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España-Pamplona P, Zamora-Martinez N, Tarazona-Álvarez B, Pangrazio-Kulbersh V, Paredes-Gallardo V. Three-dimensional quantification of mandibular asymmetries in Caucasian adult patients with different sagittal and vertical skeletal patterns. A cone beam study using 3D segmentation and mirroring procedures. Head Face Med 2023; 19:54. [PMID: 38098053 PMCID: PMC10720065 DOI: 10.1186/s13005-023-00400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION An accurate identification of mandibular asymmetries is required by modern orthodontics and orthognathic surgery to improve diagnosis and treatment planning of such deformities. Although craniofacial deformities are very frequent pathologies, some types of asymmetries can be very difficult to assess without the proper diagnostic tools. The purpose of this study was to implement the usage of three-dimensional (3D) segmentation procedures to identify asymmetries at the mandibular level in adult patients with different vertical and sagittal patterns where the asymmetries could go unnoticed at the observational level. METHODS The study sample comprised 60 adult patients (33 women and 27 men, aged between 18 and 60 years). Subjects were divided into 3 sagittal and vertical skeletal groups. CBCT images were segmented, mirrored and voxel-based registered with reference landmarks using ITK-SNAP® and 3DSlicer® software's. 3D surface models were constructed to evaluate the degree of asymmetry at different anatomical levels. RESULTS There was a degree of asymmetry, with the left hemimandible tending to contain the right one (0.123 ± 0.270 mm (CI95% 0.036-0.222; p < 0.001). Although the subjects under study did not present significant differences between mandibular asymmetries and their sagittal or vertical skeletal pattern (p = 0.809 and p = 0.453, respectively), a statistically significant difference has been found depending on the anatomical region (p < 0.001; CI95%=1.020-1.021), being higher in the condyle, followed by the ramus and the corpus. CONCLUSIONS Although mandibular asymmetries cannot be correlated with vertical and sagittal skeletal patterns in symmetric patients, knowledge about 3D segmentation procedures and color maps can provide valuable information to identify mandibular asymmetries.
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Affiliation(s)
- Pilar España-Pamplona
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain.
| | - Natalia Zamora-Martinez
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
| | - Beatriz Tarazona-Álvarez
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
| | | | - Vanessa Paredes-Gallardo
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
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Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG. Surgically assisted maxillary expansion with or without pterygoid disjunction alters maxillomandibular positioning. Oral Maxillofac Surg 2022:10.1007/s10006-022-01062-1. [PMID: 35426586 DOI: 10.1007/s10006-022-01062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/30/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD). METHODS Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and 3D Slicer software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis (3D Slicer software). RESULTS A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group. CONCLUSIONS This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
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Affiliation(s)
| | - Eduardo Costa Studart Soares
- Department of Oral and Maxillofacial Surgery, Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - José Rômulo de Medeiros
- Post-Graduation Program in Dentistry, Federal University of Ceará. Department of Oral and Maxillofacial Surgery, University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil
| | | | | | | | - Thyciana Rodrigues Ribeiro
- Department of Patients With Special Needs, Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Fábio Wildson Gurgel Costa
- Department of Oral and Maxillofacial Radiology, Post-Graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Feng B, Wang Y, Ouyang W, Yu M, Wang H. Construction and validity of a midsagittal plane based on the symmetry of a 3-dimensional model of the relevant cranial base. Am J Orthod Dentofacial Orthop 2020; 159:e49-e58. [PMID: 33357762 DOI: 10.1016/j.ajodo.2020.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/01/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The midsagittal plane (MSP) is the foundation for 3-dimensional (3D) cephalometric analyses. This article aimed to provide a protocol to construct a reliable and accurate MSP for 3D cephalometric craniofacial analysis. METHODS Cone-beam computed tomography data of 16 adult patients without obvious bilateral asymmetry were collected. The model of the anterior cranial base and sphenoid bone was constructed, and the candidate MSP was determined on the basis of the symmetry of this model. Intraclass correlation coefficients were used to assess intra- and interexaminer reliability of the candidate MSP. To investigate the accuracy of this candidate MSP, we constructed a true plane of symmetry of craniomaxillofacial structure and a control plane on the basis of 3 cranial midline points. We then compared these with the candidate MSP. RESULTS This candidate MSP resembled the true plane of symmetry with all the mean absolute errors <1 mm, and all the absolute errors for the candidate MSP were significantly smaller than the control plane (P ≤0.002). The relative intra- and interexaminer reliability for this candidate MSP was almost perfect (intraclass correlation coefficients >0.9). CONCLUSIONS The candidate MSP constructed using this method was thought to be reliable and accurate for 3D cephalometric analysis in patients without obvious cranial asymmetry.
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Affiliation(s)
- Bin Feng
- Department of Oral and Maxillofacial Radiology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yang Wang
- Department of Oral and Maxillofacial Radiology, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Wangtao Ouyang
- Department of Oral and Maxillofacial Radiology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Mengfei Yu
- Department of Oral and Maxillofacial Surgery and Implantology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China.
| | - Huiming Wang
- Department of Oral and Maxillofacial Surgery and Implantology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China.
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Fourneron M, Morant F, Boutin F, Frapier L. Is the Quad Helix more efficient to correct mandibular asymmetry before age 7? A retrospective comparative study. Int Orthod 2020; 18:443-450. [DOI: 10.1016/j.ortho.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 02/08/2023]
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Automatic detection of symmetry plane for computer-aided surgical simulation in craniomaxillofacial surgery. Phys Eng Sci Med 2020; 43:1087-1099. [PMID: 32776319 DOI: 10.1007/s13246-020-00909-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
Symmetry plane calculation is used in fracture reduction or reconstruction in the midface. Estimating a reliable symmetry plane without advanced anatomic knowledge is the most critical challenge. In this work, we developed a new automated method to find the mid-plane in CT images of an intact skull and a skull with a unilateral midface fracture. By use of a 3D point-cloud of a skull, we demonstrate that the proposed algorithm could find a mid-plane that meets clinical criteria. There is no need for advanced anatomical knowledge through the use of this algorithm. The algorithm used principal component analysis to find the initial plane. Then the rotation matrix, derived from an iterative closest point (ICP) registration method, is used to update the normal vector of the plane and find the optimum symmetry plane. A mathematical index, Hausdorff distance (HD), is used to evaluate the similarity of one mid-plane side in comparison to the contralateral side. HD decreased by 66% in the intact skull and 65% in a fractured skull and converged in just six iterations. High convergence speed, low computational load, and high accuracy suggest the use of the algorithm in the planning procedure. This easy-to-use algorithm with its advantages, as mentioned above, could be used as an operator in craniomaxillofacial software.
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Vandekerckhove D, Deibel D, Vinayahalingam S, Claeys G, Kwon TG, Bergé S, Xi T. Median Lingual Foramen, a new midmandibular cephalometric landmark. Orthod Craniofac Res 2020; 23:357-361. [PMID: 32096318 PMCID: PMC7496480 DOI: 10.1111/ocr.12372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/03/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Abstract
Purpose In asymmetrical mandibles, it is often challenging to identify the mandibular midline. The median lingual foramen (MLF) is located at the midline of the anterior mandible. The purpose of this study is to evaluate the reproducibility of identifying the MLF compared to conventional landmarks on cone beam computed tomography's (CBCT's) to mark the mandibular midline. Material and Methods Ten symmetrical class II, 10 symmetrical class III, ten asymmetrical class II and 10 asymmetrical class III patients were included. On CBCTs, the cephalometric landmarks menton, pogonion, genial tubercle and MLF were identified twice by two observers. Results A high intra‐ and interobserver reproducibility was found for all landmarks, the highest being the MLF. The gain in accuracy is 0.998 mm, 0.824 mm and 0.361 mm compared to pogonion, genial tubercle and menton, respectively (P‐value <.05). Conclusion MLF is a reliable and reproducible landmark to indicate the midline of the mandible, particularly in Class II asymmetric mandibles.
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Affiliation(s)
- David Vandekerckhove
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Dionne Deibel
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Gilles Claeys
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tae-Geon Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Katsube M, Rolfe SM, Bortolussi SR, Yamaguchi Y, Richman JM, Yamada S, Vora SR. Analysis of facial skeletal asymmetry during foetal development using μCT imaging. Orthod Craniofac Res 2019; 22 Suppl 1:199-206. [PMID: 31074127 DOI: 10.1111/ocr.12304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Asymmetry has been noted in the human craniofacial region in several pathological conditional and growth abnormalities, often with a directional predilection. Physiological asymmetry has also been reported in normal adults and adolescents, with certain regions of the cranioskeleton, such as the mandible, displaying prevalent asymmetry. However, the timing at which such asymmetries arise has not been evaluated. The objectives of this study were to assess the degree of asymmetry in facial bones during the foetal stages of human development. MATERIAL AND METHODS Twenty-one preserved conceptuses from the Congenital Anomaly Research Center at Kyoto University, between ages 15 and 20 weeks of gestation, were studied using high-resolution μCT imaging. Asymmetry analysis was performed on digitally segmented facial bone pairs, using geometric morphometric (GM) approaches as well as adapted deformation-based asymmetry (DBA) methods. RESULTS GM analysis revealed that the developing facial bones display statistically significant fluctuating and directional asymmetry. DBA methods suggest that the magnitude of asymmetry in facial bones is low and does not appear to be correlated to the estimate of overall size of conceptus. Additionally, the patterns of asymmetry are highly variable between individual specimens. CONCLUSIONS The developing foetal facial skeleton displays variable patterns of low magnitude asymmetry. GM and DBA methods offer unique advantages to assess facial asymmetry quantitatively and qualitatively.
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Affiliation(s)
- Motoki Katsube
- Plastic and Reconstructive Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sara M Rolfe
- Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Stephanie R Bortolussi
- Oral Health Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yutaka Yamaguchi
- Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Joy M Richman
- Oral Health Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shigehito Yamada
- Congenital Anomaly Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Siddharth R Vora
- Oral Health Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Kwon SM, Hwang JJ, Jung YH, Cho BH, Lee KJ, Hwang CJ, Choi SH. Similarity index for intuitive assessment of three-dimensional facial asymmetry. Sci Rep 2019; 9:10959. [PMID: 31358850 PMCID: PMC6662710 DOI: 10.1038/s41598-019-47477-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 07/18/2019] [Indexed: 12/21/2022] Open
Abstract
Evaluation of facial asymmetry generally involves landmark-based analyses that cannot intuitively assess differences in three-dimensional (3D) stereoscopic structures between deviation and non-deviation sides. This study tested a newly developed similarity index that uses a mirroring technique to intuitively evaluate 3D mandibular asymmetry, and characterised the resulting lower facial soft tissue asymmetry. The similarity index was used to evaluate asymmetry before and after surgery in 46 adult patients (27 men, 19 women; age, 22 ± 4.8 years) with skeletal Class III malocclusion and facial asymmetry who underwent conventional bimaxillary orthognathic surgery. Relative to the midsagittal plane used as the reference plane, the non-overlapping volume of the mandible significantly decreased, and the similarity index significantly increased after surgery. Similarity indexes of the mandible and lower facial soft tissue were strongly negatively correlated with non-overlapping volumes of each measurement. Differences in bilateral hemi-mandibular and hemi-lower facial soft tissue surface and volume measurements before surgery were significantly negatively correlated with similarity indexes of the mandible before and after surgery. This newly developed similarity index and non-overlapping volume using a mirroring technique can easily and intuitively evaluate overall 3D morphological discrepancies, especially 3D mandibular asymmetry, before and after surgery in skeletal Class III patients with facial asymmetry.
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Affiliation(s)
- Sun Mi Kwon
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Yun-Hoa Jung
- Department of Oral and Maxillofacial Radiology, Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Niño-Sandoval TC, Morantes Ariza CF, Infante-Contreras C, Vasconcelos BC. Evaluation of natural mandibular shape asymmetry: an approach by using elliptical Fourier analysis. Dentomaxillofac Radiol 2018; 47:20170345. [PMID: 29583032 DOI: 10.1259/dmfr.20170345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The purpose of this study was to demonstrate that asymmetry is a natural occurring phenomenon in the mandibular shape by using elliptical Fourier analysis. METHODS 164 digital orthopantomographs from Colombian patients of both sexes aged 18 to 25 years were collected. Curves from left and right hemimandible were digitized. An elliptical Fourier analysis was performed with 20 harmonics. In the general sexual dimorphism a principal component analysis (PCA) and a hotelling T2 from the multivariate warp space were employed. Exploratory analysis of general asymmetry and sexual dimorphism by side was made with a Procrustes Fit. A non-parametric multivariate analysis of variance (MANOVA) was applied to assess differentiation of skeletal classes of each hemimandible, and a Procrustes analysis of variance (ANOVA) was applied to search any relation between skeletal class and side in both sexes. RESULTS Significant values were found in general asymmetry, general sexual dimorphism, in dimorphism by side (p < 0.0001), asymmetry by sex, and differences between Class I, II, and III (p < 0.005). However, a relation of skeletal classes and side was not found. CONCLUSIONS The mandibular asymmetry by shape is present in all patients and should not be articulated exclusively to pathological processes, therefore, along with sexual dimorphism and differences between skeletal classes must be taken into account for improving mandibular prediction systems.
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Affiliation(s)
- Tania C Niño-Sandoval
- 1 Department of Oral and Maxillofacial Surgery, University of Pernambuco , Camaragibe , Brazil
| | | | - Clementina Infante-Contreras
- 3 Department of Oral Health, Growth and Development research line, National University of Colombia, Genetics Institute , Bogotá , Colombia
| | - Belmiro Ce Vasconcelos
- 4 Department of Oral and Maxillofacial Surgery, University of Pernambuco , Camaragibe , Brazil
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Bianchi J, Pinto ADS, Ignácio J, Obelenis Ryan DP, Gonçalves JR. Effect of temporomandibular joint articular disc repositioning on anterior open-bite malocclusion: An orthodontic-surgical approach. Am J Orthod Dentofacial Orthop 2017; 152:848-858. [PMID: 29173864 DOI: 10.1016/j.ajodo.2016.09.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 11/24/2022]
Abstract
An anterior open bite is a challenge to orthodontic treatment; it has a multifactorial etiology and a wide range of intervention options. Temporomandibular joint (TMJ) disorders are a risk factor for the development of malocclusions such as the anterior open bite, especially in patients who have TMJ osteoarthritis with disc displacement. Articular disc repositioning surgery is an available option for treating this pathology, and it contributes to maintaining the condyles in a more stable position. The aim of this article was to report the case of a 20-year-old woman diagnosed with anterior open bite and TMJ osteoarthritis with bilateral disc displacement. The patient received both orthodontic treatment and TMJ disc repositioning surgery. Cone-beam computed tomography was used to create 3-dimensional models of the condyles with regional superposition, and assessment of bone remodeling was performed at different time intervals. Complete orthodontic and surgical treatment time was approximately 12 months. The results provided a stable correction of the patient's anterior open bite with a 2-year follow-up and favorable bone remodeling of the condyles due to functional improvement of the TMJ.
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Affiliation(s)
- Jonas Bianchi
- Department of Pediatric Dentistry, Araraquara Dental School, Paulista State University, Araraquara, São Paulo, Brazil.
| | - Ary Dos Santos Pinto
- Department of Pediatric Dentistry, Araraquara Dental School, Paulista State University, Araraquara, São Paulo, Brazil
| | - Jaqueline Ignácio
- Department of Pediatric Dentistry, Araraquara Dental School, Paulista State University, Araraquara, São Paulo, Brazil
| | - Daniel Patrick Obelenis Ryan
- Department of Pediatric Dentistry, Araraquara Dental School, Paulista State University, Araraquara, São Paulo, Brazil
| | - João Roberto Gonçalves
- Department of Pediatric Dentistry, Araraquara Dental School, Paulista State University, Araraquara, São Paulo, Brazil
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Martini M, Klausing A, Messing-Jünger M, Lüchters G. The self-defining axis of symmetry: A new method to determine optimal symmetry and its application and limitation in craniofacial surgery. J Craniomaxillofac Surg 2017; 45:1558-1565. [DOI: 10.1016/j.jcms.2017.06.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/01/2017] [Accepted: 06/27/2017] [Indexed: 11/17/2022] Open
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3-Dimensional CBCT analysis of mandibular asymmetry in unilateral condylar hyperplasia. J Craniomaxillofac Surg 2016; 44:1970-1976. [PMID: 27818059 DOI: 10.1016/j.jcms.2016.09.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 08/12/2016] [Accepted: 09/26/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Three-dimensional quantification of asymmetry in UCH has not been reported yet, but would be useful for diagnosing and evaluating the degree of deformity in this disease. It enables profound decision-making and timing of surgery. Unilateral condylar hyperplasia (UCH) can subjectively be classified in hemimandibular elongation (HE), hemimandibular hyperplasia (HH) and a combination of these two (hybrid form). The main purpose of this study was to quantify mandibular asymmetry in UCH patients with a reliable and reproducible method. Secondly, it was evaluated whether the existing classification can be confirmed. MATERIALS AND METHODS 37 UCH-patients with progressive mandibular asymmetry, supported by a positive bone scan and/or such clinical progression that condylectomy was performed, were included in this retrospective study. A group of healthy subjects, matched for age and gender, was used as the control group. Cone-beam computed tomography (CBCT) scans were imported in Maxilim® software. Each mandibular half was divided into three skeletal segments (condyle, ramus, and body). Linear and volumetric measurements were calculated for these skeletal units on the affected and unaffected side, for both patients and controls. RESULTS Significant differences between affected and unaffected sides in the patient group were found in condylar, ramus, and body segments for linear (p < 0.01) as well as for volumetric quantitative measurements (p < 0.0040). A mean linear difference between affected and unaffected sides in the condylar region of the UCH patient group was found of 3.6 mm (sd 2.9) versus 0.2 mm (sd 1.5) in controls. For volumetric measurements there was a mean difference between the left and right condyle of 718 mm3 (sd 638) in the patient group versus 8 mm3 (sd 225) difference in the control group. The condyle was the most affected segment. Differences between sides were significantly larger in the patient group than in the control group (p < 0.001). It was not possible to objectify differences between HE and HH. CONCLUSION CBCT is a useful and accurate modality for quantification and evaluation of mandibular asymmetry in UCH. It enables objective monitoring. The existing classification in HE and HH could not be confirmed.
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Junqueira CHZ, Janson G, Junqueira MHZ, Mendes LM, Favilla EE, Garib DG. Comparison between full face and hemifacial CBCT cephalograms in clinically symmetrical patients: a pilot study. Dental Press J Orthod 2016; 20:83-9. [PMID: 25992992 PMCID: PMC4445230 DOI: 10.1590/2176-9451.20.2.083-089.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/02/2014] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: One of the advantages of cone-beam computed tomography (CBCT) is the possibility
of obtaining images of conventional lateral cephalograms derived from partial or
complete reconstruction of facial images. OBJECTIVE: This study aimed at comparing full face, right and left hemifacial CBCT
cephalograms of orthodontic patients without clinical facial asymmetry. METHODS: The sample comprised nine clinically symmetrical patients who had pretreament
full face CBCT. The CBCTs were reconstructed so as to obtain full face, right and
left hemifacial cephalograms. Two observers, at two different times, obtained
linear and angular measurements for the images using Dolphin 3D software.
Dependent and independent t-tests were used to assess the reproducibility of
measurements. Analysis of Variance and Kruskal-Wallis tests were used to compare
the variables obtained in the CBCT derived cephalometric views. RESULTS: There was good reproducibility for CBCT scans and no statistically significant
differences between measurements of full face, right and left hemifacial CBCT
scans. CONCLUSIONS: Cephalometric measurements in full face, right and left hemifacial CBCT scans in
clinically symmetrical patients are similar.
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Affiliation(s)
| | - Guilherme Janson
- Department of Orthodontics, College of Dentistry, Universidade de São Paulo, Bauru, São Paulo, Brazil
| | | | | | | | - Daniela Gamba Garib
- Department of Orthodontics, College of Dentistry, Universidade de São Paulo, Bauru, São Paulo, Brazil
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Solem RC, Ruellas A, Ricks-Oddie JL, Kelly K, Oberoi S, Lee J, Miller A, Cevidanes L. Congenital and acquired mandibular asymmetry: Mapping growth and remodeling in 3 dimensions. Am J Orthod Dentofacial Orthop 2016; 150:238-51. [PMID: 27476356 DOI: 10.1016/j.ajodo.2016.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Disordered craniofacial development frequently results in definitive facial asymmetries that can significantly impact a person's social and functional well-being. The mandible plays a prominent role in defining facial symmetry and, as an active region of growth, commonly acquires asymmetric features. Additionally, syndromic mandibular asymmetry characterizes craniofacial microsomia (CFM), the second most prevalent congenital craniofacial anomaly (1:3000 to 1:5000 live births) after cleft lip and palate. We hypothesized that asymmetric rates of mandibular growth occur in the context of syndromic and acquired facial asymmetries. METHODS To test this hypothesis, a spherical harmonic-based shape correspondence algorithm was applied to quantify and characterize asymmetries in mandibular growth and remodeling in 3 groups during adolescence. Longitudinal time points were automatically registered, and regions of the condyle and posterior ramus were selected for growth quantification. The first group (n = 9) had a diagnosis of CFM, limited to Pruzansky-Kaban type I or IIA mandibular deformities. The second group (n = 10) consisted of subjects with asymmetric, nonsyndromic dentofacial asymmetry requiring surgical intervention. A control group (n = 10) of symmetric patients was selected for comparison. A linear mixed model was used for the statistical comparison of growth asymmetry between the groups. RESULTS Initial mandibular shape and symmetry displayed distinct signatures in the 3 groups (P <0.001), with the greatest asymmetries in the condyle and ramus. Similarly, mandibular growth had unique patterns in the groups. The dentofacial asymmetry group was characterized by significant asymmetry in condylar and posterior ramal remodeling with growth (P <0.001). The CFM group was characterized by asymmetric growth of the posterior ramus (P <0.001) but relatively symmetric growth of the condyles (P = 0.47). CONCLUSIONS Forms of CFM are characterized by active and variable growth of the dysplastic side, which has a distinct pattern from other disorders of mandibular growth.
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Affiliation(s)
- R Christian Solem
- Lecturer, Section of Orthodontics, University of California, Los Angeles, Calif.
| | - Antonio Ruellas
- Associate professor, Federal University of Rio de Janerio, Rio de Janerio, Brazil; postdoctoral fellow, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Joni L Ricks-Oddie
- Statistical consultant, Institute for Digital Research and Education, University of California, Los Angeles, Calif
| | - Katherine Kelly
- Adjunct clinical assistant professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | | | | | - Arthur Miller
- Professor, School of Dentistry, University of California, San Francisco, Calif
| | - Lucia Cevidanes
- Assistant professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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Shi J, Stonnington CM, Thompson PM, Chen K, Gutman B, Reschke C, Baxter LC, Reiman EM, Caselli RJ, Wang Y. Studying ventricular abnormalities in mild cognitive impairment with hyperbolic Ricci flow and tensor-based morphometry. Neuroimage 2015; 104:1-20. [PMID: 25285374 PMCID: PMC4252650 DOI: 10.1016/j.neuroimage.2014.09.062] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 09/20/2014] [Accepted: 09/29/2014] [Indexed: 11/29/2022] Open
Abstract
Mild Cognitive Impairment (MCI) is a transitional stage between normal aging and dementia and people with MCI are at high risk of progression to dementia. MCI is attracting increasing attention, as it offers an opportunity to target the disease process during an early symptomatic stage. Structural magnetic resonance imaging (MRI) measures have been the mainstay of Alzheimer's disease (AD) imaging research, however, ventricular morphometry analysis remains challenging because of its complicated topological structure. Here we describe a novel ventricular morphometry system based on the hyperbolic Ricci flow method and tensor-based morphometry (TBM) statistics. Unlike prior ventricular surface parameterization methods, hyperbolic conformal parameterization is angle-preserving and does not have any singularities. Our system generates a one-to-one diffeomorphic mapping between ventricular surfaces with consistent boundary matching conditions. The TBM statistics encode a great deal of surface deformation information that could be inaccessible or overlooked by other methods. We applied our system to the baseline MRI scans of a set of MCI subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI: 71 MCI converters vs. 62 MCI stable). Although the combined ventricular area and volume features did not differ between the two groups, our fine-grained surface analysis revealed significant differences in the ventricular regions close to the temporal lobe and posterior cingulate, structures that are affected early in AD. Significant correlations were also detected between ventricular morphometry, neuropsychological measures, and a previously described imaging index based on fluorodeoxyglucose positron emission tomography (FDG-PET) scans. This novel ventricular morphometry method may offer a new and more sensitive approach to study preclinical and early symptomatic stage AD.
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Affiliation(s)
- Jie Shi
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | | | - Paul M Thompson
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
| | - Kewei Chen
- Banner Alzheimer's Institute and Banner Good Samaritan PET Center, Phoenix, AZ, USA
| | - Boris Gutman
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
| | - Cole Reschke
- Banner Alzheimer's Institute and Banner Good Samaritan PET Center, Phoenix, AZ, USA
| | - Leslie C Baxter
- Human Brain Imaging Laboratory, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Eric M Reiman
- Banner Alzheimer's Institute and Banner Good Samaritan PET Center, Phoenix, AZ, USA
| | | | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA.
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Can cone-beam computed tomography superimposition help orthodontists better understand relapse in surgical patients? Am J Orthod Dentofacial Orthop 2014; 146:641-54. [DOI: 10.1016/j.ajodo.2013.11.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 11/01/2013] [Accepted: 11/01/2013] [Indexed: 11/17/2022]
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17
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Jadhav AB, Tadinada A, Rengasamy K, Fellows D, Lurie AG. Clival lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature. Imaging Sci Dent 2014; 44:165-9. [PMID: 24944968 PMCID: PMC4061302 DOI: 10.5624/isd.2014.44.2.165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 12/11/2013] [Accepted: 12/15/2013] [Indexed: 12/21/2022] Open
Abstract
An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.
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Affiliation(s)
- Aniket B Jadhav
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Aditya Tadinada
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Kandasamy Rengasamy
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - Douglas Fellows
- Division of Diagnostic Sciences and Therapeutics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Alan G Lurie
- Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington, CT, USA
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Sanders DA, Chandhoke TK, Uribe FA, Rigali PH, Nanda R. Quantification of skeletal asymmetries in normal adolescents: cone-beam computed tomography analysis. Prog Orthod 2014; 15:26. [PMID: 24935152 PMCID: PMC4047766 DOI: 10.1186/s40510-014-0026-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 01/16/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The detection and quantification of skeletal asymmetries is a fundamental component to diagnosis and treatment planning in orthodontics. The purpose of this study was to identify and quantify the characteristics of facial and dental asymmetries in a normal, adolescent population using 3D imaging. METHODS Thirty consecutive Class I patients (mean age 14.32 years, SD 1.67) meeting the inclusion criteria were analyzed by three-dimensional cone-beam computed tomography (CBCT). Dental, maxillary, mandibular, and cranial base variables were measured with Dolphin 3D. CBCT analysis consisted of the localization of 34 anatomical landmarks. All reference points were digitized in 3D and analyzed using 67 skeletal and dental measurements. Student's t tests for paired samples were used with a significance level of p < 0.05. RESULTS Minor right-left discrepancies were noted in all planes. The most anterior point of the glenoid fossa and most condylar points were positioned more superior and lateral on the right side, compared to the left side. Porion was also located more superiorly on the right side relative to the left side. The posterior nasal spine was found to be located to the right of the midsagittal plane. Slight dental midline discrepancies were found, and the dental arch lengths were slightly longer on the left side compared to the right. The height of the ramus, in both 3D and 2D, and the inclination of the ramus were greater on the right than that on the left side. CONCLUSIONS The findings of this study suggest minor asymmetries exist and are likely a common occurrence in the normal human craniofacial complex. Additionally, a natural compensatory mechanism may exist which controls the size and shape of specific tissues in order to maintain functional symmetry.
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Affiliation(s)
| | - Taranpreet K Chandhoke
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut, School of Dental Medicine, 263 Farmington Avenue, Farmington CT 06030, USA.
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Shi J, Thompson PM, Gutman B, Wang Y. Surface fluid registration of conformal representation: application to detect disease burden and genetic influence on hippocampus. Neuroimage 2013; 78:111-34. [PMID: 23587689 PMCID: PMC3683848 DOI: 10.1016/j.neuroimage.2013.04.018] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 03/06/2013] [Accepted: 04/05/2013] [Indexed: 11/23/2022] Open
Abstract
In this paper, we develop a new automated surface registration system based on surface conformal parameterization by holomorphic 1-forms, inverse consistent surface fluid registration, and multivariate tensor-based morphometry (mTBM). First, we conformally map a surface onto a planar rectangle space with holomorphic 1-forms. Second, we compute surface conformal representation by combining its local conformal factor and mean curvature and linearly scale the dynamic range of the conformal representation to form the feature image of the surface. Third, we align the feature image with a chosen template image via the fluid image registration algorithm, which has been extended into the curvilinear coordinates to adjust for the distortion introduced by surface parameterization. The inverse consistent image registration algorithm is also incorporated in the system to jointly estimate the forward and inverse transformations between the study and template images. This alignment induces a corresponding deformation on the surface. We tested the system on Alzheimer's Disease Neuroimaging Initiative (ADNI) baseline dataset to study AD symptoms on hippocampus. In our system, by modeling a hippocampus as a 3D parametric surface, we nonlinearly registered each surface with a selected template surface. Then we used mTBM to analyze the morphometry difference between diagnostic groups. Experimental results show that the new system has better performance than two publicly available subcortical surface registration tools: FIRST and SPHARM. We also analyzed the genetic influence of the Apolipoprotein E[element of]4 allele (ApoE4), which is considered as the most prevalent risk factor for AD. Our work successfully detected statistically significant difference between ApoE4 carriers and non-carriers in both patients of mild cognitive impairment (MCI) and healthy control subjects. The results show evidence that the ApoE genotype may be associated with accelerated brain atrophy so that our work provides a new MRI analysis tool that may help presymptomatic AD research.
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Affiliation(s)
- Jie Shi
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Paul M. Thompson
- Laboratory of Neuro Imaging, UCLA Dept. of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Boris Gutman
- Laboratory of Neuro Imaging, UCLA Dept. of Neurology, UCLA School of Medicine, Los Angeles, CA, USA
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
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Park KR, Park HS, Piao Z, Kim MK, Yu HS, Seo JK, Lee SH. Three-dimensional vector analysis of mandibular structural asymmetry. J Craniomaxillofac Surg 2013; 41:338-44. [PMID: 23347884 DOI: 10.1016/j.jcms.2012.11.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 11/26/2012] [Accepted: 11/26/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The three-dimensional (3D) asymmetric structure of the mandible makes it necessary to analyze both its size and angle. Currently the developing 3D analysis techniques are not able to perform the simultaneous linear and angular measurements. Our aim was to evaluate mandibular asymmetry using a vector-based system by constructing 3D vectors for the mandibular functional units. MATERIAL AND METHODS We analyzed the 3D computed tomography images of normal control (N = 27) and asymmetric mandibles (N = 40). We created 3D vectors for the condylar, coronoid, body, gonial, and symphyseal functional units and compared the corresponding pairs of 3D vectors by calculating vector operations. RESULTS The vector difference and other vector components represented the individual 3D architectural pattern and severity of the asymmetric mandible. The body unit contributed most to mandibular asymmetry followed by the condylar unit. CONCLUSIONS The results indicate that 3D vector analysis can improve our understanding of the 3D architecture of asymmetric mandibles. This type of 3D vector analysis can be a useful tool for the comprehensive evaluation of its asymmetric mandibular structure.
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Affiliation(s)
- Kyung-Ran Park
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
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