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.
The process of discovering pharmaceuticals is of great importance in our contemporary life, in a way that without life becomes almost impossible, as this process is the first building block in the field of pharmaceutical industries to search for new methods and means of treatment and treatment. But in fact, the fact that talking about this process is not that simple and easy, because this process is complicated and difficult in a way that makes it take a time range that in some cases reaches what is permissible ten years to reach a chemical formula that can be used later in the manufacturing process Pharmacokinetics, and during this long period of time, this process will have a set of effects, some of which are specific to the researcher di
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... Show MoreThe study aimed at interpreting the role of architectural design quality in in build competitiveness model in accordance with the proposal included the idea of architectural design quality for its removal; interesting design factors of the environment, good design of the spaces, and design aesthetic explanatory variable. The competitiveness dimensions; the level of innovation, stimulate research, and the quality of the company's products, and activating the role of human resources, entrepreneurship, profitability, market share and competitiveness, variable responsive. The study of construction companies in the Ministry of Housing and Construction has taken the Iraqi society for the study. The sample consisted of (48) manage
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