Purpose: Despite the high clinical accuracy of dynamic navigation, inherent sources of error exist. The purpose of this study was to improve the accuracy of dynamic navigated surgical procedures in the edentulous maxilla by identifying the optimal configuration of intra-oral points that results in the lowest possible registration error for direct clinical implementation. Materials and methods: Six different 4-area configurations were tested by 3 operators against positive and negative controls (8-areas and 3-areas, respectively) using a skull model. The two dynamic navigation systems (X-Guide® and NaviDent®) and the two registration methods (bone surface tracing and fiducial markers) produced four registration groups. The accuracy of the registration was checked at the frontal process of the zygoma. Intra- and inter- operator reliability for each registration group were reported. Multiple comparisons were conducted to find the best configuration with the minimum registration error. Results: Ranking revealed one configuration in the tracing groups (Conf.3) and two configurations in the fiducial groups (Conf.3 and Conf.5) that had the best accuracy. When the inferior surfaces of the zygomatic buttress were excluded, fiducial registration produced better accuracy with both systems (p 0.006 and <0.0001). However, tracing 1 cm areas at these surfaces bilaterally resulted in similar registration accuracy as placing fiducial markers there (p 0.430 and 0.237). NaviDent® performed generally better (p 0.049, 0.001 and 0.002) albeit having a wider margin of uncertainty in the obtained values. Changing the distribution of the 4 tracing areas or fiducial markers had a less pronounced effect with X-Guide® than with the NaviDent® system. Conclusion: For edentulous maxillary surgeries, 4 fiducial markers placed according to configuration 3 or 5 result in the lowest registration error. Where implants are being placed bilaterally, an additional 2 sites may reduce the error further. For bilateral zygomatic implant placement, it is optimal to place 2 fiducials on the inferior surfaces of the maxillary tuberosities, other 2 on their buccal surfaces, and 2 on the anterior labial surface of the alveolar bone. Utilising the inferior zygomatic buttress is recommended over the inferior maxillary tuberosities in other types of maxillary surgeries.
Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intrav
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Research summary
Backbiting pronouns have gained great importance in contemporary textual linguistic studies, as they play a coordinating function in the text and link its parts.
Interpreters did not overlook the role of backbiting pronouns in achieving the function of consistency and coherence in the Qur’anic text, as they referred to this, including Ibn Ashour, who had many analytical practices related to referral issues and their complexities. The Qur'anic reference to the pronouns of backbiting, so the researcher traced these phenomena and their evidence in the Holy Qur'an, aiming to clarify their role in enriching the significance and in the coherence and harmony
... Show MoreThe current study aims to examine the experience of female students with disabilities who studying in university in kingdom of Saudi Arabia. To this end, the researcher used semi-structured interview as an instrument to collect the study data which regards as one of the descriptive approach tools. The sample comprised (12) disabled-female students from multidiscipline within both college of arts and college of education. To analyze the collected data, the author utilized a thematic analysis method following six steps as stated by (Braun and Clark, 2006). The findings revealed that disabled students have a high self-confidence which push them forward to take part in activities that hold on campus. Besides, significant variation were shown
... Show MoreThis study aims to evaluate the performance of emergency departments according to international standards through studying the performance in some of Iraqi public hospitals, where the evaluation performance is considered one of the important topics that take a great deal of officials' attention, especially decision makers in health organizations.
The researcher has derived the research idea from the importance of work in emergency department in hospitals and to what it provides of medical services and quick and immediate nursing care that help in patients' lifesaving, and it is the mirror that reflects the real image for the hospital
... Show MoreThis paper addresses the new coloring in the concept of dystopian society as represented by the positive role of one of the characters vs. the passive role of the government and its mutual effect on the people of the society. In addition, it describes how all men in the dystopian society victimize and degrade the other through unlawful acts, like: stealing, rape, and fear, which are the lowest points in a moral decay. However, it offers hope by illustrating a positive sense, as exemplified by the doctor's wife out of Saramago's optimistic view that men may be descended from good women. Accordingly, the paper aims to examine the effect of the government’s role in the lives of the people who have later turned into blind in a dystopi
... Show MoreThe present study represent the histological and histochemical structure of the esophagus of laughing dove Streptopelia senegalensis, one of the wild birds, which feed on the seeds( grainvorous).The result showed that the esophagus long tubular quit wide and highly distensible organ situated at the right side of the nick , lie between pharynx and stomach it was divided into cervical and thoracic part , the cervical part longer than the thoracic part, and the crop was merely enlargement fusiform in shape which located at the entrance of the thorax. Esophagus parts showed that composed of four layer ;the mucosa, sub mucosa, muscular and adventitia or serosa, the mucosal layer was arranged in folds which was longer in the c
... Show MoreThis paper investigated in the numerical simulation model to calculate the Earth magnetic field components at north provinces of Najaf city (Longitude 44.316 o -44.3592o E and Latitude 32.0508o - 32.0256o N). The components of the Earth magnetic field (total intensity (F), horizontal intensity (H), declination (D), inclination (I), the north component(X), the east component(Y), and Down component(Z)) were found by using spherical harmonic world magnetic model (WMM2010). A great deal of anomaly has been discovered in all components of the Earth magnetic field at the selected region (Long. 44.345o-44.335o E, Lat.32.042o-32.032o N) using Kriging method.
... Show MoreThe objective of the investigation was to analyze the structure and administration of the political system in Iraq (post-ISIS). After 2003, the Iraqi political system suffered the fundamental problem of its failure to achieve the political and social inclusion that characterizes democratic systems, to guarantee the establishment of a "state for all", while respecting differences. Political representation has moved from the system of sectarian ethnic components, under the title of consensual democracy, to the representation of leaders and the realization of their interests and the interests of their parties at the expense of the groups that claim to represent them, which complicates the problem. In this sense, the new political syste
... Show MoreWater provision is sensitive to climate change, and agricultural production and food supply are sensitive to water availability. Water scarcity affects food security and agricultural economic development through changes in agricultural production and changes in the composition of produced goods. Recent droughts also led to a decrease in the volume of water allocated to agriculture, which led to a decrease in total agricultural production and exports, and this has subsequent impacts on food security and economic development. The research aimed to measure the impact of water scarcity on agricultural economic development for the period 1990-2022. The research included three behavioral equations with three endogenous variables: the cult
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