stewart, Kelton; Chai, Billy; Liu, Sean; Ghoneima, Ahmed; Alford, TimothyObjective: To evaluate the accuracy of 3D reconstructed orthodontic models, derived by various digitization methods, as compared to conventional orthodontic plaster models. Materials and Methods: Twenty-five maxillary orthodontic plaster models were randomly selected from the Indiana University School of Dentistry Department of Orthodontics. Each plaster model was scanned with the Cadent iOC scanner and the digital data was used to print 3D reconstructed orthodontic models. The same 25 plaster models were duplicated using alginate and poured in plaster after two days. These duplicated plaster models were also scanned with the iOC scanner and 3D reconstructed. Next, the duplicate plaster models were sent to a lab, scanned with a 3Shape R700 scanner, and the digital data was 3D reconstructed. Digital calipers were used to obtain ten linear dimensional measurements on all plaster and 3D reconstructed models for comparisons. Equivalence testing was performed using 2 one-sided paired t-tests with a significance level of P <0.05. Results: Nine of the 10 linear measurements were statistically equivalent in all groups. Clinically insignificant, but statistically significant, measurement differences in maxillary central incisor height (P <0.05) were found on 3D reconstructed models derived from the 3Shape R700 desktop scanner. Conclusion: 3D reconstructed orthodontic models derived from alginate impressions, iOC scanners, and 3Shape R700 scanners are an accurate and reliable substitute for orthodontic plaster models.Item BENS, a novel regulator of bone/cartilage healing(2013) Labban, Nawaf Yousef; Windsor, L. Jack; Song, Fengyu; Ghoneima, Ahmed; Bruzzaniti, Angela; Allen, Matthew R.; Cameron, Jo AnnEnhancing osteoblast proliferation, survival, and extracellular matrix protein secretion are potential therapeutic approaches to treat bone fractures and diseases such as osteoporosis. BENS is a traditional medicine used in many countries such as India for thousands of years to treat many diseases including bone diseases. In this study, molecular, cell-based and in vivo approaches were utilized to investigate the effects of BENS on bone and cartilage regeneration. An osteosarcoma cell line (MG63) was incubated in serum free media with and without 0.8 mg/ml of BENS. BENS significantly increased cell survival up to 30 days and these cells retained their ability to proliferate in fresh media with serum. After adding BENS, there were statistically significant decreases in the expression of both anti-apoptotic and pro-apoptotic proteins. An in vivo non-critical size segmental bone defect Xenopus system was used to evaluate the ability of BENS to enhance cartilage formation. After a small segment of the anterior hemisection of the tarsus bone was excised, the frogs were divided into three groups and given subcutaneous injections of either phosphate-buffered saline or BENS once daily for 30 days and then bone/cartilage formation evaluated. The total cartilage area/total section area was significantly increased (2.6 fold) in the BENS treated samples. In an osteoporotic rat model, the anabolic properties of BENS on bone mass were assessed by histomorphometric analyses. Ovariectomized (OVX) rats received daily intraperitoneal injections for 4 weeks. Bone formation rates (BFRs) for the cortical periosteal bone surface of the midshaft tibia were 383.2, 223.9, 308.8, 304.9, and 370.9 µm3/µm2/year, and for the trabecular surface were 82.2, 113, 212.1, 157, and 165 µm3/µm2/year for the sham, OVX, PTH, 3 mg/kg BENS, and 30 mg/kg BENS groups, respectively. BENS increased both trabecular and cortical BFRs. It generated better results on cortical periosteal bone surface than did PTH. Taken together, these findings suggest that BENS promotes osteoblast survival due to its effects on altering the balance between pro-apoptotic and anti-apoptotic proteins. In addition, in vivo studies revealed that BENS enhanced cartilage formation in Xenopus and BFRs in rats. Therefore, BENS may possess anabolic bone/cartilage properties.Item Comparative Assessment of Pharyngeal Airway Dimensions in Skeletal Class I, II, and III Emirati Subjects: A Cone Beam Computed Tomography Study(MDPI, 2024-09-25) AlAskar, Sara; Jamal, Mohamed; Khamis, Amar Hassan; Ghoneima, Ahmed; School of DentistryThe aim of the current study was to evaluate the pharyngeal airway dimensions of individuals with different skeletal patterns in a cohort of the Emirati population. The specific aim was to assess the relationship between pharyngeal airway dimensions and anterior facial height in relation to different skeletal patterns. This retrospective study was conducted on a sample of 103 CBCT scans of adult Emirati subjects categorized into three groups according to their skeletal classification as indicated by the ANB angle: Class I (n = 35), Class II (n = 46), and Class III (n = 22). All CBCT scans were taken using an i-CAT CBCT imaging machine (Imaging Sciences, Hatfield, PA, USA). The age range of the patients was 19 to 68 years (62 women and 41 men). ANOVA, t-tests, Kruskal-Wallis, and Mann-Whitney tests were employed for comparing means among groups. The correlation coefficient was used to evaluate the association between variables. A p-value of less than 0.05 was considered statistically significant. This study revealed significant associations between various airway parameters and cephalometric measurements. Positive correlations were observed between nasal cavity volume and nasopharynx volume, as well as anterior facial height. Oropharynx volume exhibited positive correlations with hypopharynx volume and total airway volume, and negative correlations with overjet, ANB angle, and patient age. Hypopharynx volume correlated positively with total airway volume and the most constricted area of the airway (MCA). Total airway volume showed positive correlations with MCA and anterior facial height. MCA had negative correlations with ANB angle and patient age. Nasopharynx volume was significantly larger in the skeletal Class I group than in the Class II or Class III groups, while the other airway parameters showed no significant differences among the groups (p > 0.05). Several airway parameters showed a correlation with anterior facial height among the different skeletal patterns. Nasopharyngeal airway volume was significantly larger in the skeletal Class I group than in Class II and III groups in the studied sample.Item Computational fluid dynamics analysis of the upper airway after rapid maxillary expansion: a case report(SpringerOpen, 2015-05-24) Ghoneima, Ahmed; AlBarakati, Sahar; Jiang, Feifei; Kula, Katherine; Wasfy, Tamer; Department of Orthodontics and Oral Facial Genetics, IU School of DentistryBACKGROUND: Assessment of the upper airway volume, morphology, and mechanics is of great importance for the orthodontic patient. We hypothesize that upper airway dimensions have significant effects on the dynamics of the airway flow and that both the dimensions and mechanics of the upper airway are greatly affected by orthodontic and orthopedic procedures such as rapid maxillary expansion (RME). The aim of the current study was to assess the effect of RME on the airway flow rate and pattern by comparing the fluid dynamics results of pre- and post-treatment finite element models. METHODS: Customized pre- and post-treatment computational fluid dynamics models of the patient's upper airway were built for comparison based on three-dimensional computed tomogram. The inhalation process was simulated using a constant volume flow rate for both models, and the wall was set to be rigid and stationary. Laminar and turbulent analyses were applied. RESULTS: Comparisons between before and after RME airway volume measurements showed that increases were only detected in nasal cavity volume, nasopharynx volume, and the most constricted area of the airway. Pressure, velocity, and turbulent kinetic energy decreased after dental expansion for laminar and turbulent flow. Turbulent flow shows relatively larger velocity and pressure than laminar flow. CONCLUSIONS: RME showed positive effects that may help understand the key reasons behind relieving the symptom of breathing disorders in this patient. Turbulence occurs at both nasal and oropharynx areas, and it showed relatively larger pressure and velocity compared to laminar flow.Item Effects of rapid maxillary expansion on the cranial and circummaxillary sutures(Elsevier, 2011-10) Ghoneima, Ahmed; Abdel-Fattah, Ezzat; Hartsfield, James; El-Bedwehi, Ashraf; Kamel, Ayman; Kula, Katherine; Department of Orthodontics and Oral Facial Genetics, IU School of DentistryINTRODUCTION: The aim of this study was to determine whether the orthopedic forces of rapid maxillary expansion cause significant quantitative changes in the cranial and the circummaxillary sutures. METHODS: Twenty patients (mean age, 12.3 ± 1.9 years) who required rapid maxillary expansion as a part of their comprehensive orthodontic treatment had preexpansion and postexpansion computed tomography scans. Ten cranial and circummaxillary sutures were located and measured on one of the axial, coronal, or sagittal sections of each patient's preexpansion and postexpansion computed tomography scans. Quantitative variables between the 2 measurements were compared by using the Wilcoxon signed rank test. A P value less than 0.05 was considered statistically significant. RESULTS: Rapid maxillary expansion produced significant width increases in the intermaxillary, internasal, maxillonasal, frontomaxillary, and frontonasal sutures, whereas the frontozygomatic, zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures showed nonsignificant changes. The greatest increase in width was recorded for the intermaxillary suture (1.7 ± 0.9 mm), followed by the internasal suture (0.6 ± 0.3 mm), and the maxillonasal suture (0.4 ± 0.2 mm). The midpalatal suture showed the greatest increase in width at the central incisor level (1.6 ± 0.8 mm) followed by the increases in width at the canine level (1.5 ± 0.8 mm) and the first molar level (1.2 ± 0.6 mm). CONCLUSIONS: Forces elicited by rapid maxillary expansion affect primarily the anterior sutures (intermaxillary and maxillary frontal nasal interfaces) compared with the posterior (zygomatic interface) craniofacial structures.Item Endodontic management of an Infected Immature Tooth with Spontaneous Root Closure and Type II Dens Invaginatus: A Case Report(2015) Baker, Ryan W.; Spolnik, Kenneth J.; Ghoneima, Ahmed; Ehrlich, YgalApical periodontitis in an immature maxillary lateral incisor (#10) with arrested root development and a natural closure of the open apex in 22-year-old male was endodontically treated in a manner that conserved the existing hard tissue barrier (HTB). A dens invaginatus Oehlers II was also present. The patient reported no symptoms, but did recall an incident of dental trauma as a child. A 3D image showed the nature of the HTB closing the open foramen as well as the anatomy of the immature root with the dens invaginatus. Porosities were seen in the HTB and that is consistent with the histological “Swiss Cheese” appearance known to occur in apexification. Endodontic treatment was performed in a single-visit. Access to the root canal system (RCS) included penetration through the dens invaginatus. The canal was not mechanically cleaned, but only irrigated with sodium hypochlorite, ethylenediaminetetra-acetic acid (EDTA), chlorhexidine using the EndoVac® system. The barrier was maintained and covered with a 5mm layer of mineral trioxide aggregate (MTA). A sterile damp sponge was placed on the MTA. On the following visit the MTA had set, and an EndoSequence fiber post was placed in the canal and EndoSequence dual-cure core build-up material was used to close the access and restore the tooth. A clinical and radiographic follow-up, 30 months after the initial treatment revealed resolution of the radiolucency and apical trabecular bone deposition and the patient was asymptomatic.Item Evaluating the use of 3D imaging in creating a canal-directed endodontic access(2015-06-09) Maru, Avni Mahendra; Spolnik, Kenneth Jacob, 1950-; Ghoneima, Ahmed; Bringas, Josef; Warner, Ned A. (Ned Alan); Zunt, Susan L., 1951-; Ehrlich, YgalIntroduction: During root canal treatment (RCT), an opening is made through the crown of the tooth to access and to disinfect the root canal system (RCS). Traditional endodontic access (TEA) may sacrifice tooth structure and weaken the tooth. Cone beam computed tomography (CBCT) provides information about the exact location of the root canals. This information can be used for the design of a canal-directed endodontic access (CDEA). It may also be used for the 3D printing of an acrylic endodontic stent that could help to create a conservative CDEA. Objective: 1) Evaluate the ability of the Dolphin 3D imaging software to assist in creating a CDEA; 2) Compare tooth structure loss in a CDEA to that in a TEA by measuring the volume of remaining tooth structure, surface area of the access opening at the occlusal, and remaining dentin thickness at the CEJ. Materials and Methods: Thirty extracted human mandibular premolars were used. Teeth with large, wide canals were excluded. CBCT images will be taken for all teeth using Kodak 9000. Fifteen teeth were randomly assigned to the TEA group and 15 teeth were assigned to the CDEA group. The CDEA path was mapped using Dolphin 3D imaging software. Acrylic access stents were designed using Rhino 3D software and printed using a 3D printer. The teeth were accessed through the corresponding stents. The 15 teeth that are part of the traditional access group were accessed without a stent. A CBCT scan was taken post-access for all 30 teeth. Wilcoxon Rank Sum Tests were performed to compare the following outcomes for the two groups: the volume of remaining tooth structure, the surface area of the access opening at the occlusal, and remaining dentin thickness at the CEJ. Results: The remaining dentin thickness (percent loss) was not significantly larger for TEA than for CDEA. The surface area (post-treatment) was significantly larger for TEA than for CDEA, and volume (percent loss) was significantly larger for TEA than for CDEA. Conclusion: The use of the CBCT and Dolphin 3D imaging provided an accurate and more conservative CDEA with the guide of an acrylic stent.Item Facial Soft-Tissue Asymmetry in 3D Cone Beam Computed Tomography Images of Children with Surgically Corrected Unilateral Clefts(2014-03-01) Starbuck, John M; Ghoneima, Ahmed; Kula, KatherineCleft lip with or without cleft palate (CL/P) is a relatively common craniofacial malformation involving bony and soft-tissue disruptions of the nasolabial and dentoalveolar regions. The combination of CL/P and subsequent craniofacial surgeries to close the cleft and improve appearance of the cutaneous upper lip and nose can cause scarring and muscle pull, possibly resulting in soft-tissue depth asymmetries across the face. We tested the hypothesis that tissue depths in children with unilateral CL/P exhibit differences in symmetry across the sides of the face. Twenty-eight tissue depths were measured on cone-beam computed tomography images of children with unilateral CL/P (n = 55), aged 7 to 17 years, using Dolphin software (version 11.5). Significant differences in tissue depth symmetry were found around the cutaneous upper lip and nose in patients with unilateral CL/P.Item Influence of prenatal EGCG treatment and Dyrk1a dosage reduction on craniofacial features associated with Down syndrome(Oxford Academic, 2016-11-15) McElyea, Samantha D.; Starbuck, John M.; Tumbleson-Brink, Danika M.; Harrington, Emily; Blazek, Joshua D.; Ghoneima, Ahmed; Kula, Katherine; Roper, Randall J.; Biology, School of ScienceTrisomy 21 (Ts21) affects craniofacial precursors in individuals with Down syndrome (DS). The resultant craniofacial features in all individuals with Ts21 may significantly affect breathing, eating and speaking. Using mouse models of DS, we have traced the origin of DS-associated craniofacial abnormalities to deficiencies in neural crest cell (NCC) craniofacial precursors early in development. Hypothetically, three copies of Dyrk1a (dual-specificity tyrosine-(Y)-phosphorylation regulated kinase 1A), a trisomic gene found in most humans with DS and mouse models of DS, may significantly affect craniofacial structure. We hypothesized that we could improve DS-related craniofacial abnormalities in mouse models using a Dyrk1a inhibitor or by normalizing Dyrk1a gene dosage. In vitro and in vivo treatment with Epigallocatechin-3-gallate (EGCG), a Dyrk1a inhibitor, modulated trisomic NCC deficiencies at embryonic time points. Furthermore, prenatal EGCG treatment normalized some craniofacial phenotypes, including cranial vault in adult Ts65Dn mice. Normalization of Dyrk1a copy number in an otherwise trisomic Ts65Dn mice normalized many dimensions of the cranial vault, but did not correct all craniofacial anatomy. These data underscore the complexity of the gene–phenotype relationship in trisomy and suggest that changes in Dyrk1a expression play an important role in morphogenesis and growth of the cranial vault. These results suggest that a temporally specific prenatal therapy may be an effective way to ameliorate some craniofacial anatomical changes associated with DS.Item Mandibular advancement appliance effects on obstructive sleep apnoea: a prospective threedimensional computed tomography study(Sciendo, 2017) Ghoneima, Ahmed; Bodkin, Cynthia; Stewart, Kelton; Perlow, Mark J.; Starbuck, John; Kula, Katherine; Orthodontics and Oral Facial Genetics, School of DentistryBackground: The aim of this study was to determine the effects of an elastic mandibular advancement (EMA) appliance on upper airway dimensions, most constricted area (MCA) of the airway, and snoring in a sample of obstructive sleep apnoea (OSA) patients of varying severity. Methods: Forty-seven male subjects were classified into two groups comprising12 controls and 35 suffering from OSA. The OSA group was further divided into three subgroups based on their apnoea-hypopnoea index (AHI). All subjects completed an Epworth questionnaire and an overnight home sleep test before (T1) and at the end of the study (T2). OSA subjects were provided with a custom-made EMA appliance. Cone beam computed tomographic images were obtained for each subject at T1 and T2. Airway parameters were measured and summarised by grouping. The differences in the measurements T1 – T2 were compared using repeated measures analysis of variance (rmANOVA) and p ≤ 0.05 was considered statistically significant. Results: The use of the EMA produced a statistically significant increase in the nasopharyngeal, oropharyngeal, MCA, and total airway volume. Although sleep apnoea patients reported a reduction in snoring time, particularly in moderate and severe OSA groups, the level of improvement was not statistically significant. Patients with moderate and severe OSA demonstrated significant decreases in their AHI and Epworth scores. Conclusion: EMA is effective in reducing OSA severity and changing airway dimensions in OSA patients, specifically in the moderate and severe cases.