1
|
Wang TH, Chen YF, Chen YA, Yao CF, Xi T, Liao YF, Chen YR. Site and severity of facial asymmetry after bimaxillary surgery for class III deformity: a case-control study. Clin Oral Investig 2024; 28:334. [PMID: 38780816 DOI: 10.1007/s00784-024-05729-9] [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] [Received: 10/12/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The study aimed (1) to evaluate the site and severity of facial asymmetry in Class III patients before and after bimaxillary surgery, and (2) to identify the influence of initial severity and positional jaw asymmetry on residual facial asymmetry. MATERIALS AND METHODS Preoperative and postoperative cone-beam computed tomography of 65 patients with Class III facial asymmetry who underwent bimaxillary surgery were evaluated. Five midline and 14 paramedian facial soft tissue landmarks were identified to assess facial asymmetry. The outcomes were compared to a control group consisting of 30 age- and gender-matched Class I subjects. The postoperative positional jaw asymmetry (i.e., shift, roll, yaw) of each osteotomy segment (maxilla, mandible, chin, ramus) was also measured. RESULTS Before surgery, the asymmetry was more severe at the chin, middle and lower contour. Bimaxillary surgery effectively corrected facial asymmetry, particularly in achieving normalization of chin deviation. However, significant asymmetry persisted postoperatively in the middle and lower contour (p < 0.001 and p < 0.01, respectively), which was affected by the positional ramus asymmetry in the roll and shift. CONCLUSIONS Deviation of the chin, middle and lower contour contributed significantly to overall facial asymmetry in Class III asymmetry. Despite normalization of the chin deviation after bimaxillary surgery, asymmetry persisted at the middle and lower contour, primarily as the result of insufficient correction of the positional ramus asymmetry. CLINICAL RELEVANCE Understanding the residual asymmetry after bimaxillary surgery is important for minimizing deviation and optimizing the surgical planning for its correction.
Collapse
Affiliation(s)
- Tzu-Hsin Wang
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Guishan District, Taoyuen City, 333, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yun-Fang Chen
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Ying-An Chen
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chuan-Fong Yao
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Yu-Fang Liao
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Guishan District, Taoyuen City, 333, Taiwan.
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Yu-Ray Chen
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| |
Collapse
|
2
|
Shi Y, Guo S, Wang H, Yao Q, Wang D, Cheng J. The top 100 highly cited articles on surgery-first orthognathic surgery between 2009 and 2022: a bibliometric and visualized analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:463-475. [PMID: 38480068 DOI: 10.1016/j.oooo.2023.12.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/14/2023] [Accepted: 12/29/2023] [Indexed: 06/19/2024]
Abstract
OBJECTIVES To reveal research focuses on surgery-first orthognathic surgery by a bibliometric and visualized analysis of the top 100 highly cited articles. STUDY DESIGN Published papers related to surgery-first orthognathic surgery were retrospectively retrieved from the Web of Science Core Collection from 2009 to 2022. The number of articles, journals, countries/regions, institutions, authors, and keywords were assessed and visualized using CiteSpace software. RESULTS The top 100 cited articles included 89 research papers and 11 reviews. The average total citation was 21. The most influential article with 146 citations was published by Dr. Liou E.J.W. in 2011. The most common level of evidence was level IV (36 articles). The Journal of Oral and Maxillofacial Surgery had the largest number of papers and the highest total citation frequency. The most productive countries and institutions were Korea/China and Chang Gung Memorial Hospital, respectively. Chen Yu-ray and Choi Jong Woo published 13 and 11 articles with 434 and 299 total citations, respectively. Research interests shifted from skeletal class III malocclusion, accuracy, stability, and relapse to quality of life and virtual surgical planning. CONCLUSION Our bibliometric analyses provide a comprehensive landscape of the influential topics and developmental trends in surgery-first orthognathic surgery and inspire future studies in this booming field.
Collapse
Affiliation(s)
- Yijin Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Jiangsu, China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, China
| | - Songsong Guo
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Jiangsu, China
| | - Hong Wang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Jiangsu, China
| | - Qin Yao
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Jiangsu, China
| | - Dongmiao Wang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Jiangsu, China
| | - Jie Cheng
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Jiangsu, China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, China.
| |
Collapse
|
3
|
Lin YH, Yao CF, Chen YA, Liao YF, Chen YR. Three-dimensional positioning of the maxilla using novel intermediate splints in maxilla-first orthognathic surgery for correction of skeletal class III deformity. Clin Oral Investig 2024; 28:141. [PMID: 38340152 DOI: 10.1007/s00784-024-05526-4] [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] [Received: 10/12/2023] [Accepted: 01/23/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES Successful orthognathic surgery requires accurate transfer of the intraoperative surgical plan. This study aimed to (1) evaluate the surgical error of a novel intermediate splint in positioning the maxilla during maxilla-first orthognathic surgery and (2) determine factors influencing surgical error. MATERIALS AND METHODS This prospective study examined 83 patients who consecutively underwent Le Fort I osteotomy for correction of skeletal class III deformity using a novel intermediate splint and a bilateral sagittal split osteotomy. Surgical error was the outcome variable, measured as the difference in postoperative translational and rotational maxillary position from the virtual plan. Measures included asymmetry, need and amount for mandibular opening during fabrication of intermediate splints, and planned and achieved skeletal movement. RESULTS Mean errors in translation for vertical, sagittal, and transversal dimensions were 1.0 ± 0.7 mm, 1.0 ± 0.6 mm, and 0.7 ± 0.6 mm, respectively; degrees in rotation for yaw, roll, and pitch were 0.8 ± 0.6, 0.6 ± 0.4, and 1.6 ± 1.1, respectively. The transverse error was smaller than sagittal and vertical errors; error for pitch was larger than roll and yaw (both p < 0.001). Error for sagittal, transverse, and roll positioning was affected by the achieved skeletal movement (roll, p < 0.05; pitch and yaw, p < 0.001). Surgical error of pitch positioning was affected by planned and achieved skeletal movement (both p < 0.001). CONCLUSIONS Using the novel intermediate splint when performing Le Fort I osteotomy allowed for accurate positioning of the maxilla. CLINICAL RELEVANCE The novel intermediate splint for maxillary positioning can be reliably used in clinical routines.
Collapse
Affiliation(s)
- Yi-Hsuan Lin
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chuan-Fong Yao
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ying-An Chen
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Fang Liao
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Guishan District, Taoyuan City, 333, Taiwan.
| | - Yu-Ray Chen
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| |
Collapse
|
4
|
Vernucci RA, Da Mommio L, Vellone V, De Stefano A, Barbato E, Di Giorgio R, Galluccio G. 'Study of the maxillary yaw on cone beam computed tomography: A preliminary report and comparison between two different dento-skeletal malocclusions'. Orthod Craniofac Res 2023; 26:576-584. [PMID: 36912723 DOI: 10.1111/ocr.12652] [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] [Received: 11/01/2022] [Revised: 01/22/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES To assess the skeletal and dental maxillary transverse compensation (yaw) on the cone beam computed tomography (CBCT) three-dimensional reconstructed image of the skull in two groups of patients, both clinically affected by a class III malocclusion with deviation of the lower midline. MATERIALS AND METHODS An observational retrospective study was designed to analyse differences in two groups of patients, the first one was composed by patients affected by horizontal condylar hyperplasia, the second one by patients affected by dento-skeletal asymmetric class III malocclusion. Each group was composed by 15 patients. Transverse analysis was performed by measuring five landmarks (three bilateral and two uneven) with respect to a mid-sagittal plane; sagittal analysis was performed by measuring the sagittal distance on the mid-sagittal plane between bilateral points. Means were compared through inferential analysis. RESULTS In the condylar hyperplasia group, all differences between the two sides were not statistically significant, nor for canines' difference (P = .0817), for molars (P = .1105) or for jugular points (.05871). In the class III group, the differences between the two sides were statistically significant for molars (P = .0019) and jugular points (P = .0031) but not for canines (P = .1158). Comparing the two groups, significant differences were found only for incisors' midline deviation (P = .0343) and canine (P = .0177). CONCLUSION The study of the yaw on CBCT should be integrated into three-dimensional cephalometry and could help in differentiating the various malocclusion patterns.
Collapse
Affiliation(s)
- R A Vernucci
- Department of Oral and Maxillofacial Sciences, School of Dentistry, 'Sapienza' University of Rome, Rome, Italy
- Department of Sense Organs, 'Sapienza' University of Rome, Rome, Italy
| | - L Da Mommio
- Department of Oral and Maxillofacial Sciences, School of Dentistry, 'Sapienza' University of Rome, Rome, Italy
| | - V Vellone
- Department of Oral and Maxillofacial Sciences, School of Dentistry, 'Sapienza' University of Rome, Rome, Italy
| | - A De Stefano
- Department of Oral and Maxillofacial Sciences, School of Dentistry, 'Sapienza' University of Rome, Rome, Italy
| | - E Barbato
- Department of Oral and Maxillofacial Sciences, School of Dentistry, 'Sapienza' University of Rome, Rome, Italy
| | - R Di Giorgio
- Department of Oral and Maxillofacial Sciences, School of Dentistry, 'Sapienza' University of Rome, Rome, Italy
- Department of Sense Organs, 'Sapienza' University of Rome, Rome, Italy
| | - G Galluccio
- Department of Oral and Maxillofacial Sciences, School of Dentistry, 'Sapienza' University of Rome, Rome, Italy
| |
Collapse
|
5
|
Orthodontic Perspective for Face Asymmetry Correction. Symmetry (Basel) 2022. [DOI: 10.3390/sym14091822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Facial symmetry affects the perception of facial beauty. Overall, facial harmony with an appropriate facial proportion and satisfactory midline facial symmetry are crucial factors for facial attractiveness. The role of orthodontists in correcting facial asymmetry begins with providing suitable diagnosis of the condition and identifying patients’ expectations. Through a thorough, subjective clinical evaluation of dentofacial asymmetry, the procedures for the surgical orthodontic management of facial asymmetry are discussed. The aim of this clinical review is to provide information on surgical indications for facial asymmetry, optimal treatment goals, presurgical orthodontic preparation, the surgery-first approach, three-dimensional (3D) surgical simulation, postsurgical orthodontic finishing, and treatment outcome evaluation. A comprehensive 3D diagnosis with appropriate planning, accurate transference of surgical simulation to real surgery, slight overcorrection, periodic assessment of treatment outcomes, and awareness of treatment limitations are essential to improve treatment outcomes of facial asymmetry.
Collapse
|