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Ronsivalle V, Isola G, Lo Re G, Boato M, Leonardi R, Lo Giudice A. Analysis of maxillary asymmetry before and after treatment of functional posterior cross-bite: a retrospective study using 3D imaging system and deviation analysis. Prog Orthod 2023; 24:41. [PMID: 38072875 PMCID: PMC10710971 DOI: 10.1186/s40510-023-00494-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Previous evidence would suggest that subjects affected by functional posterior cross-bite (FPXB) present an asymmetric morphology of the maxilla. However, no evidence is available concerning the morphology (symmetry/asymmetry) of the maxilla after treatment of FPXB. This study aimed to investigate the volumetric and morphological changes of the palate in FPXB subjects treated with maxillary expansion and to compare these data with an untreated control group. The study sample included 20 FPXB subjects (mean age 8.1 ± 0.9 years) who underwent maxillary expansion (MEG group) and 21 FPXB subjects (mean age 7.7 ± 1.2 years) as controls (CG group). Digital models were recorded at T0 (first observation) and T1 (12-18 months after first observation) and analyzed to assess palatal volume and symmetry. Deviation analysis and percentage matching calculation were also performed between original and mirrored palatal models for each patient. All data were statistically analyzed for intra-timing, inter-timing and inter-groups assessments. RESULTS At T0, the cross-bite side (CBS) was significantly smaller than non-cross-bite side (non-CBS) in both groups (p < 0.05). At T1, the CBS/non-CBS difference reduced significantly in the MEG group (p < 0.05) while slightly worsened in the CG, however without statistical significance (p > 0.05). The matching percentage of the palatal models improved significantly at T1 in the MEG group (T0 = 74.02% ± 9.8; T1 = 89.95% ± 7.12) (p < 0.05) while no significant differences were recorded in the CG (T0 = 76.36 ± 8.64; 72.18% ± 9.65) (p > 0.05). LIMITATIONS The small sample size and the retrospective design of the study represent two limitations that should be overcome with further clinical trials. CONCLUSIONS Subjects with FPXB present an asymmetric development of the maxillary vault that improves after reestablishment of normal occlusion following maxillary expansion.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Gianmarco Lo Re
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Mattia Boato
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
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Lo Giudice A, Ronsivalle V, Conforte C, Marzo G, Lucchese A, Leonardi R, Isola G. Palatal changes after treatment of functional posterior cross-bite using elastodontic appliances: a 3D imaging study using deviation analysis and surface-to-surface matching technique. BMC Oral Health 2023; 23:68. [PMID: 36732751 PMCID: PMC9894513 DOI: 10.1186/s12903-023-02731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The present study aimed to evaluate the changes in palate dimension and morphology after treatment of functional posterior crossbite (FPXB) with elastodontic devices (EAs). METHODS The treatment group (TG) consisted of 25 subjects (mean age 7.3 ± 0.9 years) who received treatment with EA for one year. The control group (CG) comprised 14 untreated subjects (mean age 6.8 ± 0.7 years). INCLUSION CRITERIA intra-oral scan registered before (T0) and after treatment (T1), FPXB with a mandibular shift towards the crossbite site of ≥ 2 mm, class I molar relationship. EXCLUSION CRITERIA missing teeth, anterior crossbite, temporomandibular disorders, previous orthodontic treatment, carious lesions, mobility of deciduous posterior teeth, craniofacial deformities. Digital models were analyzed to assess the inter-canine (ICW) and inter-molar widths (IMW) and the corresponding emi-lateral measurements (eICW and eIMW) using the median palatine plane as reference. According to a specific 3D imaging technology, the morphology and symmetry of the palate was investigated by analysing the 3D deviation between the two specular models of the palate. RESULTS At T0, both groups showed a significantly narrower dimension of eICW and eIMW at the crossbite side compared to the non-crossbite side (p < 0.05). Also, the 3D deviation analysis demonstrates a limited matching percentage of the original/mirrored models in both TG (81.12%) and CG (79.36%), confirming the asymmetry of the palate. The area of mis-matching was located at the alveolar bone level. At T1, subjects in the TG showed a significant increment of ICW and IMW (p < 0.05), a reduction of the differences of eICW and eIMW between both sides (p < 0.05) and an increment of the percentage matching (TG = 92.32%) (p < 0.05), suggesting a significant recovery of the palatal asymmetry. No significant changes were found between T0 and T1 in the CG (p > 0.05). CONCLUSIONS EAs could be successfully used to correct FPXB in mixed dentition and could restore the harmonious development of the palate in children.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy. .,Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Vincenzo Ronsivalle
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Cristina Conforte
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Giuseppe Marzo
- grid.158820.60000 0004 1757 2611Department of Health, Life and Environmental Science, University of L’Aquila, Piazza Salvatore Tommasi, 67100 L’Aquila, Italy
| | - Alessandra Lucchese
- grid.15496.3f0000 0001 0439 0892Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Rosalia Leonardi
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Gaetano Isola
- grid.8158.40000 0004 1757 1969Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
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Leonardi RM, Aboulazm K, Giudice AL, Ronsivalle V, D'Antò V, Lagravère M, Isola G. Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique. Clin Oral Investig 2021; 25:1775-1785. [PMID: 32743674 DOI: 10.1007/s00784-020-03480-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment. MATERIALS AND METHODS Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a "best-fit" algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student's t tests. RESULTS A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001). CONCLUSIONS Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant. CLINICAL RELEVANCE Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings.
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Affiliation(s)
- Rosalia Maria Leonardi
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy.
| | - Khaled Aboulazm
- Department of Orthodontics, School of Dentistry, Pharos University, Alexandria, Egypt
| | - Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo D'Antò
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, Naples, Italy
| | - Manuel Lagravère
- Department of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Gaetano Isola
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
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Srivastava A, Raghav P, Pradhan S. Effectiveness of orthopantomograph in vertical mandibular measurements: A systematic review. JOURNAL OF ORAL AND MAXILLOFACIAL RADIOLOGY 2021. [DOI: 10.4103/jomr.jomr_9_21] [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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Leonardi R, Muraglie S, Lo Giudice A, Aboulazm KS, Nucera R. Evaluation of mandibular symmetry and morphology in adult patients with unilateral posterior crossbite: a CBCT study using a surface-to-surface matching technique. Eur J Orthod 2020; 42:650-657. [PMID: 31995170 DOI: 10.1093/ejo/cjz106] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate mandibular morphology in adults affected by posterior unilateral crossbite (PUXB) and to evaluate the hemi mandibular volumes from the crossbite (CB) and non-CB sides of the same patients. METHODS Thirty-eight cone beam computed tomography (CBCT) images were consecutively recruited and the Digital Imaging and Communications in Medicine (DICOM)-formatted scans were volume rendered into a surface three-dimensional (3D) mesh model and volumes to obtain the 3D model of the mandibular bone. To achieve the surface point-to-point analysis of the mandibular models, a reverse engineering software was used. The same procedure was performed for an age-matched control group (19 CBCT images). RESULTS Total mandibular volume showed a difference of 2.46 cm3 between patients and controls, which was not statistically significant. A mean difference of 1.53 cm3 was found comparing the hemi mandibular volumes from the CB and non-CB sides of PUXB patients, this difference was statistically significant (P ≤ 0.01). Findings for the surface-to-surface deviation analysis, demonstrated a higher percentage of mismatch in patients PUXB, over 10% at 0.5 mm tolerance level. LIMITATIONS Limitations are related to the intrinsic surfaces matching methodology, that make difficult to evaluate discrepancies among different mandibular anatomical units. CONCLUSION Adult patients affected by PUXB show a greater mandibular structural asymmetry compared to controls because of a lower matching percentage obtained from the surface-to-surface matching technique. IMPLICATIONS Treatment of adult patients affected by PUXB should take into consideration the possibility of a mild mandibular asymmetry mainly localized at the condyle and gonial angle levels.
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Affiliation(s)
- Rosalia Leonardi
- Department of Orthodontics, School of Dentistry, University of Catania, Italy
| | - Simone Muraglie
- Department of Orthodontics, School of Dentistry, University of Catania, Italy
| | - Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, University of Catania, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Italy
| | - K S Aboulazm
- Department of Orthodontics, School of Dentistry, Pharos University, Alexandria, Egypt
| | - R Nucera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Italy
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Ortún-Terrazas J, Fagan MJ, Cegoñino J, Illipronti-Filho E, Pérez Del Palomar A. Towards an early 3D-diagnosis of craniofacial asymmetry by computing the accurate midplane: A PCA-based method. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 191:105397. [PMID: 32092615 DOI: 10.1016/j.cmpb.2020.105397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/11/2020] [Accepted: 02/13/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Craniofacial asymmetry is a common growth disorder often caused by unilateral chewing. Although an early orthodontic treatment would avoid surgical procedures later in life, the uncertainty of defining the accurate sagittal midplane potentially leads to misdiagnosis and therefore inaccurate orthodontic treatment plans. This novel study aims to 3D-diagnose craniofacial complex malformations in children with unilateral crossbite (UXB) considering a midplane which compensates the asymmetric morphology. METHODS The sagittal midplane of 20 children, fifteen of whom exhibited UXB, was computed by a PCA-based method which compensates the asymmetry mirroring the 3D models obtained from cone-beam computed tomography data. Once determined, one side of the data was mirrored using the computed midplane to visualize the malformations on the hard and soft tissues by 3D-computing the distances between both halves. Additionally, 31 skull's landmarks were manually placed in each model to study the principal variation modes and the significant differences in the group of subjects with and without UXB through PCA and Mann-Whitney U test analyses respectively. RESULTS Morphological 3D-analysis showed pronounced deformities and aesthetic implications for patients with severe asymmetry (jaw deviation > 0.8 mm) in whole craniofacial system, while initial signs of asymmetry were found indistinctly in the mandible or maxilla. We detected significant (p < 0.05) malformations for example in mandibular ramus length (0.0086), maxillary palate width (0.0481) and condylar head width (0.0408). Craniofacial malformations increased the landmarks' variability in the group of patients with UXB over the control group requiring 8 variation modes more to define 99% of the sample' variability. CONCLUSIONS Our findings demonstrated the viability of early diagnosis of craniofacial asymmetry through computing the accurate sagittal midplane which compensates the individual's asymmetrical morphology. Furthermore, this study provides important computational insights into the determination of craniofacial deformities which are caused by UXB, following some empirical findings of previous clinical studies. Hence, this computational approach can be useful for the development of new software in craniofacial surgery or for its use in biomedical research and clinical practice.
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Affiliation(s)
- Javier Ortún-Terrazas
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain.
| | - Michael J Fagan
- Medical and Biological Engineering, School of Engineering and Computer Science, University of Hull, Hull, United Kingdom
| | - Jose Cegoñino
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Edson Illipronti-Filho
- School of Dentistry, Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil
| | - Amaya Pérez Del Palomar
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
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Evangelista K, Ferrari-Piloni C, Barros LAN, Avelino MAG, Helena Soares Cevidanes L, Ruellas ACDO, Valladares-Neto J, Silva MAG. Three-dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study. Orthod Craniofac Res 2020; 23:300-312. [PMID: 32022986 DOI: 10.1111/ocr.12370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/13/2020] [Accepted: 02/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate craniofacial asymmetry in children with transverse maxillary deficiency, with or without functional unilateral posterior crossbite (UPC), before and after rapid maxillary expansion (RME). SETTING AND SAMPLE POPULATION A sample of 51 children with cone beam computed tomography scans obtained before RME (T1) and a year after RME (T2). MATERIAL AND METHODS This prospective study consisted of 2 groups: 25 children with functional UPC (6.77 ± 1.5 years) and 26 children without UPC (7.41 ± 1.31 years). Linear and angular measurements were obtained from zygomatic, maxilla, glenoid fossa and mandible, using original and mirrored 3D overlapped models. All right and left side comparisons in both groups and intergroups asymmetries were compared using MANOVA and t test for independent samples, respectively, statistically significant at P < .05. RESULTS The UPC group showed no side differences, but mandibular horizontal rotation at T1, and this asymmetry was improved in T2. The non-UPC group showed at baseline significant lateral asymmetry in orbitale, position of palatine foramen, respectively, in average 2.95 mm and 1.16 mm, and 0.49 mm of average asymmetry in condylar height. The glenoid fossa was symmetric in both groups at T1 and T2. CONCLUSIONS Children with transverse maxillary deficiency showed slight morphological asymmetry, located in the mandible position in cases of UPC, and in the orbital and maxillary regions in cases without UPC. One year after RME, patients improved their craniofacial asymmetry, with significant changes in the mandible and correction of the mandibular rotation in patients who presented UPC.
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Khosravi M, Ugolini A, Miresmaeili A, Mirzaei H, Shahidi-Zandi V, Soheilifar S, Karami M, Mahmoudzadeh M. Tooth-borne versus bone-borne rapid maxillary expansion for transverse maxillary deficiency: A systematic review. Int Orthod 2019; 17:425-436. [PMID: 31280998 DOI: 10.1016/j.ortho.2019.06.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to compare dentoskeletal effects of bone-borne expanders with those of conventional expanders in adolescent and adults having transverse maxillary deficiency. METHODS All randomized clinical trials (RCTs) comparing the effects of bone-borne with those of tooth-borne expansion for treatment of maxillary transverse deficiency in adults and adolescents with maxillary transverse deficiency or posterior crossbite were included. The systematic search was irrespective of language and publication type. The electronic search was conducted from 1980 to January 2018. RESULTS The electronic searches retrieved 713 references after screening for eligibility criteria. Eight studies met the inclusion criteria for this systematic review involving 289 participants. Four studies compared rapid maxillary expansion (RME) between bone-borne and tooth-borne devices and indicated effectiveness of both devices on maxillary expansion. In the first molar region, there was no significant difference between two devices in either skeletal or dental expansion. Two studies compared the effects of bone-borne and tooth-borne device following SARME and suggested no significant difference regarding amount and pattern of expansion at various levels and in molar and premolar region between two groups. Two studies compared bone-borne and tooth-bone-borne devices. CONCLUSION Within the limit of the present evidence regarding maxillary expansion, it seems that both tooth-borne and bone-borne devices result in the same outcome in terms of the amount of maxillary expansion, dental tipping, stability and perceived pain both in RME and SARME procedure. PROSPERO registration: CRD42017061078.
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Affiliation(s)
- Mahdieh Khosravi
- Orthodontic Department Dental Faculty, 17 Shahrivar boulevard, Seman, Iran
| | - Alessandro Ugolini
- University of Genoa, Orthodontic Department, Largo Rosanna Benzi 10, Genova, Italy
| | - Amirfarhang Miresmaeili
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Hamed Mirzaei
- Faculty of Management of University of Tehran, Tehran, Iran
| | - Vahid Shahidi-Zandi
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Sepideh Soheilifar
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran
| | - Manoochehr Karami
- Hamedan University of medical sciences, Department of Epidemiology School of Health, Shahid Fahmide boulevard, Hamedan, Iran
| | - Majid Mahmoudzadeh
- Hamedan University of Medical sciences, Orthodontic Department Dental Faculty, Shahid Fahmide Boulevard, Hamedan, Iran.
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Yu M, Diao Y, Sun Y, Zhang F, Pan S, Chen X, Zhou F, Zhao Y, Xu N. Evaluation of a combined approach to the correction of congenital cervical or cervicothoracic scoliosis. Spine J 2019; 19:803-815. [PMID: 30447326 DOI: 10.1016/j.spinee.2018.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND CONTEXT An anteroposterior combined approach has been used for the treatment of congenital cervical or cervicothoracic scoliosis. However, its outcomes and surgical risks have not been clarified. PURPOSE We analyzed the characteristics of congenital cervical and cervicothoracic scoliosis and evaluated the outcomes of an anteroposterior combined approach for its treatment. STUDY DESIGN We carried out a retrospective clinical study of prospectively collected data. PATIENT SAMPLE Sixteen patients were treated between 2009 and 2013. Their average age was 9.2years. OUTCOME MEASURES Radiographic and surgical outcomes were measured and recorded. We compared morphological parameters and preoperative and postoperative results. METHODS All patients underwent surgery with a combined approach. The following radiographic parameters were measured: head tilt (HT), mandible incline (MI), shoulder balance (SB), structural and compensatory curves, cervical lordosis, C7 central sacral vertical line (C7-CSVL) ratio, C7 sagittal vertical axis (C7-SVA) ratio, C2-C7 SVA ratio, the angle between the upper endplate of the T2 vertebra and a horizontal line (T2 tilt), gravity line ratio. Demographic and surgical data were also collected. RESULTS On average, the duration of follow-up was 68.0 months, surgical blood loss was 675mL, and the duration of surgery was 400.5 minutes. The average correction rate was 64.9% in the structural curve and 29.5% in the compensatory curve. Statistical analysis showed that MI significantly correlated with HT and SB (p<.05). The C7-CSVL ratio correlated with the HT, MI, and SB (p<.05). The C7-SVA ratio correlated with the structural curve and cervical lordosis (p<.05), and the gravity line ratio correlated with the structural and compensatory curve, cervical lordosis, and C7-SVA ratio (p<.05). Moreover, there were correlations between the structural and compensatory curves as well as between the structural curve and cervical lordosis (p<.05). There were significant differences before and after surgery in HT, MI, and structural and compensatory curves. Four patients developed nerve root palsy after surgical correction and totally recovered by 6 months of follow-up. CONCLUSION The combined approach is an effective surgical option for congenital cervical or cervicothoracic scoliosis. The resection of the hemivertebra cannot only improve head-neck aesthetic appearance but can also maintain the growth potential of the neck.
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Affiliation(s)
- Miao Yu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Yinze Diao
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Yu Sun
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China.
| | - Fengshan Zhang
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Shengfa Pan
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Xin Chen
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Feifei Zhou
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Yanbin Zhao
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Nanfang Xu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
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Leonardi R, Lo Giudice A, Rugeri M, Muraglie S, Cordasco G, Barbato E. Three-dimensional evaluation on digital casts of maxillary palatal size and morphology in patients with functional posterior crossbite. Eur J Orthod 2019; 40:556-562. [PMID: 29474543 DOI: 10.1093/ejo/cjx103] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background and objectives Some authors have recently postulated the possibility of a unilateral contraction of the palate in patients with crossbite. This study aimed to investigate palatal dimension size and morphology in subjects with functional posterior crossbite and to localize location of the contraction through a 3D analysis procedure. Materials and methods A study sample (SS) of 35 subjects (mean age 9.2 ± 0.8 years), diagnosed with functional crossbite, and a control sample (CS) of 35 subjects (mean age 9.4 ± 0.9 years) without crossbite were selected for this study. The digital models of each patient were analysed to assess palatal dimension size and symmetry by measuring linear distances between primary canines (D1) and fist molars (D2) to the median palatine plane and by performing and analysing the 3D deviation between the two specular models of the palatal vault for each patient. Results Our findings demonstrate a significantly narrower dimension of D2 for the crossbite side than at the non-crossbite side. The 3D deviation analysis demonstrates a lower matching percentage of the palatal vault models in the SS (83.36%) compared with the CS (92.82%) and a location of that the palatal contraction is at the alveolar bone level. Conclusions It can be assumed that there is a bilateral symmetrical contraction of the palatal vault and an asymmetric contraction of the alveolar process, but further studies are needed to corroborate this hypothesis.
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Affiliation(s)
| | | | - Michele Rugeri
- Department of Orthodontics, University of Catania, Italy
| | | | | | - Ersilia Barbato
- Department of Orthodontics, University 'La Sapienza', Rome, Italy
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Tonni I, Iannazzi A, Piancino MG, Costantinides F, Dalessandri D, Paganelli C. Asymmetric molars' mesial rotation and mesialization in unilateral functional posterior crossbite and implications for interceptive treatment in the mixed dentition. Eur J Orthod 2018; 39:433-439. [PMID: 28040681 DOI: 10.1093/ejo/cjw067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Symmetric transverse expansion is the main outcome of the early treatment in subjects with unilateral functional posterior crossbite. The aim of this study was to analyse mesial rotation and mesialization of upper first molars as sagittal parameters to be corrected in the treatment of these patients during the mixed dentition. Methods Digital dental cast measurements (rotation and mesialization) were performed in a sample of 48 subjects with unilateral posterior crossbite (UPXB; 19 males and 29 females, mean age 10.2 ± 1.2 years) and in a control group of 35 subjects with normal Class I occlusion (17 males and 18 females, mean age 9.9 ± 1.3 years). An independent sample t-test, the Mann-Whitney test, Fisher's exact test, and Pearson correlation were used for statistical comparison. Results The amount of upper molar rotation was significantly greater in the experimental group when compared with the control group. A clinically significant 'upper molar rotation' (UMR) was present in 66.7 per cent of the subjects with UPXB versus 5.7 per cent of the control group. The UMR group presented also a significant mesialization of upper first molars when compared with the control group. In the experimental group, there was a significant difference between rotation and mesialization in the right and left side and a correlation has been found between these two variables and the amount of Class II molar relationship at the crossbite side. Limitations This is an epidemiological case-control study and the discussed effects of an early correction of the asymmetric upper molars' migration are only speculations based on an association relationship. Conclusions The findings of this study show an asymmetric upper first molars' migration (rotation and mesialization) in unilateral functional posterior crossbite versus a control group. An early evaluation and correction of the molars' migration during the mixed dentition should be considered in order to obtain a correct inter-occlusal sagittal molar relationship, space for an adequate eruption of permanent teeth, and perhaps reduce the need of a following fixed appliance treatment in the permanent dentition.
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Affiliation(s)
- Ingrid Tonni
- Medical and Surgical Specialties, Radiological Sciences, and Public Health, Dental School, University of Brescia
| | - Alessandra Iannazzi
- Medical and Surgical Specialties, Radiological Sciences, and Public Health, Dental School, University of Brescia
| | - Maria Grazia Piancino
- Orthodontic Division, Department of Surgical Sciences, Dental School, University of Turin, Italy
| | - Fulvia Costantinides
- Department of Medical Sciences, Surgery and Health, Dental School, University of Trieste
| | - Domenico Dalessandri
- Medical and Surgical Specialties, Radiological Sciences, and Public Health, Dental School, University of Brescia
| | - Corrado Paganelli
- Medical and Surgical Specialties, Radiological Sciences, and Public Health, Dental School, University of Brescia
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Lim YS, Chung DH, Lee JW, Lee SM. Reliability and validity of mandibular posterior vertical asymmetry index in panoramic radiography compared with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2018; 153:558-567. [PMID: 29602348 DOI: 10.1016/j.ajodo.2017.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purposes of this study were to compare the asymmetry index using panoramic radiography and cone-beam computed tomography for detecting mandibular posterior asymmetry and to evaluate the diagnostic value of the asymmetry index on panoramic radiography. METHODS A total of 43 patients were included in this study. Ten mandibular posterior distances were measured using panoramic radiography and cone-beam computed tomography, and 10 asymmetry index values were calculated. The reliability of each asymmetry index was assessed. For evaluating validity of each asymmetry index using panoramic radiography, the paired t test and the Bland-Altman analysis were used. The accuracy of the asymmetry index and the area under the curve of receiver operator characteristic were calculated. RESULTS The asymmetry index of total ramal height showed good reliability (ICC, >0.888). In condylar height 1, specificity and negative predictive value were low (0.08 and 0.17, respectively), 95% limits of agreement were ±17.9%, and area under the curve was 0.484. In total, ramal height accuracy was 0.86, and areas under the curve were 0.926 to 0.957. CONCLUSIONS For detecting asymmetry of the condyle region, the asymmetry index using panoramic radiography had little diagnostic value, and we recommend using cone-beam computed tomography images. However, the asymmetry index for total ramal height showed good reliability and relatively higher validity, and its diagnostic value was excellent.
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Affiliation(s)
- Young-Sub Lim
- Department of Orthodontics, Graduate School of Dentistry, Dankook University, Cheonan, Korea
| | - Dong-Hwa Chung
- Department of Orthodontics, Graduate School of Dentistry, Dankook University, Cheonan, Korea.
| | - Jin-Woo Lee
- Department of Orthodontics, Graduate School of Dentistry, Dankook University, Cheonan, Korea
| | - Sang-Min Lee
- Department of Orthodontics, Graduate School of Dentistry, Dankook University, Cheonan, Korea
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Iodice G, Danzi G, Cimino R, Paduano S, Michelotti A. Association between posterior crossbite, skeletal, and muscle asymmetry: a systematic review. Eur J Orthod 2016; 38:638-651. [DOI: 10.1093/ejo/cjw003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Al Taki A, Ahmed MH, Ghani HA, Al Kaddah F. Impact of different malocclusion types on the vertical mandibular asymmetry in young adult sample. Eur J Dent 2015; 9:373-377. [PMID: 26430365 PMCID: PMC4569988 DOI: 10.4103/1305-7456.163233] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objective: The aim of this study was to investigate the vertical mandibular asymmetry in a group of adult patients with different types of malocclusions, based on Angle's dental classification. Materials and Methods: A sample of 102 patients (age range 19–28) who went for routine orthodontic treatment in the institution were divided into four groups: Class I, 26 patients; Class II/1, 30 patients; Class III, 23 patients; and control group (CG) with normal occlusion, 23 patients. Condylar asymmetry index (CAI), ramal asymmetry index (RAI), condylar-plus-ramal asymmetry index values were measured for all patients on panoramic radiographs. Data were analyzed using Kruskal–Wallis and Mann–Whitney U-test at the 95% confidence level (P < 0.05). Results: The results of the analysis showed that different occlusal types significantly affected the vertical symmetry of the mandible at the condylar level. Class I and Class II/1 malocclusion groups showed a significant difference in CAI values relative to the CG (P < 0.05, P < 0.001). No statistically significant difference was found between the CG and Class III malocclusion group (P > 0.05). Comparisons between Class II/1 and Class I malocclusions revealed a significant difference in CAI values (P < 0.01). Conclusions: Both Class II/1 and Class I malocclusions patients had significantly higher CAI values compared to CG and Class III group. CAI value was significantly higher in Class II/1 malocclusion compared to Class I malocclusion. Both these malocclusions could act as a predisposing factor for having asymmetric condyles if left untreated.
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Affiliation(s)
- Amjad Al Taki
- Orthodontist, Private Practice, Dubai, United Arab Emirates
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Treatment of unilateral posterior crossbite with facial asymmetry in a female patient with transverse discrepancy. Am J Orthod Dentofacial Orthop 2015; 148:154-64. [DOI: 10.1016/j.ajodo.2014.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 09/01/2014] [Accepted: 09/01/2014] [Indexed: 11/24/2022]
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Study of Condylar Asymmetry in Angle Class III Malocclusion With Mandibular Deviation. J Craniofac Surg 2015; 26:e264-8. [DOI: 10.1097/scs.0000000000001469] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bell RA, Kiebach TJ. Posterior crossbites in children: Developmental-based diagnosis and implications to normative growth patterns. Semin Orthod 2014. [DOI: 10.1053/j.sodo.2014.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kasimoglu Y, Tuna EB, Rahimi B, Marsan G, Gencay K. Condylar asymmetry in different occlusion types. Cranio 2014; 33:10-4. [DOI: 10.1179/0886963414z.00000000039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Zhou S, Yan J, Da H, Yang Y, Wang N, Wang W, Ding Y, Sun S. A correlational study of scoliosis and trunk balance in adult patients with mandibular deviation. PLoS One 2013; 8:e59929. [PMID: 23555836 PMCID: PMC3612109 DOI: 10.1371/journal.pone.0059929] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 02/20/2013] [Indexed: 11/17/2022] Open
Abstract
Previous studies have confirmed that patients with mandibular deviation often have abnormal morphology of their cervical vertebrae. However, the relationship between mandibular deviation, scoliosis, and trunk balance has not been studied. Currently, mandibular deviation is usually treated as a single pathology, which leads to poor clinical efficiency. We investigated the relationship of spine coronal morphology and trunk balance in adult patients with mandibular deviation, and compared the finding to those in healthy volunteers. 35 adult patients with skeletal mandibular deviation and 10 healthy volunteers underwent anterior X-ray films of the head and posteroanterior X-ray films of the spine. Landmarks and lines were drawn and measured on these films. The axis distance method was used to measure the degree of scoliosis and the balance angle method was used to measure trunk balance. The relationship of mandibular deviation, spine coronal morphology and trunk balance was evaluated with the Pearson correlation method. The spine coronal morphology of patients with mandibular deviation demonstrated an "S" type curve, while a straight line parallel with the gravity line was found in the control group (significant difference, p<0.01). The trunk balance of patients with mandibular deviation was disturbed (imbalance angle >1°), while the control group had a normal trunk balance (imbalance angle <1°). There was a significant difference between the two groups (p<0.01). The degree of scoliosis and shoulder imbalance correlated with the degree of mandibular deviation, and presented a linear trend. The direction of mandibular deviation was the same as that of the lateral bending of thoracolumbar vertebrae, which was opposite to the direction of lateral bending of cervical vertebrae. Our study shows the degree of mandibular deviation has a high correlation with the degree of scoliosis and trunk imbalance, all the three deformities should be clinically evaluated in the management of mandibular deviation.
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Affiliation(s)
- Shuncheng Zhou
- Department of Orthodontics, The 161th Hospital of PLA, Wuhan, China
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