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Paknahad M, Karimnezhand Khas R, Hasani M. Comparison of Superior Semicircular Canal Bone Thickness and Patterns in Unilateral and Bilateral Cleft Patients and Normal Controls: A CBCT Study. Cleft Palate Craniofac J 2024; 61:1172-1178. [PMID: 37073078 DOI: 10.1177/10556656231165189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Superior Semicircular Canal Dehiscence (SSCD) is a recently-defined developmental defect may be associated with several craniofacial anomalies such as Cleft Lip/Palate (CLP). The present study aimed to compare subjects with unilateral and bilateral CLP and normal controls in terms of Superior Semicircular Canal (SSC) bone thickness and pattern. A total of 238 Cone Beam Computed Tomography (CBCT) images were collected from 52 unilateral Cleft Lip and Palate (UCLP) subjects (104 temporal bones) and 38 Bilateral Cleft Lip and Palate (BCLP) (76 temporal bones) subjects and 148 healthy controls (296 temporal bones). The SSC bone thickness was measured twice and validated by a maxillofacial radiologist. The samples were then classified into five categories based on bone thickness: papyraceous or thin, normal, thick, pneumatized, and dehiscence. After all, the UCLP, BCLP, and normal control groups were compared concerning the SSC pattern and thickness. The results revealed no significant difference among the three groups regarding the SSC pattern and thickness based on gender. The SSC patterns (P value = .001) and SSC thickness (0.01) were strongly correlated to the cleft type. The thinnest bone thickness and the highest incidence of SSCD were observed among the subjects with BCLP. The results showed a significant association between the SSC patterns and SSC thickness and the study groups.
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Affiliation(s)
- Maryam Paknahad
- Oral and Dental Disease Research Center, Oral and Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahvash Hasani
- Oral & Maxillofacial Radiology Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Mosavat F, Sarmadi S, Amini A, Asgari M. Evaluation of Dimension and Bridging of Sella Turcica and Presence of Ponticulus Posticus in Individuals With and Without Cleft: A Comparative Study. Cleft Palate Craniofac J 2022; 60:695-700. [PMID: 35098758 DOI: 10.1177/10556656221075935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Sella turcica abnormalities such as sella turcica bridging (STB) have been observed frequently among patients with craniofacial anomalies. Ponticulus posticus (PP) is an important structure and its presence causes complications during surgeries. Due to the importance of these structures, this study aimed to evaluate the prevalence of STB, PP, and dimensions of the sella turcica in individuals with and without cleft. DESIGN A cross-sectional study. SETTING Orthodontic and Radiology Departments in a public dental school, Tehran, Iran. PATIENTS Eighty-three lateral cephalograms of individuals with cleft and ninety-two cephalograms of class I individuals without cleft. MAIN OUTCOME MEASURES Length, depth, and maximum anterior-posterior diameter (APD) of sella turcica, presence of STB (classified as types 1, 2, and 3), and PP. RESULTS In the group with cleft, 19.3% of individuals had type I, 65.1%, type II, and 15.7%, type III STB. In the group without cleft, 15.2% had type I, 73.9%, type II, and 10.9%, type III STB. In the group with cleft, 65.1% of individuals had no PP, 24.1%, incomplete, and 10.8%, complete PP while in the group without cleft, 56.5% had no PP, 29 31.5%, incomplete, and 12%, complete PP. CONCLUSION The sella turcica dimensions, STB, and PP prevalence were not significantly different between individuals with and without cleft. The sella turcica length and prevalence of STB and PP were not affected by age, sex, and cleft type. However, the depth and the APD were affected by age.
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Affiliation(s)
- Farzaneh Mosavat
- Department of Oral and Maxillofacial Radiology, School of Dentistry, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvin Sarmadi
- Department of Orthodontics, School of Dentistry, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhesam Amini
- Dental Research Center, Dentistry Research Institute, School of Dentistry, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Asgari
- Dental Research Center, Dentistry Research Institute, School of Dentistry, 48439Tehran University of Medical Sciences, Tehran, Iran
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Abstract
INTRODUCTION Geometric morphometrics (GM) is an advanced landmark-based quantitative method used to study biological shape and form. Historically, GM has been limited to non-biomedical fields such as comparative biology; however, this technique confers advantages over traditional cephalometric methods, warranting a review of current applications of GM to human craniofacial disorders. METHODS The RISmed package was used to extract metadata associated with PubMed publications referencing GM analysis techniques in craniofacial and reconstructive surgery. PubMed search terms included "geometric AND morphometric AND craniofacial;" and "geometric AND morphometric AND reconstructive surgery." Duplicate search results were eliminated. RESULTS Search yielded 139 studies between 2005 and 2020, of which 27 met inclusion criteria. Human craniofacial studies constituted 2% of all queried GM studies. Among these, cleft lip and palate were the most commonly studied craniofacial conditions (7 studies, 26%), followed by sagittal craniosynostosis (4 studies, 15%). Seventeen studies (63%) used GM to assess skeletal structures, seven studies (26%) examined both skeletal and soft tissues, and three studies (11%) analyzed soft tissues only. Eleven studies (40.1%) employed a GM approach to evaluate postoperative changes in craniofacial morphology. Two studies (7%) systematically compared GM analysis with conventional shape measurements. CONCLUSION The ability to study shape while controlling for variability in structure size and imaging technique make GM a promising tool for understanding growth patterns in complex craniofacial diseases. Furthermore, GM overcomes many limitations of traditional cephalometric techniques, and hence may claim an expanded role in the study of human craniofacial disorders in clinical and research settings.
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De Grauwe A, Ayaz I, Shujaat S, Dimitrov S, Gbadegbegnon L, Vande Vannet B, Jacobs R. CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment. Eur J Orthod 2020; 41:381-389. [PMID: 30351398 PMCID: PMC6686083 DOI: 10.1093/ejo/cjy066] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. OBJECTIVE The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. SEARCH METHODS MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. SELECTION CRITERIA The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. DATA COLLECTION AND ANALYSIS Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. CONCLUSIONS CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. REGISTRATION None. CONFLICT OF INTEREST None to declare.
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Affiliation(s)
- Annelore De Grauwe
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Irem Ayaz
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Ajami S, Babanouri N, Afshinpoor R. Photogrammetric Evaluation of Soft Tissue Profile and Frontal Photographs in Repaired Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2019; 57:566-573. [PMID: 31665892 DOI: 10.1177/1055665619883155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the soft tissue profile and frontal photographs of 8- to 12-year-old patients with repaired complete bilateral cleft lip and palate (BCLP). METHODS The profile and frontal photographs obtained from 31 nonsyndromic BCLP children (aged 8-12 years: 14 boys and 17 girls) were analyzed and compared with an age- and sex-matched normal population (18 boys and 32 girls). In each patient, 12 soft tissue angular and proportional parameters on the frontal photograph and 12 angular parameters for the profile photographs were developed and measured. Student t test was used to compare the mean value of the parameters between both sexes. RESULTS In the frontal view, there was a significant difference between the 2 study groups in the facial symmetry angle (P < .001), lower facial height proportion (P < .001), upper lip proportion (P < .001), and interalar width/distance between the inner canthus of the eyes (P < .001). In the profile view, there was a significant difference between the control group and the patients with cleft lip and palate in terms of nasofrontal angle (P < .001), nasal angle (P < .001), angle of the inferior facial third (P = .032), head position angle (P < .001), facial convexity angle (P < .001), total facial convexity angle (P < .001), and vertical nasal angle (P < .001). CONCLUSION In comparison with the normal population, the face of patients with repaired BCLP showed several soft tissue deformities, especially in the nasofrontal region, even after a surgical repair.
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Affiliation(s)
- Shabnam Ajami
- Department of Orthodontics, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Babanouri
- Department of Orthodontics, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roya Afshinpoor
- Department of Orthodontics, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Wu W, Zhai G, Xu Z, Hou B, Liu D, Liu T, Liu W, Ren F. Whole-exome sequencing identified four loci influencing craniofacial morphology in northern Han Chinese. Hum Genet 2019; 138:601-611. [PMID: 30968251 PMCID: PMC6554238 DOI: 10.1007/s00439-019-02008-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 04/02/2019] [Indexed: 11/30/2022]
Abstract
Facial shape differences are one of the most significant phenotypes in humans. It is affected largely by skull shape. However, research into the genetic basis of the craniofacial morphology has rarely been reported. The present study aimed to identify genetic variants influencing craniofacial morphology in northern Han Chinese through whole-exome sequencing (WES). Phenotypic data of the volunteers’ faces and skulls were obtained through three-dimensional CT scan of the skull. A total of 48 phenotypes (35 facial and 13 cranial phenotypes) were used for the bioinformatics analysis. Four genetic loci were identified affecting the craniofacial shapes. The four candidate genes are RGPD3, IGSF3, SLC28A3, and USP40. Four single-nucleotide polymorphism (SNP) site mutations in RGPD3, IGSF3, and USP40 were significantly associated with the skull shape (p < 1×10−6), and three SNP site mutations in RGPD3, IGSF3, and SLC28A3 were significantly associated with the facial shape (p < 1×10−6). The rs62152530 site mutation in the RGPD3 gene may be closely associated with the nasal length, ear length, and alar width. The rs647711 site mutation in the IGSF3 gene may be closely associated with the nasal length, mandibular width, and width between the mental foramina. The rs10868138 site mutation in the SLC28A3 gene may be associated with the nasal length, alar width, width between tragus, and width between the mental foramina. The rs1048603 and rs838543 site mutations in the USP40 gene may be closely associated with the pyriform aperture width. Our findings provide useful genetic information for the determination of face morphology.
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Affiliation(s)
- Wei Wu
- School of Humanities and Management, Jinzhou Medical University, Jinzhou, 121001, Liaoning, People's Republic of China.,Biological Anthropology Institute, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, People's Republic of China.,Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou, 121001, Liaoning, People's Republic of China
| | - Guiying Zhai
- Biological Anthropology Institute, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, People's Republic of China.,Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou, 121001, Liaoning, People's Republic of China
| | - Zejun Xu
- Biological Anthropology Institute, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, People's Republic of China.,Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou, 121001, Liaoning, People's Republic of China
| | - Bo Hou
- Biological Anthropology Institute, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, People's Republic of China.,Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou, 121001, Liaoning, People's Republic of China
| | - Dahua Liu
- Biological Anthropology Institute, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, People's Republic of China.,Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou, 121001, Liaoning, People's Republic of China
| | - Tianyi Liu
- Department of Plastic and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Wei Liu
- Biological Anthropology Institute, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, People's Republic of China.,Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou, 121001, Liaoning, People's Republic of China
| | - Fu Ren
- Biological Anthropology Institute, Jinzhou Medical University, No. 40, Section 3, Songpo Road, Linghe District, Jinzhou, 121001, Liaoning, People's Republic of China. .,Liaoning Province Key Laboratory of Chinese Physical Characteristics Research (LPKL-CPCR), Jinzhou, 121001, Liaoning, People's Republic of China.
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7
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Santana N, Starbuck JM. Breaking Symmetry: A Quantitative Analysis of Facial Skeleton Disharmony in Children Born with Bilateral Cleft Lip and Palate. Anat Rec (Hoboken) 2019; 302:1726-1732. [PMID: 30851147 DOI: 10.1002/ar.24111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/15/2018] [Accepted: 10/11/2018] [Indexed: 11/12/2022]
Abstract
Bilateral cleft lip and palate (BCLP) occurs when craniofacial precursors fail to form or fuse properly during development. The aim of this retrospective, cross-sectional investigation was to quantify directional asymmetry (DA) of the facial skeleton of children born with Veau Class IV nonsyndromic BCLP. To accomplish this goal, coordinate values of anatomical landmarks were acquired from three-dimensional cone beam computed tomographic images of the craniofacial skeleton of middle- to late-aged children born with BCLP and age- and sex-matched controls and used to compare patterns of asymmetry variation. Multivariate analyses revealed different patterns of DA variation across samples and identified approximately 30% of DA measures as significantly different. Magnitudes of statistically significant linear distances differ in the craniofacial region, with most smaller DA differences located near the orbits and frontal bone, while larger differences were localized mostly to the midface, alveolar ridge, and nasal borders. Generally, areas of the craniofacial skeleton derived from the maxillary and nasal prominences demonstrated the highest magnitudes of DA. The methods and results presented will be useful to biomedical researchers when identifying the extent to which patients with BCLP diverge from typical developmental expectations. Quantifying DA and assessing local differences across the craniofacial complex can aid medical practitioners when developing treatments to improve BCLP surgical algorithms and outcomes. Anat Rec, 302:1726-1732, 2019. © 2019 American Association for Anatomy.
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Affiliation(s)
- Nicole Santana
- Department of Biology, University of Central Florida, Orlando, Florida
| | - John M Starbuck
- Department of Anthropology, University of Central Florida, Orlando, Florida
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Girinon F, Ketoff S, Hennocq Q, Kogane N, Ullman N, Kadlub N, Galliani E, Neiva-Vaz C, Vazquez MP, Picard A, Khonsari RH. Maxillary shape after primary cleft closure and before alveolar bone graft in two different management protocols: A comparative morphometric study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:406-409. [PMID: 30763782 DOI: 10.1016/j.jormas.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/21/2019] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
AIM AND SCOPE Result assessment in cleft surgery is a technical challenge and requires the development of dedicated morphometric tools. Two cohorts of patients managed according to two different protocols were assessed at similar ages and their palatal shape was compared using geometric morphometrics. MATERIAL AND METHODS Ten patients (protocol No. 1) benefited from early lip closure (1-3 months) and secondary combined soft and hard palate closure (6-9 months); 11 patients (protocol No. 2) benefited from later combined lip and soft palate closure (6 months) followed by hard palate closure (18 months). Cone-Beam Computed Tomography (CBCT) images were acquired at 5 years of age and palatal shapes were compared between protocols No. 1 and No. 2 using geometric morphometrics. RESULTS Protocols No. 1 and No. 2 had a significantly different timing in their surgical steps but were assessed at a similar age (5 years). The inter-canine distance was significantly narrower in protocol No. 1. Geometric morphometrics showed that the premaxillary region was located more inferiorly in protocol No. 1. CONCLUSION Functional approaches to cleft surgery (protocol No. 2) allow obtaining larger inter-canine distances and more anatomical premaxillary positions at 5 years of age when compared to protocols involving early lip closure (protocol No. 1). This is the first study comparing the intermediate results of two cleft management protocols using 3D CBCT data and geometric morphometrics. Similar assessments at the end of puberty are required in order to compare the long-term benefits of functional protocols.
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Affiliation(s)
- F Girinon
- Arts et métiers ParisTech, LBM, Paris, France
| | - S Ketoff
- Arts et métiers ParisTech, LBM, Paris, France; Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Q Hennocq
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - N Kogane
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - N Ullman
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - N Kadlub
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - E Galliani
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - C Neiva-Vaz
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - M P Vazquez
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - A Picard
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - R H Khonsari
- Assistance publique Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Centre de Référence des Malformations de la Face et de la Cavité Buccale (MAFACE), Filière Maladies Rares TeteCou, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France.
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Ahmad Y, Starbuck JM. Disruption of symmetry: A quantitative assessment of facial skeleton anatomy in children born with unilateral cleft lip and palate. Clin Anat 2018; 31:1129-1136. [DOI: 10.1002/ca.23277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/20/2018] [Accepted: 09/07/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Yaser Ahmad
- Department of Biomedical SciencesUniversity of Central Florida Orlando Florida 32816
| | - John M. Starbuck
- Department of AnthropologyUniversity of Central Florida Orlando Florida 32816
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10
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Ceuninck K, Starbuck JM. A morphometric analysis of developmental instability in children born with unilateral cleft lip and palate. Clin Anat 2018; 32:206-211. [PMID: 30252164 DOI: 10.1002/ca.23281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/09/2018] [Accepted: 09/18/2018] [Indexed: 11/10/2022]
Abstract
Unilateral cleft lip and palate (UCLP) is a congenital deformity that occurs due to inadequate merging of the nasal and maxillary prominences during fetal development. Randomly distributed bilateral asymmetries known as fluctuating asymmetry (FA) occur in normally symmetric organisms when evolved mechanisms of developmental stability or equilibrium are disturbed by genetic, environmental, or unknown factors. Here, we hypothesize that facial skeleton FA will be increased in a sample of individuals born with UCLP (n = 24) relative to sex- and age-matched controls (n = 24). To test this hypothesis, 23 anatomical landmarks were measured on individual anonymized cone-beam computerized tomography (CBCT) images in children and adolescents (7-17 years). For each individual, 81 pairs of linear distances were used to estimate FAs across the face. To explore sample variation and statistical differences, a principal components analysis and Euclidean Distance Matrix Analysis multivariate bootstrap approach were carried out. Samples show some separation in multivariate space with 44.44% of FA differences being significantly different. The magnitude of FA was larger in the UCLP sample for every significant measurement. The magnitude of significant FA is highest near regions derived from the maxillary and nasal prominences, such as the nasal aperture. These results are useful for medical and dental practitioners when developing treatment options for children and adolescents with UCLP. Clin. Anat. 32:206-211, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Kristyna Ceuninck
- Department of Anthropology, University of Central Florida, Orlando, Florida
| | - John M Starbuck
- Department of Anthropology, University of Central Florida, Orlando, Florida
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Altun O, Duman SB, Bayrakdar IS, Yasa Y, Duman S, Günen Yılmaz S. Cone beam computed tomography imaging of superior semicircular canal morphology: a retrospective comparison of cleft lip/palate patients and normal controls. Acta Odontol Scand 2018; 76:247-252. [PMID: 29202612 DOI: 10.1080/00016357.2017.1412498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study evaluated the prevalence and morphological characteristics of the superior semicircular canal (SSCC) in cleft lip and palate (CL/P) patients using cone beam computed tomography (CBCT). MATERIALS AND METHODS CBCT images of 53 CL/P patients (28 males and 25 females) and a control group of 76 patients (42 males and 34 females) were evaluated. Retrospectively, 258 temporal bone images from 129 patients were evaluated in terms of SSCC morphology and divided into a normal pattern (0.6-1.7 mm in thickness), a papyraceous pattern (<0.5 mm), a thick pattern (>1.8 mm), a pneumatized pattern and dehiscent. The chi-squared test was used to compare differences among semicircular canal dehiscence (SSCD) patterns in the CL/P and control groups; p ≤ .05 was taken to reflect statistical significance. RESULTS The characteristics of the SSCC were evaluated on CBCT images in patients with CL/P and controls. In total, 158 (61%) cases were normal (0.6-1.7 mm in thickness), 31 (12%) papyraceous (<0.5 mm), 8 (3%) thick, and 34 (13%) pneumatized. SSCD was observed in 27 (11%) cases. Statistically significant differences between the CL/P and control groups were evident in terms of SSCC morphology (p < .001). CONCLUSIONS SSCD should be considered if a CL/P patient exhibits a vestibular system deficiency. Oral and maxillofacial radiologists should pay attention to SSCD when interpreting CBCT images. Future studies should use high-level spatial resolution CBCT to focus on cleft site and SSCC morphology in larger patient populations.
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Affiliation(s)
- Oğuzhan Altun
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inönü University, Malatya, Turkey
| | - Suayip Burak Duman
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inönü University, Malatya, Turkey
| | - Ibrahim Sevki Bayrakdar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Yasin Yasa
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Sacide Duman
- Department of Pedodontics, Faculty of Dentistry, Inönü University, Malatya, Turkey
| | - Sevcihan Günen Yılmaz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Zhang C, Miller SF, Roosenboom J, Wehby GL, Moreno Uribe LM, Hecht JT, Deleyiannis FWB, Christensen K, Marazita ML, Weinberg SM. Soft tissue nasal asymmetry as an indicator of orofacial cleft predisposition. Am J Med Genet A 2018; 176:1296-1303. [PMID: 29663709 DOI: 10.1002/ajmg.a.38688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/04/2018] [Accepted: 03/05/2018] [Indexed: 12/23/2022]
Abstract
The biological relatives of offspring with nonsyndromic orofacial clefts have been shown to exhibit distinctive facial features, including excess asymmetry, which are hypothesized to indicate the presence of genetic risk factors. The significance of excess soft tissue nasal asymmetry in at-risk relatives is unclear and was examined in the present study. Our sample included 164 unaffected parents from families with a history of orofacial clefting and 243 adult controls. Geometric morphometric methods were used to analyze the coordinates of 15 nasal landmarks collected from three-dimensional facial surface images. Following generalized Procrustes analysis, Procrustes ANOVA and MANOVA tests were applied to determine the type and magnitude of nasal asymmetry present in each group. Group differences in mean nasal asymmetry were also assessed via permutation testing. We found that nasal asymmetry in both parents and controls was directional in nature, although the magnitude of the asymmetry was greater in parents. This was confirmed with permutation testing, where the mean nasal asymmetry was significantly different (p < .0001) between parents and controls. The asymmetry was greatest for midline structures and the nostrils. When subsets of parents were subsequently analyzed and compared (parents with bilateral vs. unilateral offspring; parents with left vs. right unilateral offspring), each group showed a similar pattern of asymmetry and could not be distinguished statistically. Thus, the side of the unilateral cleft (right vs. left) in offspring was not associated with the direction of the nasal asymmetry in parents.
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Affiliation(s)
- Charles Zhang
- Department of Anthropology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Steven F Miller
- Department of Anatomy, Midwestern University, Downers Grove, Illinois
| | - Jasmien Roosenboom
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - George L Wehby
- Department of Health Management and Policy, University of Iowa, Iowa City, Iowa
| | | | - Jacqueline T Hecht
- Department of Pediatrics, University of Texas McGovern Medical Center, Houston, Texas
| | | | - Kaare Christensen
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Seth M Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
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13
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Cone-beam CT in paediatric dentistry: DIMITRA project position statement. Pediatr Radiol 2018; 48:308-316. [PMID: 29143199 DOI: 10.1007/s00247-017-4012-9] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/11/2017] [Accepted: 10/11/2017] [Indexed: 01/05/2023]
Abstract
DIMITRA (dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks) is a European multicenter and multidisciplinary project focused on optimizing cone-beam CT exposures for children and adolescents. With increasing use of cone-beam CT for dentomaxillofacial diagnostics, concern arises regarding radiation risks associated with this imaging modality, especially for children. Research evidence concerning cone-beam CT indications in children remains limited, while reports mention inconsistent recommendations for dose reduction. Furthermore, there is no paper using the combined and integrated information on the required indication-oriented image quality and the related patient dose levels. In this paper, therefore, the authors initiate an integrated approach based on current evidence regarding image quality and dose, together with the expertise of DIMITRA's members searching for a state of the art. The aim of this DIMITRA position statement is to provide indication-oriented and patient-specific recommendations regarding the main cone-beam CT applications in the pediatric field. The authors will review this position statement document when results regarding multidisciplinary approaches evolve, in a period of 5 years or earlier.
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Cleft-Related Orthognathic Surgery Based on Maxillary Vertical Lengthening of the Anterior Facial Height. Plast Reconstr Surg 2018; 141:736-746. [DOI: 10.1097/prs.0000000000004172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Choi SH, Jung SN, Cha JY, Hu KS, Kim KD, Baik HS, Hwang CJ. Changes in the craniofacial complex and alveolar bone height of young adults: Applications to dental medicine. Clin Anat 2016; 29:1011-1017. [PMID: 27560155 DOI: 10.1002/ca.22772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/12/2016] [Accepted: 08/22/2016] [Indexed: 12/27/2022]
Abstract
The few studies on craniofacial complex changes in adults have reported contradictory findings. The aim of this study was to radiographically evaluate changes in the craniofacial complex and alveolar bone height of young adults over a 4-year period. This prospective study included 82 young adults (62 men; mean age, 19.0 ± 0.8 years; 20 women; mean age, 18.8 ± 0.9 years). Three radiographic examinations were performed longitudinally: the first (T0) was conducted at the start of the study, the second (T1) was conducted 2 years later, and the third (T2) was conducted at the end of the study period. As part of these examinations, lateral cephalograms, maxillary and mandibular anterior periapical radiographs, and bilateral posterior bitewing radiographs were obtained. During the 4-year follow-up period, all linear cephalometric measurements were significantly greater in men than in women. The amount of increase in the anterior facial height between T1 and T2 was lower in women than in men (P = 0.029). The rate of uprighting of the upper incisors was lower in men than in women over time (P = 0.020). The apex of the nose moved inferiorly between T0 and T2 (P = 0.006). The average overall change in the alveolar bone height was 0.27 mm and the yearly change was 0.07 mm over the 4-year period (P< 0.001). Significant changes in the skeletal, dental, and soft tissue, as well as, natural changes in alveolar bone, occur in young adults over time. Clin. Anat. 29:1011-1017, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sung-Hwan Choi
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Si-Nae Jung
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jung-Yul Cha
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung-Seok Hu
- Division of Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institution, BK21 PLUS Project, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee-Deog Kim
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyoung-Seon Baik
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, The Institute of Cranio-Facial Deformity, College of Dentistry, Yonsei University, Seoul, Korea.
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