Displaying publications 1 - 20 of 141 in total

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  1. Qamruddin I, Shahid F, Alam MK, Zehra Jamal W
    Case Rep Dent, 2014;2014:382367.
    PMID: 25548686 DOI: 10.1155/2014/382367
    Skeletal class II has always been a challenge in orthodontics and often needs assistance of surgical orthodontics in nongrowing patients when it presents with severe discrepancy. Difficulty increases more when vertical dysplasia is also associated with sagittal discrepancy. The advent of mini implants in orthodontics has broadened the spectrum of camouflage treatment. This case report presents a 16-year-old nongrowing girl with severe class II because of retrognathic mandible, and anterior dentoalveolar protrusion sagittally and vertically resulted in severe overjet of 13 mm and excessive display of incisors and gums. Both maxillary central incisors were trimmed by dental practitioner few years back to reduce visibility. Treatment involved use of micro implant for retraction and intrusion of anterior maxillary dentoalveolar segment while lower incisors were proclined to obtain normal overjet, and overbite and pleasing soft tissue profile. Smile esthetics was further improved with composite restoration of incisal edges of both central incisors.
  2. Alam MK, Mohd Noor NF, Basri R, Yew TF, Wen TH
    PLoS One, 2015;10(11):e0142914.
    PMID: 26562655 DOI: 10.1371/journal.pone.0142914
    This study aimed to investigate the association of facial proportion and its relation to the golden ratio with the evaluation of facial appearance among Malaysian population. This was a cross-sectional study with 286 randomly selected from Universiti Sains Malaysia (USM) Health Campus students (150 females and 136 males; 100 Malaysian Chinese, 100 Malaysian Malay and 86 Malaysian Indian), with the mean age of 21.54 ± 1.56 (Age range, 18-25). Facial indices obtained from direct facial measurements were used for the classification of facial shape into short, ideal and long. A validated structured questionnaire was used to assess subjects' evaluation of their own facial appearance. The mean facial indices of Malaysian Indian (MI), Malaysian Chinese (MC) and Malaysian Malay (MM) were 1.59 ± 0.19, 1.57 ± 0.25 and 1.54 ± 0.23 respectively. Only MC showed significant sexual dimorphism in facial index (P = 0.047; P<0.05) but no significant difference was found between races. Out of the 286 subjects, 49 (17.1%) were of ideal facial shape, 156 (54.5%) short and 81 (28.3%) long. The facial evaluation questionnaire showed that MC had the lowest satisfaction with mean score of 2.18 ± 0.97 for overall impression and 2.15 ± 1.04 for facial parts, compared to MM and MI, with mean score of 1.80 ± 0.97 and 1.64 ± 0.74 respectively for overall impression; 1.75 ± 0.95 and 1.70 ± 0.83 respectively for facial parts.
  3. Haque S, Khamis MF, Alam MK, Wan Ahmad AWM
    Front Pediatr, 2021;9:646830.
    PMID: 34262887 DOI: 10.3389/fped.2021.646830
    To evaluate dental arch relationship (DAR) using GOSLON Yardstick and also to explore the association between multiple factors (age, gender, UCLP types, UCLP side, Family history of cleft, family history of Class III malocclusion, techniques of cheiloplasty, techniques of palatoplasty) and DAR in children unilateral cleft lip and palate (UCLP) in different populations. Two hundred fifty-five laser scanned 3D digital models (LS3DM) of UCLP children (5-12 years) from Malaysia, Bangladesh, and Pakistan were included. The intra- and inter-examiner agreements were evaluated by kappa statistics, to compare the GOSLON mean score between the populations and to explore the responsible factors that affect DAR, one way ANOVA, and crude logistic regression analysis was used, respectively. The mean GOSLON score was 2.97; 3.40 and 3.09 in Malaysia, Bangladesh, and Pakistan, respectively. Twenty seven, 40, and 30 subjects were in unfavourable (category rating 4 and 5) groups in Malaysia, Bangladesh, and Pakistan, respectively. A significant association was found between techniques of palatoplasty (p = 0.03; p = 0.04 and p = 0.04 in Malaysia, Bangladesh, and Pakistan, respectively) and unfavourable DAR. Different cheiloplasty techniques (p = 0.04) and gender (p = 0.03) also exhibited noteworthy associations with unfavourable DAR in the Bangladeshi population. Bardach techniques of palatoplasty were significantly associated with unfavourable DAR in all three populations. Moreover, male UCLP and modified Millard techniques of cheiloplasty were also associated with unfavourable DAR in the Bangladeshi population.
  4. Mok PL, Koh AE, Farhana A, Alsrhani A, Alam MK, Suresh Kumar S
    Saudi J Biol Sci, 2021 Apr;28(4):2502-2509.
    PMID: 33551661 DOI: 10.1016/j.sjbs.2021.01.051
    COVID-19 is a rapidly emerging infectious disease caused by the SARS-CoV-2 virus currently spreading throughout the world. To date, there are no specific drugs formulated for it, and researchers around the globe are racing against the clock to investigate potential drug candidates. The repurposing of existing drugs in the market represents an effective and economical strategy commonly utilized in such investigations. In this study, we used a multiple-sequence alignment approach for preliminary screening of commercially-available drugs on SARS-CoV sequences from the Kingdom of Saudi Arabia (KSA) isolates. The viral genomic sequences from KSA isolates were obtained from GISAID, an open access repository housing a wide variety of epidemic and pandemic virus data. A phylogenetic analysis of the present 164 sequences from the KSA provinces was carried out using the MEGA X software, which displayed high similarity (around 98%). The sequence was then analyzed using the VIGOR4 genome annotator to construct its genomic structure. Screening of existing drugs was carried out by mining data based on viral gene expressions from the ZINC database. A total of 73 hits were generated. The viral target orthologs were mapped to the SARS-CoV-2 KSA isolate sequence by multiple sequence alignment using CLUSTAL OMEGA, and a list of 29 orthologs with purchasable drug information was generated. The results showed that the SARS CoV replicase polyprotein 1a had the highest sequence similarity at 79.91%. Through ZINC data mining, tanshinones were found to have high binding affinities to this target. These compounds could be ideal candidates for SARS-CoV-2. Other matches ranged between 27 and 52%. The results of this study would serve as a significant endeavor towards drug discovery that would increase our chances of finding an effective treatment or prevention against COVID19.
  5. Purmal K, Alam MK, Sukumaran P
    Dent Res J (Isfahan), 2013 Jan;10(1):81-6.
    PMID: 23878568 DOI: 10.4103/1735-3327.111805
    BACKGROUND: Bonding of molar tubes is becoming more popular in orthodontics. Occasionally, these bonding are done on posterior porcelain crowns or bridges. The purpose of this study was to evaluate the shear bond strength of buccal tubes on feldspathic porcelain crowns with two different methods.

    MATERIALS AND METHODS: Forty porcelain right molar crowns were fabricated for this study. The crowns were randomly divided into two groups. In group 1, the crowns were etched with 9.6% hydrofluoric acid, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT (3M Unitek, Monrovia, Calif). In group 2, the crowns were etched with phosphoric acid 37%, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT. All the crowns were stored for 24 hours at 37°C and thermo-cycled before the shear bond test. The analysis of variance (ANOVA) was used to determine whether significant difference were present between the groups.

    RESULTS: The results of the analysis of variance (F = 0.23) indicated the shear bond strength of group 1 (3.57 ± 0.87 MPa) was not significantly different (P > 0.05) from group 2 (3.46 ± 0.65 Mpa). Fisher's exact test for the adhesive remnant index (ARI) revealed significant difference between both groups (P < 0.05). Eighty percent of group 1 buccal tubes failed at buccal tube/resin interface and eighty percent of group 2 mostly failed at porcelain/resin interface.

    CONCLUSION: Etching with phosphoric acid with the use of silane coupling agent would be safer and should make it easier for clinicians to clean the adhesive on the porcelain surface after debonding.

  6. Bilgrami A, Alam MK, Qazi FUR, Maqsood A, Basha S, Ahmed N, et al.
    Polymers (Basel), 2022 Jan 24;14(3).
    PMID: 35160456 DOI: 10.3390/polym14030466
    A vital feature of conservative dentistry is the adhesion of the restorative material to the tooth structure for restoration of the tooth substance lost due to dental decay, trauma, or dental imperfections. In a perfect world, a restorative material should generate a lasting adhesion by bonding the restoration with tooth tissues. The ingress of micro-organisms, oral fluids, molecules, and ions through microscopic spaces due to faulty adhesion between restoration and tooth structure is known as microleakage. This study is focuses on the evaluation of adhesive failures between the restorative materials. In the past, studies have focused more on the bonding potential of a restorative material with the tooth surface. Therefore, there is need to carry out a study that compares the microleakage between resin-based restorative materials in a sandwich manner with and without the intermediate bonding layer after immersion in 2% methylene blue dye at different time intervals. The restorative materials used were composite Ceram X Mono plus (DENTSPLY) and Z350 (3M ESPE), Vitremer resin modified glass ionomer cement (RMGIC) (3M ESPE), smart dentine replacement SDR (3M ESPE), Bond NT (DENTSPLY), and Universal Bond (3M ESPE). A light emitting diode (LED) was used to cure the specimens. Artificial saliva was used as a storage medium for the specimens. Thermocycling of specimens was carried out at 500 cycles/30 s and 1000 cycles/30 s. The world health organization (WHO) grading tool for microleakage was used to analyze fluid ingress in the specimens through disclosing by 2% methylene blue dye. The statistical analysis was carried out with one-way analysis of variance (ANOVA) and Tukey post hoc test, keeping the level of significance at p ≤ 0.05. In Grade 0 = 85 samples, Grade 1 = 10 samples, Grade 2 = 7 samples, Grade 3 = 16 samples, and in Grade 4 = 2 samples were identified. This study describes that no microleakage was observed in SDR and resin composite groups as compared to Vitremer and resin composite groups.
  7. Alam MK, Abutayyem H, Alotha SN, H Alsiyat BM, K Alanazi SH, Hammad Alrayes MH, et al.
    Cureus, 2023 Oct;15(10):e48054.
    PMID: 37933372 DOI: 10.7759/cureus.48054
    Due to the clear depiction of facial aesthetics and other craniofacial parameters, portraiture photography (PP) is becoming more and more necessary in modern clinical practice. The studies chosen for this review's inclusion looked at how PP affected the orthodontic treatment and diagnostic procedure on the subjects who were watched in the studies. Studies published within the last decade precisely from 2013 were searched for across major online databases after devising a proper search strategy. Multiple reviewers created a specific data extraction form that was used for the investigation, followed by the evaluation of bias and the variables found in each of the chosen papers. This form was meant for the assessment for various variables encountered in this study. According to the meta-analysis, using PP was related with a statistically significant decrease in the risk of orthodontic treatment and diagnostic modalities, with odds ratios (OR) of 0.52 with a 95% confidence interval (CI) of (0.28, 0.96), and a relative risk (RR) of 0.66 with a CI of (0.45, 0.96). In orthodontics, PP is an important tool that offers useful data for diagnosis, treatment planning, and tracking treatment success. To validate the results of studies like ours, a sizable evidence sample is required due to the limited number of trials that have been performed in this area.
  8. Ahmad P, Asif JA, Alam MK, Slots J
    Periodontol. 2000, 2020 Feb;82(1):286-297.
    PMID: 31850637 DOI: 10.1111/prd.12328
    The continually high impact factor of Periodontology 2000 (7.861 for 2018), the level of which is unprecedented among dental journals, prompted the present bibliometric analysis of the Journal. Since the inception of Periodontology 2000 in 1993 and until July 2019, the top 100 most-cited articles have received a total of 21,276 (Web of Science), 23,009 (Elsevier's Scopus), and 43,518 (Google Scholar) citations. The citations of the 100 most-cited articles were found to vary from 118 to 827 (Web of Science), 10 to 1069 (Scopus), and 15 to 2028 (Google Scholar). Three articles had more than 600 (Web of Science) citations, 5 had between 400 and 600 citations, 25 had between 200 and 400 citations, and 67 had between 100 and 200 citations. The first authors of the 100 most-cited articles were based in the USA (51%), Switzerland (14%), and Australia (10%). The 5 dental institutions with the most frequently cited articles were The Forsyth Institute, USA (9 articles), The University of Queensland, Australia (8 articles), University of Bern, Switzerland (7), University of Texas Health Science Center at San Antonio, USA (6 articles), and University of Washington, USA, and Temple University School of Dentistry, USA (5 articles each). The likely reason for the high impact factor of Periodontology 2000 is publication of insightful and timely review articles produced by eminent researchers and clinicians from a wide range of dental institutions and countries.
  9. Alam MK, Alfawzan AA, Haque S, Mok PL, Marya A, Venugopal A, et al.
    Front Pediatr, 2021;9:651951.
    PMID: 34026687 DOI: 10.3389/fped.2021.651951
    To investigate whether the craniofacial sagittal jaw relationship in patients with non-syndromic cleft differed from non-cleft (NC) individuals by artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis. The study group comprised 123 subjects with different types of clefts including 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), 13 = UCL (unilateral cleft lip) and NC = 31. The mean age was 14.77 years. SNA, SNB, ANB angle and Wits appraisal was measured in lateral cephalogram using a new innovative A.I driven Webceph software. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of clefts vs. NC individuals. A significant decrease (p < 0.005) in SNA, ANB, Wits appraisal was observed in different types of clefts vs. NC individuals. SNB (p > 0.005) showed insignificant variables in relation to type of clefts. No significant difference was also found in terms of gender in relation to any type of clefts and NC group. The present study advocates a decrease in sagittal development (SNA, ANB and Wits appraisal) in different types of cleft compared to NC individuals.
  10. Asif JA, Pohchi A, Alam MK, Athar Y, Shiekh RA
    Indian J Ophthalmol, 2014 Nov;62(11):1098-1100.
    PMID: 25494256 DOI: 10.4103/0301-4738.146756
  11. Nowrin SA, Jaafar S, Ab Rahman N, Basri R, Alam MK, Shahid F
    Korean J Orthod, 2018 Nov;48(6):395-404.
    PMID: 30450332 DOI: 10.4041/kjod.2018.48.6.395
    Objective: To date, only a few studies have investigated the relationships between genetic polymorphisms and external apical root resorption (EARR). Hence, the aim of this systematic review was to explore the relationship between different gene polymorphisms and their association with EARR.

    Methods: A complete literature search was conducted by two independent reviewers. The PubMed, Science Direct, and Scopus databases were searched. In addition, the bibliographies of all textbooks and relevant articles were searched manually. A meta-analysis was performed using data entered into the electronic databases until February 28, 2017.

    Results: On the basis of the search, we identified 17 and 7 publications for the systematic review and meta-analysis, respectively. Odds ratio (OR) was used to evaluate the association of the interleukin 1B (+3954) polymorphism and the risk of EARR. The overall OR from the studies was used to estimate the risk of EARR. However, no association was found and no publication bias was apparent for the risk of EARR in patients receiving orthodontic treatment.

    Conclusions: More research on the relationship between gene polymorphism and EARR is necessary to determine better specificity of possible interactions.

  12. Jawad MM, Husein A, Azlina A, Alam MK, Hassan R, Shaari R
    J Biomed Opt, 2013 Dec;18(12):128001.
    PMID: 24337495 DOI: 10.1117/1.JBO.18.12.128001
    Bone regeneration is essential in medical treatment, such as in surgical bone healing and orthodontics. The aim of this study is to examine the effect of different powers of 940 nm diode low-level laser treatment (LLLT) on osteoblast cells during their proliferation and differentiation stages. A human fetal osteoblast cell line was cultured and treated with LLLT. The cells were divided into experimental groups according to the power delivered and periods of exposure per day for each laser power. The (3-(4,5-dimethylthiazol-2yl)-2,5 diphenyl tetrazolium bromide) (MTT) assay was used to determine cell proliferation. Both alkaline phosphatase and osteocalcin activity assays were assessed for cell differentiation. All treatment groups showed a significant increase in cell proliferation and differentiation compared to the control group. Regarding the exposure time, the subgroups treated with the LLLT for 6 min showed higher proliferation and differentiation rates for the powers delivered, the 300-mW LLLT group significantly increased the amount of cell proliferation. By contrast, the 100 and 200 mW groups showed significantly greater amounts of cell differentiation. These results suggest that the use of LLLT may play an important role in stimulating osteoblast cells for improved bone formation.
  13. Jawad MM, Husein A, Alam MK, Hassan R, Shaari R
    Lasers Med Sci, 2014 Jan;29(1):367-72.
    PMID: 22986701 DOI: 10.1007/s10103-012-1199-8
    The need for orthodontic treatment is increasing all the time. As the treatment is time consuming ranging from a year to several years, any method of reducing the period of treatment and increasing the quality of the tissue will be beneficial to patients. The use of non-invasive techniques such as low level laser therapy and low intensity pulsed ultasound in accelerating orthodontic tooth movement are promising. Thus, this overview study will help to generate more understanding about the background information and the possible applications of them in daily orthodontics, depending on previous literature searching for reviews and original research articles.
  14. Alam MK, Ganji KK, Munisekhar MS, Alanazi NS, Alsharif HN, Iqbal A, et al.
    Saudi Dent J, 2021 Nov;33(7):687-692.
    PMID: 34803320 DOI: 10.1016/j.sdentj.2020.04.008
    Objective: CBCT (cone beam computed tomography) analysis of condyle morphometry, to investigate the gender differences, symmetry and relationship with mandibular size.

    Materials and methods: This is a retrospective study. 800 CBCT scan obtained for the measurement of condyle in anterior-posterior and medio-lateral aspect using OnDemand 3D software. Participants were Saudi nationals of age above 18 years. 395 Males and 405 Females with the mean age of 38.2 ± 10.5 years. Right and left anterior-posterior width and medio-lateral width of the condyle were measured. Condyles were not isolated on the CBCT for volume measurement.

    Results: Mean right and anterior-posterior condyle width was 9.02 mm and 8.74 mm in males whereas in females it was 9.01 mm 8.69 mm respectively. For males mean medio-lateral width of the condyle in right and left side was 17.40 mm and 16.95 mm. For females, mean medio-lateral width of the condyle in right and left side was 17.14 mm and 16.93 mm. The prediction rate of gender was 57.2% for males and 53.3% for females. Statistically significant differences (p 

  15. Huqh MZU, Abdullah JY, Wong LS, Jamayet NB, Alam MK, Rashid QF, et al.
    Int J Environ Res Public Health, 2022 Aug 31;19(17).
    PMID: 36078576 DOI: 10.3390/ijerph191710860
    OBJECTIVE: The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in diagnosis and treatment prediction in children with CLP (Cleft lip and palate), (b) to create a qualitative summary of results of the studies retrieved.

    MATERIALS AND METHODS: An electronic search was carried out using databases such as PubMed, Scopus, and the Web of Science Core Collection. Two reviewers searched the databases separately and concurrently. The initial search was conducted on 6 July 2021. The publishing period was unrestricted; however, the search was limited to articles involving human participants and published in English. Combinations of Medical Subject Headings (MeSH) phrases and free text terms were used as search keywords in each database. The following data was taken from the methods and results sections of the selected papers: The amount of AI training datasets utilized to train the intelligent system, as well as their conditional properties; Unilateral CLP, Bilateral CLP, Unilateral Cleft lip and alveolus, Unilateral cleft lip, Hypernasality, Dental characteristics, and sagittal jaw relationship in children with CLP are among the problems studied.

    RESULTS: Based on the predefined search strings with accompanying database keywords, a total of 44 articles were found in Scopus, PubMed, and Web of Science search results. After reading the full articles, 12 papers were included for systematic analysis.

    CONCLUSIONS: Artificial intelligence provides an advanced technology that can be employed in AI-enabled computerized programming software for accurate landmark detection, rapid digital cephalometric analysis, clinical decision-making, and treatment prediction. In children with corrected unilateral cleft lip and palate, ML can help detect cephalometric predictors of future need for orthognathic surgery.

  16. Islam R, Islam MRR, Tanaka T, Alam MK, Ahmed HMA, Sano H
    Jpn Dent Sci Rev, 2023 Dec;59:48-61.
    PMID: 36880059 DOI: 10.1016/j.jdsr.2023.02.002
    The aim of direct pulp capping (DPC) is to promote pulp healing and mineralized tissue barrier formation by placing a dental biomaterial directly over the exposed pulp. Successful application of this approach avoids the need for further and more extensive treatment. In order to ensure a complete pulp healing with the placement of restorative materials, a mineralized tissue barrier must form to protect the pulp from microbial invasion. The formation of mineralized tissue barrier can only be induced when there is a significant reduction in pulp inflammation and infection. Consequently, promoting the healing of pulp inflammation may provide a favorable therapeutic opportunity to maintain the sustainability of DPC treatment. Mineralized tissue formation was observed as the favorable reaction of exposed pulp tissue against a variety of dental biomaterials utilized for DPC. This observation reveals an intrinsic capacity of pulp tissue for healing. Therefore, this review focuses on the DPC and its healing procedure as well as the materials used for DPC treatment and their mechanisms of action to promote pulpal healing. In addition, the factors that can affect the healing process of DPC, clinical considerations and future perspective has been described.
  17. Alazzawi MMJ, Husein A, Alam MK, Hassan R, Shaari R, Azlina A, et al.
    Prog Orthod, 2018 Apr 16;19(1):10.
    PMID: 29658096 DOI: 10.1186/s40510-018-0208-2
    BACKGROUND: Quality bone regeneration, which leads to the improvement of bone remodeling, is essential for orthodontic treatment. In order to improve bone regeneration and increase the amount of tooth movement, different techniques have been implemented. The object of this study is to compare the effects of low-level laser therapy (LLLT), low-intensity pulsed ultrasound (LIPUS), and their combination on bone remodeling during orthodontic tooth movement.

    METHODS: Eighty (80) male, 6-week-old Sprague Dawley rats were grouped in to four groups, the first group was irradiated with (940 nm) diode laser, second group with LIPUS, and third group with combination of both LLLT and LIPUS. A forth group used was a control group in an incomplete block split-mouth design. The LLLT and LIPUS were used to treat the area around the moving tooth once a day on days 0-7, then the experiment was ended in each experimental endpoint (1, 3, 7, 14, and 21 days). For amount of tooth movement, models were imaged and analyzed. Histological examination was performed after staining with (hematoxylin and eosin) and (alizarin red and Alcian Blue) stain. One step reverse transcription-polymerase chain reaction RT-PCR was also performed to elucidate the gene expression of RANK, RANKL, OPG, and RUNX-2.

    RESULTS: The amount of tooth movement, the histological bone remodeling, and the RT-PCR were significantly greater in the treatment groups than that in the control group. Among the treatment groups, the combination group was the highest and the LIPUS group was the lowest.

    CONCLUSION: These findings suggest that LLLT and LIPUS can enhance the velocity of tooth movement and improve the quality of bone remodeling during orthodontic tooth movement.

  18. Alam MK, Shahid F, Purmal K, Sikder MA, Saifuddin M
    J Contemp Dent Pract, 2015 Apr;16(4):299-303.
    PMID: 26067733
    This analysis was aimed to determine the mesiodistal tooth width of human teeth and to compare with the measurements on plaster model in a Bangladeshi population.
  19. Alam MK, Rahman SA, Rahaman SA, Basri R, Sing Yi TT, Si-Jie JW, et al.
    PLoS One, 2015;10(10):e0140438.
    PMID: 26465146 DOI: 10.1371/journal.pone.0140438
    The aim of this study is to evaluate the satisfaction of patients with posterior implants in relation to the clinical success criteria and surface electromyography (sEMG) findings of the masseter and temporalis muscles. Total 42 subjects were investigated. Twenty one subjects with posterior dental implants were interviewed using a questionnaire and the clinical success criteria were determined based on The International Congress of Oral Implantologists. The myofunction of the masticatory muscles were assessed using sEMG (21 subjects) and compared to the control group of subjects without implants (21 subjects). Out of 21 subjects, all were satisfied with the aesthetics of their implant. Twenty of them (95.2%) were satisfied with its function and stability. As for clinical criteria, 100% (50) of the implants were successful with no pain, mobility or exudates. sEMG findings showed that patients have significantly lower (p<0.01) basal or resting median power frequency but with muscle burst. During chewing, control subjects showed faster chewing action. There was no difference in reaction and recovery time of clenching for both groups. In conclusion, the satisfaction of implant patients was high, and which was in relation to the successful clinical success criteria and sEMG findings.
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