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Shimoyama M, Kanzaki H, Tohyama S, Ida T, Ishikawa M, Katsumata Y, Arai C, Wada S, Manase S, Tomonari H. Mandibular Endochondral Growth Is Specifically Augmented by Nutritional Supplementation with Myo-Inositol Even in Rabbits. Dent J (Basel) 2024; 12:49. [PMID: 38534273 DOI: 10.3390/dj12030049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
Mandibular retrognathism occurs by insufficient mandibular growth and causes several issues, such as respiratory difficulty and diminished masticatory function. At present, functional orthodontic appliances are used for stimulating mandibular growth in pediatric cases. However, the effectiveness of functional appliances is not always stable in daily practices. A more effective, reliable, and safer therapeutic method for mandibular growth promotion would be helpful for growing mandibular retrognathism patients. As we previously discovered that nutritional supplementation of myo-inositol in growing mice specifically increases mandibular endochondral growth, we performed preclinical animal experiments in rabbits in this study. Briefly, six-week-old male Japanese white rabbits were fed with or without myo-inositol supplementation in laboratory chow until 25 weeks old, and 3D image analysis using micro CT data and histological examinations was done. Myo-inositol had no systemic effect, such as femur length, though myo-inositol specifically augmented the mandibular growth. Myo-inositol increased the thickness of mandibular condylar cartilage. We discovered that the nutritional supplementation of myo-inositol during the growth period specifically augmented mandibular growth without any systemic influence, even in rabbits. Our results suggest the possibility of clinical use of myo-inositol for augmentation of the mandibular growth in growing mandibular retrognathism patients in the future.
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Affiliation(s)
- Miho Shimoyama
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Hiroyuki Kanzaki
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Syunnosuke Tohyama
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Tomomi Ida
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Misao Ishikawa
- Department of Anatomy, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Yuta Katsumata
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Chihiro Arai
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Satoshi Wada
- Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Kanazawa 920-0293, Japan
| | - Shugo Manase
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
| | - Hiroshi Tomonari
- Department of Orthodontics, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan
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Peluso A, Falone G, Pipitone R, Moscagiuri F, Caroccia F, D'Attilio M. Three-Dimensional Enlow's Counterpart Analysis: Neutral Track. Diagnostics (Basel) 2023; 13:2337. [PMID: 37510081 PMCID: PMC10378230 DOI: 10.3390/diagnostics13142337] [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: 06/08/2023] [Revised: 07/05/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study is to provide a novel method to perform Enlow's neutral track analysis on cone-beam computed tomography (CBCT) images. Eighteen CBCT images of skeletal Class I (ANB = 2° ± 2°) subjects (12 males and 6 females, aged from 9 to 19 years) with no history of previous orthodontic treatment were selected. For each subject, 2D Enlow's neutral track analysis was performed on lateral cephalograms extracted from CBCT images and 3D neutral track analysis was performed on CBCT images. A Student's t-test did not show any statistically significant difference between the 2D and 3D measurements and therefore the method proposed by this study to realize the neutral track analysis on 3D images is valid and superimposable on that described by Enlow on lateral cephalograms. Further studies with a large sample and different skeletal class subjects are needed to confirm the results of this research.
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Affiliation(s)
- Antonino Peluso
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
| | - Giulia Falone
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
| | - Rossana Pipitone
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Moscagiuri
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Caroccia
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
| | - Michele D'Attilio
- Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, 66100 Chieti, Italy
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A three-dimensional statistical shape model of the growing mandible. Sci Rep 2021; 11:18843. [PMID: 34552162 PMCID: PMC8458295 DOI: 10.1038/s41598-021-98421-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/23/2021] [Indexed: 02/04/2023] Open
Abstract
Mandibular growth and morphology are important topics in the field of oral and maxillofacial surgery. For diagnostic and planning purposes, a normative database or statistical shape model of the growing mandible can be of great benefit. A collection of 874 cadaveric children’s mandibles with dental age between 1 and 12 years old were digitized using computed tomography scanning and reconstructed to three-dimensional models. Point correspondence was achieved using iterative closest point and coherent point drift algorithms. Principal component analysis (PCA) was applied to find the main modes of variation in the data set. The average mandible was presented, along with the first ten PCA modes. The first mode explained 78% of the total variance; combining the first ten modes accumulated to 95% of the total variance. The first mode was strongly correlated with age and hence, with natural growth. This is the largest study on three-dimensional mandibular shape and development conducted thus far. The main limitation is that the samples lack information such as gender and cause of death. Clinical application of the model first requires validation with contemporary samples.
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De Los Ríos Fernández EM. [Use of skeletal-related diagnostic methods in articles published from 2018 to 2020 in four major orthodontics journals]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e041. [PMID: 38464403 PMCID: PMC10919820 DOI: 10.21142/2523-2754-0901-2021-041] [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: 10/14/2020] [Accepted: 01/20/2021] [Indexed: 03/12/2024] Open
Abstract
Objective To determine the skeletal-related diagnostic methods most commonly used according to the four most important orthodontics journals in the period from 2018 to 2020. Methods A review of the data available regarding the diagnostic procedures most frequently used to determine skeletal relationships in the four most important orthodontics journals from 2018 to 2020. Article review was performed using SCIMAGO 2018, which provides a series of parameters ranking the importance of the impact of publications and journals. We made a synopsis of the information analyzed to establish a correlation and compare sources, and critically examined the articles collected on the subject of interest. An online bibliographic search of databases including mainly Medline was carried out, followed by evaluation and selection of the bibliography, organized according to the significance and nature of the study. Results The four journals included in the bibliographic search were: AJODO, AO, EJO and KJO. The A point-Nasion-B point (ANB) method was used in 92.2% of the articles published in AJODO, and 7.8% did not describe the method used. Twenty-three articles in the AO journal were evaluated, all of which referred to the use of ANB as the method used. Finally, 16 and 11 articles from the EJO and KJO journals, respectively, were evaluated, with 93.8% and 95%, respectively of the articles using ANB as the method of choice for determining skeletal relationships. Conclusion The method of choice for skeletal-related diagnostics is ANB, although this widely known method presents a risk of geometric effect.
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Affiliation(s)
- Enrique Manuel De Los Ríos Fernández
- Facultad de Odontología, Universidad Nacional de Tucumán. Tucumán, Argentina. Universidad Nacional de Tucumán Facultad de Odontología Universidad Nacional de Tucumán Tucumán Argentina
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Migliorati M, Drago S, Calzolari C, Gallo F, Dalessandri D, Orsini A, Silvestrini-Biavati A. Long-term dentoskeletal changes of class II growing patients' treatment with the propulseur universal light appliance. A prospective controlled study. ACTA ACUST UNITED AC 2020; 69:79-86. [PMID: 32181609 DOI: 10.23736/s0026-4970.19.04283-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Class II is one of the most common malocclusions. The prevailing aspect in Class II patients is a mandibular deficiency. Various removable and fixed functional therapies are used in order to enhance the mandibular growth or position. The aim of this prospectively controlled study was to evaluate long-term dentoskeletal changes obtained by a functional appliance for Class II. METHODS Prospective controlled study, based on a sample size calculation. 26 Class II Division 1 patients (11.8±1.5 years) were consecutively treated with the propulseur universal light (PUL) appliance and a multi bracket appliance (PG), they were compared to a sample of 26 Class II untreated patients (11.5±0.8 years) (CG). Lateral cephalograms were taken before and after the PUL therapy, and after multibracket treatment. Interaction analysis was carried out to test whether the PUL parameters in treatment groups were different according to the acquisition times, using the Linear Mixed-Effects Model. RESULTS Significant ANB, Overjet and WITS differences existed in treatment groups according to the time. In particular, comparing to T1 vs. T0, the relative difference (RD) means in the control group were -0.34, -0.31 and 0.17 for ANB, Overjet and WITS, respectively. The corresponding RD means in the treated group PG were -1.58, -4.27 and -2.38. Comparing to T2 vs. T0, the RD means in the control group were -0.36, -0.51 and 0.63 for ANB, Overjet and WITS, respectively. While the corresponding RD means in the treated group were -2.08, -5.12 and -2.50. CONCLUSIONS The PUL appliance successfully corrected class II malocclusion. The long term correction was mainly due to dentoalveolar effects: therapy success was 91% for overjet correction and 76% for ANB correction. During the post functional appliance period, overjet was stable in 77% of the treated subjects, and ANB in 74% of the treated subjects.
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Affiliation(s)
- Marco Migliorati
- Department of Orthodontics, School of Dentistry, University of Genoa, Genoa, Italy
| | - Sara Drago
- Department of Orthodontics, School of Dentistry, University of Genoa, Genoa, Italy
| | - Chiara Calzolari
- Department of Orthodontics, School of Dentistry, University of Genoa, Genoa, Italy -
| | - Fabio Gallo
- Section of Biostatistics, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Domenico Dalessandri
- Department of Orthodontics, School of Dentistry, University of Brescia, Brescia, Italy
| | - Alessandro Orsini
- Department of Orthodontics, School of Dentistry, University of Genoa, Genoa, Italy
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Kyburz KS, Eliades T, Papageorgiou SN. What effect does functional appliance treatment have on the temporomandibular joint? A systematic review with meta-analysis. Prog Orthod 2019; 20:32. [PMID: 31402395 PMCID: PMC6689567 DOI: 10.1186/s40510-019-0286-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/24/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of the current systematic review was to compare the radiologic effects of functional appliance Class II treatment compared to no treatment on the temporomandibular joint and its components. METHODS Nine databases were searched up to June 2019 for randomized or prospective non-randomized clinical trials comparing Class II patients treated with functional appliances to untreated patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane tool and the ROBINS-I tool, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by the assessment of the quality of evidence with GRADE. RESULTS A total of 11 papers on 8 unique trials with 377 patients (39.8% male; average age 10.3 years) were finally included. Limited evidence indicated that compared to untreated growing patients functional appliance treatment was associated with increased condylar width (2 studies; MD 1.1 mm; 95% CI 0.1 to 2.2 mm; very low evidence quality), decreased anterior joint space (2 studies; MD - 0.7 mm; 95% CI - 0.5 to - 0.9 mm; very low evidence quality), increased superior joint space (2 studies; MD 0.7 mm; 95% CI 0.5 to 1.0 mm; very low evidence quality), increased posterior joint space (2 studies; MD 1.0 mm; 95% CI 0.9 to 1.2 mm; very low evidence quality), and vertical displacement of the glenoid fossa (2 studies; MD 0.4 mm; 95% CI 0.1 to 0.7 mm; very low evidence quality). The main limitations affecting the validity of the present findings were the inclusion of non-randomized studies with methodological issues, imprecision due to limited samples of the included studies, and inconsistencies among studies. CONCLUSIONS Currently existing evidence from controlled clinical studies on humans indicates that functional appliance treatment is associated with positional and skeletal alterations of the temporomandibular joint in the short term compared to untreated controls. However, the clinical relevance of these changes remains unclear, while the quality of existing evidence is low due to methodological issues of existing studies. REVIEW REGISTRATION PROSPERO, CRD42018109271.
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Affiliation(s)
- Karma Shiba Kyburz
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
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Pei Y, Ma G, Chen G, Zhang X, Xu T, Zha H. Superimposition of Cone-Beam Computed Tomography Images by Joint Embedding. IEEE Trans Biomed Eng 2017; 64:1218-1227. [DOI: 10.1109/tbme.2016.2598584] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Santamaría-Villegas A, Manrique-Hernandez R, Alvarez-Varela E, Restrepo-Serna C. Effect of removable functional appliances on mandibular length in patients with class II with retrognathism: systematic review and meta-analysis. BMC Oral Health 2017; 17:52. [PMID: 28148248 PMCID: PMC5289049 DOI: 10.1186/s12903-017-0339-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Orthopedic functional devices, are used to improve mandibular length in skeletal class II patients. However, the orthopedic functional device with the best effect to increasing the mandibular length, has not been identified before. Thus, the aim of the present investigation was to evaluate Randomized Controlled Trials (RCT), to determine the best functional appliance improving mandibular length in subjects with retrognathism. METHODS A systematic review and meta-analysis was performed, including studies published and indexed in databases between 1966 and 2016. RCTs evaluating functional appliances' effects on mandibular length (Condilion-Gnation (Co-Gn) and Condilion-Pogonion (Co-Po)), were included. Reports' structure was evaluated according to 2010 CONSORT guide. The outcome measure was distance between Co-Gn and/or Co-Po after treatment. Data were analyzed with Cochran Q Test and random effects model. RESULTS Five studies were included in the meta-analysis. The overall difference in mandibular length was 1.53 mm (Confidence Interval (CI) 95% 1.15-1.92) in comparison to non-treated group. The Sander Bite Jumping reported the greatest increase in mandibular length (3.40 mm; CI 95% 1.69-5.11), followed by Twin Block, Bionator, Harvold Activator and Frankel devices. CONCLUSIONS All removable functional appliances, aiming to increase mandibular length, are useful. Sander Bite Jumping was observed to be the most effective device to improve the mandibular length.
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Freudenthaler J, Čelar A, Ritt C, Mitteröcker P. Geometric morphometrics of different malocclusions in lateral skull radiographs. J Orofac Orthop 2016; 78:11-20. [PMID: 27796401 PMCID: PMC5247554 DOI: 10.1007/s00056-016-0057-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/22/2016] [Indexed: 12/01/2022]
Abstract
Background To evaluate the role of craniofacial shape in malocclusion by application of geometric morphometrics to a set of two-dimensional landmarks and semilandmarks obtained from lateral skull radiographs. Methods Cephalometric radiograph tracings of 88 untreated Caucasians (age range 7–39 years) were assigned to four groups according to their occlusion: neutrocclusion, distocclusion, mesiocclusion, and anterior open bite. The geometric morphometric shape analysis incorporated 66 landmarks and semilandmarks, which underwent generalized Procrustes analysis, between-groups principal component analysis, thin-plate spline deformation grid visualization, permutation tests, and receiver operating characteristic curves. Results The position and shape of the mandible contributed to differences between the distocclusion and mesiocclusion groups, whereas the maxillary shape showed less variation. The growth-related shape alteration during adolescence was most pronounced in the mesiocclusion group and least pronounced in the neutrocclusion group. The open bite group was associated with an altered orientation of the mandibular body and the maxilla, showed the most hyperdivergent maxillomandibular pattern but was not an own skeletal entity. Despite clear differences in mean shape across the four groups, the individual distribution of craniofacial shape overlapped between the groups without discrete clusters. Conclusions Craniofacial shape was clearly associated with dental malocclusion and showed considerable variation. Geometric morphometrics was a powerful research tool but for diagnosing individual malocclusion standard cephalometric measurements including overjet and overbite were equally or more efficient than geometric morphometric descriptors.
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Affiliation(s)
- Josef Freudenthaler
- Medical University of Vienna, Vienna, Austria.,School of Dentistry, Orthodontics, Sensengasse 2a, 1090, Vienna, Austria
| | - Aleš Čelar
- Medical University of Vienna, Vienna, Austria. .,School of Dentistry, Orthodontics, Sensengasse 2a, 1090, Vienna, Austria.
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Parton AL, Duncan WJ, Oliveira ME, Key O, Farella M. Implant-based three-dimensional superimposition of the growing mandible in a rabbit model. Eur J Orthod 2015; 38:546-52. [PMID: 26609073 DOI: 10.1093/ejo/cjv085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The reliable assessment of craniofacial morphological changes during growth requires invariant regions for image registration. As these regions have not yet been identified in three dimensions, intra-osseous implants are required as fiducial markers for the reliable assessment of three-dimensional (3D) mandibular growth changes. The objective of this study was to develop an animal model for the assessment of the 3D morphological changes of the mandible during growth, using implants as fiducial markers. MATERIALS AND METHODS Titanium implants were placed in the body of the mandible of six New Zealand White rabbits. Cone beam computed tomography (CBCT) scans were taken 1-week following implant placement and after an additional 8-weeks of growth. Segmentations of CBCT images were exported into custom-made scripts, implant centroids were identified, implant stability during growth calculated, and the segmented mandibles were registered on the implant centroids. RESULTS The buccal cortical bone of the body of the mandible was stable during growth and suitable for fiducial marker placement. Bilateral implants resulted in more accurate rigid registration of the growing rabbit mandible than only unilateral implants. 3D mandibular growth changes were visualised by means of semi-transparencies. CONCLUSIONS This animal model appears to be feasible for the assessment of the 3D morphological changes occurring during mandibular growth. To the best of our knowledge this is the first time that the implant superimposition method has been combined with 3D imaging to accurately reveal mandibular growth changes.
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Affiliation(s)
- Andrew L Parton
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
| | - Warwick J Duncan
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
| | - Marcelo E Oliveira
- **Robotic System Laboratory (LSRO), Swiss Federal Institute of Technology in Lausanne (EPFL), Lausanne, Switzerland
| | - Oscar Key
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
| | - Mauro Farella
- *Department of Oral Sciences, University of Otago, Dunedin, New Zealand and
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"Direct DICOM Slice Landmarking" A Novel Research Technique to Quantify Skeletal Changes in Orthognathic Surgery. PLoS One 2015; 10:e0131540. [PMID: 26252768 PMCID: PMC4529249 DOI: 10.1371/journal.pone.0131540] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 06/03/2015] [Indexed: 12/02/2022] Open
Abstract
The limitations of the current methods of quantifying the surgical movements of facial bones inspired this study. The aim of this study was the assessment of the accuracy and reproducibility of directly landmarking of 3D DICOM images (Digital Imaging and Communications in Medicine) to quantify the changes in the jaw bones following surgery. The study was carried out on plastic skull to simulate the surgical movements of the jaw bones. Cone beam CT scans were taken at 3mm, 6mm, and 9mm maxillary advancement; together with a 2mm, 4mm, 6mm and 8mm “down graft” which in total generated 12 different positions of the maxilla for the analysis. The movements of the maxilla were calculated using two methods, the standard approach where distances between surface landmarks on the jaw bones were measured and the novel approach where measurements were taken directly from the internal structures of the corresponding 3D DICOME slices. A one sample t-test showed that there was no statistically significant difference between the two methods of measurements for the y and z directions, however, the x direction showed a significant difference. The mean difference between the two absolute measurements were 0.34±0.20mm, 0.22±0.16mm, 0.18±0.13mm in the y, z and x directions respectively. In conclusion, the direct landmarking of 3D DICOM image slices is a reliable, reproducible and informative method for assessment of the 3D skeletal changes. The method has a clear clinical application which includes the analysis of the jaw movements “orthognathic surgery” for the correction of facial deformities.
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The validity of using surface meshes for evaluation of three-dimensional maxillary and mandibular surgical changes. Int J Oral Maxillofac Surg 2015; 44:914-20. [PMID: 25752242 DOI: 10.1016/j.ijom.2015.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/21/2014] [Accepted: 02/04/2015] [Indexed: 11/20/2022]
Abstract
The three-dimensional (3D) changes in hard tissue position following orthognathic surgery have been reported using 3D cephalometry, changes in volume, principal component analysis, and changes based on the surface model of the hard tissue. The aim of this study was to determine the validity of using surface models as a method of assessing positional changes of the maxilla and mandible. The actual unidirectional movement of the maxilla (advancement or downgraft) and the mandible (advancement), together with bidirectional movement of the maxilla (simultaneous advancement and downgraft) were simulated on a plastic skull. Following cone beam computed tomography scanning of each surgical simulation, the actual surgical movement was compared to the analysis based on surface model movement using the mean absolute distance of all points, the 90th percentile, and the root mean square (RMS) distance. All three methods of assessment of analysis consistently underestimated the actual amount of surgical movement. The movement was approximately one-third to one-half of the actual surgical movement. The use of surface meshes and point-to-point measurements grossly underestimates the 3D changes in the maxilla and mandible in simulated surgical procedures. Currently there are limitations in fully describing the true positional changes of the maxilla or the mandible in three dimensions.
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Volumetric analysis of implanted biphasic calcium phosphate/collagen composite by three-dimensional cone beam computed tomography head model superimposition. J Craniomaxillofac Surg 2015; 43:167-74. [DOI: 10.1016/j.jcms.2014.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/17/2014] [Accepted: 11/04/2014] [Indexed: 11/18/2022] Open
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Franco AA, Cevidanes LHS, Phillips C, Rossouw PE, Turvey TA, Carvalho FDAR, Paula LKD, Quintão CCA, Almeida MAO. Long-term 3-dimensional stability of mandibular advancement surgery. J Oral Maxillofac Surg 2013; 71:1588-97. [PMID: 23769460 DOI: 10.1016/j.joms.2013.04.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/03/2013] [Accepted: 04/08/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate 3-dimensional changes in the position of the condyles, rami, and chin from 1 to 3 years after mandibular advancement surgery. MATERIALS AND METHODS This prospective observational study used pre- and postoperative cone-beam computed tomograms of 27 subjects with skeletal Class II jaw relation and normal or deep overbite. An automatic technique of cranial base superimposition was used to assess positional and bone remodeling changes that were visually displayed and quantified using 3-dimensional color maps. Analysis of covariance with presence of genioplasty, age at time of surgery, and gender as explanatory variables was used to estimate and test adjusted mean changes for each region of interest. RESULTS The chin rotated downward and backward 1 to 3 years after surgery. Changes of at least 2 mm were observed in 17% of cases. Mandibular condyles presented with displacements or bone remodeling of at least 2 mm on the anterior surface (21% of cases on the left side and 13% on the right), superior surface (8% on right and left sides), and lateral poles (17% on left side and 4% on right). Posterior borders of the rami exhibited symmetric lateral or rotational displacements in 4% of cases. CONCLUSION In the hierarchy of surgical stability, mandibular advancement surgery is considered one of the most stable surgical procedures. However, 1 to 3 years after surgery, approximately 20% of patients had 2- to 4-mm changes in horizontal and vertical chin positions or changes in condylar position and adaptive bone remodeling.
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Affiliation(s)
- Alexandre A Franco
- Department of Orthodontics, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Reynolds M, Reynolds M, Adeeb S, El-Bialy T. 3-d volumetric evaluation of human mandibular growth. Open Biomed Eng J 2011; 5:83-9. [PMID: 22046201 PMCID: PMC3204416 DOI: 10.2174/1874120701105010083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 06/17/2011] [Accepted: 06/29/2011] [Indexed: 11/22/2022] Open
Abstract
Bone growth is a complex process that is controlled by a multitude of mechanisms that are not fully understood.Most of the current methods employed to measure the growth of bones focus on either studying cadaveric bones from different individuals of different ages, or successive two-dimensional (2D) radiographs. Both techniques have their known limitations. The purpose of this study was to explore a technique for quantifying the three dimensional (3D) growth of an adolescent human mandible over the period of one year utilizing cone beam computed tomography (CBCT) scans taken for regular orthodontic records. Three -dimensional virtual models were created from the CBCT data using mainstream medical imaging software. A comparison between computer-generated surface meshes of successive 3-D virtual models illustrates the magnitude of relative mandible growth. The results of this work are in agreement with previously reported data from human cadaveric studies and implantable marker studies. The presented method provides a new relatively simple basis (utilizing commercially available software) to visualize and evaluate individualized 3D (mandibular) growth in vivo.
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Affiliation(s)
- Mathew Reynolds
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, AB, Canada
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AlHadidi A, Cevidanes LHS, Mol A, Ludlow J, Styner M. Comparison of two methods for quantitative assessment of mandibular asymmetry using cone beam computed tomography image volumes. Dentomaxillofac Radiol 2011; 40:351-7. [PMID: 21831974 DOI: 10.1259/dmfr/13993523] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare two methods of measuring mandibular asymmetry. The first method uses mirroring of the mandible in the midsagittal plane; the second uses mirroring of the mandible and registration on the cranial base. METHODS Surface models were constructed from cone beam CT (CBCT) scans of 50 patients with asymmetry. For the first approach, a midsagittal plane was defined for each patient as the plane passing through nasion, anterior nasal spine and basion. Mirrors for both halves of the mandible were created. The second approach consisted of mirroring the image volume by flipping the left and right sides and then registering the mirrored image onto the cranial base using a mutual information maximization method. Surface distances between hemimandibles and mirrors were calculated for nine regions. RESULTS There was no statistically significant difference between the mean surface distance measurements obtained with the two approaches and when comparing both halves in most areas. CONCLUSION Both mirroring techniques provided similar quantification of mandibular asymmetry in this cohort.
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Alarcón JA, Bastir M, Rosas A, Molero J. Chincup treatment modifies the mandibular shape in children with prognathism. Am J Orthod Dentofacial Orthop 2011; 140:38-43. [DOI: 10.1016/j.ajodo.2009.10.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 10/01/2009] [Accepted: 10/01/2009] [Indexed: 10/14/2022]
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Kim YI, Park SB, Son WS, Hwang DS. Midfacial Soft-Tissue Changes After Advancement of Maxilla With Le Fort I Osteotomy and Mandibular Setback Surgery: Comparison of Conventional and High Le Fort I Osteotomies by Superimposition of Cone-Beam Computed Tomography Volumes. J Oral Maxillofac Surg 2011; 69:e225-33. [PMID: 21496986 DOI: 10.1016/j.joms.2010.12.035] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 10/26/2010] [Accepted: 12/28/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Yong-Il Kim
- Department of Orthodontics, Pusan National University College of Dentistry, Pusan National University Hospital, Busan, South Korea
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Cevidanes LHC, Oliveira AEF, Grauer D, Styner M, Proffit WR. Clinical application of 3D imaging for assessment of treatment outcomes. Semin Orthod 2011; 17:72-80. [PMID: 21516170 DOI: 10.1053/j.sodo.2010.08.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This paper outlines the clinical application of CBCT for assessment of treatment outcomes, and discusses current work to superimpose digital dental models and 3D photographs. Superimposition of CBCTs on stable structures of reference now allow assessment of 3D dental, skeletal and soft tissue changes for both growing and non-growing patients. Additionally, we describe clinical findings from CBCT superimpositions in assessment of surgery and skeletal anchorage treatment.
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Affiliation(s)
- Lucia H C Cevidanes
- Assistant Professor, Department of Orthodontics, School of Dentistry, University of North Carolina
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Three-dimensional regional displacements after mandibular advancement surgery: one year of follow-up. J Oral Maxillofac Surg 2011; 69:1447-57. [PMID: 21256643 DOI: 10.1016/j.joms.2010.07.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Revised: 06/05/2010] [Accepted: 07/03/2010] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the association of 3-dimensional changes in the position of the condyles, rami, and chin at splint removal and 1 year after mandibular advancement surgery. PATIENTS AND METHODS This prospective observational study used preoperative and postoperative scans of 27 subjects presenting with a skeletal Class II jaw relationship with a normal or deep overbite. An automatic technique of cranial base superimposition was used to assess the positional and/or remodeling changes in the anatomic regions of interest. The displacements were visually displayed and quantified using 3-dimensional color maps. The positive and negative values of surface distances in the color maps indicated the direction of the displacements. Pearson correlation coefficients and a linear model for correlated data were used to evaluate the association between the regional displacements. RESULTS The postoperative adaptations in the chin position between splint removal and 1 year after surgery were significantly negatively correlated with changes in the borders of the posterior ramus (left, r = -0.73, P ≤ .0001; and right, r = -0.68, P = .00) and the condyles (left, r = -0.53, P = .01; and right, r = -0.46, P = .02), indicating that these structures tended to be displaced in the same direction. Even though the mean condylar displacement with surgery was less than 1 mm, individual displacements greater than 2 mm with surgery were observed for 24% of the condyles. The condylar displacements were maintained at 1 year after surgery for 17% of the condyles. CONCLUSIONS The surface distance displacements indicated that the postoperative adaptations at different anatomic regions were significantly related.
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Marsico E, Gatto E, Burrascano M, Matarese G, Cordasco G. Effectiveness of orthodontic treatment with functional appliances on mandibular growth in the short term. Am J Orthod Dentofacial Orthop 2011; 139:24-36. [DOI: 10.1016/j.ajodo.2010.04.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 04/01/2010] [Accepted: 04/01/2010] [Indexed: 10/18/2022]
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Naser-ud-Din S, Thoirs K, Sampson WJ. Ultrasonography, lateral cephalometry and 3D imaging of the human masseter muscle. Orthod Craniofac Res 2010; 14:33-43. [DOI: 10.1111/j.1601-6343.2010.01505.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Motta ATSD, Carvalho FDAR, Cevidanes LHS, Almeida MADO. Deslocamentos esqueléticos associados à cirurgia de avanço mandibular: avaliação quantitativa tridimensional. Dental Press J Orthod 2010. [DOI: 10.1590/s2176-94512010000500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: avaliar através de imagens tridimensionais os deslocamentos dos ramos, côndilos e mento resultantes da cirurgia de avanço mandibular. MÉTODOS: este estudo prospectivo utilizou tomografias computadorizadas de feixe cônico das fases pré-cirúrgica e pós-cirúrgica de 27 indivíduos apresentando Classe II esquelética com padrão normocefálico ou braquicefálico. Uma técnica de superposição automatizada da base do crânio permitiu a avaliação de alterações esqueléticas em regiões anatômicas de interesse, e os deslocamentos foram visualizados e quantificados a partir da técnica dos mapas coloridos de superfícies. A estatística descritiva consistiu de valores médios, mínimo e máximo, e desvios-padrão. Mudanças maiores do que 2mm foram consideradas clinicamente relevantes e classificadas através de categorização dos valores. As tendências direcionais dos movimentos estruturais foram exibidas em valores positivos ou negativos. Coeficientes de correlação de Pearson foram aplicados com nível de significância de 95%, testando se deslocamentos em determinadas regiões foram associados com outras áreas. RESULTADOS: o mento apresentou deslocamento anteroinferior médio de 6,81±3,2mm, enquanto a porção inferior dos ramos apresentou movimento lateral com a cirurgia (esquerdo = 2,97±2,71mm; direito = 2,34±2,35mm). Outras regiões anatômicas mostraram deslocamento médio menor que 2mm, mas com evidente variabilidade individual. Correlações estatisticamente significativas foram positivas e moderadas. Os côndilos, bordo posterior e porção superior dos ramos apresentaram correlação bilateral, enquanto as porções superior e inferior dos ramos mostraram correlação ipsilateral. CONCLUSÃO: o método 3D utilizado permitiu uma precisa visualização e quantificação dos resultados cirúrgicos, destacando-se o movimento anteroinferior do mento e o deslocamento lateral da porção inferior dos ramos mandibulares, mas com considerável variabilidade individual em todas as regiões anatômicas avaliadas.
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Carvalho FDAR, Cevidanes LHS, da Motta ATS, Almeida MADO, Phillips C. Three-dimensional assessment of mandibular advancement 1 year after surgery. Am J Orthod Dentofacial Orthop 2010; 137:S53.e1-12; discussion S53-5. [PMID: 20381760 DOI: 10.1016/j.ajodo.2010.01.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Revised: 01/01/2010] [Accepted: 01/01/2010] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This prospective observational study evaluated changes in the 3-dimensional position and remodeling of the mandibular rami, condyles, and chin at splint removal and 1 year after mandibular advancement surgery. METHODS Presurgery, splint removal (4-6 weeks postsurgery), and 1-year postsurgery cone-beam computed tomography scans of 27 subjects were used. Superimposition on the cranial base was used to assess positional or remodeling changes in the anatomic regions of interest. Surface distance displacements were visually displayed and quantified by 3-dimensional color maps. A 1-sample t test was used to assess the average postsurgical changes of each region of interest. The level of significance was set at 0.05. RESULTS After antero-inferior chin displacement with surgery (mean, 6.81 +/- 3.2 mm at splint removal), the average 1-year postsurgery displacement was not statistically significant (P = 0.44). Postsurgical adaptations greater than 2 mm were observed in 48% of the patients: 16% with an additional anterior-inferior displacement of the chin of 2 to 4 mm, and 4% with >or= 4 mm; 20% had postero-superior movement of 2 to 4 mm, and 8% had postero-superior movement of >or= 4 mm. The condyles tended to move, on average, <or= 2 mm supero-posteriorly with surgery, and this small positional displacement was maintained 1 year postsurgery (right condyle, P = 0.58; left, P = 0.88). The rami exhibited outward (lateral) movements with surgery, with greater displacement of the inferior part of the rami (2 mm in 65% of the subjects). This torque of the ramus with surgery was stable 1 year postsurgery. CONCLUSIONS Three-dimensional assessment of skeletal changes with mandibular advancement surgery shows that nearly half of the patients have >2 mm change in chin position from splint removal to the 1-year follow-up, with approximately equal chances of anterior and posterior movement. Torque of the rami usually occurs with mandibular advancement surgery.
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Cevidanes LHC, Motta A, Proffit WR, Ackerman JL, Styner M. Cranial base superimposition for 3-dimensional evaluation of soft-tissue changes. Am J Orthod Dentofacial Orthop 2010; 137:S120-9. [PMID: 20381752 DOI: 10.1016/j.ajodo.2009.04.021] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Revised: 03/01/2009] [Accepted: 04/01/2009] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The recent emphases on soft tissues as the limiting factor in treatment and on soft-tissue relationships in establishing the goals of treatment has made 3-dimensional (3D) analysis of soft tissues more important in diagnosis and treatment planning. It is equally important to be able to detect changes in the facial soft tissues produced by growth or treatment. This requires structures of reference for superimposition and a way to display the changes with quantitative information. METHODS In this study, we outlined a technique for quantifying facial soft-tissue changes viewed in cone-beam computed tomography data, using fully automated voxel-wise registrations of the cranial base surface. The assessment of soft-tissue changes is done by calculation of the Euclidean surface distances between the 3D models. Color maps are used for visual assessment of the location and the quantification of changes. RESULTS This methodology allows a detailed examination of soft-tissue changes with growth or treatment. CONCLUSIONS Because of the lack of stable references with 3D photogrammetry, 3D photography, and laser scanning, soft-tissue changes cannot be accurately quantified by these methods.
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Affiliation(s)
- Lucia H C Cevidanes
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599, USA.
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Stratemann SA, Huang JC, Maki K, Hatcher DC, Miller AJ. Evaluating the mandible with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2010; 137:S58-70. [PMID: 20381763 DOI: 10.1016/j.ajodo.2009.01.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 01/01/2009] [Accepted: 01/01/2009] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this research was to examine methods for assessing the shape and growth of the mandible 3 dimensionally. Furthermore, 1 method was defined and applied. METHODS Thirty mandibles were assessed. An average or mean shape was determined, and the mandibles were ranked quantitatively, by using the root mean square (RMS), according to their variation from the mean. The rankings ranged from mandibles that were small, short, and narrow at the minus-RMS end, to large, tall, and broad at the plus-RMS end. A second analysis provided a method to superimpose a mandible over the average mandible and determine the differences from the average-derived mandible by using a spectrum of colors to indicate changes in a region. RESULTS Variations in the mandible were greatest in the condylar heads, coronoid tips, canine-incisor dentoalveolar segment, and chin point. CONCLUSIONS The visual images of the 30 segmented mandibles suggest that a new method of classification needs to be developed that extends the original 2-dimensional lateral evaluation to a total 3-dimensional view that provides new relationships, such as the direction of the condylar heads to the ramus and the ratio of the intergonial angle length to the intercondylar head length to define the narrowness of a mandible.
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Affiliation(s)
- Scott A Stratemann
- Division of Orthodontics, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, CA 94143-0438, USA
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de Assis Ribeiro Carvalho F, Cevidanes LHS, da Motta ATS, de Oliveira Almeida MA, Phillips C. Three-dimensional assessment of mandibular advancement 1 year after surgery. Am J Orthod Dentofacial Orthop 2010. [DOI: 10.1016/j.ajodo.2009.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Deguchi T, Katashiba S, Inami T, Foong KWC, Huak CY. Morphologic quantification of the maxilla and the mandible with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2010; 137:218-22. [PMID: 20152678 DOI: 10.1016/j.ajodo.2008.02.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Revised: 02/01/2008] [Accepted: 02/01/2008] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The purpose of this pilot study was to use cone-beam computed tomography (CBCT) to determine the volumes of the maxilla and the mandible in subjects with skeletal Class I, Class II, and Class III malocclusions. Hypothesis 1 was that the volume (size) of a skeletal Class II maxilla is larger than those of Class I and Class III. Hypothesis 2 was that the volume of a skeletal Class III mandible is larger than those of Class I and Class II. METHODS Thirty women patients were classified into 3 groups according to their skeletal pattern: skeletal Class I (0 degrees < or =ANB <6 degrees ), Class II (ANB > or =6 degrees ) and Class III (ANB <0 degrees ). The volumes of the maxilla and the mandible were measured with CBCT. CB MercuRay (Hitachi Medico, Tokyo, Japan) and CB works software (CyberMed, Seoul, Korea) were used to process the images. RESULTS There was a trend that skeletal Class III subjects might have significantly greater mandibular volume compared with Class II subjects (P = 0.089). The ratios of maxilla-to-mandible volumes between the skeletal Class II and Class III groups were significantly different (P = 0.005). Differences were observed in the ratios of maxillary and mandibular volumes across the 3 groups. CONCLUSIONS Hypotheses 1 and 2 were rejected; there was no trend for Class III subjects to have larger mandibles (P = 0.089) compared with Class II subjects. The ratio of the maxilla and mandible volumes in skeletal Class III subjects was significantly larger (P = 0.005) compared with Class II subjects.
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Cevidanes LHS, Styner M, Proffit WR. [Three-dimensional superimposition of the skull base for the longitudinal evaluation of the effects of growth and of treatment]. Orthod Fr 2009; 80:347-57. [PMID: 19954732 DOI: 10.1051/orthodfr/2009021] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
To evaluate growth or treatment change, superimposition of serial radiographs on a stable reference structure is necessary. In 2-D cephalometrics, the cranial base is often used for this purpose because it shows minimal changes after neural growth is completed, but the cranial base landmarks in lateral or P-A cephalograms are unreliable when other orientations are evaluated. In this paper we present a novel method for 3-D superimposition based on fully-automated voxel-wise registration of the surface cranial base. The software packages allow quantitative assessment of changes between two time points via calculation of the Euclidean distances between the surfaces of the 3-D models, and visual assessment of the location and magnitude of changes in the jaws over time via graphical overlays in which changes are shown in color maps. This enables a detailed examination of the adaptation patterns for patients who experience clinically significant skeletal changes with growth and/or treatment.
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Affiliation(s)
- Lucia H S Cevidanes
- University of North Carolina, Department of Orthodontics, Chapel Hill, 27599-7450, USA.
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Effects of Herbst appliance treatment on temporomandibular joint disc position and morphology: A prospective magnetic resonance imaging study. Am J Orthod Dentofacial Orthop 2009; 136:412-24. [DOI: 10.1016/j.ajodo.2007.12.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Revised: 12/01/2007] [Accepted: 12/01/2007] [Indexed: 11/21/2022]
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Cevidanes LHC, Heymann G, Cornelis MA, DeClerck HJ, Tulloch JFC. Superimposition of 3-dimensional cone-beam computed tomography models of growing patients. Am J Orthod Dentofacial Orthop 2009; 136:94-9. [PMID: 19577154 DOI: 10.1016/j.ajodo.2009.01.018] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 01/07/2009] [Accepted: 01/07/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate a new method for superimposition of 3-dimensional (3D) models of growing subjects. METHODS Cone-beam computed tomography scans were taken before and after Class III malocclusion orthopedic treatment with miniplates. Three observers independently constructed 18 3D virtual surface models from cone-beam computed tomography scans of 3 patients. Separate 3D models were constructed for soft-tissue, cranial base, maxillary, and mandibular surfaces. The anterior cranial fossa was used to register the 3D models of before and after treatment (about 1 year of follow-up). RESULTS Three-dimensional overlays of superimposed models and 3D color-coded displacement maps allowed visual and quantitative assessment of growth and treatment changes. The range of interobserver errors for each anatomic region was 0.4 mm for the zygomatic process of maxilla, chin, condyles, posterior border of the rami, and lower border of the mandible, and 0.5 mm for the anterior maxilla soft-tissue upper lip. CONCLUSIONS Our results suggest that this method is a valid and reproducible assessment of treatment outcomes for growing subjects. This technique can be used to identify maxillary and mandibular positional changes and bone remodeling relative to the anterior cranial fossa.
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Affiliation(s)
- Lucia H C Cevidanes
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599, USA.
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Abstract
BACKGROUND Population differences in tooth formation using radiographs can be determined if the entire developmental sequence of a single tooth is studied. The only developing tooth visible radiographically from initiation to root completion is the third molar or wisdom tooth. AIM The timing of mandibular third molar formation was documented for two groups of children in England and two in South Africa. SUBJECTS AND METHODS Panoramic radiographs of White and Bangladeshi children from London and Black African and Cape Coloured children from South Africa were examined (age 5-24). Mean age of entering third molar stages (crypt appearance to root completion) was calculated using logistic regression and compared between sex and group using a t-test. RESULTS Average age of third molar stages was significantly (p < 0.001) later in three groups for almost all stages of the third molar compared to Black children. The average age of entering initial mineralization ranged from 7.97 to 9.74 years while average age of apex closed was 19.27-20.88. CONCLUSION These results show for the first time a significant difference in the timing of maturation of the mandibular third molar between groups with South African Black children being earlier than other groups.
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Affiliation(s)
- H M Liversidge
- Dental Institute, Barts and The London School of Medicine and Dentistry, London, UK.
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Cevidanes LHS, Bailey LJ, Tucker SF, Styner MA, Mol A, Phillips CL, Proffit WR, Turvey T. Three-dimensional cone-beam computed tomography for assessment of mandibular changes after orthognathic surgery. Am J Orthod Dentofacial Orthop 2007; 131:44-50. [PMID: 17208105 PMCID: PMC3552292 DOI: 10.1016/j.ajodo.2005.03.029] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2005] [Revised: 03/02/2005] [Accepted: 03/10/2005] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to assess alterations in the 3-dimensional (3D) position of the mandibular rami and condyles in patients receiving either maxillary advancement and mandibular setback or maxillary surgery only. METHODS High-resolution cone-beam computed tomography scans were taken of 21 patients before and after orthognathic surgery. Ten patients with various malocclusions underwent maxillary surgery only, and 11 Class III patients received maxillary advancement and mandibular setback. Presurgery and postsurgery 3D models were registered on the surface of the cranial base. A new tool was used for graphical overlay and 3D display with color maps to visually assess the locations and to quantify positional changes in the posterior border of the mandibular rami and condyles between superimposed models. RESULTS The average displacements in condylar position were small--0.77 mm (SD, 0.12 mm) and 0.70 mm (SD, 0.08 mm)--for 2-jaw and 1-jaw surgeries, respectively (not significant, P >.05). All 2-jaw surgery patients had backward rotational displacements of the mandibular rami (mean, 1.98 mm; SD, 1.03 mm), with a maximum surface distance change of > or =2 mm in 8 of 11 subjects. For the 1-jaw surgery, all subjects had small backward rotational displacements of the mandibular rami (mean, 0.78 mm; SD, 0.25 mm), with only 1 subject having a maximum surface distance change > or =2 mm. The difference in mean backward rotational displacement was statistically significant (P <.01). CONCLUSIONS The visualization of 3D model superimposition clearly identified the location, magnitude, and direction of mandibular displacement. The 3D imaging allowed quantification of vertical, transverse, and anteroposterior ramus displacement that accompanied mandibular, but not maxillary only, surgery.
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Affiliation(s)
- Lucia H S Cevidanes
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
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Cevidanes LHS, Styner MA, Proffit WR. Image analysis and superimposition of 3-dimensional cone-beam computed tomography models. Am J Orthod Dentofacial Orthop 2006; 129:611-8. [PMID: 16679201 PMCID: PMC3586191 DOI: 10.1016/j.ajodo.2005.12.008] [Citation(s) in RCA: 213] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 07/13/2005] [Accepted: 07/13/2005] [Indexed: 01/12/2023]
Abstract
Three-dimensional (3D) imaging techniques can provide valuable information to clinicians and researchers. But as we move from traditional 2-dimensional (2D) cephalometric analysis to new 3D techniques, it is often necessary to compare 2D with 3D data. Cone-beam computed tomography (CBCT) provides simulation tools that can help bridge the gap between image types. CBCT acquisitions can be made to simulate panoramic, lateral, and posteroanterior cephalometric radioagraphs so that they can be compared with preexisting cephalometric databases. Applications of 3D imaging in orthodontics include initial diagnosis and superimpositions for assessing growth, treatment changes, and stability. Three-dimensional CBCT images show dental root inclination and torque, impacted and supernumerary tooth positions, thickness and morphology of bone at sites of mini-implants for anchorage, and osteotomy sites in surgical planning. Findings such as resorption, hyperplasic growth, displacement, shape anomalies of mandibular condyles, and morphological differences between the right and left sides emphasize the diagnostic value of computed tomography acquisitions. Furthermore, relationships of soft tissues and the airway can be assessed in 3 dimensions.
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Affiliation(s)
- Lucia H S Cevidanes
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
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Cevidanes LHS, Bailey LJ, Tucker GR, Styner MA, Mol A, Phillips CL, Proffit WR, Turvey T. Superimposition of 3D cone-beam CT models of orthognathic surgery patients. Dentomaxillofac Radiol 2006; 34:369-75. [PMID: 16227481 PMCID: PMC3552302 DOI: 10.1259/dmfr/17102411] [Citation(s) in RCA: 229] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the registration of 3D models from cone-beam CT (CBCT) images taken before and after orthognathic surgery for the assessment of mandibular anatomy and position. METHODS CBCT scans were taken before and after orthognathic surgery for ten patients with various malocclusions undergoing maxillary surgery only. 3D models were constructed from the CBCT images utilizing semi-automatic segmentation and manual editing. The cranial base was used to register 3D models of pre- and post-surgery scans (1 week). After registration, a novel tool allowed the visual and quantitative assessment of post-operative changes via 2D overlays of superimposed models and 3D coloured displacement maps. RESULTS 3D changes in mandibular rami position after surgical procedures were clearly illustrated by the 3D colour-coded maps. The average displacement of all surfaces was 0.77 mm (SD=0.17 mm), at the posterior border 0.78 mm (SD=0.25 mm), and at the condyle 0.70 mm (SD=0.07 mm). These displacements were close to the image spatial resolution of 0.60 mm. The average interobserver differences were negligible. The range of the interobserver errors for the average of all mandibular rami surface distances was 0.02 mm (SD=0.01 mm). CONCLUSION Our results suggest this method provides a valid and reproducible assessment of craniofacial structures for patients undergoing orthognathic surgery. This technique may be used to identify different patterns of ramus and condylar remodelling following orthognathic surgery.
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Affiliation(s)
- L H S Cevidanes
- Department of Orthodontics, School of Dentistry, 201 Brauer Hall, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
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Authors’ response. Am J Orthod Dentofacial Orthop 2005. [DOI: 10.1016/j.ajodo.2005.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Cevidanes LHS, Franco AA, Gerig G, Proffit WR, Slice DE, Enlow DH, Lederman HM, Amorim L, Scanavini MA, Vigorito JW. Comparison of relative mandibular growth vectors with high-resolution 3-dimensional imaging. Am J Orthod Dentofacial Orthop 2005; 128:27-34. [PMID: 16027622 DOI: 10.1016/j.ajodo.2004.03.033] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The mandibular rami and their endochondrally growing condyles develop in many directions relative to the variable anatomic patterns of the nasomaxilla and middle cranial fossae during growth and response to orthopedic treatment. METHODS High-resolution magnetic resonance images were used to compare 3-dimensional (3D) growth vectors of skeletal displacement and bone remodeling in 25 untreated subjects with Class II malocclusions, 28 subjects with Class II malocclusions who were treated with Fränkel appliance therapy, and 25 subjects with normal occlusions. Marked differences were noted over an 18-month observation period. The 3D coordinates of anatomic landmarks were registered by Procrustes fit to control for rotation, translation, and scale differences. RESULTS Compared with untreated Class II and normal-occlusion subjects, the treated group showed highly significant differences in the 3D displacement/remodeling vectors of gonion and pterygomaxillary fissure relative to condylion and middle cranial fossae bilateral skeletal landmarks, by using both permutation tests ( P < .001) and a general linear multivariate model ( P < .0001). CONCLUSIONS In a prospective and systematically controlled study, we quantitatively described significant 3D rami skeletal compensations in the structural assembly of facial morphogenesis at the beginning of the adolescent growth spurt using novel modeling techniques. These techniques have facilitated quantification of relative 3D growth vectors to illustrate skeletal changes with Fränkel appliance therapy. Future studies are required to assess the long-term clinical significance of our findings.
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Affiliation(s)
- Lucia H S Cevidanes
- Department of Orthopedics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
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