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Farronato M, Cenzato N, Crispino R, Tartaglia FC, Biagi R, Baldini B, Maspero C. Divergence between CBCT and Optical Scans for Soft Tissue Analysis and Cephalometry in Facial Imaging: A cross-sectional study on healthy adults. Int Orthod 2024; 22:100845. [PMID: 38350255 DOI: 10.1016/j.ortho.2024.100845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Facial soft tissue analysis is becoming increasingly emphasized in orthodontic diagnosis and treatment planning. While traditional cephalometry primarily focuses on hard tissues, recent non-invasive imaging techniques offer the potential to comprehensively evaluate three-dimensional (3D) facial soft tissues. The aim of the study was to establish the geometrical 3D and cephalometric divergence between Cone Beam Computed Tomography (CBCT) derived images and scanned soft tissues. Crucial for enhancing orthodontic diagnosis, minimizing patient exposure to ionizing radiation and providing facial cephalometric parameters. MATERIAL AND METHODS A cross-sectional study was conducted from January 2020 to May 2023. CBCT and 3D facial scans were obtained simultaneously using a specialized imaging system. Reproducible landmark points were selected for both cephalometric and soft tissue analysis. Angular and linear measurements were recorded, and correlations between CT and facial scans were statistically assessed. RESULTS Comparisons between 10 CBCT-derived and 10 facial scan-based soft tissue representations resulted into 1.8mm mean root median square (RMS). Angular measurements, such as ANB, right gonial angle, and left gonial angle, exhibited a 0.9° of difference with their respective soft tissue variables. In contrast, linear measurements of total anterior facial height showed a lower correlation coefficient, equal to 0.51. The correlation between soft tissues and underlying hard tissues was more pronounced for gonial angles. CONCLUSION Facial soft tissue analysis using either 3D facial scans or CBCT-derived offers similar results for orthodontic diagnosis and treatment planning. These findings support the use of non-invasive diagnostic tools in orthodontics, although further investigations are needed to comprehensively understand the complexity of hard and soft tissue relationships.
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Affiliation(s)
- Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy.
| | - Niccolò Cenzato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
| | - Roberta Crispino
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
| | - Francesco Carlo Tartaglia
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy
| | - Roberto Biagi
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Benedetta Baldini
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, Via Ponzio 34/5, 20133 Milan, Italy
| | - Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy; UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
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Luo S, Guo S, Shi Y, Wang H, Zhang P, Jiang H, Cheng J. Comprehensive 3-dimensional Positional and Morphological Analyses of Condyle and Glenoid Fossa in Patients with Skeletal Class II Malocclusion following Bimaxillary Orthognathic Surgery. J Craniofac Surg 2024:00001665-990000000-01527. [PMID: 38710064 DOI: 10.1097/scs.0000000000010224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/17/2024] [Indexed: 05/08/2024] Open
Abstract
This study aimed to comprehensively and quantitatively characterize 3-dimensional (3D) positional and morphological changes of the condyle and glenoid fossa in patients with skeletal Class II malocclusion treated with bimaxillary orthognathic surgery. Twenty eligible patients treated at our institution from January 2016 to December 2021 with more than 12 months of postoperative follow-up were retrospectively enrolled. Radiographic data of cone-beam computed tomography (CBCT) for each patient were collected at 3 stages: 1 week preoperatively (T0), immediately after surgery (T1), and at least 12 months postoperatively (T2). Positional changes, surface and volumetric alterations of condyle, and bone remodeling in glenoid fossa were measured and compared based on voxel- and surface registrations in visual 3D methods. Most patients exhibited a tendency for condyles to shift posteriorly, laterally, superiorly, and rotated outward, downward, and forward immediately after surgery. Posterior, medial, superior movement and outward, upward, and backward rotation of condyles were observed during follow-up (T1-T2). Bone resorption frequently occurred in the posterior area of condylar surfaces, while bone remodeling was more common in the anterior region of the glenoid fossa. Reduced volume of the condyle was found in most cases, which was not associated with the amount of mandibular advancement. Overall, the condyle and its corresponding glenoid fossa remained relatively stable during the follow-up. Our results reveal positional and morphological alterations in the condyle and the glenoid fossa after bimaxillary orthognathic surgery in patients with skeletal class II malocclusion. These changes predominantly fall within the spectrum of physical adaption.
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Affiliation(s)
- Si Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital
| | - Songsong Guo
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital
| | - Yijin Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital
| | - Hong Wang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital
| | - Ping Zhang
- Jiangsu Key Laboratory of Oral Disease
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, China
| | - Hongbing Jiang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital
- Jiangsu Key Laboratory of Oral Disease
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, China
| | - Jie Cheng
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital
- Jiangsu Key Laboratory of Oral Disease
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, China
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Tsolakis IA, Rontogianni A, Tsolakis AI, Papadopoulos MA. Comparing CBCT to model scanner for dental model scanning. An in vitro imaging accuracy study. Int Orthod 2024; 22:100840. [PMID: 38215684 DOI: 10.1016/j.ortho.2023.100840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE The aim of this study is to compare the accuracy of cone beam computed tomography (CBCT) for dental model scanning to the accuracy of model scanners. METHODS Subjects from private practice were collected and scanned according to specific selection criteria. A total of 10 STL files were produced and used as reference files. They were printed with a three-dimensional (3D) printer and then scanned with CBCT and model scanner. For trueness evaluation, all models were scanned once with both equipments. Each file derived from each scan was compared with the corresponding reference model file. For the precision measurements, the physical model from the first master reference model file was scanned 10 times with each equipment and compared with the reference STL file. A reverse engineering software was used for all 3D best-fit comparisons. RESULTS With regard to the measurement of trueness of each method, the calculated mean root mean square (RMS) value was 0.06±0.01mm for the CBCT, and 0.15±0.02mm for the model scanner. There was a significant difference between the two methods (P<0.01). For the evaluation of precision of each scanner, the mean RMS value was 0.0056±0.001mm for the CBCT, and 0.153±0.002mm for model scanner. There was a significant difference between the two methods (P<0.01). CONCLUSIONS Cone Beam Computed Tomography seems to be an accurate method for scanning dental models. CBCT performs better than model scanners to scan dental models in terms of trueness and precision.
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Affiliation(s)
- Ioannis A Tsolakis
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Aliki Rontogianni
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Apostolos I Tsolakis
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA; Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Moschos A Papadopoulos
- Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Shi Y, Luo S, Wang H, Yao Q, Shi Y, Cheng J. Three-dimensional bone remodelling of glenoid fossa in patients with skeletal Class III malocclusion after bimaxillary orthognathic surgery. Int J Oral Maxillofac Surg 2024; 53:133-140. [PMID: 37442687 DOI: 10.1016/j.ijom.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
This study aimed to characterize three-dimensional quantitative morphological changes of glenoid fossa in patients with skeletal Class III malocclusion treated with bimaxillary orthognathic surgery. Ninety-five eligible patients (50 male, 45 female; mean age 22.09 years) were enrolled retrospectively. Cone beam computed tomography obtained at 1 week preoperatively (T0), immediately after surgery (T1), and at ≥ 12 months postoperatively (T2) were registered based on cranial base using voxel-based registration in 3D Slicer. Glenoid fossa surface was divided spatially into four regions, and bone modelling in these regions was visualized with color maps. Our data revealed that the mean surface variations of glenoid fossa were small, with modest bone formation as a whole. No significant associations between anteroposterior or vertical mandibular displacement and overall glenoid fossa remodeling were found (P > 0.05). Moreover, bone deposition was frequently observed in the anterior-lateral region of glenoid fossa in patients with a larger mandibular movement during T0-T1 (P < 0.001). Paired bone formation in the anterior-lateral region of glenoid fossa and bone resorption in the anterior-lateral region of condylar head was frequently observed. Collectively, our results revealed that glenoid fossa underwent complex but modest bone remodeling after bimaxillary surgery in skeletal Class III patients.
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Affiliation(s)
- Y Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China
| | - S Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, PR China
| | - H Wang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - Q Yao
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - Y Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - J Cheng
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China.
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Zhang Y, Zheng J, Wu Q, Jiang T, Xiao H, Du Y, Qi Y, Jin Z, Li F. Three-dimensional spatial analysis of temporomandibular joint in adolescent Class II division 1 malocclusion patients: comparison of Twin-Block and clear functional aligner. Head Face Med 2024; 20:4. [PMID: 38184631 PMCID: PMC10770962 DOI: 10.1186/s13005-023-00404-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Our study aimed to use three-dimensional (3D) spatial morphological measurement methods to compare the influence of Twin-Block and clear functional aligners on the temporomandibular joint (TMJ) of adolescent Class II division 1 malocclusion mandibular retraction patients. We also aimed to explore the similarities and differences in the effects on the TMJ upon using Twin-Block and clear functional aligner. METHODS Cone-beam computed tomography (CBCT) data of 49 patients with Class II division 1 malocclusion (Twin-Block group: 24; clear functional aligner group: 25) were collected before and after functional orthodontic treatment, and a 3D model of the TMJ was reconstructed using MIMICS 21.0 software. Eighteen measurement parameters, including the anterior, superior, and posterior joint spaces, were measured and compared using the 3D model. RESULTS After the two groups underwent functional appliance treatment, the height, volume, and surface area of the condyle, length of the mandibular ramus and mandibular length increased; The retro-displaced condyle moved to the middle position of the articular fossa, while the rest of the condylar position did not change significantly. Remodeling of the articular fossa after treatment was not evident. The superior joint space of the clear functional aligner group increased, but there was no significant change after Twin-Block appliances treatment. CONCLUSIONS Both appliances promote condylar growth and sagittal and vertical development of the mandible in adolescent Class II division 1 malocclusion mandibular retraction patients. The length of the mandibular ramus showed a more significant increase following treatment with the Twin-Block appliances than with clear function aligners.
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Affiliation(s)
- Yueying Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Jiajing Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Qiuyue Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Tianlu Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yusen Du
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yizhe Qi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Zuolin Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
| | - Feifei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
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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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Jhamb T, AlSulaiman A, Parsi G, Will L, Motro M. Three-dimensional morphometric analysis of anterior cranial base in growing patients. Am J Orthod Dentofacial Orthop 2023; 164:530-536. [PMID: 37212768 DOI: 10.1016/j.ajodo.2023.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION The growth of the sphenoethmoidal and sphenofrontal suture in the anterior cranial base (ACB) terminates around 7 years old; therefore, ACB is used as a reference structure for superimposing radiographs in 2-dimensions (2D) and 3-dimensions (3D). The data in the literature regarding the cessation of growth of ACB in 3D is insufficient. The study aimed to evaluate the volumetric changes of ACB in growing patients on cone-beam computed tomography (CBCT) data in 3D. METHODS The CBCT sample was obtained from a repository of scans of subjects (n = 30) aged 6-11 years with no craniofacial anomalies or growth-related disorders. CBCTs were taken at 2 time points (approximately 12 months apart). The mean age at the initial scan (T1) was 8.4 ± 0.89 years, and the follow-up scan (T2) was 9.6 ± 0.99 years. The bones of the ACB were segmented, and 3D models of the bones were generated using Mimics software. The volumetric measurement was performed on the 3D-rendered model. Linear measurements were performed on the slices. RESULTS The volumetric analysis of the ACB between T1 and T2 showed a significant change (P <0.0001). There were no significant differences in volumetric changes of the ACB between the male and female subjects. The linear measurements on the right side of the cranial base showed continued growth between T1 and T2. CONCLUSIONS In the studied sample, growth-related changes of ACB were observed through volumetric analysis after 7 years old.
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Affiliation(s)
- Tania Jhamb
- Department of Orthodontics and Dentofacial Orthopedics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass
| | - Ahmed AlSulaiman
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Goli Parsi
- Department of Orthodontics and Dentofacial Orthopedics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass
| | - Leslie Will
- Department of Orthodontics and Dentofacial Orthopedics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass
| | - Melih Motro
- Department of Orthodontics and Dentofacial Orthopedics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass.
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Fan Y, Han B, Zhang Y, Guo Y, Li W, Chen H, Meng C, Penington A, Schneider P, Pei Y, Chen G, Xu T. Natural reference structures for three-dimensional maxillary regional superimposition in growing patients. BMC Oral Health 2023; 23:655. [PMID: 37684645 PMCID: PMC10492283 DOI: 10.1186/s12903-023-03367-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Assessment of growth-related or treatment-related changes in the maxilla requires a reliable method of superimposition. Such methods are well established for two-dimensional (2D) cephalometric images but not yet for three-dimensions (3D). The aims of this study were to identify natural reference structures (NRS) for the maxilla in growing patients in 3D, opportunistically using orthodontic mini-screws as reference; and to test the applicability of the proposed NRS for maxillary superimposition by assessing the concordance of this approach with Björk's 'stable reference structures' in lateral projection. METHODS The stability of the mini-screws was tested on longitudinal pairs of pre- and post-orthodontic cone-beam computed tomography (CBCT) images by measuring the distance changes between screws. After verifying the stability of the mini-screws, rigid registration was performed for aligning the stable mini-screws. Then, non-rigid registration was used to establish the dense voxel-correspondence among CBCT images and calculate the displacement of each voxel belonging to the maxilla relative to the mini-screws. The displacement vectors were transformed to a standardized maxillary template to categorize the stability of the internal structures statistically. Those voxels that displaced less relative to the mini-screws were considered as the natural reference structures (NRS) for the maxilla. Test samples included another dataset of longitudinal CBCT scans. They were used to evaluate the applicability of the proposed NRS for maxillary superimposition. We assessed whether aligning the maxilla with proposed NRS is in concordance with the maxillary internal reference structures superimposition in the traditional 2D lateral view as suggested by Björk. This was quantitively assessed by comparing the mean sagittal and vertical tooth movements for both superimposition methods. RESULTS The stability of the mini-screws was tested on 10 pairs of pre- and post-orthodontic cone-beam computed tomography (CBCT) images (T1: 12.9 ± 0.8 yrs, T2: 14.8 ± 0.7 yrs). Both the loaded and the unloaded mini-screws were shown to be stable during orthodontic treatment, which indicates that they can be used as reference points. By analyzing the deformation map of the maxilla, we confirmed that the infraorbital rims, maxilla around the piriform foramen, the infrazygomatic crest and the hard palate (palatal vault more than 1 cm distal to incisor foramen except the palatal suture) were stable during growth. Another dataset of longitudinal CBCT scans (T1: 12.2 ± 0.63 yrs, T2: 15.2 ± 0.96 yrs) was used to assess the concordance of this approach with Björk's 'stable reference structures'. The movement of the maxillary first molar and central incisor showed no statistically significant difference when superimposing the test images with the proposed NRS or with the classic Björk maxillary superimposition in the lateral view. CONCLUSIONS The infraorbital rims, maxilla around the piriform foramen, the infrazygomatic crest and the hard palate (palatal vault more than 1 cm posterior to incisal foramen except the palatal suture) were identified as stable regions in the maxilla. These stable structures can be used for maxillary superimposition in 3D and generate comparable results to Björk superimposition in the lateral view.
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Affiliation(s)
- Yi Fan
- Third Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Bing Han
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yungeng Zhang
- Key Laboratory of Machine Perception (MOE), Department of Machine Intelligence, School of Artificial Intelligence and Technology, Peking University, Beijing, China
| | - Yixiao Guo
- Key Laboratory of Machine Perception (MOE), Department of Machine Intelligence, School of Artificial Intelligence and Technology, Peking University, Beijing, China
| | - Wei Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huanhuan Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Chenda Meng
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Anthony Penington
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Australia
- Facial Science, Murdoch Children's Research Institute, Melbourne, Australia
| | - Paul Schneider
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - Yuru Pei
- Key Laboratory of Machine Perception (MOE), Department of Machine Intelligence, School of Artificial Intelligence and Technology, Peking University, Beijing, China
| | - Gui Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Tianmin Xu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
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Wang Z, Shi Y, Wang Y, Chen W, Jiang H, Cheng J. Three-dimensional quantitative changes of condyle in patients with skeletal class III malocclusion after bimaxillary orthognathic surgery with 5-year follow-up. Clin Oral Investig 2023:10.1007/s00784-023-05032-z. [PMID: 37145152 DOI: 10.1007/s00784-023-05032-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE The present study aimed to characterize three-dimensional (3D) long-term quantitative condyle change including positional, surface, and volumetric alterations in patients with skeletal class III malocclusion treated with bimaxillary orthognathic surgery. MATERIAL AND METHODS Twenty-three eligible patients (9 males, 14 females, mean age: 28.28 years old) treated from Jan. 2013 to Dec. 2016 with postoperative follow-up over 5 years were retrospectively enrolled. Cone-beam computed tomography scan for each patient was conducted at 4 stages: 1 week preoperatively (T0), immediately after surgery (T1), 12 months postoperatively (T2), and 5-year postoperatively (T3). Positional changes, surface, and volumetric remodeling of condyle were measured in segmented visual 3D models and statistically compared between stages. RESULTS Our 3D quantitative calibrations revealed that the condylar center shifted in anterior (0.23 ± 1.50 mm), medial (0.34 ± 0.99), and superior (1.11 ± 1.10 mm) directions and rotated outward (1.58 ± 3.11°), superior (1.83 ± 5.08°), and backward (4.79 ± 13.75°) from T1 to T3. With regard to condylar surface remodeling, bone formation was frequently observed in the anteromedial areas, while bone resorption was commonly detected in the anterolateral area. Moreover, condylar volume remained largely stable with a minimal reduction during the follow-up. CONCLUSION Collectively, although condyle undergoes positional changes and bone remodeling after bimaxillary surgery in patients with mandibular prognathism, these changes largely fall in the range of physical adaptations in the long run. CLINICAL RELEVANCE These findings advance the current understanding of long-term condylar remodeling after bimaxillary orthognathic surgery in skeletal class III patients.
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Affiliation(s)
- Ziyu Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Jiangsu, 210029, People's Republic of China
| | - Yijin Shi
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, 210029, People's Republic of China
| | - Yi Wang
- Department of Oral and Maxillofacial Surgery, Anhui Provincial Hospital/The Affiliated Hospital of University of Science and Technology of China, He Fei, 230031, People's Republic of China
| | - Wenjing Chen
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, 210029, People's Republic of China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Jiangsu, 210029, People's Republic of China
| | - Hongbing Jiang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, 210029, People's Republic of China
| | - Jie Cheng
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
- Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, 210029, People's Republic of China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Jiangsu, 210029, People's Republic of China.
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10
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Feng JL, Ma RH, Du H, Zhao YP, Meng JH, Li G. Diagnostic accuracy of fused CBCT images in the evaluation of temporomandibular joint condylar bone resorption. Clin Oral Investig 2023; 27:1277-1288. [PMID: 36303076 DOI: 10.1007/s00784-022-04761-x] [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: 06/28/2022] [Accepted: 10/18/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the diagnostic accuracy of fused CBCT images for patients with condylar bone resorption of temporomandibular joint (TMJ) osteoarthrosis. MATERIALS AND METHODS Forty-two TMJs from twenty-one patients were included. Bone resorption of condyles evaluated by three experts was used as the reference standard. Three oral and maxillofacial radiology residents evaluated the resorption of condyles with a five-point scale for the four sets of images (two consecutive CBCT images without fusion, fused 2D cross-sectional images, fused 3D images, and combining fused 2D cross-sectional images and fused 3D images) randomly and independently. Each set of images was evaluated at least 1 week apart, and a second evaluation was performed 4 weeks later. Intraclass correlation coefficients were calculated to assess the intra- and inter-observer agreement. The areas under the ROC curves (AUCs) were compared among the four image sets using the Z test. RESULTS Twenty-four TMJs were determined as condylar bone resorption, and eighteen were determined as no obvious change. The average AUC values from the three observers for the three fused image sets (0.94, 0.93, 0.93) were significantly higher than the image set without fusion (p < 0.01). The intra- and inter-observer agreement on the three fused image sets (0.70-0.89, 0.91-0.92) was higher than the image set without fusion (0.37-0.63, 0.75). CONCLUSIONS Fused CBCT images of TMJ osteoarthrosis patients can intuitively display the condylar bone resorption and significantly improve the diagnostic accuracy. CLINICAL RELEVANCE Fused CBCT images can help clinicians intuitively observe bone changes of the condyle in TMJ osteoarthrosis patients.
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Affiliation(s)
- Ji-Ling Feng
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Ruo-Han Ma
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Han Du
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.,Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Yan-Ping Zhao
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.,Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing, China
| | - Juan-Hong Meng
- Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing, China
| | - Gang Li
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
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11
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Mangal U, Lee SM, Lee S, Cha JY, Lee KJ, Yu HS, Jung H, Choi SH. Reorientation methodology for reproducible head posture in serial cone beam computed tomography images. Sci Rep 2023; 13:3220. [PMID: 36828940 PMCID: PMC9958024 DOI: 10.1038/s41598-023-30430-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/22/2023] [Indexed: 02/26/2023] Open
Abstract
Low dose and accessibility have increased the application of cone beam computed tomography (CBCT). Often serial images are captured for patients to diagnose and plan treatment in the craniofacial region. However, CBCT images are highly variable and lack harmonious reproduction, especially in the head's orientation. Though user-defined orientation methods have been suggested, the reproducibility remains controversial. Here, we propose a landmark-free reorientation methodology based on principal component analysis (PCA) for harmonious orientation of serially captured CBCTs. We analyzed three serial CBCT scans collected for 29 individuals who underwent orthognathic surgery. We first defined a region of interest with the proposed protocol by combining 2D rendering and 3D convex hull method, and identified an intermediary arrangement point. PCA identified the y-axis (anterioposterior) followed by the secondary x-axis (transverse). Finally, by defining the perpendicular z-axis, a new global orientation was assigned. The goodness of alignment (Hausdorff distance) showed a marked improvement (> 50%). Furthermore, we clustered cases based on clinical asymmetry and validated that the protocol was unaffected by the severity of the skeletal deformity. Therefore, it could be suggested that integrating the proposed algorithm as the preliminary step in CBCT evaluation will address a fundamental step towards harmonizing the craniofacial imaging records.
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Affiliation(s)
- Utkarsh Mangal
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | | | - Seeyoon Lee
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | - Jung-Yul Cha
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | - Kee-Joon Lee
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | - Hyung-Seog Yu
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | | | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722, Korea.
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12
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Three-dimensional soft tissue landmark detection with marching cube algorithm. Sci Rep 2023; 13:1544. [PMID: 36707701 PMCID: PMC9883223 DOI: 10.1038/s41598-023-28792-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023] Open
Abstract
Current method of analyzing three-dimensional soft tissue data, especially in the frontal view, is subjective and has poor reliability. To overcome this limitation, the present study aimed to introduce a new method of analyzing soft tissue data reconstructed by marching cube algorithm (Program S) and compare it with a commercially available program (Program A). Cone-beam computed tomography images of 42 patients were included. Two orthodontists digitized six landmarks (pronasale, columella, upper and lower lip, right and left cheek) twice using both programs in two-week intervals, and the reliability was compared. Furthermore, computer-calculated point (CC point) was developed to evaluate whether human error could be reduced. The results showed that the intra- and inter-examiner reliability of Program S (99.7-100% and 99.9-100%, respectively) were higher than that of Program A (64.0-99.9% and 76.1-99.9%, respectively). Moreover, the inter-examiner difference of coordinate values and distances for all six landmarks in Program S was lower than Program A. Lastly, CC point was provided as a consistent single point. Therefore, it was validated that this new methodology can increase the intra- and inter-examiner reliability of soft tissue landmark digitation and CC point can be used as a landmark to reduce human error.
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13
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Three-Dimensional Accuracy and Stability of Personalized Implants in Orthognathic Surgery: A Systematic Review and a Meta-Analysis. J Pers Med 2023; 13:jpm13010125. [PMID: 36675786 PMCID: PMC9867342 DOI: 10.3390/jpm13010125] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
This systematic review aimed to determine the accuracy/stability of patient-specific osteosynthesis (PSI) in orthognathic surgery according to three-dimensional (3D) outcome analysis and in comparison to conventional osteosynthesis and computer-aided designed and manufactured (CAD/CAM) splints or wafers. The PRISMA guidelines were followed and six academic databases and Google Scholar were searched. Records reporting 3D accuracy/stability measurements of bony segments fixated with PSI were included. Of 485 initial records, 21 met the eligibility (566 subjects), nine of which also qualified for a meta-analysis (164 subjects). Six studies had a high risk of bias (29%), and the rest were of low or moderate risk. Procedures comprised either single-piece or segmental Le Fort I and/or mandibular osteotomy and/or genioplasty. A stratified meta-analysis including 115 subjects with single-piece Le Fort I PSI showed that the largest absolute mean deviations were 0.5 mm antero-posteriorly and 0.65° in pitch. PSIs were up to 0.85 mm and 2.35° more accurate than conventional osteosynthesis with CAD/CAM splint or wafer (p < 0.0001). However, the clinical relevance of the improved accuracy has not been shown. The literature on PSI for multi-piece Le Fort I, mandibular osteotomies and genioplasty procedure is characterized by high methodological heterogeneity and a lack of randomized controlled trials. The literature is lacking on the 3D stability of bony segments fixated with PSI.
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14
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Sheeran S, Hartsfield J, Omami G, Bazina M. Comparison of two 3-dimensional user-friendly voxel-based maxillary and 2-dimensional superimposition methods. Am J Orthod Dentofacial Orthop 2023; 163:117-125. [PMID: 36549828 DOI: 10.1016/j.ajodo.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cephalometric superimpositions have many uses in orthodontics, including growth evaluation and outcome assessment. However, 2-dimensional (2D) cephalograms can be distorted and yield incomplete 2D data. Cone-beam computed tomography (CBCT) imaging provides a 3-dimensional (3D), undistorted, and more complete patient analysis. CBCT imaging provides many unique advantages to the orthodontic practice and can influence how treatment outcomes are assessed. This study aimed to investigate the validity of 3D maxillary voxel-based superimpositions compared with the 2D method recommended by the American Board of Orthodontists. METHODS This retrospective study included pretreatment and posttreatment CBCT images of 30 adolescent patients. The images were superimposed using the 3D voxel-based tools in Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). Two different 3D anatomic registration areas (3DA-3DB) were tested for the validity and reproducibility of the 3D maxillary superimpositions as compared with the 2D method. Linear and angular measurements were used to evaluate the dental changes of the maxillary right central incisor and first molar. Data distribution was normal by the Shapiro-Wilk W test. A mixed model analysis of variance test was done to compare the 3 superimposition types within each subject, followed by pairwise Tukey-Kramer comparisons when indicated. RESULTS After applying the Benjamini-Hochberg procedure to control the false discovery rate at 0.05 with multiple testing, the U1 vertical difference was statistically significant (P <0.0001) for the superimposition method, though the mean differences were clinically nonsignificant (0.52 mm, 0.76 mm). The U1 angular and U6 vertical differences were not statistically significant for the superimposition method (P = 0.3636 and P = 0.1863, respectively). CONCLUSIONS The 3D voxel-based maxillary superimpositions showed similar results to conventional 2D superimpositions recommended by the American Board of Orthodontists.
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Affiliation(s)
- Shelby Sheeran
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Ky
| | - James Hartsfield
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Galal Omami
- Division of Oral Medicine, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Mohamed Bazina
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Ky.
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15
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Chung EJ, Yang BE, Park IY, Yi S, On SW, Kim YH, Kang SH, Byun SH. Effectiveness of cone-beam computed tomography-generated cephalograms using artificial intelligence cephalometric analysis. Sci Rep 2022; 12:20585. [PMID: 36446924 PMCID: PMC9708822 DOI: 10.1038/s41598-022-25215-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Lateral cephalograms and related analysis constitute representative methods for orthodontic treatment. However, since conventional cephalometric radiographs display a three-dimensional structure on a two-dimensional plane, inaccuracies may be produced when quantitative evaluation is required. Cone-beam computed tomography (CBCT) has minimal image distortion, and important parts can be observed without overlapping. It provides a high-resolution three-dimensional image at a relatively low dose and cost, but still shows a higher dose than a lateral cephalogram. It is especially true for children who are more susceptible to radiation doses and often have difficult diagnoses. A conventional lateral cephalometric radiograph can be obtained by reconstructing the Digital Imaging and Communications in Medicine data obtained from CBCT. This study evaluated the applicability and consistency of lateral cephalograms generated by CBCT using an artificial intelligence analysis program. Group I comprised conventional lateral cephalometric radiographs, group II comprised lateral cephalometric radiographs generated from CBCT using OnDemand 3D, and group III comprised lateral cephalometric radiographs generated from CBCT using Invivo5. All measurements in the three groups showed non-significant results. Therefore, a CBCT scan and artificial intelligence programs are efficient means when performing orthodontic analysis on pediatric or orthodontic patients for orthodontic diagnosis and planning.
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Affiliation(s)
- Eun-Ji Chung
- grid.488421.30000000404154154Department of Conservative Dentistry, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea ,grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea
| | - Byoung-Eun Yang
- grid.488421.30000000404154154Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea ,grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.256753.00000 0004 0470 5964Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.488421.30000000404154154Dental Implant Robotic Center, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea
| | - In-Young Park
- grid.488421.30000000404154154Department of Orthodontics, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea ,grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.256753.00000 0004 0470 5964Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea
| | - Sangmin Yi
- grid.488421.30000000404154154Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea ,grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.256753.00000 0004 0470 5964Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea
| | - Sung-Woon On
- grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.256753.00000 0004 0470 5964Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.488450.50000 0004 1790 2596Department of Oral and Maxillofacial Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, 18450 Korea
| | - Young-Hee Kim
- grid.488421.30000000404154154Department of Oral and Maxillofacial Radiology, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea ,grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.256753.00000 0004 0470 5964Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea
| | - Sam-Hee Kang
- grid.488421.30000000404154154Department of Conservative Dentistry, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea ,grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.256753.00000 0004 0470 5964Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea
| | - Soo-Hwan Byun
- grid.488421.30000000404154154Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea ,grid.256753.00000 0004 0470 5964Graduate School of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.256753.00000 0004 0470 5964Institute of Clinical Dentistry, Hallym University, Chuncheon, 24252 Republic of Korea ,grid.488421.30000000404154154Dental Implant Robotic Center, Hallym University Sacred Heart Hospital, Anyang, 14068 Korea
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Accuracy of Segmented Le Fort I Osteotomy with Virtual Planning in Orthognathic Surgery Using Patient-Specific Implants: A Case Series. J Clin Med 2022; 11:jcm11195495. [PMID: 36233363 PMCID: PMC9572233 DOI: 10.3390/jcm11195495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background: When maxillary transversal expansion is needed, two protocols of treatment can be used: a maxillary orthodontic expansion followed by a classical bimaxillary osteotomy or a bimaxillary osteotomy with maxillary segmentation. The aim of this study was to assess the accuracy of segmented Le Fort I osteotomy using computer-aided orthognathic surgery and patient-specific titanium plates in patients who underwent a bimaxillary osteotomy for occlusal trouble with maxillary transversal insufficiencies. Methods: A virtual simulation of a Le Fort I osteotomy with maxillary segmentation, a sagittal split ramus osteotomy, and genioplasty (if needed) was conducted on a preoperative three-dimensional (3D) model of each patient’s skull using ProPlan CMF 3.0 software (Materialise, Leuven, Belgium). Computer-assisted osteotomy saw-and-drill guides and patient-specific implants (PSIs, titanium plates) were produced and used during the surgery. We chose to focus on the maxillary repositioning accuracy by comparing the preoperative virtual surgical planning and the postoperative 3D outcome skulls using surface superimpositions and 13 standard dental and bone landmarks. Errors between these preoperative and postoperative landmarks were calculated and compared to discover if segmental maxillary repositioning using PSIs was accurate enough to be safely used to treat transversal insufficiencies. Results: A total of 22 consecutive patients—15 females and 7 males, with a mean age of 27.4 years—who underwent bimaxillary computer-assisted orthognathic surgery with maxillary segmentation were enrolled in the study. All patients presented with occlusion trouble, 13 with Class III malocclusions (59%) and 9 (41%) with Class II malocclusions. A quantitative analysis revealed that, overall, the mean absolute discrepancies for the x-axis (transversal dimension), y-axis (anterior−posterior dimensions), and z-axis (vertical dimension) were 0.59 mm, 0.74 mm, and 0.56 mm, respectively. The total error rate of maxillary repositioning was 0.62 mm between the postoperative cone-beam computed tomography (CBCT) and the preoperatively planned 3D skull. According to the literature, precision in maxilla repositioning is defined by an error rate (clinically relevant) at each landmark of <2 mm and a total error of <2 mm for each patient. Conclusions: A high degree of accuracy between the virtual plan and the postoperative result was observed.
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Tinano MM, Becker HMG, Franco LP, dos Anjos CPG, Ramos VM, Nader CMFF, Godinho J, de Párcia Gontijo H, Souki BQ. Morphofunctional changes following adenotonsillectomy of obstructive sleep apnea children: a case series analysis. Prog Orthod 2022; 23:29. [PMID: 35934732 PMCID: PMC9357578 DOI: 10.1186/s40510-022-00422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To perform a case series analysis of the changes in the pulmonary artery systolic pressure (PASP), nasal inspiratory flow (NIF), upper airway volume, obstructive apnea/hypopnea index (OAHI), and the maxillomandibular three-dimensional (3D) morphology after adenotonsillectomy (T&A) of obstructive sleep apnea children (OSA).
Materials and methods
Retrospective assessment of files from 1002 children screened between 2012 and 2020 in a hospital-based mouth-breather referral center. From this universe, 15 obstructive sleep apnea children (7 females; 8 males), ages 4.1 to 8.9 years old (mean age of 5.4 years ± 1.3), who presented indications of tonsillectomy and/or adenoidectomy were selected. The complete baseline examination (T0) was carried out before T&A and a second complete examination (T1) was made 18.7-month follow-up after T&A (ranging from 12 to 30 months). Eleven patients were submitted to T&A, and four patients had indications but did not receive authorization for surgery from the public health system. According to the protocol of the outpatient clinic for OSA patients, Doppler echocardiography, polysomnography, rhinomanometry, and computed tomography imaging was performed at (T0) and (T1).
Results
PASP decreased 16.6% after T&A. NIF increased more in T&A children (40.3%) than in non-T&A children (16.8%). The upper airway volume increased in T&A and non-T&A children, but greater volumetric gain (45.6%) was found in the nasopharynx of T&A patients. OAHI did not change in six T&A children (55%) and three non-T&A children (75%). The maxilla displaced downward and backward relative to the cranial base in six T&A children (55%) and two untreated children (50%). Nine of the T&A children (85%) and three untreated children (75%) presented extensive condylar growth and increased mandibular length. The qualitative 3D assessment showed similar morphological 3D changes in T&A and non-T&A patients.
Conclusion
Pulmonary artery systolic pressure decreased, nasal inspiratory flow increased, and nasopharynx volume increased following adenotonsillectomy, but obstructive apnea/hypopnea index and maxillomandibular morphology were similar in surgical and non-surgical patients.
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Santana LG, Cheib PL, de Pársia HG, Franchi L, Moro A, Souki BQ. Stability of fiducial cephalometric landmarks of growing Class II malocclusion patients: a three-dimensional retrospective study. Angle Orthod 2022; 92:482423. [PMID: 35653223 PMCID: PMC9374362 DOI: 10.2319/090721-692.1] [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: 09/01/2021] [Accepted: 04/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate three-dimensionally (3D) the stability of Nasion (Na), Sella (S), Basion (Ba), Porion (Po), and Orbitale (Or) in different age groups of growing Class II malocclusion patients and, additionally, to assess rotational changes of the S-Na and Ba-Na lines and the Frankfurt Horizontal Plane (FHP). MATERIALS AND METHODS Cone-beam computed tomography studies of 67 Class II division 1 malocclusion patients, acquired at baseline (T0) and 1 year later (T1), were retrospectively assessed. Anterior cranial fossa was used for volumetric superimposition. Subjects were grouped according to their age at T0: group 1 (G1) (8-10 years), G2 (11-13 years), and G3 (14-17 years). Quantitative assessments of the 3D linear displacements (Euclidean distance) in the position of Na, S, Ba, Po, and Or were performed. Displacement in the X, Y, and Z projections and the rotation of S-Na, Na-Ba, and FHP were also quantified. RESULTS All cephalometric landmarks showed 3D displacement (P = .001) in the three age groups. Orbitale remained stable in the vertical and sagittal dimension from 8 to 17 years (P > .05). S-Na, Na-Ba, and the FHP showed statistically significant angular rotation (P < .05) in younger patients (G1), while in older individuals (G2 and G3) they were stable (P > .05). CONCLUSIONS Na, S, Ba, and Po showed vertical and sagittal positional changes relative to the anterior cranial fossa during the growth of Class II individuals. After age 11, S-Na, Na-Ba, and FHP did not show rotation and, thus, are valid parameters for angular cephalometric analysis in Class II growing patients.
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Takahara N, Tomomatsu N, Kimura A, Kosugi M, Kurasawa Y, Morita KI, Yoda T. Changes in the condylar volume and skeletal relapse following orthognathic surgery in patients with dentofacial deformity: A retrospective study. Cranio 2022:1-11. [PMID: 35506653 DOI: 10.1080/08869634.2022.2070333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the relationship between the changes in condylar volume and maxillofacial skeletal morphology according to sex as well as the relationship between condylar volume reduction and skeletal relapse in patients who underwent orthognathic surgery. METHODS Ninety-five patients were categorized into skeletal Class III, Class II, and facial asymmetry groups. Computed tomography scans taken preoperatively and at 1 year postoperatively were used for quantitative measurement. RESULTS Postoperative condylar volume was reduced in both the Class II group and the deviated side of the asymmetry group. Both female and Class II deformity were significant predictors of postoperative reduction in the condylar volume. There was a significant correlation between skeletal relapse and postoperative change in condylar volume in the Class II group. CONCLUSION Postoperative condylar resorption may be associated with preoperative maxillofacial skeletal morphology and sex and also with skeletal relapse in the Class II group.
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Affiliation(s)
- Namiaki Takahara
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobuyoshi Tomomatsu
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Kimura
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Machiko Kosugi
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhiro Kurasawa
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kei-Ichi Morita
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Andriola FDO, Haas Junior OL, Guijarro-Martínez R, Hernández-Alfaro F, de Oliveira RB, Pagnoncelli RM, Swennen GRJ. Computed tomography imaging superimposition protocols to assess outcomes in orthognathic surgery: a systematic review with comprehensive recommendations. Dentomaxillofac Radiol 2022; 51:20210340. [PMID: 34520241 PMCID: PMC8925870 DOI: 10.1259/dmfr.20210340] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES A systematic review was performed to analyze the current evidence on three-dimensional (3D) computed tomography (CT) superimposition protocols used to assess dentomaxillofacial changes after orthognathic and orthofacial surgery. Accuracy, reproducibility, and efficiency were evaluated. METHODS The search was divided into Main Search (PubMed, EMBASE, Cochrane Library, LILACS, and SciELO), Grey Literature search (Google Scholar and Open Grey), and Manual search. Thirteen studies were included. Of these, 10 reported data on accuracy, 10 on reproducibility and five on efficiency. Seven proposed or evaluated methods of voxel-based superimposition, three focused on the surface-based technique, one compared surface- and voxel-based superimposition protocols, one used the maximum mutual information algorithm, and one described a landmark-based superimposition method. Cone-beam computed tomography (CBCT) was the most common imaging technique, being used in 10 studies. RESULTS The accuracy of most methods was high, showing mean differences smaller than voxels' dimensions, ranging between 0.05 and 1.76 mm for translational accuracy, and 0.10-1.09° for rotational accuracy. The overall reproducibility was considered good as demonstrated by the small mean error (range: 0.01-0.26 mm) and high correlation coefficients (range: 0.53-1.00). Timing to complete virtual superimposition techniques ranged between a few seconds up to 40 min. CONCLUSIONS Voxel-based superimposition protocols presented the highest accuracy and reproducibility. Moreover, superimposition protocols that used automated processes and involved only one software were the most efficient.
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Affiliation(s)
| | | | | | | | - Rogério Belle de Oliveira
- Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rogério Miranda Pagnoncelli
- Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Holte M, Diaconu A, Ingerslev J, Thorn J, Pinholt E. Virtual surgical analysis: long-term cone beam computed tomography stability assessment of segmental bimaxillary surgery. Int J Oral Maxillofac Surg 2022; 51:1188-1196. [DOI: 10.1016/j.ijom.2022.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/21/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
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Diaconu A, Holte MB, Cattaneo PM, Pinholt EM. A semi-automatic approach for longitudinal 3D upper airway analysis using voxel-based registration. Dentomaxillofac Radiol 2022; 51:20210253. [PMID: 34644181 PMCID: PMC8925868 DOI: 10.1259/dmfr.20210253] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To propose and validate a reliable semi-automatic approach for three-dimensional (3D) analysis of the upper airway (UA) based on voxel-based registration (VBR). METHODS Post-operative cone beam computed tomography (CBCT) scans of 10 orthognathic surgery patients were superimposed to the pre-operative CBCT scans by VBR using the anterior cranial base as reference. Anatomic landmarks were used to automatically cut the UA and calculate volumes and cross-sectional areas (CSA). The 3D analysis was performed by two observers twice, at an interval of two weeks. Intraclass correlations and Bland-Altman plots were used to quantify the measurement error and reliability of the method. The relative Dahlberg error was calculated and compared with a similar method based on landmark re-identification and manual measurements. RESULTS Intraclass correlation coefficient (ICC) showed excellent intra- and inter-observer reliability (ICC ≥ 0.995). Bland-Altman plots showed good observer agreement, low bias and no systematic errors. The relative Dahlberg error ranged between 0.51 and 4.30% for volume and 0.24 and 2.90% for CSA. This was lower when compared with a similar, manual method. Voxel-based registration introduced 0.05-1.44% method error. CONCLUSIONS The proposed method was shown to have excellent reliability and high observer agreement. The method is feasible for longitudinal clinical trials on large cohorts due to being semi-automatic.
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Affiliation(s)
- Alexandru Diaconu
- 3D Lab Denmark, Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | | | - Paolo Maria Cattaneo
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
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Lim YN, Yang BE, Byun SH, Yi SM, On SW, Park IY. Three-Dimensional Digital Image Analysis of Skeletal and Soft Tissue Points A and B after Orthodontic Treatment with Premolar Extraction in Bimaxillary Protrusive Patients. BIOLOGY 2022; 11:biology11030381. [PMID: 35336755 PMCID: PMC8945223 DOI: 10.3390/biology11030381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022]
Abstract
Aim. To investigate the effect of changes in incisor tip, apex movement, and inclination on skeletal points A and B and characterize changes in skeletal points A and B to the soft tissue points A and B after incisor retraction in Angle Class I bimaxillary dentoalveolar protrusion. Methods. Twenty-two patients with Angle Class I bimaxillary dentoalveolar protrusion treated with four first premolar extractions were included in this study. The displacement of skeletal and soft tissue points A and B was measured using cone-beam computed tomography (CBCT) using a three-dimensional coordinate system. The movement of the upper and lower incisors was also measured using CBCT-synthesized lateral cephalograms. Results. Changes in the incisal tip, apex, and inclination after retraction did not significantly affect the position of points A and B in any direction (x, y, z). Linear regression analysis showed a statistically significant relationship between skeletal point A and soft tissue point A on the anteroposterior axis (z). Skeletal point A moved forward by 0.07 mm, and soft tissue point A moved forward by 0.38 mm, establishing a ratio of 0.18: 1 (r = 0.554, p < 0.01). Conclusion. The positional complexion of the skeletal points A and B was not directly influenced by changes in the incisor tip, apex, and inclination. Although the results suggest that soft tissue point A follows the anteroposterior position of skeletal point A, its clinical significance is suspected. Thus, hard and soft tissue analysis should be considered in treatment planning.
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Affiliation(s)
- You Na Lim
- Division of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14066, Korea;
| | - Byoung-Eun Yang
- Division of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Korea; (B.-E.Y.); (S.-H.B.); (S.-M.Y.)
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
| | - Soo-Hwan Byun
- Division of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Korea; (B.-E.Y.); (S.-H.B.); (S.-M.Y.)
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
| | - Sang-Min Yi
- Division of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Korea; (B.-E.Y.); (S.-H.B.); (S.-M.Y.)
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
| | - Sung-Woon On
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
- Division of Oral & Maxillofacial Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea
| | - In-Young Park
- Division of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14066, Korea;
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
- Correspondence: ; Tel.: +82-31-380-3870; Fax: +82-31-380-1726
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Sangalli KL, Dutra-Horstmann KL, Correr GM, Topolski F, Flores-Mir C, Lagravère MO, Moro A. Three-dimensional skeletal and dentoalveolar sagittal and vertical changes associated with cantilever Herbst appliance in prepubertal patients with Class II malocclusion. Am J Orthod Dentofacial Orthop 2022; 161:638-651.e1. [PMID: 35016812 DOI: 10.1016/j.ajodo.2020.11.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 11/01/2022]
Abstract
INTRODUCTION This study aimed to assess sagittal and vertical skeletal and dentoalveolar changes through the use of 3-dimensional imaging in prepubertal Class II malocclusion patients treated with a cantilever Herbst appliance (HA). Condyle-glenoid fossa positional changes were also quantified. METHODS This retrospective cohort study assessed 22 children (11.2 years ± 1.2) consecutively treated with a cantilever HA for 12 months and 11 untreated children (aged 9.3 ± 0.30 years) that served as controls. Cone-beam computed tomography was performed at baseline (T1) and at the end of the observation period (T2). Movements in the regions of interest were measured as linear displacements from cone-beam computed tomography images through algebraic calculations. A Student t test for independent samples was used for group equivalence testing at T1, and the treatment differences between T2 and T1 were evaluated by 2 analyses of covariance, one considering the expected growth unit as a covariate and the other with an annualized factor. RESULTS The largest dental movement was a mesial movement of mandibular molars (3.70 mm), whereas the largest skeletal changes consisted of a larger relative length of the mandible (difference of 1.2 mm) in the HA group than in the control group. CONCLUSIONS Within the study limitations (retrospective cohort, historical control group, and sample size), 3-dimensional imaging suggests that HA corrected Class II malocclusion in a predominantly prepubertal sample through more dental than skeletal changes. The changes were more significant in the sagittal than in the vertical direction. In addition, relative stability in the condyle-fossa relationship was noted.
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Affiliation(s)
- Kamilla Leonardo Sangalli
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | | | - Gisele Maria Correr
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Francielle Topolski
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Manuel O Lagravère
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Alexandre Moro
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Department of Orthodontics, Federal University of Paraná, Curitiba, Paraná, Brazil.
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Apostolopoulos K, Palomo JM, Rizzante FAP, Pugliese F. A 3D mirroring and colormap asymmetry study of Class II subdivision patients. Orthod Craniofac Res 2021; 25:429-436. [PMID: 34863033 DOI: 10.1111/ocr.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients with Class II subdivision malocclusion present skeletal and dental asymmetries. The purpose of this study is to assess those asymmetries by 3D mirroring and colormap quantification. METHODS This study analyzed 50 initial CBCTs divided into two groups: Class I (control group) and Class II subdivision (study group) malocclusion patients. CBCTs were oriented and full skull was segmented generating a 3D model. The right side of the 3D models was mirrored, using a midsagittal plane as reference, resulting in a perfectly symmetric skull based on two right sides. Original and mirrored models were superimposed on the unchanged right half, and differences were quantified using a colormap. Eight regions of interest were assessed: gonion, mandibular front, maxillary front, zygomatic process, maxillary and mandibular canine and molar areas. RESULTS Statistically significant differences using the Mann-Whitney test were found in six of the eight evaluated areas when comparing the control to the study group. The maxillary skeletal areas did not show any difference between the groups. CONCLUSIONS Patients with Class II subdivision malocclusion show true skeletal and dental asymmetries when comparing right and left sides. The maxilla showed no significant skeletal asymmetry, but the maxillary teeth were positioned more mesially on the Class II side. The maxillary canine on the Class II side was also more bucally positioned. The mandible showed significant asymmetries with both skeletal and dental areas in the Class II side more distally and bucally positioned.
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Affiliation(s)
- Konstantinos Apostolopoulos
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fabio Antonio Piola Rizzante
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fernando Pugliese
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Kato M, Arai K. Relationship between dental and basal arch forms in mandibular anterior crowding. Am J Orthod Dentofacial Orthop 2021; 161:53-64. [PMID: 34872828 DOI: 10.1016/j.ajodo.2020.06.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Positive correlations between the mandibular dental and basal arch forms in patients with minimum crowding have been observed; however, the relationship in orthodontic patients with mandibular anterior crowding (MnAC) remains unclear. Therefore, we evaluated this relationship in patients with MnAC requiring premolar extraction. METHODS Thirty women with normal occlusion (mean age, 20.6 ± 2.5 years) and 30 women with Class I MnAC (mean age, 20.3 ± 2.9 years) were selected as control and MnAC groups, respectively. The widths and depths of the mandibular dental and basal arches at the FA and WALA points were measured and compared between groups. Relationships between the arch widths at the FA and WALA points were analyzed by Pearson correlation coefficient. RESULTS Larger variances were found for dental arch widths at canine and premolars and depth at canine in the MnAC group. Positive correlations were observed between dental and corresponding basal arch widths for both groups, except at the canine in the MnAC group, and higher correlations were observed between dental arch widths for all teeth except the first molar and basal arch widths for posterior adjacent teeth when comparing the corresponding basal arch widths. CONCLUSIONS The positive correlations observed between the dental and basal arch widths suggest the basal arch widths at the posterior adjacent tooth can be used as an additional reference to create an individualized postorthodontic dental arch form for MnAC patients.
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Affiliation(s)
- Makiko Kato
- Department of Orthodontics, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Kazuhito Arai
- Department of Orthodontics, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan.
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Moon HW, Nam W, Ahn HW, Oh SH, Kook YA, Kim SH. Development of a maxillomandibular arch form based on the center of resistance of teeth using cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 161:208-219. [PMID: 34753591 DOI: 10.1016/j.ajodo.2020.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Controlling transverse discrepancies is necessary to ensure stable and functional occlusion. Altered molar inclinations can camouflage the transverse relationship. The purpose of this research was to evaluate the maxillomandibular relationship of the center of resistance (CR) of the arch form created by the CR of teeth and compare these CR arch forms by their skeletal patterns. METHODS Sixty patients with minor crowding and normal posterior overjet were divided into 3 groups according to ANB angle: skeletal Class I group had ANB angle between 0° and 4° (n = 20), skeletal Class II group had ANB angle >4° (n = 20), and skeletal Class III group had ANB angle <0° (n = 20). The 3-dimensional coordinates of the CR were estimated using cone-beam computed tomography images and projected on the CR occlusal plane to obtain the 2-dimensional coordinates. The CR arch forms were constructed and evaluated using Matlab (MathWorks, Natick, Mass). RESULTS On comparing maxillomandibular CR arch form widths, the maxilla was significantly larger than the mandible of the canine and first premolar. The mandible was larger in the first molar of the skeletal Class III group. The maxillomandibular CR arch form width ratios were between 0.97 and 1.35. On comparing maxillomandibular CR arch form areas, the maxilla was significantly larger than the mandible in the anterior segment, and the mandible was larger in the posterior segment. The ratios were between 0.86 and 2.25. In between-group comparison, the skeletal Class III group showed significantly greater arch forms in the mandible. CONCLUSIONS CR arch forms had significant maxillomandibular differences throughout the arch. The maxillomandibular ratios could be a reference for site-specific transverse discrepancy analysis.
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Affiliation(s)
- Hyung-Wook Moon
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Woochul Nam
- School of Mechanical Engineering, Chung-Ang University, Seoul, South Korea
| | - Hyo-Won Ahn
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, Postgraduate School of Dentistry, The Catholic University of Korea, Seoul St Mary's Hospital, Seoul, South Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, South Korea.
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Two- and Three-Segment Surgically Assisted Rapid Maxillary Expansion: A Clinical Trial. Plast Reconstr Surg 2021; 148:1086-1097. [PMID: 34705783 DOI: 10.1097/prs.0000000000008491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The literature shows no consensus on whether two- or three-segment surgically assisted rapid maxillary expansion is the best operative technique. METHODS The present clinical trial was designed to compare the outcome of two- and three-segment osteotomy surgically assisted rapid maxillary expansion. Thirty-two adult patients with transverse maxillary deficiency greater than or equal to 5 mm were randomly assigned to two- and three-segment groups (n = 16). Dimensional and psychological assessments (Oral Health Impact Profile and Brazilian Orthognathic Quality of Life Questionnaire) were carried out before surgical intervention and at one of the following time points: completion of expansion, removal of expanding device, 6 months after completion of expansion, or 10 months after completion of expansion. Dimensional assessments for asymmetric expansion of the maxilla and for changes in the area and volume of the palatine vault were performed on digital data from tomographic and laser scanning with the aid of an engineering inspection software. RESULTS No statistically significant differences were found in asymmetry or stability outcomes between groups. The psychological benefit provided by the three-segment technique did not spread through the domains of the quality-of-life questionnaires. CONCLUSIONS The current findings suggest that three-segment surgically assisted rapid maxillary expansion outcomes do not exceed those obtained with its two-segment counterpart regarding symmetry of maxillary expansion and stability of area and volume of the palatine vault. Furthermore, psychological nuances evidenced in two- and three-segment groups with the tools used play a limited, short-lasting role, or a specific, more sensitive assessment tool needs to be developed. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, II.
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Le C, Deleat-Besson R, Prieto J, Brosset S, Dumont M, Zhang W, Cevidanes L, Bianchi J, Ruellas A, Gomes L, Gurgel M, Massaro C, Aliaga-Del Castillo A, Yatabe M, Benavides E, Soki F, Al Turkestani N, Evangelista K, Goncalves J, Valladares-Neto J, Alves Garcia Silva M, Chaves C, Costa F, Garib D, Oh H, Gryak J, Styner M, Fillion-Robin JC, Paniagua B, Najarian K, Soroushmehr R. Automatic Segmentation of Mandibular Ramus and Condyles. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2952-2955. [PMID: 34891864 PMCID: PMC8994041 DOI: 10.1109/embc46164.2021.9630727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In order to diagnose TMJ pathologies, we developed and tested a novel algorithm, MandSeg, that combines image processing and machine learning approaches for automatically segmenting the mandibular condyles and ramus. A deep neural network based on the U-Net architecture was trained for this task, using 109 cone-beam computed tomography (CBCT) scans. The ground truth label maps were manually segmented by clinicians. The U-Net takes 2D slices extracted from the 3D volumetric images. All the 3D scans were cropped depending on their size in order to keep only the mandibular region of interest. The same anatomic cropping region was used for every scan in the dataset. The scans were acquired at different centers with different resolutions. Therefore, we resized all scans to 512×512 in the pre-processing step where we also performed contrast adjustment as the original scans had low contrast. After the pre-processing, around 350 slices were extracted from each scan, and used to train the U-Net model. For the cross-validation, the dataset was divided into 10 folds. The training was performed with 60 epochs, a batch size of 8 and a learning rate of 2×10-5. The average performance of the models on the test set presented 0.95 ± 0.05 AUC, 0.93 ± 0.06 sensitivity, 0.9998 ± 0.0001 specificity, 0.9996 ± 0.0003 accuracy, and 0.91 ± 0.03 F1 score. This study findings suggest that fast and efficient CBCT image segmentation of the mandibular condyles and ramus from different clinical data sets and centers can be analyzed effectively. Future studies can now extract radiomic and imaging features as potentially relevant objective diagnostic criteria for TMJ pathologies, such as osteoarthritis (OA). The proposed segmentation will allow large datasets to be analyzed more efficiently for disease classification.
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Gallagher AL, Ruellas ACDO, Benavides E, Soki FN, Aronovich S, Magraw CBL, Turvey T, Cevidanes L. Mandibular condylar remodeling characteristics after simultaneous condylectomy and orthognathic surgery. Am J Orthod Dentofacial Orthop 2021; 160:705-717. [PMID: 34353687 DOI: 10.1016/j.ajodo.2020.06.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The objectives of this study were to evaluate postsurgical condylar remodeling using a radiographical interpretation, quantify condylar volumetric asymmetry, and assess soft tissue symmetry after simultaneous unilateral high condylectomy and bimaxillary osteotomies. METHODS Sixteen patients diagnosed with unilateral condylar hyperplasia underwent unilateral high condylectomy and orthognathic surgery to correct skeletal and facial asymmetries. Cone-beam computed tomography scans were acquired before and 1-year after surgery. A radiographic consensus was evaluated for signs of reparative or degenerative changes. The condyles were mirrored and registered for assessment of volumetric and morphologic asymmetry. Soft tissue symmetry was evaluated by measurement of the distance of soft tissue pogonion from the skeletal midsagittal plane. RESULTS Patients who undergo unilateral high condylectomy and orthognathic surgery present radiographic signs suggestive of degenerative changes, including sclerosis, osteophytes, flattening, and erosion in both the surgical and nonsurgical condyles (P ≤0.01). There was an average volumetric improvement of 531.9 ± 662.3 mm3 1-year postsurgery (P = 0.006). Soft tissue symmetry improved in all patients, with an average improvement of 65.8% (4.0 mm ± 2.6 mm, P ≤ 0.01). There was no correlation between the change in condylar volumetric asymmetry and the stability of the soft tissue correction. CONCLUSIONS High condylectomy for the correction of a skeletal asymmetry in patients with condylar hyperplasia successfully reduces the volumetric asymmetry between the condyles. Postsurgical dysmorphic remodeling and degenerative changes were noted in both the surgical and nonsurgical condyles. Despite remarkable changes and remaining joint asymmetry, the soft tissue correction is stable 1-year postsurgery.
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Affiliation(s)
| | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Erika Benavides
- University of Michigan School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, Mich
| | - Fabiana Naomi Soki
- University of Michigan School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, Mich
| | - Sharon Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, Mich
| | | | - Timothy Turvey
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich.
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Holte MB, Diaconu A, Ingerslev J, Thorn JJ, Pinholt EM. Virtual Analysis of Segmental Bimaxillary Surgery: A Validation Study. J Oral Maxillofac Surg 2021; 79:2320-2333. [PMID: 34245697 DOI: 10.1016/j.joms.2021.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/17/2021] [Accepted: 06/02/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Three-dimensional (3D) assessment of orthognathic surgery is often time consuming, relies on manual re-identification of anatomical landmarks or is limited to non-segmental osteotomies. The purpose of the present study was to propose and validate an automated approach for 3D assessment of the accuracy and postoperative outcome of segmental bimaxillary surgery. METHODS A semi-automatic approach was developed and validated for virtual surgical analysis (VSA) of segmental bimaxillary surgery using a pair of pre- and postoperative (2 weeks) cone-beam computerized tomography (CBCT) scans. The output of the VSA, the accuracy of the surgical outcome, was calculated as 3D translational and rotational differences between the planned and postoperative movements of the individual bone segments. To evaluate the reliability of the proposed VSA, intra-class correlation coefficients (ICC) were calculated at a 95% confidence interval on measurements of 2 observers. The VSA was deemed reliable if the ICC was excellent (> 0.80) and the absolute difference of the repeated intra- and inter-observer translational and rotational measurements were significantly lower (p < 0.05) than a hypothesized clinical relevant threshold of 1 voxel (0.45 mm) and 1 degree, respectively. RESULTS A total of 10 subjects (6 male; 4 women; mean age 24.4 years) with skeletal class 2 and 3, who underwent segmental bimaxillary surgery, 3-piece Le Fort I, bilateral sagittal split osteotomy and genioplasty, were recruited. The intra- and inter-observer reliability was excellent, ICC range [0.96 - 1.00]. The range of the mean absolute difference of the repeated intra- and inter-observer translational and rotational measurements were [0.07 mm (0.05) - 0.20 mm (0.19)] and [0.11˚ (0.08) - 0.63˚ (0.42)], respectively. This was significantly lower than the hypothesized clinical relevant thresholds (P < .001). CONCLUSION The validation showed that the VSA has excellent reliability for quantitative assessment of the postoperative outcome and accuracy of segmental bimaxillary surgery.
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Affiliation(s)
- Michael Boelstoft Holte
- Associate Professor and Head of 3D-Laboratory, University Hospital of Southern Denmark, Department of Oral and Maxillofacial Surgery & University of Southern Denmark, Faculty of Health Sciences, Department of Regional Health Research, Esbjerg Denmark
| | - Alexandru Diaconu
- Technical Engineer, Department of Oral and Maxillofacial Surgery, 3D-Laboratory, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Janne Ingerslev
- Senior Oral Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Jens Jørgen Thorn
- Senior Oral Maxillofacial Surgeon and Head of Department, Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Else Marie Pinholt
- Professor, Senior Oral Maxillofacial Surgeon and Head of Research, University of Southern Denmark, Faculty of Health Sciences, Department of Regional Health Research & University Hospital of Southern Denmark, Department of Oral and Maxillofacial Surgery, Finsensgade 35, 6700 Esbjerg, Denmark.
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Ren R, Luo H, Su C, Yao Y, Liao W. Machine learning in dental, oral and craniofacial imaging: a review of recent progress. PeerJ 2021; 9:e11451. [PMID: 34046262 PMCID: PMC8136280 DOI: 10.7717/peerj.11451] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 04/22/2021] [Indexed: 02/05/2023] Open
Abstract
Artificial intelligence has been emerging as an increasingly important aspect of our daily lives and is widely applied in medical science. One major application of artificial intelligence in medical science is medical imaging. As a major component of artificial intelligence, many machine learning models are applied in medical diagnosis and treatment with the advancement of technology and medical imaging facilities. The popularity of convolutional neural network in dental, oral and craniofacial imaging is heightening, as it has been continually applied to a broader spectrum of scientific studies. Our manuscript reviews the fundamental principles and rationales behind machine learning, and summarizes its research progress and its recent applications specifically in dental, oral and craniofacial imaging. It also reviews the problems that remain to be resolved and evaluates the prospect of the future development of this field of scientific study.
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Affiliation(s)
- Ruiyang Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Haozhe Luo
- School of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Chongying Su
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yang Yao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wen Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Orthodontics, Osaka Dental University, Hirakata, Osaka, Japan
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Masyte V, Sefeldaite S, Venskutonis T. A Questionnaire of Digital Radiography and CBCT Use and Knowledge among Lithuanian Dentists. J Oral Maxillofac Res 2021; 12:e2. [PMID: 33959237 PMCID: PMC8085677 DOI: 10.5037/jomr.2021.12102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022]
Abstract
Objectives Digital radiography is an increasingly used technology in Lithuania. However, there is no published information about using cone-beam computed tomography. The aims of this cross-sectional study performed in Lithuania were (1) to obtain information about the prevalence and accessibility of digital radiography and cone-beam computed tomography usage, and (2) to estimate dental practitioners’ knowledge about this diagnostic method and their need for education. Material and Methods Questionnaires consisting of 31 questions were distributed during the 2019 International Dentist Congress in Lithuania. Results This study analyses the data obtained from 248 respondents. Most of the clinicians use digital radiographic methods in their practice. The institutions usually have a digital dental X-ray machine, less often a digital panoramic X-ray machine, and least often a cone-beam computed tomography (CBCT) unit. Most dental practitioners performed 1 to 10 CBCT scans per month for adult patients and the most frequent reason for its use was implantation planning. Of the practitioners, 81.7% would like to improve their CBCT knowledge and skills. Conclusions The number of digital X-ray machines has increased throughout the last decade. Lithuanian dental practitioners do not excessively use cone-beam computed tomography. Some concerns were raised regarding respondents’ knowledge about exposure factors and this diagnostic method’s performance for paediatric patients. Additional training should be provided to Lithuanian dental specialists.
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Affiliation(s)
- Vestina Masyte
- Department of Dental and Oral Pathology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania
| | | | - Tadas Venskutonis
- Department of Dental and Oral Pathology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania;
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Evaluation of facial asymmetry by stereophotogrammetry in individuals with unilateral maxillary impacted canine. J Orofac Orthop 2021; 82:226-235. [PMID: 33725142 DOI: 10.1007/s00056-021-00285-3] [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: 08/21/2020] [Accepted: 01/29/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study is to compare the symmetry of the facial and dentoalveolar structures of patients with unilateral impacted maxillary canine teeth with a control group of individuals without impacted teeth using three-dimensional face scans. METHODS The study included 28 patients (10 females, 18 males) with unilateral impacted maxillary canine teeth and 28 patients (15 females, 13 males) without any impacted maxillary canine between 12 and 25 years of age. The 3dMDface™ (3dMD Inc., Atlanta, GA, USA) imaging system was used to obtain 3D face images. 3dMD Vultus® (3dMD Inc., Atlanta, GA, USA) software was used for the measurements. RESULTS According to the study findings, there were differences in linear measurements and volume measurements between the right and left sides of the face in patients with an impacted canine. However, these differences were not statistically significant. In patients with an impacted canine, surface differences between the right and left halves of the face were not found to be statistically different from the control group. CONCLUSION There was no difference in the amount of facial asymmetry between patients with unilateral maxillary impacted canine and patients with normal tooth alignment in the control group.
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Analysis of Sagittal Position Changes of the Condyle After Mandibular Setback Surgery Across the Four Different Types of Plating Systems. J Craniofac Surg 2021; 32:2441-2445. [PMID: 33710053 PMCID: PMC8478309 DOI: 10.1097/scs.0000000000007578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The authors analyzed the three-dimensional postoperative condylar position change across the plating systems. This retrospective study was conducted with the patients who underwent bilateral sagittal split ramus osteotomy with setback surgery. The condylar change was analyzed from preoperative cone-beam computed tomography to postoperative 1 month (T1) and postoperative 6 months (T2) using superimposition software, automatically merging based on the anterior cranial base. The condylar changes during T1 and T2 were analyzed across the four types of plates (4-hole sliding, heart-shaped, 3-hole sliding, and 4-hole conventional) Mean intraclass correlation coefficient values were consistently high for each measurement (>0.850). During T1, the conventional plate had a decreased condylar anterior distance when compared with the 3-hole sliding plate (P = 0.032). During T2, the conventional plate had an increased condylar posterior distance when compared with the 3-hole sliding plate (P = 0.031). Superimposition software based on the anterior cranial base could be available for measurement of condylar position with highly reproducible results. After bilateral sagittal split ramus osteotomy, the 3-hole sliding plate could effectively compensate for the anterior displacement of the condyle compared to other plates.
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Apostolopoulos K, Bous RM, ElNaghy R, Kumar AR, Valiathan M. Examining the variability of bone and soft tissue morphology in Hemifacial Microsomia: A case series of 8 patients. J Craniomaxillofac Surg 2021; 49:352-357. [PMID: 33612409 DOI: 10.1016/j.jcms.2021.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/08/2020] [Accepted: 02/07/2021] [Indexed: 11/28/2022] Open
Abstract
AIM OF THE STUDY Patients with Hemifacial Microsomia (HFM) exhibit highly variable skeletal and soft tissue asymmetries. The purpose of this study was to evaluate soft tissue discrepancies in patients with HFM and correlate them to the skeletal discrepancy. Eight patients were selected and studied retrospectively using 3-dimensional (3D) superimposition and color mapping of the soft and hard tissues. The skeletal and soft tissue facial structures were segmented and mirrored, resulting in a perfectly symmetric skull and face. Original and mirrored 3D models were superimposed. Differences between the affected and normal side were assessed in seven areas: frontal, endocanthion, exocanthion, malar, maxillary frontal, mandibular frontal and gonion area. The correlations between the skeletal and soft tissue asymmetry were evaluated by Pearson correlations. Hard tissue asymmetry ranged from 1.4 mm (Endocanthion) to 5.5 mm (Gonion), while soft tissue asymmetry ranged from 1.5 mm (Endocanthion) to 5.6 mm (Malar). Correlation between skeletal and soft tissue deficiency were highly variable, with the highest correlation at gonion and the lowest at exocanthion. Bone and soft tissue hypoplasia were highly correlated at the gonion and the malar area, while the remaining evaluated areas demonstrated poor correlation between skeletal and soft tissue asymmetries. Future studies will determine if target treatment can reliably improve bone and soft tissue hypoplasia in this area.
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Affiliation(s)
- Konstantinos Apostolopoulos
- Department of Craniofacial and Special Care Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Rany M Bous
- Department of Craniofacial and Special Care Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Rahma ElNaghy
- Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.
| | - Anand R Kumar
- Division of Plastic and Reconstructive Surgery, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Manish Valiathan
- Department of Craniofacial and Special Care Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
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Maxillary dentoskeletal outcomes of the expander with differential opening and the fan-type expander: a randomized controlled trial. Clin Oral Investig 2021; 25:5247-5256. [PMID: 33580351 DOI: 10.1007/s00784-021-03832-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/05/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of this study was to compare the maxillary dentoskeletal outcomes of the expander with differential opening (EDO) and the fan-type expander (FE). MATERIAL AND METHODS Forty-eight patients with maxillary arch constriction in the mixed dentition were randomly allocated into EDO and FE groups. Cone-beam computed tomography scans were acquired before and after expansion. Linear and angular three-dimensional changes were assessed after cranial base superimposition using the ITK-SNAP and the 3D Slicer software. T or Mann-Whitney U tests were used for intergroup comparisons (P<0.05). RESULTS The EDO group comprised 24 patients treated with the EDO (13 female, 11 male; 7.6 years). The FE group comprised 24 patients treated with the FE (14 female, 10 male; 7.8 years). Skeletal lateral displacements were greater in the EDO group with greater expansion in the orbital, nasal cavity, zygomatic bone, and palate regions (mean intergroup differences of 0.4, 0.8, 0.9, and 1.1 mm, respectively). Intercanine expansion and canine buccal inclination were greater in the FE group, while intermolar distance changes and molar buccal inclination were greater in the EDO group. Similar changes were observed for vertical and anteroposterior displacements and palatal plane rotation. CONCLUSIONS The EDO produced greater transverse skeletal expansion compared to the FE, with similar vertical and anteroposterior effects. Dental changes were greater in the molar region for patients treated with the EDO and in the canine region for patients treated with the FE. CLINICAL RELEVANCE The EDO and the FE are capable of producing skeletal changes in the mixed dentition. The decision between both expanders will depend on the amount of expansion required in the molar region and in the nasomaxillary complex. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov , under the identifier NCT03705871.
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Lo Giudice A, Ronsivalle V, Zappalà G, Leonardi R, Campagna P, Isola G, Palazzo G. The Evolution of the Cephalometric Superimposition Techniques from the Beginning to the Digital Era: A Brief Descriptive Review. Int J Dent 2021; 2021:6677133. [PMID: 33981342 PMCID: PMC8088383 DOI: 10.1155/2021/6677133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/13/2021] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
Superimposition of craniofacial structures from radiographic examination has been always used for assessing changes in the maxilla-mandibular complexes, especially for the evaluation of potential changes occurring during growth as well as after orthodontic treatment and/or maxillofacial surgery. However, the availability of cone beam computed tomography (CBCT) and the recent advancement in 3D imaging have allowed the development of specific techniques for the registration and superimposition of virtual three-dimensional anatomical structures, improving the diagnosis and treatment plan strategies. In the present paper, it will be discussed the evolution of superimposition techniques from the beginning (2D) to the newest 3D approach, describing the most used methods and their main advantages and disadvantages, focusing primarily on accuracy and reproducibility of each technique.
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Affiliation(s)
- A. Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - V. Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - G. Zappalà
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - R. Leonardi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - P. Campagna
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - G. Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - G. Palazzo
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
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Sendyk M, Cevidanes LHS, Ruellas ACDO, Fattori L, Mendes FM, Paiva JBD, Rino Neto J. Three-dimensional evaluation of dental decompensation and mandibular symphysis remodeling on orthodontic-surgical treatment of Class III malocclusion. Am J Orthod Dentofacial Orthop 2020; 159:175-183.e3. [PMID: 33390311 DOI: 10.1016/j.ajodo.2019.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 11/01/2019] [Accepted: 12/01/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purposes of this research were to identify the buccolingual inclinations of the mandibular teeth and the mandibular symphysis remodeling that result from the orthodontic decompensation movement. METHODS The sample consisted of 30 adults with Class III dentofacial deformity, who had presurgical orthodontic treatment. Three-dimensional images were generated by cone-beam computed tomography scans at 2 different times (initial and before orthognathic surgery). Three-dimensional virtual models were obtained and superimposed using automated voxel-based registration at the mandible to evaluate B-point displacement, mandibular molar and incisor decompensation movement, and symphysis inclination and thickness. The 3-dimensional displacements of landmarks at the symphysis were quantified and visualized with color-coded maps using 3D Slicer (version 4.0; www.slicer.org) software. RESULTS The measurements showed high reproducibility. The patients presented mandibular incisor proclination, which was consistent with the movement of tooth decompensation caused by the presurgical orthodontic treatment. Statistically significant correlations were found between the inclination of the mandibular incisors, symphysis inclination, and B-point displacement. Regarding the thickness of the symphysis and the inclination of the incisors, no statistically significant correlation was found. CONCLUSIONS The buccolingual orthodontic movement of the mandibular incisors with presurgical leveling is correlated with the inclination of the mandibular symphysis and repositioning of the B-point but not correlated to the thickness of the symphysis.
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Affiliation(s)
- Michelle Sendyk
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | | | | | - Liana Fattori
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João Batista de Paiva
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - José Rino Neto
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Ku JK, Chang NH, Jeong YK, Baik SH, Choi SK. Development and validation of a difficulty index for mandibular third molars with extraction time. J Korean Assoc Oral Maxillofac Surg 2020; 46:328-334. [PMID: 33122457 PMCID: PMC7609930 DOI: 10.5125/jkaoms.2020.46.5.328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 11/07/2022] Open
Abstract
Objectives This study aimed to validate the effectiveness of a recently proposed difficulty index for removal of impacted mandibular third molars based on extraction time and suggest a modified difficulty index including the presence of pathologic conditions associated with third molars. Materials and Methods This retrospective study enrolled 65 male patients younger than 25 years with third molars. Extraction time was calculated from start of the incision to the last suture. The difficulty scores for third molars were based on spatial relationship (1-5 points), depth (1-4 points), and ramus relationship (1-3 points) using cone-beam computed tomography. The difficulty index was defined as follows I (3-4 points), II (5-7 points), III (8-10 points), and IV (11-12 points). The modified difficulty score was calculated by adding one point to the difficulty score if the third molar was associated with a pathologic condition. Two modified difficulty indices, based on the presence of pathologic conditions, were as follows the half-level up difficulty index (HDI) and the one-level up difficulty index (ODI) from the recently proposed difficulty index. Results The correlations between extraction time and difficulty index and or modified difficulty indices were significant (P<0.001). The correlation coefficient between extraction time and difficulty index was 0.584. The correlation coefficients between extraction time and HDI and ODI were 0.728 and 0.764, respectively. Conclusion Extraction time of impacted third molars exhibited a moderate correlation with difficulty index and was strongly correlated with the modified indices. Considering the clinical implications, the difficulty index of surgical extraction should take into consideration the pathologic conditions associated with third molars.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Dental Hospital, Armed Forces Medical Command, Seongnam, Korea
| | - Na-Hee Chang
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yeong-Kon Jeong
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Dental Hospital, Armed Forces Medical Command, Seongnam, Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sun-Kyu Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
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Comparison of Changes in the Condylar Volume and Morphology in Skeletal Class III Deformities Undergoing Orthognathic Surgery Using a Customized versus Conventional Miniplate: A Retrospective Analysis. J Clin Med 2020; 9:jcm9092794. [PMID: 32872568 PMCID: PMC7565602 DOI: 10.3390/jcm9092794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 11/28/2022] Open
Abstract
With the great leap in the development of three-dimensional computer-assisted surgical technology, surgeons can use a variety of assistive methods to achieve better results and evaluate surgical outcomes in detail. This retrospective study aimed to evaluate the postoperative stability after bilateral sagittal split ramus osteotomy by volume rendering methods and to evaluate how postoperative stability differs depending on the type of surgical plate. Of the patients who underwent BSSRO, ten patients in each group (non-customized miniplate and customized miniplate) who met the inclusion criteria were selected. Preoperative and postoperative cone-beam computed tomography data were collected, and condylar morphological and landmark measurements were obtained using Checkpoint and OnDemand software, respectively. The postoperative condylar morphological dataset revealed no significant difference (p > 0.05) between the two groups. No significant difference (p > 0.05) was observed between the two groups in horizontal, vertical, or angular landmark measurements used to quantify operational stability. These results indicate that there is no difference in the surgical outcome between the patient-specific system and the conventional method, which will allow clinicians to take advantage of the patient-specific system for this surgical procedure, with favorable results, as with the conventional method.
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Three-Dimensional Cephalometric Analysis: The Changes in Condylar Position Pre- and Post-Orthognathic Surgery With Skeletal Class III Malocclusion. J Craniofac Surg 2020; 32:546-551. [PMID: 32833820 PMCID: PMC7908865 DOI: 10.1097/scs.0000000000006873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The study includes 21 adult patients with skeletal class III malocclusion who underwent orthognathic surgery and had computed tomography images records presurgery (T0) up to 6 months after the surgery (T1). The computed tomography images were analyzed three-dimensionally using the Proplan CMF 3.0 software. Different skeletal and dental parameters were used in analyzing the cephalometric analysis of the patients. The change in the condylar axis angle was evaluated on 3 planes: axial, coronal, and sagittal. The anteroposterior position of the condyle in relation to the glenoid fossa was evaluated in the sagittal plane. ∠SNB, ∠ANB, ∠Left Y-axis, ∠Right Y-axis were statistically significant (P < 0.01). Significant differences on the condylar axis angle were found between the groups on the sagittal plane (P < 0.05) whereas no significant differences were noted on the axial and the coronal plane. In the anteroposterior condylar position related to the glenoid fossa, the condyle exhibited different displacement on different condyles. The right condyle exhibited more of the posterior displacement whereas the left condyle exhibited more of anterior displacement of the condyle in relation to the glenoid fossa. Numerous studies have done regarding the changes after postsurgery using the two-dimensional cephalometric analysis. Using the 3D techniques helps us to identify the cephalometric point more accurately which thus enhances the accuracy in the cephalometric analysis. However, care should be taken not to change the axis of rotation of the condyle to prevent from the treatment relapse and to avoid temporo-mandibular disorders.
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Huang J, Ban C, Liu L, Ye Y. Dynamics and risk indicators of intrasinus elevation height following transalveolar sinus floor elevation with immediate implant placement: a longitudinal cohort study. Int J Oral Maxillofac Surg 2020; 50:109-115. [PMID: 32507405 DOI: 10.1016/j.ijom.2020.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/19/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022]
Abstract
Successful intrasinus graft consolidation is essential for the treatment outcome of transalveolar sinus floor elevation (SFE). This study was performed to examine the dynamics and risk indicators related to the elevation height after transalveolar SFE with grafting material and simultaneous implant placement. Fifty-two patients with 55 sites undergoing transalveolar SFE with immediate implant placement were enrolled retrospectively. Cone beam computed tomography (CBCT) images were collected and saved in DICOM format, at the following time-points: pre-surgery (T0), immediately post-surgery (T1), and 6 months post-surgery (T2). Voxel-based CBCT superimposition was performed to measure the sinus width, residual alveolar height, implant protrusion length, total elevation height, and apical graft height. The change in total elevation height from T1 to T2 was defined as the study outcome. Clinical and linear variables were analysed using linear regression. From T1 to T2, the total elevation height showed an average reduction of 1.0±1.1mm, while 10.9% sites showed an increased elevation height. Univariate regression analysis showed no significant correlation between tested clinical or linear variables and the study outcome. The results suggest that the change in elevation height was not influenced by the alveolar or sinus dimensions, graft materials, implant diameter, implant protrusion length, or the total elevation height at T1.
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Affiliation(s)
- J Huang
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - C Ban
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - L Liu
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Y Ye
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China.
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Jiang YY, Sun L, Wang H, Zhao CY, Zhang WB. Three-dimensional cone beam computed tomography analysis of temporomandibular joint response to the Twin-block functional appliance. Korean J Orthod 2020; 50:86-97. [PMID: 32257934 PMCID: PMC7093662 DOI: 10.4041/kjod.2020.50.2.86] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/06/2020] [Accepted: 02/08/2020] [Indexed: 12/11/2022] Open
Abstract
Objective To propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment. Methods Seventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption. Results Significant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG. Conclusions We successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.
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Affiliation(s)
- Yuan-Yuan Jiang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Lian Sun
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Hua Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Chun-Yang Zhao
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Wei-Bing Zhang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China.,Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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Lee EH, Yu HS, Lee KJ, Han SS, Jung HD, Hwang CJ. Comparison of three midsagittal planes for three-dimensional cone beam computed tomography head reorientation. Korean J Orthod 2020; 50:3-12. [PMID: 32042715 PMCID: PMC6995832 DOI: 10.4041/kjod.2020.50.1.3] [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: 03/26/2019] [Revised: 09/08/2019] [Accepted: 09/10/2019] [Indexed: 11/20/2022] Open
Abstract
Objective This study compared three prominent midsagittal planes (MSPs) to identify the MSP that best approximates the true symmetrical MSP. Methods Forty-three patients (mean age, 23.0 ± 8.20 years) were grouped as follows: group 1 consisted of 10 patients with skeletal Class I and a menton (Me) deviation of < 2 mm; group 2, 11 patients with skeletal Class III and a Me deviation < 2 mm; group 3, nine patients with skeletal Class III and a Me deviation of 2 to less than 4 mm; and group 4, 13 patients with skeletal Class III and an Me deviation ≥ 4 mm. The candidate MSPs were established by three-dimensional (3D) cone beam computed tomography (CBCT) reorientation methods (RMs): (1) the MSP perpendicular to the Frankfort horizontal (FH) plane while passing through the crista galli and basion; (2) the MSP including the nasion, incisive foramen, and basion; (3) the MSP including the nasion, anterior nasal spine, and posterior nasal spine. The mean absolute distances (MADs) to the MSPs were calculated from the coordinates of 1,548 points on 129 CBCT images. The differences in the values of the 3D coordinates among RMs were compared. Results The MADs of the three RMs showed significant differences (p < 0.05). Most of the differences in values of the coordinates were not significant among RMs. Conclusions Although the differences in distance among the three MSPs were minor, the MSP perpendicular to the FH plane while passing through the crista galli and basion best approximated the true symmetrical MSP.
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Affiliation(s)
- Eon-Hwa Lee
- Department of Orthodontics, Korea University Anam Hospital, Seoul, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics and The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics and The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hwi-Dong Jung
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Chung-Ju Hwang
- Department of Orthodontics and The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
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Verhelst P, Verstraete L, Shaheen E, Shujaat S, Darche V, Jacobs R, Swennen G, Politis C. Three-dimensional cone beam computed tomography analysis protocols for condylar remodelling following orthognathic surgery: a systematic review. Int J Oral Maxillofac Surg 2020; 49:207-217. [DOI: 10.1016/j.ijom.2019.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/13/2019] [Accepted: 05/10/2019] [Indexed: 11/25/2022]
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Yatabe M, Prieto JC, Styner M, Zhu H, Ruellas AC, Paniagua B, Budin F, Benavides E, Shoukri B, Michoud L, Ribera N, Cevidanes L. 3D superimposition of craniofacial imaging-The utility of multicentre collaborations. Orthod Craniofac Res 2019; 22 Suppl 1:213-220. [PMID: 31074129 DOI: 10.1111/ocr.12281] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/18/2023]
Abstract
Clinical applications of 3D image registration and superimposition have contributed to better understanding growth changes and clinical outcomes. The use of 3D dental and craniofacial imaging in dentistry requires validate image analysis methods for improved diagnosis, treatment planning, navigation and assessment of treatment response. Volumetric 3D images, such as cone-beam computed tomography, can now be superimposed by voxels, surfaces or landmarks. Regardless of the image modality or the software tools, the concepts of regions or points of reference affect all quantitative of qualitative assessments. This study reviews current state of the art in 3D image analysis including 3D superimpositions relative to the cranial base and different regional superimpositions, the development of open source and commercial tools for 3D analysis, how this technology has increased clinical research collaborations from centres all around the globe, some insight on how to incorporate artificial intelligence for big data analysis and progress towards personalized orthodontics.
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Affiliation(s)
- Marilia Yatabe
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | | | - Martin Styner
- University of North Carolina, Chapel Hill, North Carolina
| | - Hongtu Zhu
- University of North Carolina, Chapel Hill, North Carolina
| | - Antonio Carlos Ruellas
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | | | | | - Erika Benavides
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Brandon Shoukri
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Loic Michoud
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Nina Ribera
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Lucia Cevidanes
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
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Adding Depth to Cephalometric Analysis: Comparing Two- and Three-Dimensional Angular Cephalometric Measurements. J Craniofac Surg 2019; 30:1568-1571. [PMID: 31299770 DOI: 10.1097/scs.0000000000005555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Lateral cephalometric radiographs (LCR) have been the standard tool used for cephalometric analysis in craniofacial surgery. Over the past decade, a three-dimensional (3D) revolution in cephalometric analysis and surgical planning has been underway. To date, research has not validated whether cephalometric measurements taken from two-dimensional (2D) and 3D data sources are equivalent and interchangeable. The authors sought to compare angular cephalometric measurements taken with 2D and 3D modalities. METHODS Sixty-two head CT scans (36 females, 26 males) with an average age of 63 ± 20 years were studied. Twelve cephalometric angular measurements were taken from 3D reconstructed skulls using the software package Mimics 19.0 (Materialize; Leuven, Belgium). These same facial angles were measured from 2D lateral cephalograms reconstructed from the original CT scans using Dolphin 11.9. Measurements taken with both techniques were compared for agreement using a paired t test. Intra-class correlation coefficient assessment was used to determine inter-rater reliability. Statistical significance was set at P < 0.05. RESULTS Five of the 12 angular measurements (SNA, SNB, MP-FH, U1-SN, and U1-L1) demonstrated statistically significant differences (P < 0.05) between the 2D and 3D analyses. All of these differences were less than the standard deviations for the respective measure. CONCLUSION The differences between angular cephalometric values obtained from 2D LCRs and 3D CT reconstructions are small. This supports the practices of using 2D and 3D cephalometric data interchangeably in most applications. Clinicians must be selective in which measures they employ to maximize accuracy and care must be taken when measuring dental inclination with lateral cephalograms.
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Taylor KL, Evangelista K, Muniz L, Ruellas ACDO, Valladares-Neto J, McNamara J, Franchi L, Kim-Berman H, Cevidanes LHS. Three-dimensional comparison of the skeletal and dentoalveolar effects of the Herbst and Pendulum appliances followed by fixed appliances: A CBCT study. Orthod Craniofac Res 2019; 23:72-81. [PMID: 31514261 DOI: 10.1111/ocr.12345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare three-dimensional (3D) skeletal and dentoalveolar effects of the Herbst and Pendulum appliances followed by fixed orthodontic treatment in growing patients. SETTING AND SAMPLE POPULATION A sample of 35 adolescents with cone-beam computed tomography scans obtained prior to Herbst and Pendulum treatment (T1) and immediately after fixed appliance treatment (T2). MATERIALS AND METHODS Patients with Class II malocclusion was assessed retrospectively and divided into two treatment groups: Herbst group (n = 17, age: 12.0 ± 1.6 years) and Pendulum group (n = 18, age: 12.1 ± 1.5 years), with a mean treatment duration of 2.8 ± 0.8 years and 2.5 ± 0.7 years, respectively. Reconstructions of the maxillomandibular and dentoalveolar regions and data in 3D were obtained relative to cranial base, maxillary and mandibular regional superimpositions. Treatment outcomes (T2-T1) were compared between both groups using t tests for independent samples (P<.05). RESULTS Significant increase in mandibular length was observed in the Herbst group (7.3 ± 3.5 mm) relative to the Pendulum group (4.6 ± 4.5 mm). Inferior and anterior displacements of Pogonion were 2.2 mm and 1.6 mm greater in the Herbst group, respectively. The mesial displacement of the lower first molars was significantly greater in the Herbst group (1.9 mm). The upper first molars had contrasting results in sagittal displacement, with 0.6 ± 1.7 mm of distal displacement with the Pendulum and 1.4 ± 2.1 mm of mesial displacement with the Herbst. Lower incisor projection and proclination were similar between groups. CONCLUSIONS The Herbst and Pendulum appliances followed by comprehensive orthodontic treatment effectively corrected Class II malocclusion in growing patients, but with differing skeletal and dentoalveolar effects.
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Affiliation(s)
- Kyle L Taylor
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Karine Evangelista
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | - Luciana Muniz
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | | | | | - James McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, Orthodontics, Università degli Studi di Firenze, Florence, Italy
| | - Hera Kim-Berman
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Almuzian M, Almukhtar A, Ulhaq A, Alharbi F, Darendeliler MA. 3D effects of a bone-anchored intra-oral protraction in treating class III growing patient: a pilot study. Prog Orthod 2019; 20:37. [PMID: 31531735 PMCID: PMC6749004 DOI: 10.1186/s40510-019-0290-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this prospective case series study is to assess the three-dimensional (3D) skeletal and soft tissue effects of the alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol in conjunction with a miniscrew-supported class III elastic wear in class III growing patients. MATERIALS AND METHODS Fourteen consecutive participants (mean age 12.05 ± 1.09 years), who displayed class III malocclusions with retrognathic maxillae, were recruited. A cone beam computed tomography (CBCT) scan was acquired before commencing treatment (T1). All participants were treated with a tooth-bone-borne rapid maxillary expansion (hybrid MARME) appliance that was activated by the Alt-RAMEC protocol for 9 weeks. This was followed by full-time class III elastics, delivering 400 g/side, to protract the maxilla. When a positive overjet was achieved, protraction was ceased and a post-treatment CBCT scan (T2) was taken. The 3D analysis of pre- and post-treatment CBCT scans was blinded. The scans were registered on the anterior cranial base. The Euclidean distance between the two extracted surface models of the pre- and post-treatment scans was displayed as a color surface map. RESULTS All participants completed the intervention successfully. The majority of the participants showed protraction of the anterior maxillary region (71.4%) and in the zygomatic processes (64.2%). The maxilla significantly protracted (SNA 1.87° ± 1.06°; Vert.T-A 3.29 ± 1.54 mm), while the mandibular base significantly redirected posteriorly (SNB - 2.03° ± 0.85°, Vert.T-B - 3.43 ± 4.47 mm) and that was reflected on the ANB and Wits measurements. No adverse effects were observed. CONCLUSION Class III elastics combined with the Alt-RAMEC activation protocol of the hybrid MARME appliance is an effective treatment method for mild/moderate class III malocclusions. A long-term follow-up and comparisons with other treatment modalities are required.
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Affiliation(s)
- Mohammed Almuzian
- Faculty of Dentistry, University of Sydney, Sydney, Australia.,Edinburgh Dental Institute, University of Edinburgh, Edinburgh, UK
| | - Anas Almukhtar
- College of Dentistry, University of Mosul, Mosul, Iraq.,University of Glasgow, Glasgow, UK
| | - Aman Ulhaq
- Edinburgh Dental Institute, University of Edinburgh, Edinburgh, UK
| | - Fahad Alharbi
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz, AL-Kharj, 11942, Saudi Arabia.
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