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El-Beblawy YM, Bakry AM, Mohamed MEA. Accuracy of formula-based volume and image segmentation-based volume in calculation of preoperative cystic jaw lesions' volume. Oral Radiol 2024; 40:259-268. [PMID: 38112919 DOI: 10.1007/s11282-023-00731-5] [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: 03/20/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE The aim of this study was to assess the accuracy of formula-based volume measurements and the 3D volume analysis with different software packages in the calculation of preoperative cystic jaw lesions' volume. The secondary aim was to assess the reliability and the accuracy of 3 imaging software programs for measuring the cystic jaw lesions' volume in CBCT images. MATERIALS AND METHODS This study consisted of two parts: an in vitro part using 2 dry human mandibles that were used to create simulated osteolytic lesions to assess the accuracy of the volumetric analysis and formula-based volume. As a gold standard, the volume of each bone defect was determined by taking an impression using rapid soft silicone (Vinylight) and then quantifying the volume of the replica. Afterward, each tooth socket was scanned using a high-resolution CBCT. A retrospective part using archived CBCT radiographs that were taken from the database of the outpatient clinic of the oral and maxillofacial radiology department, Faculty of Dentistry, Minia University to assess the reliability of the 3 software packages. The volumetric data set was exported for volume quantification using the 3 software packages (MIMICS-OnDemand and InVesalius software). Also, the three greatest orthogonal diameters of the lesions were calculated, and the volume was assessed using the ellipsoid formula. Dunn's test was used for pair-wise comparisons when Friedman's test was significant. The inter-examiner agreement was assessed using Cronbach's alpha reliability coefficient and intra-class correlation coefficient. RESULTS Regarding the results of the retrospective part, there was a statistically significant difference between volumetric measurements by equation and different software (P value < 0.001, Effect size = 0.513). The inter-observer reliability of the measurements of the cystic lesions using the different software packages was very good. The highest inter-examiner agreement for volume measurement was found with InVesalius (Cronbach's alpha = 0.992). On the other hand, there was a statistically significant difference between dry mandible volumetric measurements and Gold Standard. All software showed statistically significantly lower dry mandible volumetric measurements than the gold standard. CONCLUSION Computer-aided assessment of cystic lesion volume using InVesalius, OnDemand, and MIMICS is a readily available, easy to use, non-invasive option. It confers an advantage over formula-based volume as it gives the exact morphology of the lesion so that potential problems can be detected before surgery. Volume analysis with InVesalius software was accurate in determining the volume of simulated periapical defects in a human cadaver mandible as compared to true volume. InVesalius software proved that open-source software can be robust yet user-friendly with the advantage of minimal cost to use.
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Affiliation(s)
- Yasmein Maher El-Beblawy
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Minia University, Shalaby Street, Minya, Egypt.
| | - Ahmed Mohamed Bakry
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Minia University, Shalaby Street, Minya, Egypt
| | - Maha Eshaq Amer Mohamed
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Minia University, Shalaby Street, Minya, Egypt
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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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Tsolakis IA, Kolokitha OE. Comparing Airway Analysis in Two-Time Points after Rapid Palatal Expansion: A CBCT Study. J Clin Med 2023; 12:4686. [PMID: 37510801 PMCID: PMC10381283 DOI: 10.3390/jcm12144686] [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: 06/05/2023] [Revised: 07/08/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The aim of this study is to investigate the upper airway analysis at two-time points after the rapid maxillary expansion was performed, using cone-beam computed tomography. METHODS Subjects from the Orthodontic Department at the Aristotle University of Thessaloniki with unilateral or bilateral posterior crossbite were screened according to the selection criteria. A sample size calculation was performed, and a total of 14 subjects were recruited. All subjects received a rapid maxillary expansion with a Hyrax-type device as part of their comprehensive treatment. A CBCT was taken before the treatment (T1), immediately after the expansion was completed (T2), and 6 months after (T3). Their upper airway was measured using the CBCT images. Airway volume (V) and minimal cross-sectional area (MCS) were extracted and compared using SPSS to analyze the means. RESULTS A statistically significant difference was found between all time points regarding both V and MCS (p < 0.001, p = 0.001). There was a statistically significant increase in both V and MCS measurements immediately after RPE expansion (T1-T2) and six months after expansion (T1-T3). Between the end of expansion and 6 months after (T2-T3), there was a decrease in V and no statistical difference in MCS. CONCLUSIONS RPE can significantly increase the volume and minimal cross-sectional area of the nasal passage airway.
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Affiliation(s)
- Ioannis A Tsolakis
- Department of Orthodontics, Faculty of Health Sciences, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Olga-Elpis Kolokitha
- Department of Orthodontics, Faculty of Health Sciences, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Zhang Z, Wang S, Li J, Yang Z, Zhang X, Bai X. Quantification of pharyngeal airway space changes after two-jaw orthognathic surgery in skeletal class III patients. BMC Oral Health 2023; 23:345. [PMID: 37264397 DOI: 10.1186/s12903-023-03075-y] [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: 08/16/2022] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Skeletal class III malocclusion is a common dentofacial deformity. Orthognathic treatment changes the position of the jaws and affects the shape of the upper airway to some extent. The aim of this study was to use multislice spiral computer tomography data and orthognathic knowledge to quantify the relationship between the amount of surgical movement of the maxilla or mandible in all three spatial planes and the changes in airway volume that occurred. METHODS A retrospective study of 50 patients was conducted. Preoperative and postoperative linear changes related to skeletal movements of the maxilla and mandible were measured and compared to changes in the most constricted axial level (MCA) and its anteroposterior (MCA-AP) and transverse diameters (MCA-TV). Correlation tests and linear regression analysis were performed. RESULTS Significant interactions were observed between the anterior vertical movement of the maxilla and the MCA-AP. The anteroposterior movement distance of the mandible was significantly correlated with changes in the oropharyngeal, velopharyngeal, total airway volume, MCA, MCA-AP, and MCA-TV. The change in the mandibular plane angle was significantly correlated with the change in velopharyngeal volume, total airway volume (nasopharynx, oropharynx, velopharynx), and MCA. The linear regression model showed that oropharyngeal volume decreased by 350.04 mm3, velopharyngeal volume decreased by 311.50 mm3, total airway volume decreased by 790.46 mm3, MCA decreased by 10.96 mm2 and MCA-AP decreased by 0.73 mm2 when point B was setback by 1 mm. CONCLUSIONS Anteroposterior mandibular control is the key to successful airway management in all patients. This study provides estimates of volume change per millimeter of setback to guide surgeons in treatment planning.
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Affiliation(s)
- Ziqi Zhang
- Department of Oral and Maxillofacial SurgerySchool and Hospital of StomatologyLiaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Shuze Wang
- Department of Oral and Maxillofacial SurgerySchool and Hospital of StomatologyLiaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Jing Li
- Department of Oral and Maxillofacial SurgerySchool and Hospital of StomatologyLiaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Zhijie Yang
- Department of Oral and Maxillofacial SurgerySchool and Hospital of StomatologyLiaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Xia Zhang
- Department of Oral and Maxillofacial SurgerySchool and Hospital of StomatologyLiaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Xiaofeng Bai
- Department of Oral and Maxillofacial SurgerySchool and Hospital of StomatologyLiaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China.
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Ileșan RR, Beyer M, Kunz C, Thieringer FM. Comparison of Artificial Intelligence-Based Applications for Mandible Segmentation: From Established Platforms to In-House-Developed Software. Bioengineering (Basel) 2023; 10:604. [PMID: 37237673 PMCID: PMC10215609 DOI: 10.3390/bioengineering10050604] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Medical image segmentation, whether semi-automatically or manually, is labor-intensive, subjective, and needs specialized personnel. The fully automated segmentation process recently gained importance due to its better design and understanding of CNNs. Considering this, we decided to develop our in-house segmentation software and compare it to the systems of established companies, an inexperienced user, and an expert as ground truth. The companies included in the study have a cloud-based option that performs accurately in clinical routine (dice similarity coefficient of 0.912 to 0.949) with an average segmentation time ranging from 3'54″ to 85'54″. Our in-house model achieved an accuracy of 94.24% compared to the best-performing software and had the shortest mean segmentation time of 2'03″. During the study, developing in-house segmentation software gave us a glimpse into the strenuous work that companies face when offering clinically relevant solutions. All the problems encountered were discussed with the companies and solved, so both parties benefited from this experience. In doing so, we demonstrated that fully automated segmentation needs further research and collaboration between academics and the private sector to achieve full acceptance in clinical routines.
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Affiliation(s)
- Robert R. Ileșan
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (M.B.); (C.K.); (F.M.T.)
| | - Michel Beyer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (M.B.); (C.K.); (F.M.T.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Christoph Kunz
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (M.B.); (C.K.); (F.M.T.)
| | - Florian M. Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (M.B.); (C.K.); (F.M.T.)
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
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de Bataille C, Bernard D, Dumoncel J, Vaysse F, Cussat-Blanc S, Telmon N, Maret D, Monsarrat P. Machine Learning Analysis of the Anatomical Parameters of the Upper Airway Morphology: A Retrospective Study from Cone-Beam CT Examinations in a French Population. J Clin Med 2022; 12:84. [PMID: 36614885 PMCID: PMC9820916 DOI: 10.3390/jcm12010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
The objective of this study is to assess, using cone-beam CT (CBCT) examinations, the correlation between hard and soft anatomical parameters and their impact on the characteristics of the upper airway using symbolic regression as a machine learning strategy. Methods: On each CBCT, the upper airway was segmented, and 24 anatomical landmarks were positioned to obtain six angles and 19 distances. Some anatomical landmarks were related to soft tissues and others were related to hard tissues. To explore which variables were the most influential to explain the morphology of the upper airway, principal component and symbolic regression analyses were conducted. Results: In total, 60 CBCT were analyzed from subjects with a mean age of 39.5 ± 13.5 years. The intra-observer reproducibility for each variable was between good and excellent. The horizontal soft palate measure mostly contributed to the reduction of the airway volume and minimal section area with a variable importance of around 50%. The tongue and the position of the hyoid bone were also linked to the upper airway morphology. For hard anatomical structures, the anteroposterior position of the mandible and the maxilla had some influence. Conclusions: Although the volume of the airway is not accessible on all CBCT scans performed by dental practitioners, this study demonstrates that a small number of anatomical elements may be markers of the reduction of the upper airway with, potentially, an increased risk of obstructive sleep apnea. This could help the dentist refer the patient to a suitable physician.
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Affiliation(s)
- Caroline de Bataille
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - David Bernard
- Institute of Research in Informatics (IRIT) of Toulouse, CNRS—UMR5505, 31062 Toulouse, France
- RESTORE Research Center, Department of Oral Medicine, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse University Hospital (CHU), Batiment INCERE, 4bis Avenue Hubert Curien, 31100 Toulouse, France
| | - Jean Dumoncel
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
| | - Frédéric Vaysse
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - Sylvain Cussat-Blanc
- Institute of Research in Informatics (IRIT) of Toulouse, CNRS—UMR5505, 31062 Toulouse, France
- Artificial and Natural Intelligence Toulouse Institute ANITI, 31013 Toulouse, France
| | - Norbert Telmon
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, CEDEX 9, 31059 Toulouse, France
| | - Delphine Maret
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - Paul Monsarrat
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
- RESTORE Research Center, Department of Oral Medicine, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse University Hospital (CHU), Batiment INCERE, 4bis Avenue Hubert Curien, 31100 Toulouse, France
- Artificial and Natural Intelligence Toulouse Institute ANITI, 31013 Toulouse, France
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Madhan S, Holte MB, Diaconu A, Thorn JJ, Ingerslev J, Nascimento GG, Cornelis M, Pinholt EM, Cattaneo PM. Pharyngeal airway changes five years after bimaxillary surgery - A retrospective study. J Craniomaxillofac Surg 2022; 50:848-857. [PMID: 36473761 DOI: 10.1016/j.jcms.2022.09.009] [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: 06/21/2022] [Revised: 08/31/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to retrospectively evaluate pharyngeal airway (PA) changes after bimaxillary surgery (BMS). Preoperative, immediate- and 5-year postoperative cone-beam computed tomography images of subjects who underwent BMS were assessed. The primary outcome variable was the PA volume. The secondary outcome variables were the retropalatal and oropharyngeal volumes, cross-sectional area, minimal hydraulic diameter, soft tissue, skeletal movements and sleep-disordered breathing (SDB). A total of 50 patients were included, 33 female and 17 male, with a mean age of 26.5 years. A significant increase in the PA volume was seen immediately after surgery (40%), and this increase was still present at 5-year follow-up (34%) (P < 0.001). A linear mixed model regression analysis revealed that a mandibular advancement of ≥5 mm (P = 0.025) and every 1-mm upward movement of epiglottis (P = 0.016) was associated with a volume increase of the oropharyngeal compartment. Moreover, ≥5-mm upward movement of hyoid bone (P = 0.034) and every 1-mm increase in minimal hydraulic diameter (P < 0.001) correlated with an increase of the PA volume. A total of 30 subjects reported improvement in the SDB at 5-year follow-up. This study demonstrated that BMS led to an increase in PA dimensions in non-OSA patients, and these changes were still present at 5-year follow-up. BMS seemed to induce clinical improvement in SDB.
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Affiliation(s)
- Sivaranjani Madhan
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark; Section of Orthodontics, Section of Orofacial Pain and Joint Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark.
| | - Michael Boelstoft Holte
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark.
| | - Alexandru Diaconu
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark.
| | - Jens Jørgen Thorn
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark.
| | - Janne Ingerslev
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark.
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus, Denmark.
| | - Marie Cornelis
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 720 Swanston St, Carlton, 3053, Victoria, Australia.
| | - Else Marie Pinholt
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark.
| | - Paolo M Cattaneo
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Finsensgade 35, 6700, Esbjerg, Denmark; Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 720 Swanston St, Carlton, 3053, Victoria, Australia.
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Ertugrul BY. Evaluation of effects of removable functional orthodontic apparatus on the upper airway size by cephalometric films. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e121-e125. [PMID: 34563728 DOI: 10.1016/j.jormas.2021.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/08/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Respiration is a vital functional process that has effects on normal craniofacial development. Since the upper airway formations and dentofacial structures are adjacent to each other, the interaction between them is possible. The aim of this study is to evaluate the effects of removable functional appliances used in the treatment of patients with mandibular and maxillary growth retardation-stenosis in Class I, Class II, and Class III malocclusion on the upper airway. MATERIALS AND METHODS Thirty two patients were studied in the study. The patients were divided into 4 groups according to treatment modalities. Maxillary expansion device group (Group A), Twinblock-Monoblock group (Group B), Face mask group (Group C), and Chincup group (Group D). The upper airway size in the lateral cephalometric images of the patients before orthodontic treatment with removable functional appliances (T0) and the upper airway size in the lateral cephalometric images taken after the end of the orthodontic treatment with the removable functional appliances (T1) were retrospectively compared. RESULT Most upper airway size increased after orthodontic treatment (T1) in the individuals who received orthodontic treatment with A, B, C, and D type removable functional appliances compared to pre-treatment (T0). When the changes in upper airway size pre-treatment (T0) and post-treatment (T1) were compared, the change in upper airway size according to treatment groups was found to be statistically different (p <0.05). CONCLUSION Since a large part of the upper airway is located in the craniofacial complex, orthodontists also examine the airway for diagnosis and planning and can regulate the airway in case of occlusion that has occurred or may occur. This puts orthodontists in an important place to intervene when complications occur or may develop in the upper airway. By determining the effects of removable functional appliances on the airways, airway problems that may be experienced at an early age can be prevented.
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Affiliation(s)
- Betul Yuzbasioglu Ertugrul
- Izmir Demokrasi University Faculty of Dentistry, Department of Orthodontics, Izmir, Turkey; Van Yüzüncü Yıl University Faculty of Dentistry, Department of Orthodontics, Van, Turkey.
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Lo Giudice A, Ronsivalle V, Gastaldi G, Leonardi R. Assessment of the accuracy of imaging software for 3D rendering of the upper airway, usable in orthodontic and craniofacial clinical settings. Prog Orthod 2022; 23:22. [PMID: 35691961 PMCID: PMC9189077 DOI: 10.1186/s40510-022-00413-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several semi-automatic software are available for the three-dimensional reconstruction of the airway from DICOM files. The aim of this study was to evaluate the accuracy of the segmentation of the upper airway testing four free source and one commercially available semi-automatic software. A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the upper airway. The software tested were Invesalius, ITK-Snap, Dolphin 3D, 3D Slicer and Seg3D. The same upper airway models were manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the upper airway model obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the upper airway models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analyzed for software comparisons. RESULTS Statistically significant differences were found in the volumetric dimensions of the upper airway models and in the matching percentage among the tested software (p < 0.001). Invesalius was the most accurate software for 3D rendering of the upper airway (mean bias = 1.54 cm3; matching = 90.05%) followed by ITK-Snap (mean bias = - 2.52 cm3; matching = 84.44%), Seg 3D (mean bias = 3.21 cm3, matching = 87.36%), 3D Slicer (mean bias = - 4.77 cm3; matching = 82.08%) and Dolphin 3D (difference mean = - 6.06 cm3; matching = 78.26%). According to the color-coded map, the dis-matched area was mainly located at the most anterior nasal region of the airway. Volumetric data showed excellent inter-software reliability (GS vs semi-automatic software), with coefficient values ranging from 0.904 to 0.993, confirming proportional equivalence with manual segmentation. CONCLUSION Despite the excellent inter-software reliability, different semi-automatic segmentation algorithms could generate different patterns of inaccuracy error (underestimation/overestimation) of the upper airway models. Thus, is unreasonable to expect volumetric agreement among different software packages for the 3D rendering of the upper airway anatomy.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Giorgio Gastaldi
- Department Orthodontics, Vita-Salute San Raffaele University, Milan, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
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A 3D CBCT Analysis of Airway and Cephalometric Values in Patients Diagnosed with Juvenile Idiopathic Arthritis Compared to a Control Group. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction: The temporomandibular joint (TMJ) is affected in 30–45% of juvenile idiopathic arthritis (JIA) patients, with all JIA subtypes at risk for TMJ involvement. JIA patients with TMJ involvement may present with altered craniofacial morphology, including micrognathia, mandibular retrognathia, a hyperdivergent mandibular plane angle, and skeletal anterior open bite. These features are also commonly present and associated with non-JIA pediatric patients with obstructive sleep apnea (OSA). Materials and Methods: The study was comprised of a group of 32 JIA patients and a group of 32 healthy control subjects. CBCT images were taken for all patients and were imported into Dolphin Imaging software. The Dolphin Imaging was used to measure the upper airway volumes and the most constricted cross-sectional areas of each patient. Cephalometric images were rendered from the CBCT data for each patient, and the following cephalometric values were identified: SNA angle, SNB angle, ANB angle, anterior facial height (AFH), posterior facial height (PFH), mandibular plane angle (SN-MP), FMA (FH-MP), overjet (OJ), and overbite (OB). Airway volumes, the most constricted cross-sectional area values, and cephalometric values were compared between the JIA and control groups. Results: For airway values, statistically significant differences were seen in the nasopharynx airway volume (p = 0.004), total upper airway volume (p = 0.013), and the most constricted cross-sectional area (p = 0.026). The oropharynx airway volume was not statistically significant (p = 0.051). For cephalometric values, only the posterior facial height showed a statistically significant difference (p = 0.024). Conclusions: There was a significant difference in airway dimensions in the JIA patients as compared to the control patients. In addition, the posterior facial dimensions seem to be affected in JIA patients. The ODDs ratio analysis further corroborated the findings that were significant.
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A Replicable and Reproducible Digital Method for Quantifying Maxillary Sinus Airway Changes after Sinus Lifts Using the Lateral Window Approach Technique-A Retrospective Study. J Pers Med 2021; 11:jpm11111093. [PMID: 34834446 PMCID: PMC8622529 DOI: 10.3390/jpm11111093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/11/2021] [Accepted: 10/24/2021] [Indexed: 12/30/2022] Open
Abstract
In the present retrospective study, we aimed to assess the replicability and reproducibility of a novel digital measurement technique for analyzing the volumes of the left and right maxillary sinuses and the nasal and maxillary sinus airway complex after a sinus lift procedure using the lateral window approach, to provide an accurate measurement technique for easily applying in clinical practice and to allow pre-operative assessment of maxillary sinus lift surgery, avoiding complications and making surgery more predictable. Material and Methods: Thirty patients with partially edentulous posterior maxilla were selected and submitted to bilateral sinus lift using the lateral window approach technique, with grafting materials selected and submitted to cone beam computed tomography (CBCT) scans, both pre- and postoperatively. Then, datasets were uploaded to therapeutic digital planning software to measure the volume of the right and left maxillary sinuses and the nasal and maxillary sinus airway complex. Gage R&R statistical analysis was performed to assess the replicability and reproducibility of the digital measurement technique. Results: The variability attributable to the novel digital measurement technique was 3.4% for replicability and 3.4% for reproducibility of the total variability of the samples. Conclusion: The novel digital method proposed is a replicable and reproducible technique for analyzing the volume of the right and left maxillary sinuses and the nasal and maxillary sinus airway complex after a sinus lift using the lateral window approach technique, allowing an accurate pre-operative assessment of maxillary sinus lift surgery, avoiding complications and making surgery more predictable.
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Kalaskar R, Balasubramanian S, Kalaskar A. Evaluation of the Average Nasal and Nasopharyngeal Volume in 10-13-year-old Children: A Preliminary CBCT Study. Int J Clin Pediatr Dent 2021; 14:187-191. [PMID: 34413589 PMCID: PMC8343683 DOI: 10.5005/jp-journals-10005-1917] [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] [Indexed: 11/28/2022] Open
Abstract
Aim and objective Mouth breathing is one of the most common deleterious habits prevalent in children which leads to various skeletal and dental malocclusions. Due to the close relationship between nasal and nasopharyngeal cavity volume and maxilla, transverse maxillary deficiency causes reduced nasal and nasopharyngeal cavity volume leading to mouth breathing. Therefore, knowledge of average nasal and nasopharyngeal cavity volume is essential to accurately diagnose mouth breathing and to evaluate underlying causative factors. Materials and methods Cone-beam computed tomographic scans of 60 children were taken and nasal cavity and nasopharyngeal volumes were calculated using Planmeca Romexis 5.2.0.R software. Average volumes were computed using predetermined landmarks and compared among gender. Results The nasal cavity and nasopharyngeal volume showed significant differences among the gender (p value < 0.001 and 0.018, respectively). Conclusion and clinical significance Knowledge of the average nasal and nasopharyngeal cavity volumes can be a useful diagnostic aid for mouth breathing patients and also assess the causative factors and treatment outcomes in these patients. How to cite this article Kalaskar R, Balasubramanian S, Kalaskar A. Evaluation of the Average Nasal and Nasopharyngeal Volume in 10–13-year-old Children: A Preliminary CBCT Study. Int J Clin Pediatr Dent 2021;14(2):187–191.
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Affiliation(s)
- Ritesh Kalaskar
- Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Medical College Premises, Medical Square, Nagpur, Maharashtra, India
| | - Shruti Balasubramanian
- Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Medical College Premises, Medical Square, Nagpur, Maharashtra, India
| | - Ashita Kalaskar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Medical College Premises, Medical Square, Nagpur, Maharashtra, India
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AlSaty G, Burns M, Ngan P. Effects of maxillomandibular advancement surgery on a skeletal Class III patient with obstructive sleep apnea: A case report. APOS TRENDS IN ORTHODONTICS 2021. [DOI: 10.25259/apos_191_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This case report describes the successful surgical treatment of a patient diagnosed with obstructive sleep apnea (OSA). A 55-year-old Caucasian male patient with a body mass index (BMI) of 25.6 kg/m2 sought treatment with a chief concern of excessive daytime sleepiness and fatigue. An initial polysomnography report showed moderate OSA with an apnea-hypopnea index (AHI) of 21.2 events/h, and Epworth Sleepiness Score (ESS) of 12/24. The patient was initially prescribed with CPAP treatment but was unable to tolerate treatment after a few months. Clinical and radiographic examination revealed a concave facial profile with maxillary retrognathism. Intraoral examination revealed generalized gingival recession, missing upper lateral incisors and lower first premolars, anterior crossbite, and maxillary transverse deficiency with bilateral posterior crossbite. The lateral cephalogram showed a narrow posterior airway space at the level of the base of the tongue. The patient was treated with maxillomandibular advancement (MMA) surgery to improve airway obstruction. Results showed balanced facial esthetic and stable occlusion with a complete resolution of the patient’s OSA and a post-operative improvement of AHI from 21.2 to 0.7 events/h and ESS from 12/24 to 3/24. The lowest oxyhemoglobin saturation during sleep was improved to 97%, and the BMI decreased from 25.6 to 25.2 kg/m2. These results suggest that MMA surgical procedure can be used as a definitive treatment for patients with maxillomandibular deficiency and OSA.
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Affiliation(s)
- Ghaddy AlSaty
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, West Virginia, United States,
| | - Mary Burns
- Einstein Medical Center, Philadelphia, Pennsylvania, United States,
| | - Peter Ngan
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, West Virginia, United States,
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Cheung GC, Dalci O, Mustac S, Papageorgiou SN, Hammond S, Darendeliler MA, Papadopoulou AK. The upper airway volume effects produced by Hyrax, Hybrid-Hyrax, and Keles keyless expanders: a single-centre randomized controlled trial. Eur J Orthod 2021; 43:254-264. [PMID: 32377675 DOI: 10.1093/ejo/cjaa031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess upper airway volume changes after rapid maxillary expansion (RME) with three different expanders. TRIAL DESIGN Three-arm parallel randomized clinical trial. METHODS Sixty-six patients, 10-16 years old, in permanent dentition, with maxillary transverse deficiency were recruited and assigned with block randomization (1:1:1 ratio) and allocation concealment to three groups of 22 patients each (Hyrax, Hybrid-Hyrax, and Keles keyless expander). The primary outcome (overall upper airway volume change) and secondary outcomes (volume changes in the nasal cavity, nasopharynx, oropharynx, and hypopharynx) were blindly assessed on the initial (T0) and final (T1, 6 months at appliance removal) cone beam computed tomography. Differences across groups were assessed with crude or adjusted for confounders (gender, age, growth stage, skeletal pattern, baseline airway volume, and amount of expansion) linear regression models. RESULTS Fifty-one patients were analysed (19, 19, and 13 in the Hyrax, Hybrid-Hyrax, and Keles groups). Maxillary expansion resulted in considerable increases in total airway volume in the Hybrid-Hyrax group (+5902.1 mm3) and less in the Hyrax group (+2537.9 mm3) or the Keles group (+3001.4 mm3). However, treatment-induced changes for the primary and all secondary outcomes were of small magnitude and no significant difference was seen among the three expanderes in the total airway volume in either crude or adjusted analyses (P > 0.05 in all instances). Finally, among pre-peak patients (CVM 1-3), the Hybrid-Hyrax expander was associated with significantly greater increases in total airway volume compared to the Hyrax expander (P = 0.02). CONCLUSIONS RME resulted in relatively small increases in total upper airway volume and its separate compartments, with mostly no statistically significant differences across the Hyrax, Hybrid-Hyrax, and Keles groups. LIMITATIONS Significantly greater attrition was found in the Keles group due to appliance failure. The current trial might possibly be under-powered to detect differences between groups, if such exist. HARMS Keles expanders blocked during activations and required substitution for completion of treatment. PROTOCOL The protocol was not published before trial commencement. REGISTRATION Australian and New Zealand Clinical Trial Registry (ACTRN12617001136392).
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Affiliation(s)
- Gordon C Cheung
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney; Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
| | - Oyku Dalci
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney; Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
| | - Simone Mustac
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney; Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Shanya Hammond
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney; Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
| | - M Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney; Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
| | - Alexandra K Papadopoulou
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney; Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
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Leonardi R, Giudice AL, Isola G, Spampinato C. Deep learning and computer vision: Two promising pillars, powering the future in orthodontics. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Niu X, Madhan S, Cornelis MA, Cattaneo PM. Novel three-dimensional methods to analyze the morphology of the nasal cavity and pharyngeal airway. Angle Orthod 2021; 91:320-328. [PMID: 33523094 DOI: 10.2319/070620-610.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/01/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To assess the intraexaminer and interexaminer reliabilities of novel semiautomatic methods to segment the nasal cavity (NC) and pharyngeal airway (PA) and to determine the minimal cross-sectional area (CS) and hydraulic diameter (HD) of the PA. MATERIALS AND METHODS To test reproducibility, two examiners analyzed the NC and PA independently in 10 retrospectively selected cone beam computed tomography (CBCT) images using semiautomatic segmentation. The PA centerline was determined to assess the minimal CS and HD. The intraclass correlation coefficient (ICC) was used to calculate intraexaminer and interexaminer reliabilities. Measurement errors were assessed by Dahlberg's formula and paired t-tests. The level of agreement was assessed using the Bland-Altman method. RESULTS Intraexaminer and interexaminer reliabilities were excellent (minimal ICC, 0.960). The error of the method was good except for interexaminer values for the oropharynx (P = .016). The minimal CS and HD measurements were reliable (minimal ICC, 0.993; narrow limits of agreement). CONCLUSIONS The novel methods for analysis of the NC and PA are reliable. The minimal CS and HD demonstrated excellent reliabilities, which are critical to detect the most constricted part of the PA. Separation of the oropharynx from the voids close to the retroglossal area is not trivial and should be considered with caution.
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Computer-aided superimposition of the frontal sinus via 3D reconstruction for comparative forensic identification. Int J Legal Med 2021; 135:1993-2001. [PMID: 33890165 DOI: 10.1007/s00414-021-02585-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/19/2021] [Indexed: 02/05/2023]
Abstract
The anatomical uniqueness of the frontal sinus morphology has been widely used for comparative forensic identification using various techniques, mostly including 2D X-rays or one fixed slice of an axial computed tomography (CT) scan image. However, computer-aided 3D automatic graphical comparison techniques can provide accurate comparisons between two 3D models that allow users to comply with even the strictest deviation standards, avoiding error-prone identification of frontal sinuses with similar morphologies. The study proposes the use of a computer-aided comparative paradigm based on the 3D-3D frontal sinus model superimposition process and further assesses the anatomical uniqueness of frontal sinuses using a large Chinese Han sample. Three hundred thirty-six patients older than 20 years with two multi-slice CT scans were collected. Frontal sinus 3D models were semi-automatically segmented through Dolphin Imaging software. Automatic pairwise comparisons of 336 matched pairs from the same person and 340 mismatched pairs from different individuals with an analysis of average root mean square (RMS) point-to-point distance were performed using Geomagic Studio Qualify software. RMS ranged between 0.005 and 1.032 (mean RMS 0.390 ± 0.25 mm) in the group of matches and between 1.107 and 19.363 (mean RMS 4.49 ± 2.69 mm) in the group of mismatches. On average, the RMS value was over ten-fold greater in mismatches than in matches. Statistically significant differences in RMS between the group of matches and mismatches were assessed using the Mann-Whitney U test (p < 0.05). This study supports the value of the frontal sinus with a 3D computer-aided superimposition method for human identification with large samples when DNA, fingerprints, and dental materials are not accessible.
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Deep Learning Based Airway Segmentation Using Key Point Prediction. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the accuracy of the airway volume measurement by a Regression Neural Network-based deep-learning model. A set of manually outlined airway data was set to build the algorithm for fully automatic segmentation of a deep learning process. Manual landmarks of the airway were determined by one examiner using a mid-sagittal plane of cone-beam computed tomography (CBCT) images of 315 patients. Clinical dataset-based training with data augmentation was conducted. Based on the annotated landmarks, the airway passage was measured and segmented. The accuracy of our model was confirmed by measuring the following between the examiner and the program: (1) a difference in volume of nasopharynx, oropharynx, and hypopharynx, and (2) the Euclidean distance. For the agreement analysis, 61 samples were extracted and compared. The correlation test showed a range of good to excellent reliability. A difference between volumes were analyzed using regression analysis. The slope of the two measurements was close to 1 and showed a linear regression correlation (r2 = 0.975, slope = 1.02, p < 0.001). These results indicate that fully automatic segmentation of the airway is possible by training via deep learning of artificial intelligence. Additionally, a high correlation between manual data and deep learning data was estimated.
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Truong CT, Jeon HH, Sripinun P, Tierney A, Boucher NS. Short-term and long-term effects of rapid maxillary expansion on the nasal soft and hard tissue. Angle Orthod 2021; 91:46-53. [PMID: 33289784 DOI: 10.2319/022320-120.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 07/01/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To evaluate nasal soft and hard tissue changes immediately post-rapid maxillary expansion (RME) and to assess the stability of these changes using cone beam computed tomography (CBCT). MATERIALS AND METHODS A total of 35 treatment group (TG) patients (18 girls, 17 boys; 9.39 ± 1.4) had a pre-RME CBCT and a post-RME CBCT approximately 66 days after expansion, and 25 patients had a follow-up CBCT 2.84 years later. A total of 28 control group (CG; no RME) patients (16 girls, 12 boys; 8.81 ± 1.6) had an initial CBCT and a CBCT an average of 2.25 years later. Soft and hard tissue nasal landmarks were measured in transverse, sagittal, and coronal planes of space on CBCT scans. Differences within the same group were evaluated by paired t-tests or Wilcoxon signed-rank tests. Long-term comparisons between TG and CG were evaluated by independent-sample t-tests or Wilcoxon rank-sum tests. RESULTS Immediately post-RME, there were statistically significant mean increases of 1.6 mm of alar base width, 1.77 mm of pyriform height, and 3.57 mm of pyriform width (P < .05). CG showed the significant increases over 2.25 years (P < .001). Compared with CG, the long-term evaluation of TG demonstrated only pyriform height and pyriform width showed a statistically significant difference (P < .01). CONCLUSIONS Although RME produced some significant increase on the nasal soft tissue immediately after expansion, it regressed to the mean of normal growth and development over time. However, long-term evaluation of TG compared with CG showed only pyriform height and pyriform width to be affected by RME.
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Kim YJ, Shin HK, Lee DY, Ryu JJ, Kim TH. Decreased maxillary sinus volume is a potential predictor of obstructive sleep apnea. Angle Orthod 2021; 90:556-563. [PMID: 33378503 DOI: 10.2319/080819-520.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/01/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To investigate the associations between nasal airway volume and the presence and severity of obstructive sleep apnea (OSA) in adults. MATERIALS AND METHODS The medical records of adult patients who visited the sleep clinic at University Hospital between June 2013 and April 2017 and underwent overnight polysomnography for the diagnosis of obstructive sleep apnea were reviewed retrospectively. Using computed tomography, the volumes of the nasal airways and maxillary sinuses were measured, and associations with the presence and severity of OSA were analyzed while controlling for the effects of possible confounders such as lateral cephalometric variables, maxillary widths, tongue/hyoid position, and soft palate dimensions. RESULTS Comparison between normal subjects and patients with OSA revealed that the latter had decreased ratios of maxillary sinus volume to whole nasal airway volume (P = .029) than normal subjects. OSA severity was greater in those with inferior positions of the hyoid (P = .010), in older patients (P = .011), and in those with high body mass index (P = .001). The volume of the total nasal airway or maxillary sinuses were not associated with OSA severity. CONCLUSIONS A decreased ratio of maxillary sinus volume to whole nasal airway volume is associated with adult OSA. However, OSA severity is not associated with either maxillary sinus volume or whole nasal airway volume.
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Yavan MA, Kaya S, Kervancioglu P, Kocahan S. Evaluation of effects of a modified asymmetric rapid maxillary expansion appliance on the upper airway volume by cone beam computed tomography. J Dent Sci 2021; 16:58-64. [PMID: 33384779 PMCID: PMC7770327 DOI: 10.1016/j.jds.2020.05.019] [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: 02/13/2020] [Revised: 05/19/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND/PURPOSE The rapid maxillary expansion is accepted as the gold standard for the treatment of unilateral posterior crossbite in growing children. This study used cone beam computed tomography (CBCT) to evaluate the effects of a modified asymmetric rapid maxillary expansion (ARME) appliance on the upper airway volumes. MATERIALS AND METHODS A modified ARME appliance was used on 12 adolescent male patients (mean age: 13.92 ± 0.82 years) with a class I skeletal relationship and posterior unilateral crossbite. Lateral cephalometric measurements and upper airway volume were evaluated using CBCT images. The posterior airway volumes of the oropharyngeal and nasopharyngeal airways were measured. RESULTS Cephalometric measurements showed significant (P < 0.05) posterior rotation of the mandible. There was no significant movement of the maxilla according to the cranial base on the sagittal plane. Nasopharyngeal and oropharyngeal airway volumes increased significantly (P < 0.05). CONCLUSION The results of this study demonstrate that treatment with the modified ARME has no significant effect on the maxilla but may increase the upper airway volume.
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Affiliation(s)
- Mehmet Ali Yavan
- Department of Orthodontics, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Seda Kaya
- Depatment of Dentomaksilliofacial Radiology, Hospital of Okmeydanı, Istanbul, Turkey
| | - Piraye Kervancioglu
- Department of Anatomy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Sayad Kocahan
- Department of Physiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
- International Scientetific Center, Baku State University, Baku, Azerbaijan
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Corte-Real A, Kato RM, Nunes T, Vale F, Garib D. Reproducibility of mandibular landmarks for three-dimensional assessment. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2020. [DOI: 10.1016/j.fsir.2020.100144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Donaldson CD, Manisali M, Naini FB. Three-dimensional virtual surgical planning (3D-VSP) in orthognathic surgery: Advantages, disadvantages and pitfalls. J Orthod 2020; 48:52-63. [PMID: 32988276 DOI: 10.1177/1465312520954871] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this article, the advantages, disadvantages and pitfalls of three-dimensional virtual surgical planning (3D-VSP) compared to traditional two-dimensional (2D) planning methods in orthognathic surgery are discussed, alongside a standardised protocol that can be utilised. A skeletal Class II, skeletal Class III and an anterior open bite clinical case along with their 3D-VSP management are presented, highlighting modifications that can be made to computer-aided design/computer-aided manufacture (CAD/CAM) cutting guide and plate designs.
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Affiliation(s)
- Chris D Donaldson
- King's College Hospital NHS Foundation Trust, London, UK.,St. George's University Hospitals NHS Foundation Trust, London, UK
| | - Mehmet Manisali
- St. George's University Hospitals NHS Foundation Trust, London, UK
| | - Farhad B Naini
- St. George's University Hospitals NHS Foundation Trust, London, UK.,Kingston Hospital NHS Foundation Trust, London, UK
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Tandon R, Aljadeff L, Finn RA. Contemplations and Ruminations of Methodological Error. J Oral Maxillofac Surg 2020; 79:49-56. [PMID: 32966768 DOI: 10.1016/j.joms.2020.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/09/2020] [Accepted: 08/24/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Journal articles in our field of oral and maxillofacial surgery are rife with case studies, cohort reviews, meta-analysis, basic science studies, surgical techniques, and anatomic studies. The data found in these studies often rely on multiple measurements by which the authors draw their conclusions. Accurate measurements play a critical role in the design of the study, which in turn affects the conclusion that the author is attempting to convey. Investigators must determine and develop the processes to determine the methodological errors associated with each project to help with determining the accuracy of these measurements. The aim of this study is to highlight some of the methodological errors contained in the material and methods in oral and maxillofacial surgery studies over the calendar years of 2018 and 2019 and how best to evaluate them. MATERIALS AND METHODS The inclusion criteria involved articles that used measurements where discrepancies could exist such as clinical measurements, histological measurements, and radiological measurements. The number of specimens or subjects measured in each study was tabulated. RESULTS Over the 2-year period considered, 744 articles were published, and 116 (15.6%) of them met the inclusion criteria. Of these articles, 37 (32%) reported a methodological error, while 79 (68%) did not. In addition, 31 (84%) of the articles with a methodological error were radiographic, while only 6 (16%) were not radiographic. Among the studies that reported methodological error, there were approximately 7 different types used with no rationale given for the choice. CONCLUSIONS We believe that it is important to ensure sound methods and materials, including a stated methodological error. An attempt at standardization will help to serve to enhance and strengthen the different research studies seen in our field.
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Affiliation(s)
- Rahul Tandon
- Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Texas Southwestern/Parkland Memorial Hospital, Dallas, TX.
| | - Lior Aljadeff
- Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Texas Southwestern/Parkland Memorial Hospital, Dallas, TX
| | - Richard A Finn
- Professor, Department of Surgery, Division of Oral and Maxillofacial Surgery, Department of Cell Biology-Anatomy, University of Texas Southwestern Medical Center; Chief, Oral and Maxillofacial, Surgery, Veterans Administration North Texas Health Care System
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Radwan ES, Scribante A, Sfondrini MF, Montasser MA. Imaging Software Programs for Reliable Mathematical Measurements in Orthodontics. Dent J (Basel) 2020; 8:E81. [PMID: 32756303 PMCID: PMC7558395 DOI: 10.3390/dj8030081] [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: 04/28/2020] [Revised: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022] Open
Abstract
AIM To evaluate the reliability of linear and angular measurements taken using different software programs in orthodontics. MATERIALS AND METHODS A sample of four software programs from different manufacturers, namely MicroDicom viewer, Photoshop® CS3, AutoCAD®, and Image-Pro®, were used for measuring the geometric features of four types of miniscrews from different manufacturers. Each miniscrew type presented a group: Group I, Tomas® (Dentaurum, Ispringen, Germany); Group II, HUBIT® (HUBIT, Gyeonggi-do, Korea); Group III, AbsoAnchor® (Dentos, Daegu, Korea); and Group IV, Creative (Creative, Zhejiang, China). Measurements of apical face angle, thread angle, lead angle, flank, pitch depth, and width were taken on 45 × magnification scanning electron microscope images of the shafts of the miniscrews. One assessor measured the seven geometric features for the four types of miniscrews using the four software programs twice in two sessions separated by a three week interval. RESULTS Pairwise comparisons, for each of the four miniscrew groups, showed that the only common result observed was the significant difference (p < 0.001) between measurements of flank taken by the four software programs. When measurements of the four types of miniscrews were pooled into one group, a high degree of intra-rater reliability (ICC range from 0.9 to 1.0) for all the seven geometric features was found with all the four software programs. The paired t-test showed insignificant difference (at p ≤ 0.05) between the first and second measurements, except for a few measurements including pitch width measured by Image-Pro® (p = 0.012), MicroDicom (p = 0.023), and Photoshop® (p = 0.001). CONCLUSIONS Results did not give absolute superiority to one software program over the others and suggested an assessor effect. Assessor estimates could have been affected, among other factors, by the design of the miniscrews and the technical features of the software programs.
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Affiliation(s)
- Eman Saad Radwan
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt;
| | - Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry–Section of Dentistry–Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Maria Francesca Sfondrini
- Unit of Orthodontics and Paediatric Dentistry–Section of Dentistry–Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Mona A Montasser
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura 35516, Egypt;
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Lo Giudice A, Quinzi V, Ronsivalle V, Farronato M, Nicotra C, Indelicato F, Isola G. Evaluation of Imaging Software Accuracy for 3-Dimensional Analysis of the Mandibular Condyle. A Comparative Study Using a Surface-to-Surface Matching Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134789. [PMID: 32635238 PMCID: PMC7370104 DOI: 10.3390/ijerph17134789] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to assess the accuracy of 3D rendering of the mandibular condylar region obtained from different semi-automatic segmentation methodology. A total of 10 Cone beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the condyles by using three free-source software (Invesalius, version 3.0.0, Centro de Tecnologia da Informação Renato Archer, Campinas, SP, Brazil; ITK-Snap, version2.2.0; Slicer 3D, version 4.10.2) and one commercially available software Dolphin 3D (Dolphin Imaging, version 11.0, Chatsworth, CA, USA). The same models were also manually segmented (Mimics, version 17.01, Materialise, Leuven, Belgium) and set as ground truth. The accuracy of semi-automatic segmentation was evaluated by (1) comparing the volume of each semi-automatic 3D rendered condylar model with that obtained with manual segmentation, (2) deviation analysis of each 3D rendered mandibular models with those obtained from manual segmentation. No significant differences were found in the volumetric dimensions of the condylar models among the tested software (p > 0.05). However, the color-coded map showed underestimation of the condylar models obtained with ITK-Snap and Slicer 3D, and overestimation with Dolphin 3D and Invesalius. Excellent reliability was found for both intra-observer and inter-observer readings. Despite the excellent reliability, the present findings suggest that data of condylar morphology obtained with semi-automatic segmentation should be taken with caution when an accurate definition of condylar boundaries is required.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Vincenzo Quinzi
- Post Graduate School of Orthodontics, Department of Life, Health and Environmental Sciences, University of L’Aquila, V.le San Salvatore, 67100 L’Aquila, Italy;
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Marco Farronato
- Department of Medicine, Surgery and Dentistry, Section of Orthodontics, University of Milan, 20122 Milan, Italy;
| | - Carmelo Nicotra
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Francesco Indelicato
- Department of General Surgery and Surgical-Medical Specialties, Section of Oral Surgery and Periodontology, School of Dentistry, University of Catania, 95123 Catania, Italy;
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Section of Oral Surgery and Periodontology, School of Dentistry, University of Catania, 95123 Catania, Italy;
- Correspondence: ; Tel.: +39-095-3782453
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Lo Giudice A, Ronsivalle V, Grippaudo C, Lucchese A, Muraglie S, Lagravère MO, Isola G. One Step before 3D Printing-Evaluation of Imaging Software Accuracy for 3-Dimensional Analysis of the Mandible: A Comparative Study Using a Surface-to-Surface Matching Technique. MATERIALS 2020; 13:ma13122798. [PMID: 32575875 PMCID: PMC7345160 DOI: 10.3390/ma13122798] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/10/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023]
Abstract
The accuracy of 3D reconstructions of the craniomaxillofacial region using cone beam computed tomography (CBCT) is important for the morphological evaluation of specific anatomical structures. Moreover, an accurate segmentation process is fundamental for the physical reconstruction of the anatomy (3D printing) when a preliminary simulation of the therapy is required. In this regard, the objective of this study is to evaluate the accuracy of four different types of software for the semiautomatic segmentation of the mandibular jaw compared to manual segmentation, used as a gold standard. Twenty cone beam computed tomography (CBCT) with a manual approach (Mimics) and a semi-automatic approach (Invesalius, ITK-Snap, Dolphin 3D, Slicer 3D) were selected for the segmentation of the mandible in the present study. The accuracy of semi-automatic segmentation was evaluated: (1) by comparing the mandibular volumes obtained with semi-automatic 3D rendering and manual segmentation and (2) by deviation analysis between the two mandibular models. An analysis of variance (ANOVA) was used to evaluate differences in mandibular volumetric recordings and for a deviation analysis among the different software types used. Linear regression was also performed between manual and semi-automatic methods. No significant differences were found in the total volumes among the obtained 3D mandibular models (Mimics = 40.85 cm3, ITK-Snap = 40.81 cm3, Invesalius = 40.04 cm3, Dolphin 3D = 42.03 cm3, Slicer 3D = 40.58 cm3). High correlations were found between the semi-automatic segmentation and manual segmentation approach, with R coefficients ranging from 0,960 to 0,992. According to the deviation analysis, the mandibular models obtained with ITK-Snap showed the highest matching percentage (Tolerance A = 88.44%, Tolerance B = 97.30%), while those obtained with Dolphin 3D showed the lowest matching percentage (Tolerance A = 60.01%, Tolerance B = 87.76%) (p < 0.05). Colour-coded maps showed that the area of greatest mismatch between semi-automatic and manual segmentation was the condylar region and the region proximate to the dental roots. Despite the fact that the semi-automatic segmentation of the mandible showed, in general, high reliability and high correlation with the manual segmentation, caution should be taken when evaluating the morphological and dimensional characteristics of the condyles either on CBCT-derived digital models or physical models (3D printing).
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
| | - Cristina Grippaudo
- Department of Orthodontics, University of Sacred Heart of Rome, 00168 Rome, Italy;
| | - Alessandra Lucchese
- Department of Orthodontics, Vita-Salute San Raffaele University, 10,090 Milan, Italy;
| | - Simone Muraglie
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
| | - Manuel O. Lagravère
- Orthodontic Graduate Program, ECHA 5-524, Faculty of Medicine and Dentistry, University of Alberta, 11405-87 Ave, Edmonton, AB T6G1Z1, Canada;
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
- Correspondence: ; Tel.: +39-0953-782-453
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Comparison of the Pharyngeal Airway Volume Between Patients With Ectodermal Dysplasia and Unaffected Controls: A Cone-Beam Computed Tomography Study. J Oral Maxillofac Surg 2020; 78:1629.e1-1629.e9. [PMID: 32417317 DOI: 10.1016/j.joms.2020.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Ectodermal dysplasias (EDs) are a diverse set of hereditary conditions in which 2 or more ectodermal structures develop abnormally. The purpose of this study was to use cone-beam computed tomography (CBCT) scans to measure the pharyngeal airway volume and minimum cross-sectional area (MC) among patients with ED and compare them with healthy controls. PATIENTS AND METHODS The pretreatment CBCT scans of 9 individuals with ED and 61 controls were analyzed. Lateral cephalograms were created from the CBCT volumes and then traced and compared between the 2 groups. Airway volumes were evaluated by Dolphin 3D software (Dolphin Imaging, Chatsworth, CA) to compare the total pharyngeal volume, nasopharyngeal volume, oropharyngeal volume, hypopharyngeal volume, and MC. The mean airway volumes of the 2 groups were compared, and the odds ratio and relative risk of having an MC of less than 100 mm2 in the ED group were calculated. RESULTS Intraclass correlation analysis showed excellent inter-rater reliability. All cephalometric features of controls were within the norms of patients with ideal skeletal-dental relationships. Patients with ED displayed significantly lower values for SNA (angle between sella-nasion and nasion-A point) (P = .018), ANB (angle between nasion-A point and nasion-B point) (P = .002), L1-MP (angle between long axis of mandibular incisor and gonion-menton plane) (P = .013), and L1-NB (distance between mandibular incisor and perpendicular line between nasion and B point) (P < .001). Although the ED group exhibited slightly smaller airway volumes for all subregions, the differences were not statistically significant for total pharyngeal volume, nasopharyngeal volume, oropharyngeal volume, hypopharyngeal volume, or MC (P > .05). The odds of having an MC of less than 100 mm2 were almost 3 times greater among ED patients, and the relative risk of an MC of less than 100 mm2 among ED patients was double that of controls. CONCLUSIONS Although the craniofacial structures of individuals with ED are characterized by maxillary and midface deficiency, the airway volumes among affected individuals may not be significantly different from those of unaffected controls. However, patients with ED displayed a higher risk of having an MC of less than 100 mm2, which may be of clinical significance and warrants further investigations with larger samples.
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Torres HM, Evangelista K, Torres EM, Estrela C, Leite AF, Valladares-Neto J, Silva MAG. Reliability and validity of two software systems used to measure the pharyngeal airway space in three-dimensional analysis. Int J Oral Maxillofac Surg 2019; 49:602-613. [PMID: 31564477 DOI: 10.1016/j.ijom.2019.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/29/2019] [Accepted: 09/12/2019] [Indexed: 12/12/2022]
Abstract
The aim of this study was to test the reliability and validity of two software systems used to measure the pharyngeal airway space three-dimensionally. A sample of 40 cone beam computed tomography images from adult patients was taken from a database. The cone beam computed tomography images were analysed by InVivoDental and Dolphin 3D software systems by two calibrated examiners. Three nasopharynx and oropharynx prototypes were used as a reference standard to validate the software systems. The volume, minimum area and minimum area localization were the measurements tested. Measurements were compared using a paired t-test; correlated using Pearson's correlation and linear regression. Bland-Altman analysis was also used. We found significant differences in the oropharynx volume (P=0.002) and nasopharynx minimum area localization (P=0.009). The Dolphin 3D software presented higher-volume values than the ones found in the prototype, while the InVivoDental software presented lower values. Strong (r>0.7; P>0.001) or very strong (r>0.9; P>0.001) correlations were observed between the software systems. Bland-Altman analysis found good agreement between prototypes and the software systems. The measurements obtained from the Dolphin 3D and InVivoDental software systems are both reliable, strongly correlated, but should not be assumed as equal. Dolphin 3D software overestimates the nasopharynx and oropharynx volumes, while the InVivoDental software underestimates them.
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Affiliation(s)
- H M Torres
- Department of Stomatological Sciences, Dental School, Federal University of Goiás, Goiás, Brazil
| | - K Evangelista
- Department of Stomatological Sciences, Dental School, Federal University of Goiás, Goiás, Brazil
| | - E M Torres
- Department of Stomatological Sciences, Dental School, Federal University of Goiás, Goiás, Brazil
| | - C Estrela
- Department of Stomatological Sciences, Dental School, Federal University of Goiás, Goiás, Brazil
| | - A F Leite
- Department of Stomatological Sciences, Dental School, Federal University of Goiás, Goiás, Brazil
| | - J Valladares-Neto
- Department of Stomatological Sciences, Dental School, Federal University of Goiás, Goiás, Brazil
| | - M A G Silva
- Department of Stomatological Sciences, Dental School, Federal University of Goiás, Goiás, Brazil.
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Abdelkarim A. Cone-Beam Computed Tomography in Orthodontics. Dent J (Basel) 2019; 7:E89. [PMID: 31480667 PMCID: PMC6784482 DOI: 10.3390/dj7030089] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/05/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.
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Affiliation(s)
- Ahmad Abdelkarim
- Department of Orthodontics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
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Joy A, Park J, Chambers DW, Oh H. Airway and cephalometric changes in adult orthodontic patients after premolar extractions. Angle Orthod 2019; 90:39-46. [PMID: 31403835 DOI: 10.2319/021019-92.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To examine changes in the airway and cephalometric measurements associated with orthodontic treatment of adults with and without premolar extractions. The study investigated whether extractions had a direct or indirect effect on the airway and examined selected skeletal and dental features. MATERIALS AND METHODS This retrospective study used pre- (T1) and posttreatment (T2) cone-beam computed tomography scans of 83 adult patients matched for age and sex. A total of 15 airway and 10 skeletal and dental measures were analyzed by means of repeated-measures analysis of variance. RESULTS There were no results showing that extractions affected airway dimensions that could not be accounted for as reflections of measurement error. There was no evidence that extractions affected the airway indirectly through skeletal and dental changes. There were strong and consistent findings that patients with small airways showed larger ones after treatment and that patients with large airways showed smaller ones later. These effects were independent of whether or not extractions were part of treatment. The measurement phenomena of regression toward the mean and of differential unfolding of natural changes over time could have accounted for the results observed. CONCLUSIONS There was no evidence that extractions in nongrowing patients have negative consequences on the size of various airway measures in the nasopharynx, retropalatal, or retroglossal regions.
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Two-Year Postoperative Upper Airway Cone-Beam Computed Tomographic Outcomes Based on a Verified Upper Airway Analysis Following Bimaxillary Orthognathic Surgery. J Oral Maxillofac Surg 2019; 77:1435-1445. [DOI: 10.1016/j.joms.2019.02.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 01/14/2023]
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Souza Pinto GND, Iwaki Filho L, Previdelli ITDS, Ramos AL, Yamashita AL, Stabile GAV, Stabile CLP, Iwaki LCV. Three-dimensional alterations in pharyngeal airspace, soft palate, and hyoid bone of class II and class III patients submitted to bimaxillary orthognathic surgery: A retrospective study. J Craniomaxillofac Surg 2019; 47:883-894. [DOI: 10.1016/j.jcms.2019.03.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 02/11/2019] [Accepted: 03/11/2019] [Indexed: 11/29/2022] Open
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Liang Q, Auvenshine R. Pharyngeal airway dimension in patients before and after treatment of myofascial pain syndrome. Cranio 2019; 39:125-132. [PMID: 31007142 DOI: 10.1080/08869634.2019.1602310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study aimed: (1) to assess the localization of the anatomic landmarks of the pharyngeal airway on cone beam computed tomography (CBCT) images; and (2) to evaluate if resolution of myofascial pain syndrome (MPS) changed the airway dimensions.Methods: Twenty-nine patients with pre- and post-treatment CBCT scans were randomly selected to locate five landmarks twice, with a two-week interval. The same landmarks were used to measure the airway volume and minimal cross-sectional area (CSAmin).Results: The intra-observer reliability (ICC) was 0.99-1.00 for volumetric and CSAmin measurements, based on the five landmarks used. The paired t test showed no significant difference in the airway volume (p = 0.68) and CSAmin (p = 0.96).Discussion: The outcomes showed that the landmarks used had excellent ICCs for the volumetric and CSAmin measurements. There was no change in volume and CSAmin of the pharyngeal airway after resolution of MPS.
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Affiliation(s)
- Qiuyi Liang
- Prosthodontics Department, UTHealth at the University of Texas School of Dentistry, and Michael E. DeBakey VA Medical Center, Houston, TX, USA
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Zhang C, Bruggink R, Baan F, Bronkhorst E, Maal T, He H, Ongkosuwito EM. A new segmentation algorithm for measuring CBCT images of nasal airway: a pilot study. PeerJ 2019; 7:e6246. [PMID: 30713816 PMCID: PMC6354662 DOI: 10.7717/peerj.6246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/07/2018] [Indexed: 11/21/2022] Open
Abstract
Background Three-dimensional (3D) modeling of the nasal airway space is becoming increasingly important for assessment in breathing disorders. Processing cone beam computed tomography (CBCT) scans of this region is complicated, however, by the intricate anatomy of the sinuses compared to the simpler nasopharynx. A gold standard for these measures also is lacking. Previous work has shown that software programs can vary in accuracy and reproducibility outcomes of these measurements. This study reports the reproducibility and accuracy of an algorithm, airway segmentor (AS), designed for nasal airway space analysis using a 3D printed anthropomorphic nasal airway model. Methods To test reproducibility, two examiners independently used AS to edit and segment 10 nasal airway CBCT scans. The intra- and inter-examiner reproducibility of the nasal airway volume was evaluated using paired t-tests and intraclass correlation coefficients. For accuracy testing, the CBCT data for pairs of nasal cavities were 3D printed to form hollow shell models. The water-equivalent method was used to calculate the inner volume as the gold standard, and the models were then embedded into a dry human skull as a phantom and subjected to CBCT. AS, along with the software programs MIMICS 19.0 and INVIVO 5, was applied to calculate the inner volume of the models from the CBCT scan of the phantom. The accuracy was reported as a percentage of the gold standard. Results The intra-examiner reproducibility was high, and the inter-examiner reproducibility was clinically acceptable. AS and MIMICS presented accurate volume calculations, while INVIVO 5 significantly overestimated the mockup of the nasal airway volume. Conclusion With the aid of a 3D printing technique, the new algorithm AS was found to be a clinically reliable and accurate tool for the segmentation and reconstruction of the nasal airway space.
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Affiliation(s)
- Chen Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Robin Bruggink
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands.,3DLAB The Netherlands, Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Frank Baan
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands.,3DLAB The Netherlands, Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Ewald Bronkhorst
- Department of Dentistry, Section of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Thomas Maal
- 3DLAB The Netherlands, Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Hong He
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Edwin M Ongkosuwito
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands
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Kamaruddin N, Daud F, Yusof A, Aziz ME, Rajion ZA. Comparison of automatic airway analysis function of Invivo5 and Romexis software. PeerJ 2019; 7:e6319. [PMID: 30697493 PMCID: PMC6347961 DOI: 10.7717/peerj.6319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 12/17/2018] [Indexed: 11/20/2022] Open
Abstract
Background Visualization and calculation of the airway dimensions are important because an increase of airway resistance may lead to life-threatening emergencies. The visualization and calculation of the airway are possible using radiography technique with their advance software. The aim of this study was to compare and to test the reliability of the measurement of the upper airway volume and minimum area using airway analysis function in two software. Methods The sample consisted of 11 cone-beam computed tomography (CBCT) scans data, evaluated using the Invivo5 (Anatomage) and Romexis (version 3.8.2.R, Planmeca) software which afford image reconstruction, and airway analysis. The measurements were done twice with one week gap between the two measurements. The measurement obtained was analyzed with t-tests and intraclass correlation coefficient (ICC), with confidence intervals (CI) was set at 95%. Results From the analysis, the mean reading of volume and minimum area is not significantly different between Invivo5 and Romexis. Excellent intrarater reliability values were found for the both measurement on both software, with ICC values ranging from 0.940 to 0.998. Discussion The results suggested that both software can be used in further studies to investigate upper airway, thereby contributing to the diagnosis of upper airway obstructions.
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Affiliation(s)
- Noorshaida Kamaruddin
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Firdaus Daud
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Asilah Yusof
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Mohd Ezane Aziz
- School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu, Kelantan, Malaysia
| | - Zainul A Rajion
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia.,College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Dos Santos Trento G, Moura LB, Spin-Neto R, Jürgens PC, Aparecida Cabrini Gabrielli M, Pereira-Filho VA. Comparison of Imaging Softwares for Upper Airway Evaluation: Preliminary Study. Craniomaxillofac Trauma Reconstr 2018; 11:273-277. [PMID: 30574270 DOI: 10.1055/s-0037-1606247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/27/2017] [Indexed: 10/19/2022] Open
Abstract
The interest about upper airway evaluation has increased lately. Therefore, many softwares have been developed aiming to improve and facilitate the analysis of airway volume. The objective of this study was to compare two different softwares packages, Mimics and Dolphin, in their accuracy and precision in upper airway space measurements. Preoperative cone beam computed tomography scans of nine nonsyndromic patients submitted to surgically assisted rapid maxillary expansion were included in this study. The imaging exams were converted to DICOM (digital imaging and communications in medicine) files and imported to the softwares. The mean volume for the Dolphin group (G1) was 10.791 cm 3 (SD = 4.269 cm 3 ) and for the Mimics group (G2) was 10.553 cm 3 (SD = 4.564 cm 3 ). There was no statistically significant difference between the two groups ( p = 0.105).
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Affiliation(s)
- Guilherme Dos Santos Trento
- Department of Diagnosis and Surgery, Dental School of Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Lucas Borin Moura
- Department of Diagnosis and Surgery, Dental School of Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | | | | | - Valfrido Antônio Pereira-Filho
- Department of Diagnosis and Surgery, Dental School of Araraquara, São Paulo State University, Araraquara, São Paulo, Brazil
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Zimmerman JN, Vora SR, Pliska BT. Reliability of upper airway assessment using CBCT. Eur J Orthod 2018; 41:101-108. [DOI: 10.1093/ejo/cjy058] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Jason N Zimmerman
- Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Siddharth R Vora
- Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Benjamin T Pliska
- Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
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Adisen SR, Adisen MZ, Ozdiler FE. The evaluation of the relationship between cervical vertebral anomalies with skeletal malocclusion types and upper airway dimensions. Cranio 2018; 38:149-157. [PMID: 30063196 DOI: 10.1080/08869634.2018.1503136] [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: 10/28/2022]
Abstract
Objectives: To compare the prevalence of cervical vertebral anomalies (CVAs) in different skeletal malocclusions and to evaluate the relationship between upper airway dimension and vertebral anomalies. Methods: A retrospective study was performed on lateral cephalometric radiographs of 2062 patients aged 7-49 years. Skeletal malocclusion type, presence of CVAs, and upper airway area of 1856 patients who met the inclusion criteria of the study were recorded. The obtained data were transferred to the SPSS program for statistical analysis. Results: The mean age of the patients was 13.8 ± 3.7 years. The prevalence of CVAs was 45.7%. There was no significant difference in prevalence between skeletal malocclusions (p = 0.89). According to airway measurements, no significant difference was found between patients with and without CVAs (p = 0.718). Conclusion: The present results suggest that there is no direct effect of skeletal malocclusion type and upper airway dimension in the etiology of CVAs.
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Affiliation(s)
- Sirin Rabia Adisen
- Department of Orthodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
| | - Mehmet Zahit Adisen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
| | - Ferabi Erhan Ozdiler
- Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Tepecik T, Ertaş Ü, Akgün M. Effects of bimaxillary orthognathic surgery on pharyngeal airway and respiratory function at sleep in patients with class III skeletal relationship. J Craniomaxillofac Surg 2018; 46:645-653. [DOI: 10.1016/j.jcms.2018.01.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/18/2017] [Accepted: 01/22/2018] [Indexed: 11/28/2022] Open
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41
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Vizzotto M, Martins L, Liedke G, Da Silveira Dias H, Da Silveira Tiecher P, Arus N, Ongkosuwito E. Important queries for the airway analysis in cone-beam computed tomography scans: Threshold tool and voxel size protocol. JOURNAL OF ORAL AND MAXILLOFACIAL RADIOLOGY 2018. [DOI: 10.4103/jomr.jomr_18_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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42
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Ristow O, Rückschloß T, Berger M, Grötz T, Kargus S, Krisam J, Seeberger R, Engel M, Hoffmann J, Freudlsperger C. Short- and long-term changes of the pharyngeal airway after surgical mandibular advancement in Class II patients—a three-dimensional retrospective study. J Craniomaxillofac Surg 2018; 46:56-62. [DOI: 10.1016/j.jcms.2017.10.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/03/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022] Open
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43
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ElShebiny T, Venkat D, Strohl K, Hans MG, Alonso A, Palomo JM. Hyoid Arch Displacement with Hypoglossal Nerve Stimulation. Am J Respir Crit Care Med 2017; 196:790-792. [PMID: 28535072 DOI: 10.1164/rccm.201612-2521le] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Tarek ElShebiny
- 1 Case Western Reserve University School of Dental Medicine Cleveland, Ohio
| | - Divya Venkat
- 2 Case Western Reserve University School of Medicine Cleveland, Ohio
| | - Kingman Strohl
- 3 Louis Stokes Cleveland DVA Medical Center Cleveland, Ohio and
| | - Mark G Hans
- 1 Case Western Reserve University School of Dental Medicine Cleveland, Ohio
| | | | - Juan Martin Palomo
- 1 Case Western Reserve University School of Dental Medicine Cleveland, Ohio
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Neelapu BC, Kharbanda OP, Sardana HK, Gupta A, Vasamsetti S, Balachandran R, Rana SS, Sardana V. The reliability of different methods of manual volumetric segmentation of pharyngeal and sinonasal subregions. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:577-587. [DOI: 10.1016/j.oooo.2017.08.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 08/21/2017] [Accepted: 08/27/2017] [Indexed: 11/25/2022]
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45
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Gupta JV, Makhija PG, Gupta KC. Does a correlation exist between nasal airway volume and craniofacial morphology: A cone beam computed tomography study. Indian J Dent Res 2017; 27:359-363. [PMID: 27723630 DOI: 10.4103/0970-9290.191882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM To find the correlation between nasal airway volume and the craniofacial morphology using cone beam computed tomography (CBCT). MATERIALS AND METHODS This study consisted of preorthodontic anonymized CBCT scans of 34 healthy adults in the age span of 18-28 years. The volume was calculated using Dolphin 3D R software 11.5 version using semiautomatic segmentation method to calculate nasal volume after determining the nasal airway boundary. The subjects were grouped according to sagittal skeletal relation, craniofacial width, facial index, and facial form. RESULTS There was statistically significant correlation between nasal volume and craniofacial width (P = 0.009). CONCLUSION Nasal volume was correlated only with width of the face and not with width/length ratio of face that could have affected the nasal volume.
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Affiliation(s)
- Jeenal V Gupta
- Department of Orthodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - P G Makhija
- Department of Orthodontics, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
| | - K C Gupta
- Department of Oral and Maxillofacial Surgery, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India
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Yamashita AL, Iwaki Filho L, Leite PCC, Navarro RDL, Ramos AL, Previdelli ITS, Ribeiro MHDM, Iwaki LCV. Three-dimensional analysis of the pharyngeal airway space and hyoid bone position after orthognathic surgery. J Craniomaxillofac Surg 2017; 45:1408-1414. [PMID: 28743605 DOI: 10.1016/j.jcms.2017.06.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 05/11/2017] [Accepted: 06/27/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate changes in the pharyngeal airway space (PAS) and hyoid bone position after orthognathic surgery with cone-beam computed tomography (CBCT). MATERIAL AND METHODS This study was conducted with the tomographic records of 30 patients with skeletal class II or III deformities submitted to two different types of orthognathic surgery: Group 1 (n = 15), maxillary advancement, and mandibular setback; and Group 2 (n = 15), maxillomandibular advancement. CBCT scans were acquired preoperatively (T0); and at around 1.5 months (T1) and 6.7 months (T2) postoperatively. PAS volume, minimum cross-sectional area (min CSA), and hyoid bone position changes were assessed with Dolphin Imaging 3D software, and results analyzed with ANOVA and a Tukey-Kramer test (p < 0.05). RESULTS The hyoid bone was significantly displaced in the horizontal dimension, moving posteriorly in Group 1, and anteriorly in Group 2. Although PAS volume and min CSA increased after both surgeries, these measurements were significantly larger only in Group 2. The significant differences that existed between groups preoperatively no longer existed after the surgeries. CONCLUSIONS Both orthognathic surgeries assessed resulted in changes in hyoid bone position and increased PAS volume and min CSA, particularly after maxillomandibular advancement surgery.
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Affiliation(s)
- Amanda Lury Yamashita
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil
| | - Liogi Iwaki Filho
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil
| | - Pablo Cornélius Comelli Leite
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil
| | - Ricardo de Lima Navarro
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil
| | - Adilson Luiz Ramos
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil
| | - Isolde Terezinha Santos Previdelli
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil
| | - Matheus Henrique Dal Molin Ribeiro
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil
| | - Lilian Cristina Vessoni Iwaki
- Dentistry Department (Head: Prof. Carlos Alberto Herrero de Morais, DDS, PhD), State University of Maringá, Avenida Mandacaru, nº 1550, 87080-000, Maringá, Paraná, Brazil.
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De Oliveira DL, Calcagnotto T, Vago TM, Filho HN, Valarelli DP, Bellato CP. Tomographic Analysis of the Impact of Mandibular Advancement Surgery on Increased Airway Volume. Ann Maxillofac Surg 2017; 7:256-259. [PMID: 29264295 PMCID: PMC5717904 DOI: 10.4103/ams.ams_136_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study aimed to quantify, using cone-beam computed tomography (CBCT) in patients who underwent a mandibular advancement surgery associated with genioplasty, three-dimensional changes in airway space and to evaluate whether these changes differ between men and women. MATERIALS AND METHODS Preoperative and 8-month postoperative CBCT scans of 38 patients aged 18-45 years of either sex and any ethnicity who underwent mandibular advancement surgery associated with genioplasty were analyzed using the Xoran software (Xoran Technologies, Ann Arbor, MI, USA). The linear distances gonion-gnathion (Go-Gn) and condylion-menton (Co-Me) were obtained. Airway volume was measured using the Dolphin Imaging software, version 11.0. Then, data were tabulated and analyzed using Student's t-test. RESULTS Mean patient age was 30.3 years; 39.47% were men and 60.63% were women. The mean Go-Gn distance was 72.05 mm before surgery and 78.56 mm after surgery, with a mean gain of 6.51 mm. The mean Co-Me distance was 113.47 mm before surgery and 119.89 mm after surgery, with a mean increase of 6.42 mm. Both differences were statistically significant. The mean volume of airway space was 17,272.92 mm3 before surgery and 24,173.74 mm3 after surgery, with a statistically significant mean increase of 6900.82 mm3. There was no statistically significant difference in mean volumetric gain between men (7566.69 mm3) and women (7456.69 mm3). CONCLUSION Mandibular advancement surgery results in significant increase of airway space, and there is no difference in airway volume between men and women.
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Affiliation(s)
- Danilo Louzada De Oliveira
- Department of Oral and Maxillofacial Surgery, Universidade Do Oeste Paulista, Presidente Prudente, Bauru, SP, Brazil
| | - Thiago Calcagnotto
- Department of Oral and Maxillofacial Surgery, Faculdade Tecnológica Dental CEEO, Igrejinha, RS, Brazil
| | - Thessio Mina Vago
- Department of Oral and Maxillofacial Surgery, Centro Universitário Fluminense, Campos dos Goytacazes, RJ, Brazil
| | - Hugo Nary Filho
- Department of Oral and Maxillofacial Surgery, Universidade Sagrado Coração, Bauru, SP, Brazil
| | | | - Caio Peres Bellato
- Department of Oral and Maxillofacial Surgery, Instituto Branemark, Bauru, SP, Brazil
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Chen H, van Eijnatten M, Wolff J, de Lange J, van der Stelt PF, Lobbezoo F, Aarab G. Reliability and accuracy of three imaging software packages used for 3D analysis of the upper airway on cone beam computed tomography images. Dentomaxillofac Radiol 2017; 46:20170043. [PMID: 28467118 DOI: 10.1259/dmfr.20170043] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the reliability and accuracy of three different imaging software packages for three-dimensional analysis of the upper airway using CBCT images. METHODS To assess the reliability of the software packages, 15 NewTom 5G® (QR Systems, Verona, Italy) CBCT data sets were randomly and retrospectively selected. Two observers measured the volume, minimum cross-sectional area and the length of the upper airway using Amira® (Visage Imaging Inc., Carlsbad, CA), 3Diagnosys® (3diemme, Cantu, Italy) and OnDemand3D® (CyberMed, Seoul, Republic of Korea) software packages. The intra- and inter-observer reliability of the upper airway measurements were determined using intraclass correlation coefficients and Bland & Altman agreement tests. To assess the accuracy of the software packages, one NewTom 5G® CBCT data set was used to print a three-dimensional anthropomorphic phantom with known dimensions to be used as the "gold standard". This phantom was subsequently scanned using a NewTom 5G® scanner. Based on the CBCT data set of the phantom, one observer measured the volume, minimum cross-sectional area, and length of the upper airway using Amira®, 3Diagnosys®, and OnDemand3D®, and compared these measurements with the gold standard. RESULTS The intra- and inter-observer reliability of the measurements of the upper airway using the different software packages were excellent (intraclass correlation coefficient ≥0.75). There was excellent agreement between all three software packages in volume, minimum cross-sectional area and length measurements. All software packages underestimated the upper airway volume by -8.8% to -12.3%, the minimum cross-sectional area by -6.2% to -14.6%, and the length by -1.6% to -2.9%. CONCLUSIONS All three software packages offered reliable volume, minimum cross-sectional area and length measurements of the upper airway. The length measurements of the upper airway were the most accurate results in all software packages. All software packages underestimated the upper airway dimensions of the anthropomorphic phantom.
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Affiliation(s)
- Hui Chen
- 1 Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands.,2 Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands
| | - Maureen van Eijnatten
- 3 3D Innovation Lab, Department of Oral and Maxillofacial Surgery/Pathology, Academic Centre for Dentistry Amsterdam (ACTA) and VU University Medical Center, University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands
| | - Jan Wolff
- 3 3D Innovation Lab, Department of Oral and Maxillofacial Surgery/Pathology, Academic Centre for Dentistry Amsterdam (ACTA) and VU University Medical Center, University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands
| | - Jan de Lange
- 4 Department of Oral and Maxillofacial Surgery, Academic Centre for Dentistry Amsterdam (ACTA) and Academic Medical Center (AMC), University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands
| | - Paul F van der Stelt
- 1 Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands
| | - Frank Lobbezoo
- 2 Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands
| | - Ghizlane Aarab
- 2 Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Netherlands
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Feng B, Jiang M, Xu X, Li J. A new method of volumetric assessment of alveolar bone grafting for cleft patients using cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:e171-e182. [PMID: 28606827 DOI: 10.1016/j.oooo.2017.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/01/2016] [Accepted: 04/05/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aims of this study were to propose a new method for volumetric assessment of alveolar bone grafting and to quantitatively assess alveolar bone grafting based on this method. STUDY DESIGN Cone beam computed tomography images of 18 patients with unilateral cleft alveolus were selected. Volume of the alveolar cleft before grafting operation (VOLcleft), graft bone filled into cleft immediately after operation (VOLgraft), and bony bridge formed 1 year after operation (VOLbridge) were obtained. The grafting fill rate (VOLgraft/VOLcleft × 100%), bony bridge formation rate (VOLbridge/VOLcleft × 100%), and grafting resorption rate [(VOLgraft - VOLbridge)/VOLgraft × 100%] were calculated. Correlations between these parameters were investigated. Intraobserver and interobserver reliability of this method was assessed. RESULTS Intraobserver and interobserver reliability was good as no statistically significant difference was seen, and the Pearson correlation coefficient was significant (intraobserver R ≥ .953; interobserver, R ≥ .859). A positive linear correlation (R2 = .808; P < .001) between grafting fill rate and bony bridge formation rate and a negative linear correlation (R2 = .458, P = .002) between grafting fill rate and grafting resorption rate were found. CONCLUSIONS This method was practical and valuable for quantitative assessment of alveolar bone grafting.
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Affiliation(s)
- Bin Feng
- Department of Oral Radiology, Stomatology Hospital affiliated with Zhejiang University of Medicine, Zhejiang University, Hangzhou, China.
| | - Meng Jiang
- State Key Laboratory of Oral Diseases and Department of Oral Radiology, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Xue Xu
- State Key Laboratory of Oral Diseases and Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Jingtao Li
- State Key Laboratory of Oral Diseases and Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
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Al-Fahdawi MA, Farid MM, El-Fotouh MA, El-Kassaby MA. Cone-Beam Computed Tomography Analysis of the Nasopharyngeal Airway in Nonsyndromic Cleft Lip and Palate Subjects. Cleft Palate Craniofac J 2017; 54:202-209. [DOI: 10.1597/15-134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objective To assess the nasopharyngeal airway volume, cross-sectional area, and depth in previously repaired nonsyndromic unilateral cleft lip and palate versus bilateral cleft lip and palate patients compared with noncleft controls using cone-beam computed tomography with the ultimate goal of finding whether cleft lip and palate patients are more liable to nasopharyngeal airway obstruction. Design A retrospective analysis comparing bilateral cleft lip and palate, unilateral cleft lip and palate, and control subjects. Significance at P ≤ .05. Setting Cleft Care Center and the outpatient clinic that are both affiliated with our faculty. Participants Cone-beam computed tomography data were selected of 58 individuals aged 9 to 12 years: 14 with bilateral cleft lip and palate and 20 with unilateral cleft lip and palate as well as 24 age- and gender-matched noncleft controls. Variables Volume, depth, and cross-sectional area of nasopharyngeal airway were measured. Results Patients with bilateral cleft lip and palate showed significantly larger nasopharyngeal airway volume than controls and patients with unilateral cleft lip and palate ( P < .001). Patients with bilateral cleft lip and palate showed significantly larger cross-sectional area than those with unilateral cleft lip and palate ( P < .001) and insignificant cross-sectional area compared with controls ( P > .05). Patients with bilateral cleft lip and palate showed significantly larger depth than controls and those with unilateral cleft lip and palate ( P < .001). Patients with unilateral cleft lip and palate showed insignificant nasopharyngeal airway volume, cross-sectional area, and depth compared with controls ( P > .05). Conclusions Unilateral and bilateral cleft lip and palate patients did not show significantly less volume, cross-sectional area, or depth of nasopharyngeal airway than controls. From the results of this study we conclude that unilateral and bilateral cleft lip and palate patients at the studied age and stage of repaired clefts are not more prone to nasopharyngeal airway obstruction than controls.
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Affiliation(s)
| | - Mary Medhat Farid
- Department of Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mona Abou El-Fotouh
- Department of Oral Radiology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Marwa Abdelwahab El-Kassaby
- Cleft Care Center, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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