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Zhang L, Cao C, Ma T, Zhang Y, Bi Z, Liu D. Classification and characterization of facial asymmetry in adult patients with skeletal Class III malocclusion using cluster analysis. Am J Orthod Dentofacial Orthop 2024:S0889-5406(24)00203-8. [PMID: 38904566 DOI: 10.1016/j.ajodo.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 05/01/2024] [Accepted: 05/01/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION This study aimed to analyze the comprehensive maxillofacial features of patients with skeletal Class III malocclusion and facial asymmetry to develop a classification system for diagnosis and surgical planning. METHODS A total of 161 adult patients were included, with 121 patients in the asymmetry group (menton deviation >2 mm) and 40 patients in the symmetry group (menton deviation ≤2 mm). Twenty-eight variables were determined, including transverse translation, roll and yaw of each facial unit, transverse width, mandibular morphology, and transverse dental compensation. Principal component (PC) analysis was conducted to extract PCs, and cluster analysis was performed using these components to classify the asymmetry group. A decision tree was constructed on the basis of the clustering results. RESULTS Six PCs were extracted, explaining 80.622% of the data variability. The asymmetry group was classified into 4 subgroups: (1) atypical type (15.7%) showed an opposite roll direction of maxillary dentition than of menton deviation; (2) compound type (34.71%) demonstrated significant ramus height differences, maxillary roll, and mandibular roll and yaw; (3) mandibular yaw type (44.63%) showed slight mandibular yaw without mandibular morphology asymmetry; and (4) maxillary-shift type (4.96%) shared similarities with the compound type but showed significant maxillary translation. The classification and regression tree model achieved a prediction accuracy of up to 85.11%. CONCLUSIONS This study identified 4 distinct phenotypes using cluster analysis and proposed tailored treatment recommendations on the basis of their specific characteristics. The classification results emphasized the importance of spatial displacement features, especially mandibular yaw, in diagnosing facial asymmetry. The established classification and regression tree model enables clinicians to identify patients conveniently.
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Affiliation(s)
- Linlin Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration and Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, China
| | - Cong Cao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration and Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, China
| | - Ting Ma
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration and Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, China
| | - Yuan Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Shandong, China
| | - Zhiwei Bi
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration and Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, China
| | - Dongxu Liu
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration and Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, China.
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Li J, Wu S, Mei L, Wen J, Marra J, Lei L, Li H. Facial asymmetry of the hard and soft tissues in skeletal Class I, II, and III patients. Sci Rep 2024; 14:4966. [PMID: 38424179 PMCID: PMC10904784 DOI: 10.1038/s41598-024-55107-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
To investigate and compare the facial asymmetry (hard and soft tissues) among skeletal Class I, II, and III patients. A total of 221 subjects, including skeletal Class I (n = 80), skeletal Class II (n = 75), and skeletal Class III (n = 66), were included in the study. CBCT, 22 skeletal landmarks, and 10 soft tissue landmarks were used for the measurements and the asymmetry index was calculated to assess the facial asymmetry. Statistical analyses included one-way ANOVA, Kruskal-Wallis test, and Spearman correlation analysis. The skeletal Class III patients presented greater asymmetry than Class II patients for 10 hard tissue landmarks and 3 soft tissue landmarks (p < 0.05). High correlation of asymmetry was found between four soft tissue landmarks and their corresponding skeletal landmarks (rs ≥ 0.71), as well as Me and ANS (r > 0.86). The ANS and Me in 21.3% patients deviated to contralateral sides. The skeletal Class III patients had more facial asymmetry than the Class II patients. Soft tissues showed similar asymmetry as the underlying hard tissues rather than a compensation of the hard tissue asymmetry. The inconsistency in the deviation of Me and ANS may exacerbate facial asymmetry.
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Affiliation(s)
- Jialing Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, People's Republic of China
| | - Sujuan Wu
- Department of Orthodontics, Nanjing Lishui Stomatological Hospital, Nanjing, People's Republic of China
| | - Li Mei
- Discipline of Orthodontics, Department of Oral Science, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Juan Wen
- Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, People's Republic of China
| | - Jamie Marra
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lang Lei
- Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, People's Republic of China.
| | - Huang Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, People's Republic of China.
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Huang M, Chen B, Lin H, Guo W, Luo G, Chen W, Zhang W, Liu C. Analysis of mandibular asymmetry in adolescent and adult patients with unilateral posterior crossbite on cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2024; 165:27-37. [PMID: 37676219 DOI: 10.1016/j.ajodo.2023.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION This study aimed to evaluate mandibular asymmetry in unilateral posterior crossbite (UPXB) patients and compare the asymmetry between adolescents and adults with UPXB. METHODS This study included and analyzed cone-beam computed tomography scans of 125 subjects. The subjects were divided into a UPXB group and a control group according to the presence or absence of UPXB, and each group included adolescent patients (aged 10-15 years) and adult patients (aged 20-40 years). Linear, angular, and volumetric measurements were obtained to evaluate the asymmetries of the mandibles. RESULTS Both adolescent and adult patients in the UPXB group presented asymmetries in condylar unit length, ramal height, body length, and mediolateral ramal inclination (P <0.05). Adult patients with UPXB showed greater asymmetries than adolescents. Differences with condylar unit length, condylar unit width, ramal height, condylar unit volume, and hemimandibular volume were significantly greater in adult UPXB patients than adolescent UPXB patients (P <0.05). CONCLUSIONS The worsening of mandibular asymmetries in UPXB adults suggests that asymmetry in UPXB patients may progress over time; therefore, early treatment should be considered for UPXB adolescent patients. Further studies are still needed to evaluate the effectiveness of early treatment.
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Affiliation(s)
- Min Huang
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Baoyi Chen
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Huiyi Lin
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Weiqi Guo
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Guan Luo
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Wenjun Chen
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Weijun Zhang
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China
| | - Chang Liu
- Department of Orthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong, China.
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Wang Y, Wang Y, Wang C, Cao Y, Zhang B, Chen Y, Liu C. Mandibular asymmetry in patients with skeletal class I and skeletal class II Malocclusions: A cone-beam computed tomography study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101441. [PMID: 36933658 DOI: 10.1016/j.jormas.2023.101441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/15/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To study the difference in mandibular asymmetry between patients with skeletal Class I and skeletal Class II malocclusions and analyze the correlation between mandibular asymmetry and different facial skeletal sagittal patterns based on CBCT measurements. METHODS One hundred and twenty patients were selected according to the inclusion and exclusion criteria. Patients were divided into two groups (60 in the skeletal Class I group and 60 in the skeletal Class II group) based on ANB angles and Wits values. Patients' CBCT data were collected. Dolphin Imaging 11.0 was used to determine the mandibular anatomic landmarks and calculate the linear distance in patients in the two groups. RESULTS Intragroup comparison: in skeletal Class I group, measurements of the most posterior point of the condyle (Cdpost), the outer lateral point of the condyle (Cdlat), sigmoid notch point (Sn)), coronoid process point (Cop), gonion point (GO) and antimony notch point (Ag), right>left (P<0.05); in skeletal Class II group, measurements of Cdpost and Cop, right>left (P<0.05). Intergroup comparison: for measurements of GO and Ag, skeletal Class I group>skeletal Class II group (P<0.05). The asymmetry of the Ag and GO points was negatively correlated with the ANB angle (p<0.05). CONCLUSION Mandibular asymmetry was significantly different between patients with skeletal Class I and skeletal Class II malocclusions. The asymmetry of the mandible angle region in the former group was greater than that in the latter group, and the asymmetry of the mandibular angle was negatively correlated with the ANB angle.
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Affiliation(s)
- Yu Wang
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University, 59th Huangsha Road, Guangzhou, Guangdong 510120, China
| | - Yan Wang
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107th Yanjiang Xi Road, Guangzhou, Guangdong 510120, China
| | - Chunhui Wang
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University, 59th Huangsha Road, Guangzhou, Guangdong 510120, China
| | - Yuming Cao
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University, 59th Huangsha Road, Guangzhou, Guangdong 510120, China
| | - Bing Zhang
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University, 59th Huangsha Road, Guangzhou, Guangdong 510120, China
| | - Yitian Chen
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University, 59th Huangsha Road, Guangzhou, Guangdong 510120, China
| | - Chang Liu
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University, 59th Huangsha Road, Guangzhou, Guangdong 510120, China.
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Chen Z, Zhong Y, Li B, Ma H, Lei B, Yang B. Application of Surgery-First Approach in Treating Skeletal Dentofacial Asymmetry with Orthognathic Surgery. J Craniofac Surg 2023; 34:1817-1821. [PMID: 37276330 DOI: 10.1097/scs.0000000000009396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/06/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Skeletal dentofacial asymmetry decreases patient's attractiveness by deteriorating symmetry of facial appearance which is of great significance to individuals. Surgery-first orthognathic approach manifests its advantages of shortening treatment time and improving patient's quality of life. However, current literature on surgery-first approach mainly focuses on treating prognathism, overlooking its efficacy in improving facial symmetry of skeletal dentofacial asymmetry patients. This study aimed to assess SFA's efficacy in improving facial appearance by analyzing morphological features of asymmetric bone and facial soft tissue in a three-dimensional manner. METHODS Thirty-four patients who received orthognathic surgery in a surgery-first fashion were included. Based on three-dimensional CT reconstruction, bilateral preoperative morphological features and postoperative symmetry of hard tissue were compared respectively. Efficacy of facial soft tissue symmetry restoration was evaluated using root mean square deviation (RMSD). RESULTS Asymmetric features mainly located in menton, mandibular body length, angulation between ramus and midsagittal plane (MSP), distance between gonion and MSP and so on, which were significantly restored after the whole treatment. RMSD of facial soft tissue surface were significantly declined after the treatment and prognathism was corrected simultaneously if existed. CONCLUSIONS Surgery-first orthognathic approach is proved to be capable of treating skeletal dentofacial asymmetry effectively and efficiently.
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Affiliation(s)
| | | | - Binghang Li
- Digital Research Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Hengyuan Ma
- Digital Research Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Bowen Lei
- Department of Craniomaxillofacial Surgery
| | - Bin Yang
- Department of Craniomaxillofacial Surgery
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Xi T, Vinayahalingam S, Bergé S, Maal T, Kwon TG. Skeletal structure of asymmetric mandibular prognathism and retrognathism. Maxillofac Plast Reconstr Surg 2023; 45:27. [PMID: 37556073 PMCID: PMC10412507 DOI: 10.1186/s40902-023-00393-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND This study aimed to compare the skeletal structures between mandibular prognathism and retrognathism among patients with facial asymmetry. RESULTS Patients who had mandibular asymmetry with retrognathism (Group A) in The Netherlands were compared with those with deviated mandibular prognathism (Group B) in Korea. All the data were obtained from 3D-reformatted cone-beam computed tomography images from each institute. The right and left condylar heads were located more posteriorly, inferiorly, and medially in Group B than in Group A. The deviated side of Group A and the contralateral side of Group B showed similar condylar width and height, ramus-proper height, and ramus height. Interestingly, there were no inter-group differences in the ramus-proper heights. Asymmetric mandibular body length was the most significantly correlated with chin asymmetry in retrognathic asymmetry patients whereas asymmetric elongation of condylar process was the most important factor for chin asymmetry in deviated mandibular prognathism. CONCLUSION Considering the 3D positional difference of gonion and large individual variations of frontal ramal inclination, significant structural deformation in deviated mandibular prognathism need to be considered in asymmetric prognathism patients. Therefore, Individually planned surgical procedures that also correct the malpositioning of the mandibular ramus are recommended especially in patients with asymmetric prognathism.
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Affiliation(s)
- Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands
| | - Thomas Maal
- 3D Imaging Lab, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands
| | - Tae-Geon Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-Daero, Jung-Gu, Daegu, 41940 Republic of Korea
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Zhao J, Xu Y, Wang J, Lu Z, Qi K. 3-dimensional analysis of hard- and soft-tissue symmetry in a Chinese population. BMC Oral Health 2023; 23:432. [PMID: 37386472 PMCID: PMC10308641 DOI: 10.1186/s12903-023-03163-z] [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: 01/04/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Facial symmetry severely affects appearance and function. Large numbers of patients seek orthodontic treatment to improve facial symmetry. However, the correlation between hard- and soft-tissue symmetry is still unclear. Our aim was to investigate the hard- and soft-tissue symmetry in subjects with different levels of menton deviation and sagittal skeletal classes with 3D digital analysis and to investigate the relationship between the entire and individual hard- and soft-tissues. METHODS A total of 270 adults (135 males and 135 females) consisting of 45 subjects of each sex in each sagittal skeletal classification group. All subjects were further classified into relative symmetry (RS), moderate asymmetry (MA) and severe asymmetry (SA) groups based on the degree of menton deviation from the mid-sagittal plane (MSP). The 3D images were segmented into anatomical structures and mirrored across the MSP after establishing a coordinate system. Original and mirrored images were registered by a best-fit algorithm, and the corresponding root mean square (RMS) values and colormap were obtained. The Mann‒Whitney U test and Spearman correlation were conducted for statistical analysis. RESULTS The RMS increased with greater deviations with regard to the deviation of the menton in most of anatomical structures. Asymmetry was represented in the same way regardless of sagittal skeletal pattern. The soft-tissue asymmetry had a significant correlation with dentition in the RS group (0.409), while in the SA group, it was related to the ramus (0.526) and corpus (0.417) in males and was related to the ramus in the MA (0.332) and SA (0.359) groups in females. CONCLUSIONS The mirroring method combining CBCT and 3dMD provides a new approach for symmetry analysis. Asymmetry might not be influenced by sagittal skeletal patterns. Soft-tissue asymmetry might be reduced by improving the dentition in individuals with RS group, while among those with MA or SA, whose menton deviation was larger than 2 mm, orthognathic treatment should be considered.
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Affiliation(s)
- Jiamin Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
| | - Yifei Xu
- Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Jinxiu Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
| | - Zhen Lu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
| | - Kun Qi
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China.
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China.
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Chou ST, Tsai PL, Chen SC, Lin SH, Chen CM, Tseng YC. Condylar and ramus volume in asymmetric and symmetric skeletal class III malocclusion: A cone-beam computed tomography study. J Dent Sci 2023; 18:175-183. [PMID: 36643236 PMCID: PMC9831784 DOI: 10.1016/j.jds.2022.06.016] [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: 05/30/2022] [Revised: 06/19/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose Among the craniofacial structures, the mandible is the only bony structure with movable joints. Each part (including condyle process, coronoid process, and ramus) of mandible would interaction with the muscles and proceed different osteogenesis progress. The objective of this study was to evaluate the mandibles with symmetric and asymmetric skeletal Class III jaw relations by quantifying differences in the condyle process, coronoid process and ramus on CBCT (Cone-beam computer tomography) images. Our hypothesis was that CBCT would reveal no voluminal differences between deviated and non-deviated mandibular segments in asymmetric skeletal Class III. Materials and methods CBCT imagines were collected from dental department, KMUH and then divided into symmetric Class III group (Menton deviation < 4mm) and asymmetric Class III group (Menton deviation≧4mm). The mandibular structure would be segmented to ramus, condylar and coronoid process. Each volume was measured. Independent t test was used for comparison between groups, and paired t test was applied for comparison between both segmented parts within each group. Results Significant differences between deviation and non-deviation sides in the asymmetric group were found in condylar and ramus segments for volumetric quantitative measurements. There has no significant difference in ramus parts between groups. Significant greater condylar volume was found in non-deviation side of asymmetric group. Conclusion The results demonstrated that in the side with greater mandible growth potential, the condylar and the ramus volume would be greater as well. CBCT is a useful and accurate modality for quantification and evaluation of mandibular asymmetry.
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Affiliation(s)
- Szu-Ting Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pei-Lun Tsai
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Chieh Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Hsuan Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Chuan Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,Corresponding author. School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Tun Oo L, Miyamoto JJ, Takada JI, Cheng SWE, Yoshizawa H, Moriyama K. Three-dimensional characteristics of temporomandibular joint morphology and condylar movement in patients with mandibular asymmetry. Prog Orthod 2022; 23:50. [PMID: 36577877 PMCID: PMC9797632 DOI: 10.1186/s40510-022-00445-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/20/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Investigating the morphological and functional effects on mandibular asymmetry (MA) is important not only to understand the developmental process of masticatory dysfunction, but also to provide suggestions for evidence-based occlusal treatment. AIM To evaluate three-dimensional temporomandibular joint (TMJ) morphology and its relationship to asymmetrical condylar movement in MA patients. MATERIALS AND METHODS Fifty subjects were divided into MA and control groups (n = 25 each) according to a menton deviation of 4 mm from the mid-sagittal plane. TMJ morphology (condyle, glenoid fossa and TMJ spaces) were evaluated using a three-dimensional analysis programme. Three-dimensional condylar movements (from the sagittal and horizontal planes) were recorded and measured by computerized axiography on protrusion. Side-to-side asymmetry was measured for each parameter. The asymmetry index value was calculated to assess the correlation between TMJ morphology and condylar movement. For the statistical analysis, Wilcoxon's signed-ranked test, the Mann-Whitney U test, and Spearman's rank correlation were used. RESULTS Glenoid fossa volume, surface area, anteroposterior length, and condylar volume were significantly smaller, and articular eminence angle, glenoid fossa, and condylar axial angle were significantly larger, on the shifted side of the MA group when compared with those on the non-shifted side and the mean values of the control group (P < 0.05). The TMJ spaces of the MA group showed no bilateral difference but were significantly narrower in the medial, superior, and anterior joint spaces when compared with the control group (P < 0.05). Condylar path length and sagittal condylar inclination were significantly asymmetrical. The asymmetry index of the condyle volume was significantly correlated with that of the condylar path length (P = 0.005). The asymmetry index of the glenoid fossa volume and the articular eminence angle were significantly correlated with that of the sagittal condylar inclination (P = 0.009 and P = 0.002, respectively), and the asymmetry index of glenoid fossa volume was significantly correlated with the bilateral transverse condylar inclination (P = 0.006 and P = 0.016, respectively). CONCLUSIONS Morphological asymmetry of the TMJ is significantly different between the shifted and non-shifted sides and is closely related to functional asymmetry of condylar movement in MA patients. (350/350).
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Affiliation(s)
- Lin Tun Oo
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Jun J. Miyamoto
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Jun-Ichi Takada
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Shih-Wei Eric Cheng
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Hideyuki Yoshizawa
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
| | - Keiji Moriyama
- grid.265073.50000 0001 1014 9130Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8549 Japan
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Ng WH, Goh BT, Lim AAT, Tan MH. Mandibular asymmetry: Is there a difference in the bone and soft tissue thickness between both sides? Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:e299-e306. [PMID: 36229374 DOI: 10.1016/j.oooo.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/02/2022] [Accepted: 05/13/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The asymmetric mandible presents the clinician with unique anatomic challenges in orthognathic surgery correction. This study aims to investigate these characteristics of the asymmetric mandible: mandible bone thickness, soft tissue thickness, and the proximity of the bone cortex to the inferior alveolar nerve (IAN) canal. STUDY DESIGN Three-dimensional virtual models were created of 35 participants of Asian descent with mandibular asymmetry. Mandibular bone thicknesses and soft tissue thicknesses were measured at certain landmarks. Statistical analysis of the thicknesses of both sides of the mandible was performed. Comparison of thicknesses between patients with minor and major asymmetry were also performed. RESULTS The bone was significantly thinner at the longer side at all 4 mandible landmarks (P < .001). The bone lateral to the IAN was significantly thinner at the longer side, as well (P < .001). The soft tissue thickness did not differ significantly across sides, except at 1 landmark. These findings were even more exaggerated in the major asymmetry group. CONCLUSIONS The longer side of the asymmetric mandible bone was thinner, and the bone lateral to the IAN was also thinner as a result. This asymmetric thinness was exaggerated in patients with severe asymmetry, which may predispose the longer side to IAN injury and unfavorable fractures. The differences in bone thickness in the asymmetric mandible may also result in residual postoperative asymmetry.
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Affiliation(s)
- Wee Hsuan Ng
- Discipline of Oral Maxillofacial Surgery, Department of Dentistry, Khoo Teck Puat Hospital, Singapore
| | - Bee Tin Goh
- Department of Oral & Maxillofacial Surgery, National Dental Centre Singapore, Singapore
| | - Asher Ah Tong Lim
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, National University Centre for Oral Health, Singapore
| | - Mei Hui Tan
- Department of Oral & Maxillofacial Surgery, National Dental Centre Singapore, Singapore.
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Fan Y, Zhang Y, Chen G, He W, Song G, Matthews H, Claes P, Pei Y, Zha H, Penington A, Kilpatrick N, Schneider P, Jiang R, Xu T. Automated assessment of mandibular shape asymmetry in 3-dimensions. Am J Orthod Dentofacial Orthop 2022; 161:698-707. [DOI: 10.1016/j.ajodo.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
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12
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Bilateral Sagittal Split Mandibular Ramus Osteotomy Alters the Temporomandibular Joint. J Craniofac Surg 2021; 32:e598-e600. [PMID: 34387266 DOI: 10.1097/scs.0000000000007898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT In this retrospective analysis, we examined temporomandibular joint space volume and condyle position in 10 patients undergoing bilateral sagittal split mandibular ramus osteotomy plus Le Fort I osteotomy to correct mandibular asymmetry. Cone beam computed tomography was used to map temporomandibular joint prior to (T0), immediately after (T1), and at 1 year after surgery (T2). In the deviated side, we detected significant lateral shift of the condyle in 5 patients at T1, and the shift disappeared at T2. In the non-deviated side, we detected significant medial shift of the condyle in all 10 patients at T1; the shift continued in 9 patients at T2. Temporomandibular joint space volume increased significantly at T1 and returned to presurgical volume at T2. In conclusion, there is significant shift in position of condyle in majority of the patients after bilateral sagittal split mandibular ramus osteotomy. The most consistent and persisting change was medial shift on the nondeviated side.
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Lv W, Nie Q, Gu Y. Three-dimensional analysis of mandibular characteristics in patients with skeletal Class II malocclusion and chin deviation. Am J Orthod Dentofacial Orthop 2021; 160:392-400. [PMID: 34175163 DOI: 10.1016/j.ajodo.2020.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed to analyze adults with mandibular characteristics of skeletal Class II malocclusion with chin deviation. METHODS Seventy-five adult patients aged from 18 to 35 years were included and divided into 3 groups on the basis of sagittal skeletal pattern and chin deviation: skeletal Class I symmetry group, skeletal Class II symmetry group, and skeletal Class II asymmetry group (25 patients per group). Mandibular measurements on cone-beam computed tomography images were performed, and the differences between 2 sides in each group and the differences among the 3 groups were investigated. RESULTS Compared with the contralateral side, the deviated side of patients in the Class II asymmetry group showed significantly smaller condyle angle to midsagittal plane, condylar height, ramal length, and length of the mandibular body, whereas it showed a significantly larger distance from condylion to the midsagittal plane, ramus angle to the horizontal plane, and distance from gonion to the midsagittal plane. Most linear measurements in the Class II symmetry group were significantly smaller than those in the Class I symmetry group. These linear measurements on the contralateral side of the Class II asymmetry group showed no significant difference with the Class I symmetry group, and these measurements on the deviated side of the Class II asymmetry group showed no significant difference with the Class II symmetry group. CONCLUSIONS Length of the mandible, rotation of condyle, the inclination of the ramus, and position of gonion should be considered in subjects with skeletal Class II asymmetry when making diagnosis and treatment planning.
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Affiliation(s)
- Wenxin Lv
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qiong Nie
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Yan Gu
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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14
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De Los Ríos Fernández EM. [Use of skeletal-related diagnostic methods in articles published from 2018 to 2020 in four major orthodontics journals]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e041. [PMID: 38464403 PMCID: PMC10919820 DOI: 10.21142/2523-2754-0901-2021-041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/20/2021] [Indexed: 03/12/2024] Open
Abstract
Objective To determine the skeletal-related diagnostic methods most commonly used according to the four most important orthodontics journals in the period from 2018 to 2020. Methods A review of the data available regarding the diagnostic procedures most frequently used to determine skeletal relationships in the four most important orthodontics journals from 2018 to 2020. Article review was performed using SCIMAGO 2018, which provides a series of parameters ranking the importance of the impact of publications and journals. We made a synopsis of the information analyzed to establish a correlation and compare sources, and critically examined the articles collected on the subject of interest. An online bibliographic search of databases including mainly Medline was carried out, followed by evaluation and selection of the bibliography, organized according to the significance and nature of the study. Results The four journals included in the bibliographic search were: AJODO, AO, EJO and KJO. The A point-Nasion-B point (ANB) method was used in 92.2% of the articles published in AJODO, and 7.8% did not describe the method used. Twenty-three articles in the AO journal were evaluated, all of which referred to the use of ANB as the method used. Finally, 16 and 11 articles from the EJO and KJO journals, respectively, were evaluated, with 93.8% and 95%, respectively of the articles using ANB as the method of choice for determining skeletal relationships. Conclusion The method of choice for skeletal-related diagnostics is ANB, although this widely known method presents a risk of geometric effect.
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Affiliation(s)
- Enrique Manuel De Los Ríos Fernández
- Facultad de Odontología, Universidad Nacional de Tucumán. Tucumán, Argentina. Universidad Nacional de Tucumán Facultad de Odontología Universidad Nacional de Tucumán Tucumán Argentina
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15
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Comprehensive 3D analysis of condylar morphology in adults with different skeletal patterns - a cross-sectional study. Head Face Med 2020; 16:33. [PMID: 33256789 PMCID: PMC7708118 DOI: 10.1186/s13005-020-00245-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022] Open
Abstract
Background The correlation between individuals’ condylar morphology and their skeletal pattern is of great interest for treatment strategies ranging from orthodontic orthopaedics to orthognathic surgery. The objective of the present study was to investigate this relationship three-dimensionally. Methods A total of 111 adult patients (mean age = 27.0 ± 10.2 years) who underwent head computed tomography or cone beam computed tomography scans were included. Based on these data, 3D models of the skull and the condyles were calculated. The craniofacial skeleton was evaluated (1) transversally regarding skeletal symmetry (menton deviation), (2) sagittally regarding skeletal classes (Wits appraisal) and vertically regarding the inclination of the jaws (maxillomandibular plane angle). The condylar morphology was assessed (a) linearly by the condylar width, height and depth; (b) angularly by the antero-posterior and medio-lateral condylar inclination; and (c) volumetrically by the ratio of the condylar volume/mandibular volume (C/Mand). Results (1) Transversal: Asymmetric patients showed significantly higher discrepancies in the volumetric ratio C/Mand on the deviation and non-deviation side compared to symmetric patients. (2) Sagittal: Class III subjects demonstrated longer, more voluminous condyles with higher antero-posterior and medio-lateral inclination angles compared to Class II participants. (3) Vertical: Hyperdivergent subjects had smaller condyles with higher antero-posterior inclination angles than those of hypodivergent subjects. No interactions of skeletal class and vertical relationships regarding condylar morphology were observed. Conclusions This study demonstrates a clear correlation between pronounced skeletal patterns and condylar morphology in an adult population. The description of radiographic condyle characteristics in relation to the craniofacial morphology improves orthodontic treatment planning and could be helpful in the diagnosis of temporomandibular joint pathologies.
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Outcomes of conventional versus virtual surgical planning of orthognathic surgery using surgery-first approach for class III asymmetry. Clin Oral Investig 2020; 24:1509-1516. [PMID: 32100114 DOI: 10.1007/s00784-020-03241-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine if patient outcome variables differ between conventional and virtual surgical planning of orthognathic surgery for class III asymmetry. MATERIAL AND METHODS This retrospective case-control study examined 95 patients with class III asymmetry who had been consecutively treated with at least a Le Fort I osteotomy and a bilateral sagittal split osteotomy with a surgery-first approach. Two groups were examined: 51 patients treated with conventional surgical planning and 44 with virtual surgical planning. After treatment, quantitative assessment was determined with measurements of midline symmetry, contour symmetry, and overall facial symmetry using standardized frontal photographs. Subject assessments were analyzed with questionnaires regarding self-perception of overall appearance, satisfaction with appearance, and quality of life. RESULTS Conventional and virtual surgical planning resulted in significant improvements in outcomes for all patients. However, facial midline and overall facial symmetry were significantly greater for the virtual compared with the conventional group. There were no significant differences in subjective measures of appearance, satisfaction with appearance, and quality of life for patients treated with conventional or virtual surgical planning; measures were high for both groups. CONCLUSIONS Conventional and virtual surgical planning of surgery-first bimaxillary orthognathic surgery resulted in quantitative and qualitative improvements in facial symmetry. Although patient satisfaction was similar for both approaches, virtual surgical planning was superior to conventional surgical planning for the improvement of midline and overall asymmetry. CLINICAL RELEVANCE Improvements with virtual surgical planning in facial midline, facial contour, and overall facial symmetry are as good as or better than conventional surgical planning.
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Craniofacial Morphometric Features Associated With Pericondylar Fractures of the Mandible. J Craniofac Surg 2019; 30:2065-2068. [PMID: 31490441 DOI: 10.1097/scs.0000000000005960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The research aimed at investigating potential correlations between craniofacial morphological measurements and mandibular pericondylar fractures, based on a retrospective study of 380 mandible fractures treated in our department, during 2010 to 2017. Predictors included morphological measurements and features. Primary outcome was presence of pericondylar fracture; 133 pericondylar fractures were found, including subcondylar, condylar neck, and condylar head fractures. Condylar neck fractures showed negative correlations with condylar neck width (5.7 mm versus 6.7 mm sagittaly, and 6.1 mm versus 6.8 mm coronally, respectively). Gonial angle (117.3 degrees versus 128.7), and mandibular length 106.2 mm versus 110.4 mm, respectively) showed negative correlation with all pericondylar fractures. Ramus height correlated positively with pericondylar fractures (53.6 mm versus 51.2 mm, respectively). Thus, our results showed condylar neck width was a predictor for condylar neck fractures. In addition, individuals suffering from pericondylar fractures had significantly smaller gonial angles, longer ramus height, and shorter mandibular length. These morphologic features are characteristic of individuals with decreased anterior facial height. Our results corroborated a previous study we had conducted, which suggested that increased anterior vertical growth correlates with angle fractures.
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18
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Thiesen G, Freitas MPM, Gribel BF, Kim KB. Comparison of maxillomandibular asymmetries in adult patients presenting different sagittal jaw relationships. Dental Press J Orthod 2019; 24:54-62. [PMID: 31508707 PMCID: PMC6733234 DOI: 10.1590/2177-6709.24.4.054-062.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 10/22/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study aims at using cone beam computed tomography (CBCT) to analyze the maxillomandibular characteristics present in adults with mandibular asymmetries and different sagittal jaw relationships. METHODS 360 patients were selected and divided into three groups (Class I, Class II, and Class III), with 120 individuals per group. The groups were then subdivided according to the intensity of lateral deviation of the gnathion point, into: 1) relative symmetry, 2) moderate asymmetry, and 3) severe asymmetry. Three planes of reference were established in the CBCT images and several measurements were taken to compare the bilateral skeletal differences between the intensities of asymmetry for the different sagittal jaw relationships. RESULTS When the groups were compared by the intensity of asymmetry, significant differences among patients with relative symmetry and moderate to severe asymmetry were found. This was especially noticed for severe asymmetry, suggesting that the deviation of the chin did not constitute the only morphological alteration for these patients, especially because a series of measurements showed significant bilateral differences. When comparing sagittal jaw relationships, the only significant finding was the vertical positioning of the gonion between Class II and III patients with severe asymmetry. CONCLUSIONS When comparing the three sagittal jaw relationships with the same intensity of asymmetry, most maxillofacial aspects were quite similar. The only difference was found for patients with severe asymmetry, as the individuals with Class II showed greater bilateral difference in the vertical positioning of the gonion, when compared to patients with Class III.
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Affiliation(s)
- Guilherme Thiesen
- Universidade do Sul de Santa Catarina, Departamento de Ortodontia (Florianópolis/SC, Brazil)
| | | | | | - Ki Beom Kim
- Saint Louis University, Department of Orthodontics (Saint Louis/MO, USA)
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Evaluation of facial soft tissue thickness in symmetric and asymmetric subjects with the use of cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2019; 155:216-223. [DOI: 10.1016/j.ajodo.2018.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 11/16/2022]
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20
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Liao YF, Chen YF, Yao CF, Chen YA, Chen YR. Long-term outcomes of bimaxillary surgery for treatment of asymmetric skeletal class III deformity using surgery-first approach. Clin Oral Investig 2018; 23:1685-1693. [PMID: 30155572 DOI: 10.1007/s00784-018-2603-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/22/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Although several studies have reported the advantages of the surgery-first approach for orthognathic correction of Class III deformity, there are few reports of the success of this approach for patients with facial asymmetry. Therefore, the purpose of this study was to evaluate the outcome of bimaxillary surgery for asymmetric skeletal Class III deformity using a surgery-first approach. MATERIALS AND METHODS Sixty-five patients who consecutively underwent at least a combined Le Fort I and a bilateral sagittal split osteotomy for asymmetric skeletal Class III deformity were identified in the authors' patient database. Standardized frontal photographs were used to measure the change in midface, intercommissural line, chin from midface, and chin deviation angles as well as upper, middle, and lower contour deviation angles. The facial midline symmetry index, facial contour symmetry index, and overall facial symmetry index were also calculated. Self-reported questionnaires regarding overall appearance and satisfaction with facial areas were administered at least 1 year post-surgery. RESULTS Forty-six patients had genioplasty. There was a statistically significant improvement in the deviation angles measured and the facial midline, facial contour, and overall facial symmetry index. Self-reported questionnaires, completed at least 1 year post-surgery, showed that patient satisfaction was high. CONCLUSIONS These findings demonstrate that the surgical-orthodontic treatment with surgery-first approach can successfully maintain or improve facial symmetry. CLINICAL RELEVANCE The surgery-first approach for improving facial asymmetry using the guidelines described for setups of the models is a feasible alternative to the classic orthodontic-first approach for bimaxillary orthognathic surgery.
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Affiliation(s)
- Yu-Fang Liao
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road Gueishan Township, Taoyuan, 333, Taiwan. .,Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. .,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yun-Fang Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Chuan-Fong Yao
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yin-An Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Ray Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
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Thiesen G, Freitas MPM, Araújo EA, Gribel BF, Kim KB. Three-dimensional evaluation of craniofacial characteristics related to mandibular asymmetries in skeletal Class I patients. Am J Orthod Dentofacial Orthop 2018; 154:91-98. [PMID: 29957327 DOI: 10.1016/j.ajodo.2017.10.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 10/01/2017] [Accepted: 10/01/2017] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Our objective was to analyze the characteristics that affect skeletal Class I adults with mandibular asymmetries using cone-beam computerized tomography. METHODS The sample included cone-beam computerized tomography images of 120 subjects. Asymmetry was determined by the deviation of gnathion from the midsagittal plane and classified as relative symmetry, moderate asymmetry, or severe asymmetry. Maxillary and mandibular measurements were made, and the differences between the contralateral side and the deviated side were evaluated, as well as the differences between the categories of asymmetry. RESULTS For patients with moderate asymmetry, there were significant differences between the contralateral and deviated sides for some measuments in the transverse and vertical planes. For those with severe asymmetry, statistically significant differences were found between the sides for all measurements, except for the measuments that evaluated the position of the mandibular condyle in the transverse and sagittal directions. Furthermore, a strong correlation was found in patients with severe asymmetry, between the deviation of the mandibular dental midline and the lateral displacement of gnathion. CONCLUSIONS Patients with relative symmetry had a bilateral balance, whereas those with moderate and severe asymmetries showed several skeletal imbalances. A great deviation of the mandibular dental midline may indicate severe skeletal asymmetry in Class I adults.
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Affiliation(s)
- Guilherme Thiesen
- Department of Orthodontics, Saint Louis University, St Louis, Mo; Department of Orthodontics, Universidade do Sul de Santa Catarina, Florianopolis, Santa Catarina, Brazil.
| | | | | | - Bruno Frazão Gribel
- Private practice, Belo Horizonte, MG, Brazil; Department of Orthodontics, University of Michigan, Ann Arbor
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, St Louis, Mo
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22
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Roque-Torres GD, Peyneau PD, Dantas da Costa E, Bóscolo FN, Maria de Almeida S, Ribeiro LW. Correlation between midline deviation and condylar position in patients with Class II malocclusion: A cone-beam computed tomography evaluation. Am J Orthod Dentofacial Orthop 2018; 154:99-107. [DOI: 10.1016/j.ajodo.2017.10.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 12/26/2022]
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Abstract
To evaluate the feasibility of the orthodontic traction after local resection of the condylar osteochondroma (OC).From November 2011 to September 2016, consecutive patients with condylar OC who underwent orthodontic extraction after local resection of the mass were reviewed. Clinical data and cone-beam computed tomography (CT) were obtained before treatment (T0), 1 week after surgery (T1), and at least 6-month follow-up after OC resection (T2). Repeated-measures analysis of variance with Bonferroni multiple-comparison test was used to compare the 3-dimensional cephalometric variables at different time points and the paired t test was used to compare changes of temporomandibular joint (TMJ) space between the 2 sides at T1 and T2.The sample consisted of 23 patients (16 females and 7 males). The mean postoperative follow-up interval was 10.9 months. No recurrence was observed during the postoperative follow-up period. Facial symmetry and occlusion were greatly improved. B deviation and the distance of gonion on the OC-affected side to the Frankfort horizontal (FH) were significantly improved from T0 to T1 and T2 (P < .01). The anterior space (AS) and superior space (SS) of the OC-affected side were significantly larger than that of the contralateral side at T1 in parasagittal CT views (P < .05), while no difference was found between the two sides at T2.Local resection is an effective technique with less damage to the condyle. The application of postoperative directional traction could guide the condyle into the fossa, achieve normal TMJ space and stable occlusion, and eventually provide functional and esthetic outcomes.
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Kogou T, Takaki T, Shibahara T. Three-dimensional Analysis and Evaluation in Orthognathic Surgical Cases with Facial Asymmetry. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 59:147-161. [DOI: 10.2209/tdcpublication.2017-0008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tadashi Kogou
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Takashi Takaki
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
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Yu J, Hu Y, Huang M, Chen J, Ding X, Zheng L. A three-dimensional analysis of skeletal and dental characteristics in skeletal class III patients with facial asymmetry. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2018; 26:449-462. [PMID: 29562577 DOI: 10.3233/xst-17333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the skeletal and dental characteristics in skeletal class III patients with facial asymmetry and to analyse the relationships among various parts of the stomatognathic system to provide a theoretical basis for clinical practice. METHODS Asymmetric cone-beam computed tomography data acquired from 56 patients were evaluated using Mimics 10.0 and 3-Matic software. Skeletal and dental measurements were performed to assess the three-dimensional differences between two sides. Pearson correlation analysis was used to determine the correlations among measurements. RESULTS Linear measurements, such as ramal height, mandible body length, ramal height above the sigmoid notch (RHASN), maxillary height, condylar height, buccal and total cancellous bone thickness, and measurements of condylar size, were significantly larger on the nondeviated side than on the deviated side (P < 0.05). Crown root ratio and buccolingual angle of mandibular first molar were found to be significantly smaller on the nondeviated side than on the deviated side (P < 0.05). A negative correlation was also discovered between the buccolingual angle of mandibular first molar and the ramal height (P < 0.01). CONCLUSIONS In patients with facial asymmetry, asymmetries in the mandible, maxilla and condylar morphology, and skeletal canting served as major components of skeletal asymmetry. Furthermore, a reduced thickness of buccal cancellous bone and a larger crown root ratio were found on the deviated side, indicating that orthodontic camouflage has limitations and potential risks. A combination of orthodontics and orthognathic surgery may be the advisable choice in patients with a menton deviation greater than 4 mm. An important association between vertical skeletal disharmony and dental compensation was also observed.
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Affiliation(s)
- Jinfeng Yu
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yun Hu
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Mingna Huang
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jun Chen
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiaoqian Ding
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Leilei Zheng
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Plane-to-plane analysis of mandibular misalignment in patients with facial asymmetry. Am J Orthod Dentofacial Orthop 2018; 153:70-80. [DOI: 10.1016/j.ajodo.2017.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/19/2022]
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Association between 3-dimensional mandibular morphology and condylar movement in subjects with mandibular asymmetry. Am J Orthod Dentofacial Orthop 2017; 151:324-334. [PMID: 28153162 DOI: 10.1016/j.ajodo.2016.06.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the hypothesis that 3-dimensional mandibular morphology is correlated with condylar movement in patients with mandibular asymmetry. METHODS Subjects were classified into 2 groups (n = 25 each): mandibular asymmetry with a menton deviation greater than 4 mm and no mandibular asymmetry with a menton deviation less than 4 mm. Linear and volumetric measurements of 3-dimensional mandibular morphology were recorded using computed tomography. Mandibular functional movement was recorded by computerized axiography (CADIAX; Gamma Dental, Klosterneuburg, Austria), and condylar path length, sagittal condylar inclination, and transverse condylar inclination on protrusion were measured. We calculated side-to-side asymmetry (shifted side vs nonshifted side) in mandibular morphology and assessed condylar movement by using an asymmetry ratio (nonshifted side/shifted side). RESULTS Significant differences in mandibular morphology and condylar movement were found between the 2 groups. In the group with menton deviation greater than 4 mm, significant correlations were found between the asymmetry ratio of mandibular morphology and condylar movement: ie, condylar path length and transverse condylar inclination. No significant correlations were found between any of these measurements in the group with menton deviation less than 4 mm. CONCLUSIONS In support of our hypothesis, the results suggested that 3-dimensional mandibular morphologic asymmetry is associated with condylar movement in subjects with mandibular asymmetry.
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Upper airway asymmetry in skeletal Class III malocclusions with mandibular deviation. Sci Rep 2017; 7:12185. [PMID: 28939844 PMCID: PMC5610333 DOI: 10.1038/s41598-017-12076-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 09/04/2017] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to investigate the relationship between bilateral differences of upper airway and mandibular morphologic patterns in subjects with skeletal Class III mandibular deviation. 47 skeletal Class III (ANB < 0°) adult patients with and without mandibular deviation were divided into 2 groups. Bilateral differences of minimum cross-sectional area, mean cross-sectional area, volume of subdivisions (nasopharynx, palatopharynx, glossopharynx, hypopharynx) were assessed paired t test. Stepwise linear regression analysis and Pearson correlation coefficients were computed between a significant pair of upper airway variables and a pair of mandibular deviation variables to examine the quantitative relationship between the upper airway asymmetry and mandibular deviation. The mean cross-sectional area and the volume of palatopharynx on the deviated side in mandibular deviated group was significantly smaller than non-deviated side. The asymmetry index of the palatopharyngeal volume showed significant correlations with CRA asymmetry (r = 0.49) and Ramus asymmetry (r = 0.54). However, in the glossopharyngeal and hypopharyngeal segment, the mandibular deviated group showed significant asymmetry, characterized by larger mean cross-sectional area and volume in deviated side. The asymmetry index of the glossopharyngeal volume and hypopharyngeal volume showed significant correlations with CRA asymmetry (r = 0.42), Me-s (r = 0.72) and Me-s (r = 0.67) respectively.
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Three-dimensional analysis of mandibular condyle position in patients with deviated mandibular prognathism. Int J Oral Maxillofac Surg 2017; 46:1052-1058. [DOI: 10.1016/j.ijom.2017.02.1272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 01/08/2017] [Accepted: 02/23/2017] [Indexed: 11/21/2022]
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Thiesen G, Gribel BF, Kim KB, Freitas MPM. Maxillofacial Features Related to Mandibular Asymmetries in Skeletal Class III Patients. J Oral Maxillofac Surg 2017; 75:1015-1025. [DOI: 10.1016/j.joms.2016.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/09/2016] [Accepted: 11/09/2016] [Indexed: 11/15/2022]
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Kim KA, Lee JW, Park JH, Kim BH, Ahn HW, Kim SJ. Targeted presurgical decompensation in patients with yaw-dependent facial asymmetry. Korean J Orthod 2017; 47:195-206. [PMID: 28523246 PMCID: PMC5432441 DOI: 10.4041/kjod.2017.47.3.195] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 09/20/2016] [Accepted: 09/28/2016] [Indexed: 11/10/2022] Open
Abstract
Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.
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Affiliation(s)
- Kyung-A Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Ji-Won Lee
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jeong-Ho Park
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Byoung-Ho Kim
- Private Practice, Seoul, Korea.,Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyo-Won Ahn
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
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Fang JJ, Tu YH, Wong TY, Liu JK, Zhang YX, Leong IF, Chen KC. Evaluation of mandibular contour in patients with significant facial asymmetry. Int J Oral Maxillofac Surg 2016; 45:922-31. [DOI: 10.1016/j.ijom.2016.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 12/22/2015] [Accepted: 02/15/2016] [Indexed: 11/29/2022]
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Kim SJ, Baik HS, Hwang CJ, Yu HS. Diagnosis and evaluation of skeletal Class III patients with facial asymmetry for orthognathic surgery using three-dimensional computed tomography. Semin Orthod 2015. [DOI: 10.1053/j.sodo.2015.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kim SJ, Lee KJ, Yu HS, Jung YS, Baik HS. Three-dimensional effect of pitch, roll, and yaw rotations on maxillomandibular complex movement. J Craniomaxillofac Surg 2015; 43:264-73. [DOI: 10.1016/j.jcms.2014.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 11/21/2014] [Accepted: 11/21/2014] [Indexed: 12/01/2022] Open
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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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Lee ST, Mori Y, Minami K, An CH, Park JW, Kwon TG. Does skeletal surgery for asymmetric mandibular prognathism influence the soft tissue contour and thickness? J Oral Maxillofac Surg 2013; 71:1577-87. [PMID: 23800674 DOI: 10.1016/j.joms.2013.04.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 04/09/2013] [Accepted: 04/09/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the present study was to investigate whether asymmetric mandibular prognathism accompanies a fundamental difference in soft tissue thickness and whether asymmetric mandibular setback surgery would influence the contour and thickness of the soft tissue of the chin. MATERIALS AND METHODS The present retrospective study included skeletal class III patients with significant mandibular chin deviation greater than 6 mm at the pogonion, who had undergone cone-beam computed tomography before and 6 months after surgery during a 2-year period. The predictor variables were timing (pre- and postoperatively) and side (asymmetric vs contralateral). The outcome measures were the hard and soft tissue contours and soft tissue thickness of the chin at the infradentale, B-point, and pogonion level evaluated with reformatted computed tomography images. The study variables were statistically compared using regression model and correlation analysis. RESULTS The present study consisted of 20 patients (10 males and 10 females; average age 20.2 years; range, 18 to 25). Preoperatively, the chin deviation side showed a more prominent hard and soft tissue outline but had a thinner soft tissue thickness, which camouflaged the hard tissue asymmetry. After surgery, the hard and soft tissue outline was greatly improved, and the soft tissue thickness had become nearly symmetric. Most of the soft tissue thickness changes correlated negatively with the hard tissue changes. CONCLUSIONS Asymmetric mandibular prognathism accompanied the 3-dimensional soft tissue contour and thickness asymmetry. Because the soft tissue responds favorably after skeletal surgery, the correction of 3-dimensional asymmetry of bone should be emphasized in patients with asymmetric mandibular prognathism.
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Affiliation(s)
- Sung-Tak Lee
- Center for Orthognathic surgery, Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry, Daegu, Korea
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Bayome M, Park JH, Kook YA. New three-dimensional cephalometric analyses among adults with a skeletal Class I pattern and normal occlusion. Korean J Orthod 2013; 43:62-73. [PMID: 23671831 PMCID: PMC3650215 DOI: 10.4041/kjod.2013.43.2.62] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 12/31/2012] [Accepted: 01/02/2013] [Indexed: 11/23/2022] Open
Abstract
Objective The purpose of this study was to assess new three-dimensional (3D) cephalometric variables, and to evaluate the relationships among skeletal and dentoalveolar variables through 3D cephalometric analysis. Methods Cone-beam computed tomography (CBCT) scans were acquired from 38 young adults (18 men and 20 women; 22.6 ± 3.2 years) with normal occlusion. Thirty-five landmarks were digitized on the 3D-rendered views. Several measurements were obtained for selected landmarks. Correlations among different variables were calculated by means of Pearson's correlation coefficient values. Results The body of the mandible had a longer curve length in men (102.3 ± 4.4 mm) than in women (94.5 ± 4.7 mm) (p < 0.001), but there was no significant difference in the maxillary basal curve length. Men had significantly larger facial dimensions, whereas women had a larger gonial angle (117.0 ± 4.0 vs. 113.8 ± 3.3; p < 0.001). Strong-to-moderate correlation values were found among the vertical and transverse variables (r = 0.71 to 0.51). Conclusions The normative values of new 3D cephalometric parameters, including the maxillary and mandibular curve length, were obtained. Strong-to-moderate correlation values were found among several vertical and transverse variables through 3D cephalometric analysis. This method of cephalometric analyses can be useful in diagnosis and treatment planning for patients with dentofacial deformities.
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Affiliation(s)
- Mohamed Bayome
- Graduate School, The Catholic University of Korea, Seoul, Korea
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Yáñez-Vico RM, Iglesias-Linares A, Torres-Lagares D, Gutiérrez-Pérez JL, Solano-Reina E. A new three-dimensional analysis of asymmetry for patients with craniofacial syndromes. Oral Dis 2013; 19:755-62. [PMID: 23294171 DOI: 10.1111/odi.12059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 11/29/2012] [Accepted: 12/05/2012] [Indexed: 11/30/2022]
Abstract
OBJECIVES The use of three-dimensional computed tomography (3D-CT) analyses represents a substantial improvement in planning treatment. The aim of this study is to introduce a new three-dimensional (3D) analysis of clinical value for evaluating asymmetry in cases of craniofacial syndrome. SUBJECTS AND METHODS Virtual 3D models were reconstructed from CT images of 62 normal subjects (35 males and 27 females), more than 18 years old. Measurements of asymmetrical skeletal and dentoalveolar relationships were evaluated and standardized data obtained. The feasibility of the new 3D craniofacial analysis was then evaluated on one patient with severe maxillomandibular asymmetry in the form of hemifacial microsomia. RESULTS Standardized 3D data from the analysis were obtained and classified into 6 maxillary measurements, eight mandibular measurements and seven dentoalveolar process measurements. No significant differences were found between males and females (U-Mann-Whitney test, P > 0.05). Useful data of clinical value was provided for planning orthodontic and surgical treatment of asymmetries, as well as a diagnostic chart. CONCLUSION This method is useful for the clinical evaluation of asymmetry in craniofacial syndromes. The use of 3D analysis facilitates surgical and orthodontic treatment planning.
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Affiliation(s)
- R M Yáñez-Vico
- Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain
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