Background:To evaluate the efficacy and safety of collagen-based dressings in the management of diabetic foot ulcers (DFUs), compared to standard wound care (SWC), human amniotic membrane allografts (hAMA), and decellularized extracellular matrix (dECM) products. Methods:A systematic review of randomized controlled trials (RCTs) and cohort studies published between December 2013 and March 2025 was conducted using PubMed, Scopus, and Web of Science. Eligible studies assessed collagen-based dressings for DFUs, with primary outcomes including wound area reduction, closure rates, and healing time. Adverse events were considered secondary outcomes. Due to heterogeneity, findings were narratively synthesized by dressing type. Results:Twenty-two studies (15 RCTs, 7 cohort studies) were included. Collagen-based dressings consistently outperformed SWC, achieving greater wound reduction (54.5--88.2%), higher closure rates (22.2--82.4%), and shorter healing times (21--83.5 days), with no serious treatment-related adverse events. Helicoll showed superior performance (wound reduction: 84--86.5%; closure: 50--71.4%). Comparisons with hAMA and dECM yielded mixed and heterogeneous results, without consistent evidence of superiority. RCTs favored hAMA over Apligraf, while some real-world studies reported the opposite. Findings on collagen/ORC/silver dressings versus dECM were also inconsistent. Conclusions:Collagen-based dressings are safe and effective for improving DFU healing when compared with standard wound care. However, current evidence is insufficient and heterogeneous to establish superiority over other advanced biologic therapies. Further head-to-head randomized trials are warranted.
Background: This study reported two cases of crowned dens syndrome (CDS) occurring in rheumatoid arthritis (RA) patients, along with a systematic literature review of similar cases, aiming to explore the association between RA and CDS within the context of calcium pyrophosphate deposition disease (CPPD disease). Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed an online systematic literature search using the PICO (Patient, Intervention, Comparison, Outcome) strategy, to identify articles reporting the association between RA and CDS. A total of five studies were included in the systematic review. Results: Most cases involved older adults aged between 60 and 80 years old. A marked predominance of female cases was observed in most cases. Clinical presentation typically included chronic or acute neck pain, stiffness, and headache. In all the studied cases, no neurological complications were reported. Standard radiographs identified atlanto-axial instability in two cases. CT imaging included calcifications of the transverse, alar, and apical ligaments encircling the odontoid process, as seen in most cases. CT might also reveal erosions, pseudotumors, or structural abnormalities. Management strategies combined colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, resulting in significant clinical and biological improvement. Conclusion: CDS is an uncommon condition that should be more frequently considered in patients with RA presenting with neck pain, headache, and fever. Further research studies are required to elucidate potential shared pathophysiological features between RA and CDS and to explore common treatment options.
Epidemiological studies have recently shown a very high correlation between consumption of red meat and meat products, the most important source of protein for humans, and cancer. The molecular basis of the red meat-cancer relationship is still poorly understood. The study of heme iron and N-nitroso metabolites, derived from the digestion of red meat, as possible inducers of oxidative stress and DNA damage, which is a major culprit of carcinogenic compounds and mutagenesis, has been pioneering. However, some other factors, like the time of cooking, temperature of cooking, and the direct or indirect contact of meat with flame during preparation, can also help in the formation and release of carcinogenic substances. This review aims to discuss the current evidence on the mechanistic associations between red meat intake and the activation of oncogenes that are central to tumorigenesis, and to generate new ideas for future studies. The synthesis and analysis of the existing evidence are a valuable resource for researchers and healthcare professionals trying to understand the complex interrelationships between dietary patterns, oncogenes, and the development of various cancers.
Wilson disease is classically defined as an autosomal recessive disorder of copper metabolism that leads to neurological and hepatic dysfunction. It is one of the most prevalent genetic liver disorders caused by pathogenic mutations in the ATP7B gene, leading to defective copper transport and toxic accumulation in tissues. Without timely diagnosis and appropriate treatment, Wilson disease can progress to life-threatening hepatic failure and severe neurological impairment, ultimately resulting in death. Clinically, Wilson disease exhibits marked phenotypic heterogeneity, presenting with a wide spectrum of hepatic, neurological, and psychiatric symptoms. Differential diagnosis can be complicated by other inherited metabolic disorders with overlapping clinical and biochemical features, collectively referred to as Wilson's mimicry disease. These disorders may contribute to diagnostic uncertainty, potentially delaying the identification of Wilson disease and timely initiation of effective therapy. In this review, we collated pertinent information on Wilson disease and its related differential diagnoses based on a broad review of the scientific literature. Our findings highlight disorders that closely mimic Wilson disease clinically and biochemically, outlining their distinguishing clinical, biochemical, and genetic features, which can be differentiated through specific diagnostic markers and genetic testing. Enhancing awareness and understanding of these entities is essential to improve diagnostic accuracy in pediatric neurology and hepatology.
Background:Strongyloides stercoralis is a soil-transmitted intestinal nematode capable of establishing chronic autoinfection, allowing infection to persist for decades. Its nonspecific clinical manifestations and variable presentation often result in delayed diagnosis, particularly in older adults and in endemic regions, where unrecognized infection may progress to severe complications. Case Report:A 78-year-old man presented with progressive bilateral lower-extremity edema lasting four months, accompanied by functional class II dyspnea, fever, chills, night sweats, nausea, lethargy, and an unintentional 20-kg weight loss over eight months. Laboratory and imaging investigations failed to identify a clear etiology, prompting further diagnostic evaluation. Histopathological examination together with stool analysis ultimately confirmed Strongyloides stercoralis infection associated with protein-losing enteropathy. The patient was treated with albendazole for seven days, leading to marked clinical improvement and complete resolution of symptoms during follow-up, with recovery of nutritional status and no evidence of recurrence. Conclusion:This case highlights the diagnostic challenge posed by strongyloidiasis in elderly patients presenting with nonspecific constitutional symptoms and protein-losing enteropathy. Clinicians practicing in endemic settings or caring for individuals with relevant epidemiologic risk factors should maintain a high index of suspicion, even in the absence of classic gastrointestinal manifestations or eosinophilia. Early recognition, appropriate parasitological and histopathological investigations, and timely antiparasitic therapy are essential to achieve favorable outcomes and prevent potentially life-threatening complications, including hyperinfection syndrome and disseminated disease.
Multiple sclerosis (MS) is an autoimmune disease that affects various parts of the central nervous system and often occurs in young population (between 20-40 years old). Given that MS is a lifelong disease and there is currently no definitive treatment for MS, early diagnosis, initiation of treatment with the most appropriate medication, and patient monitoring are three challenging factors in determining the status of MS patients. Magnetic resonance imaging (MRI) and optical coherence tomography (OCT) are two important and useful imaging methods in all the three aspects of diagnosing, monitoring, and determining the effectiveness of treatment in MS patients. In recent years, the use of artificial intelligence in analyzing MRI and OCT data in these aspects has been rapidly increasing. In this article, we reviewed and discussed the usage of deep learning as a class of machine learning and a method of artificial intelligence for analyzing data obtained from MRI and OCT in MS patients.
Background: Investigating the importance of exercise tolerance test (ETT) in the diagnosis of coronary artery disease (CAD) among people with left-sided dominant coronary circulation is very important. Methods: This retrospective study aimed to explore the relevance of ETT in CAD diagnosis by analyzing medical records of 2084 patients who underwent ETT and coronary angiography in Urmia's educational therapeutic hospitals between 2018 and 2019. SPSS Version 16 was used for data analysis. Results: The study included 5.58% males and 5.41% females. The prevalence of codominancy was 10.2%, right coronary dominance (RD) was 65%, and left coronary dominance (LD) was 24.8%. There were no significant differences between gender, age, smoking, blood pressure, diabetes mellitus (DM), the prevalence of hyperlipidemia (HLP), family history (FH) and left ventricular ejection fraction (LVEF). The frequency of non-significant CAD was higher in women than in men. Additionally, the frequency of women with LD was significantly higher than that of men. The results of angiography in normal cases, it was observed that the highest frequency was related to female patients with a history of DM. The sensitivity of the ETT was 94%, and the accuracy and diagnostic power of the exercise test for the presence of CAD in individuals with LD were 53% (p = 0.03). Conclusion: The study highlights the potential for false-positive exercise tests in diabetic individuals with left coronary dominance, providing valuable insights into the nuanced interplay of gender, cardiovascular health, and coronary circulation patterns in CAD risk.
Atherosclerosis, a chronic inflammatory disease of arterial walls, remains a leading cause of global mortality, with ischemic heart disease (IHD) and stroke as primary contributors. In people living with HIV (PLWH), this risk is amplified due to persistent immune activation and conventional cardiovascular risk factors such as hypertension and dyslipidemia. HIV-specific mechanisms, including viral proteins, gut microbial translocation, and chronic inflammation, drive monocyte dysfunction, foam cell formation, and vascular damage, contributing to accelerated atherogenesis. Antiretroviral therapy (ART) has significantly improved the life expectancy of PLWH, transforming HIV into a chronic condition. However, ART does not fully normalize immune activation, particularly monocyte-driven inflammation, which remains central to atherosclerosis progression. Protease inhibitor (PI)-based ART regimens are associated with metabolic disturbances, exacerbating dyslipidemia and insulin resistance, further increasing cardiovascular disease (CVD) risk. Imaging techniques, such as carotid intima-media thickness (CIMT) and coronary artery calcium (CAC) scoring, reveal subclinical atherosclerosis in this population. Adjunctive therapies like statins and anti-inflammatory agents, including interleukin (IL)-1β antagonists, show promise in mitigating inflammation and CVD risk. Targeted strategies addressing monocyte activation, chronic inflammation, and gut microbial translocation are critical. Comprehensive care for PLWH requires integrating ART optimization with lifestyle interventions, lipid-lowering therapies, and novel treatments targeting immune dysfunction. Future research should refine biomarkers for early atherosclerosis detection, tailor CVD risk assessments, and explore therapeutic innovations to reduce cardiovascular morbidity and mortality in PLWH.
Background: Azithromycin, a macrolide antibiotic with notable anti-inflammatory properties, is widely used in the treatment of bronchiectasis. This study aimed to assess changes in serum fractional exhaled nitric oxide (FeNO), immunoglobulin E (IgE), and eosinophils levels before and after azithromycin treatment in bronchiectasis patients. Methods: A retrospective cohort study was conducted at Rasul Akram Hospital involving bronchiectasis patients. Participants were evaluated in two phases: before receiving azithromycin (500 mg on every other day) and three months following oral azithromycin treatment. Demographic data, medical history, and baseline FeNO, IgE, and eosinophil levels were collected during the initial visit. These biomarkers were measured again at the follow-up visit. Results: The study included 50 participants, with a mean (±SD) age of 40.78 (±5.45) years; 48% were females, and 52% were males. FeNO levels showed a significant decrease from 47.64±16.20 ppb at baseline to 18.6 ±5.99 ppb post-treatment (p<0.001). IgE levels also declined significantly from 747.90±166.87 IU/mL initially to 280.40±115.93 IU/mL (p<0.001). Additionally, eosinophil counts decreased from an initial mean of 687.00±199.18 cells/µL to 236.30±203.17 cells/µL at post-treatment (p<0.001). Patients with mild and moderate bronchiectasis exhibited significant reductions in inflammatory markers (p<0.001), those with more severe bronchiectasis did not show a comparable level of improvement. Gender and smoking status had no significant impact on treatment outcomes. Conclusion: Azithromycin administration significantly improved IgE, FeNO, and eosinophil serum levels, underscoring its therapeutic potential in modifying bronchiectasis-related inflammation.
Background: Doege-Potter syndrome (DPS) is a condition characterized by severe, symptomatic, and sustained hypoglycemia, refractory to medical treatment, due to non-insular tumor cells. Case Presentation: We describe the case of a 73-year-old male with acromegalic features and two months of hypoglycemic episodes, in whom a giant mass was identified in the right hemithorax via radiography. Surgical resection of the tumor resolved hypoglycemia and improved the acromegalic traits. Solitary fibrous tumors (SFTs) are rare neoplasms that predominantly affect individuals aged 50 to 60 years. Doege-Potter syndrome is a cause of hypoglycemia, present in 2-4% of SFT cases. Its manifestations arise from abnormal synthesis and secretion of insulin-like growth factor (IGF)-2 by the SFT. In rare instances, patients with DPS may exhibit signs of acromegaly, attributed to the stimulation of the IGF-1 receptor by IGF-2. The initial diagnostic approach to DPS includes imaging and hormonal studies, while the definitive diagnosis is made through histopathology. Conclusions: We emphasize the importance of considering DPS in patients with thoracic tumors and persistent hypoglycemia, especially when accompanied by acromegalic features.
Background:The present study aimed to evaluate the relationship between Carotid intima-media thickening (CIMT) with subclinical myocardial ischemia in acute cardiac ischemia (ACI) patients. Methods:This prospective, observational study was conducted on 75 ACI patients referred to Golestan and Imam Khomeini hospitals of Ahvaz in 2023. The patients in healthy (CIMT≤0.8mm) and at risk of cardiac ischemia (CIMT>0.8mm) groups underwent carotid Doppler ultrasound to check CIMT and the presence of carotid plaque. Results:CIMT mean was 1.07±0.12 mm in healthy ACI patients and 1.4±0.19 mm in those at risk of cardiac ischemia. Among patients at risk of CIMT and carotid plaque, 85.1% and 80.8% had at least one cardiovascular risk factor, respectively. However, no significant differences were found between CIMT, carotid plaque, and patients' risk factor profiles (P = 0.129 vs. P = 0.515). The adjusted odds ratio (OR) for CIMT was 1.50 (95% CI: 0.58-3.94, P = 0.400), indicating no significant association with the outcome. No significant associations were observed for age, sex, diabetes, hypertension, LDL, or HDL. While the prevalence of vessel disease was higher in at-risk group than healthy CIMT group, no dramatic differences were observed between CIMT and vessel involvement (P = 0.136). Conclusion:The presence of one or more cardiovascular risk factors combined with increased CIMT may increase heart attack susceptibility, highlighting the potential of CIMT as an effective screening tool for predicting coronary artery disease. Further large-scale studies are needed to define its role in clinical practice more definitively.
Background: Diabetic nephropathy (DN) is the most prevalent reason for chronic kidney diseases that end up with renal failure if it is not diagnosed and treated at early stages. Therefore, low-cost, non-invasive, and easy-to-use tests are necessary for efficient follow-up and early diagnosis of DN in diabetic patients. Interleukin-8 (IL-8) as the main recruiter of neutrophils may play a role in inflammatory responses that end up with renal damage and dysfunction in DN. Methods: In a case-control study, serum levels of IL-8 and neutrophil-to-lymphocyte ratios (NLR) were evaluated in correlation with clinical findings in 60 patients with DN, 60 type 2 diabetic patients without renal involvement, and 60 age and sex-matched healthy subjects. Results: IL-8 levels were significantly higher in diabetic nephropathy patients than in diabetic patients without nephropathy and healthy controls (both p-value<0.0001). However, the frequency of neutrophils in both groups of patients was higher than that of healthy individuals. Despite increased NLRs in diabetic patients, the difference was only significant between DN and healthy groups (P-value: 0.03). A direct correlation was observed between IL-8 levels and NLR (P-value: 0.02), and a negative correlation between IL-8 and eGFR (P-value: 0.01). In addition, UACR was associated with IL-8 concentrations (P-value: 0.04) in DN patients. IL-8 level showed a higher diagnostic value for diabetic nephropathy [AUC: 0.87 (p<0.0001)] than NLR and neutrophil count. Conclusion: Increased level of IL-8 in DN is associated with elevated NLR and UACR, and reduced eGFR. Therefore, IL-8 levels might be considered a diagnostic or prognostic biomarker for DN.
Background: Analyzing the clinical efficacy and mechanism of action of cardiac rehabilitation after revascularization for coronary multibranch lesions. Methods: 150 patients with multiple coronary artery lesions were selected for the study from July 2022 to March 2023, and were randomly divided into observation group (75 cases, complete revascularization + cardiac rehabilitation intervention) and control group (75 cases, complete revascularization). The level of patients' 6 min walking experiment, quality of life, cardiac function indexes, and laboratory indexes were analyzed. Results: The level of 6-min walking test was significantly higher in the observation group than in the control group (p<0.05); the quality of life of patients in the observation group was significantly higher than that of the control group (p<0.05); the levels of left ventricular end-systolic internal diameter (LVESD), left ventricular end-diastolic internal diameter (LVEDD), left ventricular pressure (LVP), and interventricular septal thickness (LVS) in patients in the observation group were significantly lower than that of the control group; and the level of LV ejection fraction (LVEFA) levels were significantly higher than those of the control group (P=0.00); serum homocysteine (Hcy) and blood uric acid (SUA) levels of patients in the observation group were significantly lower than those of the control group (P=0.00). Conclusion: Complete revascularization + cardiac rehabilitation intervention can effectively improve patients' 6-min walking test level, improve patients' cardiac function indexes, improve patients' quality of life, improve patients' laboratory index levels, and play a significant role in improving patients' prognosis, which is worthy of widespread promotion.
Background: Acne vulgaris (AV) is a common inflammatory skin disorder. Systemic treatments like azithromycin and doxycycline are frequently used. The Angiotensin-Converting Enzyme (ACE) has been implicated in inflammation and skin diseases. This study investigated the association between ACE I/D polymorphism and therapeutic response to azithromycin versus doxycycline in moderate AV. Methods: This clinical trial enrolled 54 moderate AV patients divided equally into two groups: one received 100 mg/day doxycycline, the other 250 mg/day azithromycin for 3 months. DNA was extracted via salting-out method, and ACE I/D polymorphism was analyzed by PCR and electrophoresis. Treatment efficacy was assessed using Michelson's acne score and standardized photography. Post-treatment, genotype-phenotype correlations were evaluated. Results: The doxycycline group showed significantly higher recovery rates (59.3%) compared to azithromycin (18.5%) (p<0.001). However, no statistically significant association was observed between improvement percentages and genotypes in either the doxycycline ((P = 0.567) or azithromycin (P = 0.533) groups. Conclusion: Doxycycline was significantly more effective than azithromycin for moderate AV. However, no significant association was found between ACE I/D polymorphism and treatment response for either antibiotic. These findings guide therapeutic selection while suggesting that ACE genotyping may not predict treatment response in moderate AV.
Background: For patients with advanced, diffuse Coronary artery disease (CAD), surgical myocardial revascularization via coronary artery bypass grafting (CABG) continues to represent the gold standard therapeutic approach. Given the paucity of studies demonstrating CABG benefits in patients with significant left intraventricular dyssynchrony (LVD), we conducted this study to evaluate how viable myocardial tissue volume, quantified by dobutamine stress echocardiography (DSE), predicts postoperative LVD improvement. Methods: This investigation employed a cross-sectional analytical design to assess 30 CABG candidates with moderate-severe ischemic cardiomyopathy. Myocardial viability evaluation utilized dobutamine stress echocardiography, complemented by tissue Doppler Imaging for synchronized assessment of regional LV contractility. Results: Demographic analysis revealed a study population aged 61.5±7.9 years (range: 47 to 85 years), comprising 73.3% males. Left ventricular ejection fraction (LVEF) measurements improved from 32.2±4.6% at baseline to 39.6±5.2 % following surgical revascularization (p<0.001). Postoperative resolution of left ventricular dyssynchrony occurred in 9 patients (30.0 %), whereas 19 patients (63.3 %) showed no improvement (p<0.001). Two patients (6.6 %) died due to progressive heart failure and inadequate revascularization. Conclusion: Our current study demonstrates significant postoperative improvements in LVEF, LVEDD, and left ventricular dyssynchrony. However, given that approximately two-thirds of cases showed only minimal improvement in dyssynchrony, it would be reasonable to consider cardiac resynchronization therapy (CRT) for these patients.
Background: Skeletal muscle index (SMI) is a measure for evaluating skeletal muscle status. However, its specific association with liver steatosis and fibrosis remains unclear. The aim of this study was to investigate the association between SMI and liver steatosis and fibrosis. Methods: We conducted a cross-sectional study with a random selection of 328 participants over the age of 18, with no history of alcohol consumption or liver disease, from a nutrition clinic in Iran. Waist circumference (WC) and hip circumference (HC) were measured using a tape measure according to standards. Total fat mass, SMI, and other body composition parameters were obtained via bioelectrical impedance analysis. Liver status was assessed in all participants using elastography (FibroScan®). Results: The participants included 64.0% males and 36.0% females, with a median age of 41 (IQR:14) years. After adjusting for confounders, SMI had no significant association with liver steatosis (P=0.647). Indeed, body mass index (BMI) (P=0.028), WC (P=0.038), and HC (P=0.007) were the significant predictors of liver steatosis. Conversely, each unit increase in SMI value decreased the chance of liver fibrosis by 48% after controlling the confounders (aOR=0.519, 95%CI: 0.283-0.951, P=0.034). Additionally, BMI (P=001), WC (P=0.006), and HC (P=0.026) were other significant predictors of liver fibrosis. Conclusion: In conclusion, while a higher SMI did not mitigate obesity-linked liver steatosis risk, it independently lowered the odds of fibrosis. Furthermore, increased waist circumference was a stronger predictor of both steatosis and fibrosis than increased trunk fat mass.
Background: This study aimed to evaluate the effect of pirfenidone on lung CT scan lesions in patients with severe COVID-19. Methods: In this cross-sectional study, data were extracted from the electronic medical records of patients with severe COVID-19 who received one of the following treatments: pirfenidone alone (n= 40), prednisolone alone (n= 55), pirfenidone combined with methylprednisolone (n= 18), or supportive care only (n= 32). Chest CT images taken at baseline and two months post-treatment were assessed by a trained radiologist. p< 0.05 was considered statistically significant. Results: The distribution of initial CT scan findings, Comparison of CT scan findings at admission and two months post-discharge, as well as the extent of pulmonary fibrosis and ground-glass opacity (GGO) grades across the groups, showed no statistically significant differences. However, significant differences were observed in CT scan findings and GGO grades between the four study groups at two months post-discharge. Moreover, in both the pirfenidone (p= 0.00) and supportive care (p= 0.01) groups, the extent of pulmonary fibrosis between admission and two months post-discharge showed statistically significant changes. Conclusion: In summary, although antifibrotic agents such as pirfenidone may not lead to significant improvement in lung CT scan findings in patients with severe COVID-19, they may help slow the progression of pulmonary fibrosis following the acute phase of the disease.
Background: Multiple cystic brain metastases are a rare form of cancer dissemination and usually originate from adenocarcinomas of the lung and breast. Managing these lesions is challenging, and cyst drainage plays an essential role in reducing intracranial pressure. This article presents a case of multiple cystic brain metastases from lung adenocarcinoma. Case Presentation: A 40-year-old female with a two-year history of stage IV lung adenocarcinoma presented with debilitating progressive neurologic symptoms. Imaging studies showed multiple cystic lesions on brain MRI most consistent with brain metastases. She underwent a craniotomy to drain the biggest cysts, followed by whole-brain radiotherapy (WBRT). The patient experienced dramatic alleviation of symptoms. Following a year of follow-up, she had no neurological symptoms. Conclusion: Despite the rarity of cystic brain metastases, these lesions should be ruled out in case of signs of increased intracranial pressure in a patient with a history of malignant disease.
Background:Diet can play a significant role in sleep regulation, particularly in older adults. This study aimed to investigate the association between the Dietary Phytochemical Index (DPI) and sleep quality among the elderly in Amirkola City. Methods:This case-control study was part of the second phase of the Amirkola Cohort Study on aging. A total of 800 elderly individuals aged ≥60 years (400 with good sleep quality and 400 with poor sleep quality, matched for age and sex) were randomly selected. Inclusion criteria comprised having complete demographic data in the cohort profile, no known history of malignancy (including gastric and intestinal cancers), absence of psychiatric or cognitive disorders (such as psychiatric hospitalization), and no drug addiction. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and a semi-quantitative food frequency questionnaire (SQ-FFQ), which were then analyzed statistically. Results:Total energy intake and the number of chronic diseases significantly impacted sleep quality (OR=1.002, 95% CI: 1.001-1.003, P = 0.004 and OR=1.257, 95% CI:1.170-1.352, p < 0.001, respectively). Furthermore, Poorer sleep quality was significantly associated with a higher number of chronic diseases in both gender, male and female (OR=1.244, 95% CI: 1.097-1.411, P = 0.001 and OR=1.225, 95% CI: 1.106-1.357, P < 0.001). However, Dietary Phytochemical Index (DPI) and Energy intake from plant sources did not show a significant effect on sleep quality. Conclusion:Dietary modifications and management of chronic diseases could be effective in improving sleep quality among the elderly. However, further research is recommended.
Background:Cone Beam Computed Tomography (CBCT) is used to evaluate the hard tissue of the maxillofacial area, and the dose received by the patient depends on the resolution of the images. This study investigated the effect of CBCT resolution (voxel size) on its linear measurement accuracy. Methods:This in vitro study was conducted on 19 human mandibles and 11 dry maxillae. On each jaw, four anterior and four posterior regions were examined. Markers were placed in the designated areas using gutta-percha. The jaws were scanned at three voxel sizes (100, 150, 200 µm). The bone height and thickness were measured in the prepared images and compared with the sizes obtained. Paired t-test, t-test, one-way ANOVA, and Tukey's post-hoc tests were used for statistical analysis. Results:Buccal and lingual bone height measurements showed significant differences across voxel sizes (p < 0.05), with higher resolution (100 µm) yielding greater accuracy. No significant difference was found in bone thickness measurements between resolutions (p = 0.20). Height measurements were significantly less accurate in anterior than posterior regions (p < 0.05). No significant difference was observed between maxilla and mandible except for buccal height at medium and standard resolutions. All CBCT measurements underestimated actual dimensions. Thickness measurements were more accurate than height measurements. Conclusion:Using high resolution in CBCT machines is recommended to reduce linear measurement error when there is a short distance to the critical anatomical structures.
