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The aim of the study was to develop and evaluate the reliability and agreement of new computer planimetric method for measurement and assessment of plaque on all types of removable dental prostheses RPDs. The instrument (new method) was tested by evaluating the efficacy of the rotating needles device in cleaning specific parts of RPD. From a database containing 780 images, which were taken in a standardized method for 65 RDPs for 49 participants, 55 images were selected randomly for image analysis. Adobe Photoshop software was used according to a standard operating procedure (SOP) by a main examiner two times in different sessions, and 1 time by 3 other examiners. In order to estimate the intra- and inter-examiner reliability, intraclass correlation coefficients ICC(2,1) was used. Three parameters were used to estimate agreement: standard error of measurement (SEM), smallest detectable change at 95% confidence level (SDC95%), and limits of agreement (LoA) according to Bland¨CAltman method. In the database, only 34 subjects were found with double crown retained removable denture and veneer over the secondary crown. 49x2 (before x after) images for 34 RDPs went under image analyses to calculate POP before and after cleaning the RDPs with the rotating needle device. Data were analysed using Wilcoxon signed-rank test. In all steps of image analysis, both intra-examiner and inter- examiner reliability were excellent with ICC(2,1) values > 0.85 at 95% confidence level. Intra- and inter-examiner values for both, SEM and SDC95% were ¡Ü 6% and ¡Ü17% respectively. The Bland¨CAltman analysis revealed a satisfactory level of agreement. POP is significantly more on the veneer than on the base(B-O), P <0.05. The rotating needles device is effective in cleaning the veneer and base(B-O), P <0.05 with absolute effect size 0.62. No statistical significance was detected in the effectiveness of the rotating needles device between base(B-O) and veneer. This study showed an excellent inter- and intra-examiner reproducibility, satisfactory level of examiners agreement, and acceptable measurement error of the new computer planimetric method . Furthermore, the method can be used with all types of RDPs. The rotating needles device can significantly reduce plaque on the double crown retained removable denture. The Computerized Planimetric Method (CPM) is more suitable for clinical researches because of its objectivity, reliability, high level of standardization, and the ability to detect and quantify small changes in plaque. Extra attention should be given to the veneer over the secondary crown as they are a potential part for RDP plaque accumulation.
Objective: The purpose of this study was to determine the accuracy and reliability of Frankfort horizontal plane identification using displays of multi-planar reconstructed MRI images, and propose it as a sufficiently stable and standardized reference plane for craniofacial structures Materials and Methods: MRI images of 43 adolescent randomly selected subjects were obtained from the longitudinal population based cohort study SHIP-2 using a T1-weighted 3D sequence. Five examiners independently identified the three landmarks that form FH plane. Intra-examiner reproducibility and inter-examiner reliability, correlation coefficients (ICC), coefficient of variability and Bland-Altman plots were obtained for all landmarks coordinates to assess reproducibility. Intra-examiner reproducibility and inter-examiner reliability in terms of location and plane angulation were also assessed. Results: Intra- and inter-examiner reliabilities for X, Y and Z coordinates of all three landmarks were excellent with ICC values ranging from 0.914 to 0.998. Differences among examiners were more in X and Z than in Y dimensions. The Bland–Altman analysis demonstrated excellent intra- as well as inter-examiner agreement between examiners in all coordinates for all landmarks. Intra-examiner reproducibility and inter-examiner reliability of the three landmarks in terms of distance showed mean differences between 1.3 to 2.9 mm, Mean differences in plane angulation were between 1.0° to 1.5° among examiners. Conclusion: This study revealed excellent intra-examiner and inter-examiner reproducibility of Frankfort Horizontal plane through 3D landmark identification in MRI. Sufficiently stable landmark-based reference plane could be used for different treatments and studies.