The project's director, Ed Moses, said that getting to the cusp of ignition (defined as the successful achievement of fusion) had taken some 7,000 workers and 3,000 contractors a dozen years, their labors creating a precision colossus of millions of parts and 60,000 points of control, 30 times as many as on the space shuttle.
The occlusal plane was defined using three points (mesiobuccal cusp tips of both mandibular first molars and a mid-point of both mandibular central incisors) as the horizontal reference plane, and a plane along the line from the cusp of the canine to the mesiobuccal cusp of the first molar and perpendicular to the occlusal plane was defined as the sagittal reference plane (Figs. 1 and 2).
Maxillary width is defined as the distance between the right and left most concave point on maxillary vestibule at the level of the mesio-buccal cusp of first molars.
BAV cusp fusion morphology was defined as right-left cusp fusion, right non-coronary cusp fusion, or left non-coronary cusp fusion.
Severe AS was defined as no cusp movement seen by the EP reviewers.
Higher sensitivity could be obtained at the expense of specificity if severe AS were defined as single cusp movement as opposed to no cusp movement.
Maxillary expansion was performed until dental overcorrection, defined as when lingual cusps of the upper first molars occluded onto lingual side of buccal cuspids of the lower first molars, was achieved.
The presence of AVP was defined as bowing of any cusp of the AoV during diastole into the LVOT from a long axis view and apparent movement out of the visualisation plane in a short axis view.
Molar Class I was defined as occurring where the mesiobuccal cusp of the upper first molar occluded with the mesiobuccal groove of the lower first molar, or within less than half a cusp width anteriorly or posteriorly.
Based on this study, when severe AS on echocardiography is defined as absence of any cusp movement, EPs with ultrasonography training are able to identify severe AS with high specificity and moderate sensitivity compared with cardiology interpretations.
