1
|
Steegman RM, Klein Meulekamp AF, Renkema AM, Janssen KI, Kuijpers-Jagtman AM, Ren Y. Three-Dimensional Cone Beam Computed Tomography (CBCT)-Derived Soft Tissue Changes in Patients with Unilateral Cleft Lip, Alveolus, and Palate with Midfacial Deficiency after 1.5 Years of Bone-Anchored Maxillary Protraction. J Clin Med 2024; 13:2890. [PMID: 38792430 PMCID: PMC11122183 DOI: 10.3390/jcm13102890] [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: 04/01/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Bone-anchored maxillary protraction (BAMP) aims to correct midfacial deficiencies, with proven positive skeletal changes without potential unwanted side effects. However, the influence of BAMP treatment on facial soft tissues, particularly in subjects with complete unilateral cleft lip, alveolus, and palate (CUCLAP), remains unclear. Methods: This single-center longitudinal cohort study examined the effects of 1.5 years of BAMP treatment on facial soft tissues in growing subjects with complete unilateral cleft lip, alveolus, and palate. The sample consisted of 25 patients, age range 9.7 to 12.6 years. Three-dimensional surface models derived from CBCT scans were superimposed on stable structures of the anterior cranial base and on the occipital area posterior of the foramen magnum to assess three-dimensional changes due to growth and BAMP therapy. Results: The results revealed a moderate positive correlation (Pearson's correlation coefficient from 0.203 to 0.560) between changes in hard tissue and soft tissue; some correlations were found to be weak (<0.300). Linear changes in soft tissue following BAMP were in the same direction as skeletal changes, showing downward, forward, and outward displacement. The only exception was in the vertical dimension. The lower facial third showed a slight but significant reduction, mainly in lip length (-1.2 mm), whereas the middle facial third showed a small increase (1.1 mm). Conclusions: It was concluded that during BAMP, soft tissue changes occur in the same direction as skeletal changes, although with a larger variability and less pronounced effects.
Collapse
Affiliation(s)
- Ralph M. Steegman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (R.M.S.); (A.F.K.M.); (A.-M.R.); (K.I.J.); (Y.R.)
- Zijlweg Orthodontie, Orthodontic Private Practice, Zijlweg 148B2, 2015 BJ Haarlem, The Netherlands
| | - Annemarlien F. Klein Meulekamp
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (R.M.S.); (A.F.K.M.); (A.-M.R.); (K.I.J.); (Y.R.)
| | - Anne-Marie Renkema
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (R.M.S.); (A.F.K.M.); (A.-M.R.); (K.I.J.); (Y.R.)
| | - Krista I. Janssen
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (R.M.S.); (A.F.K.M.); (A.-M.R.); (K.I.J.); (Y.R.)
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (R.M.S.); (A.F.K.M.); (A.-M.R.); (K.I.J.); (Y.R.)
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010 Bern, Switzerland
- Faculty of Dentistry, Universitas Indonesia, Campus Salemba, Jalan Salemba Raya No. 4, Jakarta 10430, Indonesia
| | - Yijin Ren
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (R.M.S.); (A.F.K.M.); (A.-M.R.); (K.I.J.); (Y.R.)
| |
Collapse
|
2
|
Farha P, Arqub SA, Ghoussoub MS. Correlation Between Cephalometric Values and Soft Tissue Profile in Class I and Class II Adult Patients based on Vertical Patterns. Turk J Orthod 2024; 37:36-43. [PMID: 38556951 PMCID: PMC10986451 DOI: 10.4274/turkjorthod.2023.2022.20] [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: 03/29/2022] [Accepted: 03/28/2023] [Indexed: 04/02/2024]
Abstract
Objective To compare soft tissue profile variations between Class I and Class II adult patients due to three vertical skeletal facial patterns (normodivergent, hypodivergent and hyperdivergent) and determine which skeletal variation has the most significant impact on soft tissue profile. Methods Retrospective soft tissue profile analysis was performed on lateral cephalograms of 131 adult patients. The analysis was divided into two categories correlated with subnasal and general soft tissue profiles. The sample was divided based on two sagittal skeletal patterns (Class I and II) and three vertical groups. In addition, comparisons were made between males and females. Viewbox 4 was used for the analysis. Descriptive, comparative, and correlation statistics were performed using SPSS software. Results Statistically significant inter-gender differences were found at the subnasal profile level, but not at the general profile level. No significant differences were observed when comparing subnasal profiles for the sagittal groups. However, significant differences were observed at the level of the general profile, especially at the level of Z-angle, lower lip, and chin prominence. In the vertical groups, hyperdivergent facial patterns had significant differences at the level of subnasal and general profiles compared with other vertical facial patterns. Conclusion Females had more convex subnasal profiles than males. Hyperdivergent facial patterns had an impact on both general and subnasal soft tissue profiles. The sagittal dimension affected only the general soft tissue profile. Therefore, changes in the vertical dimension had the greatest impact on facial esthetics.
Collapse
Affiliation(s)
- Philippe Farha
- Boston University Henry M. Goldman School of Dental Medicine, Boston, USA
| | - Sarah Abu Arqub
- Department of Orthodontics, University of Florida, Gainesville, USA
| | - Mona Sayegh Ghoussoub
- Lebanese University Faculty of Dental Medicine, Department of Orthodontics and Dentofacial Orthopedics, Beirut, Lebanon
| |
Collapse
|
3
|
Ozbilen EO, Ari MO, Yilmaz HN, Biren S. Soft tissue evaluation after maxillary protraction with RPE or with the ALT-RAMEC protocol : A controlled 3D study. J Orofac Orthop 2023; 84:200-209. [PMID: 36169663 DOI: 10.1007/s00056-022-00428-0] [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: 12/03/2021] [Accepted: 08/16/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate soft tissue changes following maxillary protraction with different expansion protocols using three-dimensional (3D) stereophotogrammetry. METHODS Pretreatment (T0) and postprotraction (T1) stereophotogrammetry and lateral cephalometric images of skeletal class III patients were included in this retrospective study. In all, 32 patients were treated either with a combination of rapid palatal expansion and facemask (RPE/FM; n = 16; mean age: 9.94 ± 0.68 years) or with alternate rapid maxillary expansion and constriction together with a facemask (Alt-RAMEC/FM; n = 16; mean age: 9.74 ± 1.35 years). As a control group 16 untreated patients were recruited (mean age: 9.46 ± 0.8 years). For superimpositioning of the 3D images taken at T0 and T1, the face was divided into defined regions and 3D and differences between the groups were evaluated using 3‑matic software (Materialise Europe, Leuven, Belgium). Cephalometric analyses were also performed. RESULTS While the increases in the cephalometric parameters SNA and ANB were significantly greater in the treatment groups, the value for SNB also increased in the control group (p < 0.05). The results of the stereophotogrammetry analyses demonstrated that the mean changes in the RPE/FM and in the Alt-RAMEC/FM groups were significantly different for the midface compared to the control group (0.33 ± 0.26 mm, 0.3 ± 0.31 mm, 0.1 ± 0.18 mm). The maximum positive, negative, and mean changes were also significantly different between the treatment and control groups for the upper lip (p < 0.05). For the lower lip and the chin significant backward movements in the RPE/FM as well as in the Alt-RAMEC/FM group (-1.06 ± 1.26 mm, -0.68 ± 0.45 mm) were observed, while the control group (0.09 ± 0.53 mm) presented changes in the opposite direction. Regarding soft tissue changes, no significant differences were found between the RPE/FM and Alt-RAMEC/FM groups. CONCLUSION Both treatment protocols improved the soft tissue profile due to a forward movement of the midface and the upper lip, and a backward movement of the lower lip and chin, compared to the control group.
Collapse
Affiliation(s)
- Elvan Onem Ozbilen
- Department of Orthodontics, Faculty of Dentistry, Marmara University, 9/34854, Maltepe/Istanbul, Turkey.
| | | | - Hanife Nuray Yilmaz
- Department of Orthodontics, Faculty of Dentistry, Marmara University, 9/34854, Maltepe/Istanbul, Turkey
| | - Sibel Biren
- Department of Orthodontics, Faculty of Dentistry, Istanbul Kent University, Istanbul, Turkey
| |
Collapse
|
4
|
Kamel AM, Tarraf NE, Fouda AM, Hafez AM, El-Bialy A, Wilmes B. Dentofacial effects of miniscrew-anchored maxillary protraction on prepubertal children with maxillary deficiency: a randomized controlled trial. Prog Orthod 2023; 24:22. [PMID: 37303011 DOI: 10.1186/s40510-023-00473-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The introduction of bone-anchored maxillary protraction eliminated the side effects of facemask in the early treatment of patients with maxillary retrusion. This study aimed to evaluate the effects of miniscrew-anchored maxillary protraction (MAMP) and compare them with the growth changes in an untreated control group in growing patients with Class III malocclusion. METHODS Forty growing patients with Class III malocclusion and retrognathic maxilla were randomly allocated into two groups: treated and control groups. In the treated group, patients were treated with full-time intermaxillary Class III elastics (C3E) anchored by a hybrid hyrax (HH) in the maxilla and a bone-supported bar in the mandible. Protraction was stopped after obtaining a positive overjet. Cephalometric radiographs were acquired before and after the treatment. Data were statistically analyzed on an intention-to-treat basis. Intergroup comparisons were also made using analysis of covariance with the readings at T0 as a covariate. RESULTS Forty patients agreed to participate, and 30 of them completed the study (treated group, n = 17; control group, n = 13). The average treatment duration was 11.9 months. MAMP resulted in a significant maxillary advancement (A-VR, 4.34 mm) with significant control over the mandibular growth. No significant increase in the mandibular plane angle was found in the treated group compared with the control group. The upper and lower incisors showed significant protrusion in the treated group. CONCLUSIONS Within the limitations of this study and high attrition rate, the MAMP protocol can effectively increase maxillary forward growth with good control over the growth of the mandible antero-posteriorly and vertically.
Collapse
Affiliation(s)
- Ahmed Mohamed Kamel
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 1 El-Gomhouria St, Mansoura, Dakahlia Governorate, 35516, Egypt.
| | - Nour Eldin Tarraf
- Department of Orthodontics, Faculty of Medicine and Health, Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, University of Sydney, Sydney, Australia
| | - Ahmed Maher Fouda
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 1 El-Gomhouria St, Mansoura, Dakahlia Governorate, 35516, Egypt
| | - Ahmad Mohammed Hafez
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 1 El-Gomhouria St, Mansoura, Dakahlia Governorate, 35516, Egypt
| | - Ahmed El-Bialy
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 1 El-Gomhouria St, Mansoura, Dakahlia Governorate, 35516, Egypt
| | - Benedict Wilmes
- Department of Orthodontics, University of Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
5
|
Tyler G, Machaalani R, Waters KA. Three-dimensional orthodontic imaging in children across the age spectrum and correlations with obstructive sleep apnea. J Clin Sleep Med 2023; 19:275-282. [PMID: 36123956 PMCID: PMC9892738 DOI: 10.5664/jcsm.10312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES To determine baseline facial convexity measurements in children with obstructive sleep apnea (OSA) across the age spectrum. METHODS Polysomnogram, stereophotogrammetry, and biometric data were collected from children aged 0-18 years who were being investigated for OSA. Analyses evaluated differences in facial convexity according to OSA severity and other sleep parameters, while adjusting for age, ethnicity, and sex. RESULTS Ninety-one children, aged 0.05-16.02 years, met the inclusion criteria for this study. Initial analysis showed that the logarithm of age had a significant effect on facial convexity (P = 8.3·10-7) with significant effects of sex (P = 1.3·10-2), while excluding OSA. Ordinal logistic regression taking into consideration age, sex, weight, height, and ethnicity with OSA severity categorized as obstructive apnea-hypopnea index negative, mild, moderate, or severe showed that facial convexity was associated with OSA severity (P = 2.2·10-3); an increasing obtuse angle of convexity increased the tendency to be classified as having severe OSA. CONCLUSIONS Using three-dimensional imaging, we found an added impact of infancy on changes of facial convexity with age. While modeling could describe facial convexity without any OSA-associated sleep parameters, differences in facial convexity were present among groups with different levels of OSA severity adjusted for growth (age, weight, and height), sex, and ethnicity. The method provides a safer and cheaper alternative to other medical imaging techniques in children and holds potential for future use in studies of craniofacial structure. CITATION Tyler G, Machaalani R, Waters KA. Three-dimensional orthodontic imaging in children across the age spectrum and correlations with obstructive sleep apnea. J Clin Sleep Med. 2023;19(2):275-282.
Collapse
Affiliation(s)
- Gemma Tyler
- Faculty of Science, University of Sydney, Camperdown, New South Wales 2006, Australia
- Sleep Unit, The Children’s Hospital at Westmead, Westmead, New South Wales 2145, Australia
| | - Rita Machaalani
- Sleep Unit, The Children’s Hospital at Westmead, Westmead, New South Wales 2145, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales 2050, Australia
| | - Karen A. Waters
- Sleep Unit, The Children’s Hospital at Westmead, Westmead, New South Wales 2145, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales 2050, Australia
| |
Collapse
|
6
|
Kamath A, Sudhakar SS, Kannan G, Rai K, SB A. Bone-anchored maxillary protraction (BAMP): A review. J Orthod Sci 2022; 11:8. [PMID: 35754417 PMCID: PMC9214452 DOI: 10.4103/jos.jos_153_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/04/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Protraction therapy for maxillary deficiency in the treatment of skeletal class III malocclusion involves the use of facemask. Conventionally facemask has been anchored to the maxillary dentition, which is responsible for some of the counter-productive effects of facemask therapy including backward and downward rotation of the chin, increase in the lower anterior facial height, proclination of maxillary incisors, retroclination of mandibular incisors apart from mesialization of maxillary molars with extrusion and decreased overbite. AIM The aim of this article is to highlight the nuances of Bone-Anchored Maxillary Protraction (BAMP) including a literature review, which is comprehensive and narrative and comparing the different techniques involved such as type 1 BAMP versus type 2 BAMP and BAMP versus facemask. MATERIALS AND METHODS A computerized search was performed in electronic databases such as PubMed, PubMed Central, Cochrane, Embase, DOAJ, and Google scholar using key words such as "bone-anchored maxillary protraction" and "BAMP." The search was confined to articles in English published till March 2021. Forty-seven case-controlled, cross-sectional, retrospective and prospective studies, as well as systematic reviews and meta-analysis were included in this article, which were limited to human subjects. A hand search of the reference lists of the included articles was also carried out to include missed out articles. CONCLUSION To overcome these drawbacks, BAMP was introduced, which causes both maxillary protraction, restraint of mandibular growth with minimal dentoalveolar changes. BAMP is used widely nowadays in the treatment of skeletal class III malocclusion.
Collapse
Affiliation(s)
- Apoorva Kamath
- Department of Orthodontics, Srinivas Institute of Dental Sciences, Mukka, Mangaluru, Karnataka, India
| | - Shetty Suhani Sudhakar
- Department of Orthodontics, Srinivas Institute of Dental Sciences, Mukka, Mangaluru, Karnataka, India
| | - Greeshma Kannan
- Department of Orthodontics, Srinivas Institute of Dental Sciences, Mukka, Mangaluru, Karnataka, India
| | - Kripal Rai
- Public Health Dentistry, Srinivas Institute of Dental Sciences, Mukka, Mangaluru, Karnataka, India
| | - Athul SB
- Department of Orthodontics, Kannur Dental College, Kerala, India
| |
Collapse
|
7
|
Lim YN, Yang BE, Byun SH, Yi SM, On SW, Park IY. Three-Dimensional Digital Image Analysis of Skeletal and Soft Tissue Points A and B after Orthodontic Treatment with Premolar Extraction in Bimaxillary Protrusive Patients. BIOLOGY 2022; 11:biology11030381. [PMID: 35336755 PMCID: PMC8945223 DOI: 10.3390/biology11030381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022]
Abstract
Aim. To investigate the effect of changes in incisor tip, apex movement, and inclination on skeletal points A and B and characterize changes in skeletal points A and B to the soft tissue points A and B after incisor retraction in Angle Class I bimaxillary dentoalveolar protrusion. Methods. Twenty-two patients with Angle Class I bimaxillary dentoalveolar protrusion treated with four first premolar extractions were included in this study. The displacement of skeletal and soft tissue points A and B was measured using cone-beam computed tomography (CBCT) using a three-dimensional coordinate system. The movement of the upper and lower incisors was also measured using CBCT-synthesized lateral cephalograms. Results. Changes in the incisal tip, apex, and inclination after retraction did not significantly affect the position of points A and B in any direction (x, y, z). Linear regression analysis showed a statistically significant relationship between skeletal point A and soft tissue point A on the anteroposterior axis (z). Skeletal point A moved forward by 0.07 mm, and soft tissue point A moved forward by 0.38 mm, establishing a ratio of 0.18: 1 (r = 0.554, p < 0.01). Conclusion. The positional complexion of the skeletal points A and B was not directly influenced by changes in the incisor tip, apex, and inclination. Although the results suggest that soft tissue point A follows the anteroposterior position of skeletal point A, its clinical significance is suspected. Thus, hard and soft tissue analysis should be considered in treatment planning.
Collapse
Affiliation(s)
- You Na Lim
- Division of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14066, Korea;
| | - Byoung-Eun Yang
- Division of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Korea; (B.-E.Y.); (S.-H.B.); (S.-M.Y.)
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
| | - Soo-Hwan Byun
- Division of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Korea; (B.-E.Y.); (S.-H.B.); (S.-M.Y.)
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
| | - Sang-Min Yi
- Division of Oral & Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, Korea; (B.-E.Y.); (S.-H.B.); (S.-M.Y.)
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
| | - Sung-Woon On
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
- Division of Oral & Maxillofacial Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea
| | - In-Young Park
- Division of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14066, Korea;
- Graduate School of Clinical Dentistry, Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea;
- Correspondence: ; Tel.: +82-31-380-3870; Fax: +82-31-380-1726
| |
Collapse
|
8
|
Cornelis MA, Tepedino M, Riis NDV, Niu X, Cattaneo PM. Treatment effect of bone-anchored maxillary protraction in growing patients compared to controls: a systematic review with meta-analysis. Eur J Orthod 2021; 43:51-68. [PMID: 32815989 DOI: 10.1093/ejo/cjaa016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The aim of this systematic review was to determine which evidence level supports maxillary advancement after bone-anchored maxillary protraction (BAMP) in growing patients compared to controls. SEARCH METHODS PubMed, Cochrane, Embase, Scopus, and Web-of-Science databases were searched with no restrictions on publication status or year. SELECTION CRITERIA Prospective and retrospective human studies about BAMP, in at least three patients, were included. Authors were contacted when necessary, and reference lists of the included studies were screened. DATA COLLECTION AND ANALYSIS Two authors undertook independent data extraction with conflict resolution by a third author. Risks of bias were assessed. A meta-analysis for estimates of changes for ANB angle, Wits appraisal, and incisor to mandibular plane angle (IMPA) angle of BAMP treatment compared to control groups was performed. RESULTS A total of 449 articles were initially retrieved; 28 full-text articles met the inclusion criteria. Sample sizes ranged from 3 to 52 patients. There was heterogeneity in cephalometric outcomes reported, which prevented the comparison of certain outcomes. ANB angle improved more with BAMP in the maxilla combined with facemask (bone-anchored facemask, BAFM) compared to traditional facemask therapy: this was statistically but not clinically significant (0.2 degrees). No data are available for BAMP with skeletal anchorage in both jaws in combination with Class III elastics (bone-anchored Class III elastics, BAC3E). Likewise, no statistically significant differences in Wits appraisal were found (less than 1 mm). Lower incisor retroclination and facial height seemed to be better controlled with BAC3E compared to BAFM. CONCLUSIONS The level of evidence available to support the maxillary advancement effect after BAMP was low. Publications reporting results based on identical samples tended to suggest overly positive results of BAMP. The differences in sagittal correction between BAMP and traditional facemask therapy were small and of questionable clinical significance. Long-term follow-up results are not available and, therefore, much needed. LIMITATIONS Most articles had a low level of evidence and some included a historical control group. REGISTRATION PROSPERO database number CRD42015023366.
Collapse
Affiliation(s)
- Marie A Cornelis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Neel de Vos Riis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Xiaowen Niu
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Paolo M Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
9
|
Fastuca R, Beccarini T, Rossi O, Zecca PA, Caprioglio A. Influence of facial components in class III malocclusion esthetic perception of orthodontists, patients, and laypersons. J Orofac Orthop 2021; 83:48-58. [PMID: 33929556 DOI: 10.1007/s00056-021-00287-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 02/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of the present study was to investigate the influence of different facial components (face length, lip volume, nose size, and cheekbone contour) on the perception of facial attractiveness of patients with Angle class III malocclusion in different categories of responders (orthodontists, laypersons, patients) with two-dimensional (2D) and three-dimensional (3D) simulations. METHODS An ideal standard 3D face was manipulated to create a class III facial malocclusion. Four facial components were modified (face length, lip volume, nose size and cheekbone contour) and the resulting simulations were used to obtain 2D figures and 3D videos, which were evaluated in a survey by orthodontists, patients, and laypersons. RESULTS No significant differences were detected between the 2D figures and 3D video simulations. Good correspondence was shown between the three categories of responders for the most and the least attractive faces. Smaller lips and bigger nose, regardless to the vertical dimension (short or long face), were found to be the least attractive features with agreement of all respondents. CONCLUSION Regarding class III facial attractiveness perception, the sum of all facial features and not the alteration of a single component alone seems to play a key role in the perception of facial attractiveness. The 2D or 3D perspective did not play a significant role in perception and the analyzed categories of responders did not show significant differences when perceiving facial attractiveness of the utilized simulations.
Collapse
Affiliation(s)
- Rosamaria Fastuca
- Research Fellow, Department of Medicine and Surgery, University of Insubria, Varese, Italy. .,C/O Dental School, Via G. Piatti, 10, 21100, Velate (Va), Italy.
| | | | - Ornella Rossi
- Resident, Orthodontic Program, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Alberto Caprioglio
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| |
Collapse
|
10
|
Güler ÖÇ, Malkoç S. Comparison of facial soft tissue changes after treatment with 3 different functional appliances. Am J Orthod Dentofacial Orthop 2020; 158:518-526. [PMID: 32988567 DOI: 10.1016/j.ajodo.2019.06.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to evaluate the effects of 3 different fixed or removable functional appliances on the soft tissue changes in patients with Class II Division 1 malocclusion using 3-dimensional images. METHODS A total of 60 patients with Class II Division 1 malocclusion (38 girls and 22 boys; mean age, 12.35 ± 1.01 years) were treated with 3 different functional appliances, namely, Twin-block (TB) (group TB, n = 20), mono-block (MB) (group MB, n = 20), or Herbst (H) (group H, n = 20) for 9.55 ± 1.46 months. Three-dimensional photographs of each patient were taken at the baseline and the end of the therapy with a 3dMD Face system (3dMD, Atlanta, Ga). Statistical analyses were performed using the dependent samples t test, 1-way analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed rank tests. RESULTS No statistically significant differences were detected for soft tissue changes except for the lower facial width found, at least in group H (P <0.05). Volumetric differences in the mandible were similar between the groups (P >0.05). A statistically significant decrease in total facial height and an increase in convexity angle and facial depth were detected in all groups after treatment compared with the baseline (P <0.05). The upper and lower facial height, lower lip height, and nasal width were statistically significantly increased in the TB and MB groups after treatment compared with the baseline (P <0.05) and similar to those in group H (P >0.05). CONCLUSIONS TB, MB, and H appliances may promote the facial soft tissue profile, including volumetric improvement, in the mandibular region.
Collapse
Affiliation(s)
- Özge Çelik Güler
- Department of Orthodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | | |
Collapse
|
11
|
Lee SH, Koh SD, Chung DH, Lee JW, Lee SM. Comparison of skeletal anchorage and tooth-borne maxillary protraction followed by fixed appliance in Class III malocclusion. Eur J Orthod 2019; 42:193-199. [DOI: 10.1093/ejo/cjz086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Summary
Objectives
The purpose of this study was to compare the results of skeletal anchorage (SAMP) and tooth- borne (TBMP) maxillary protraction followed by fixed appliance in growing skeletal Class III patients.
Materials and methods
Patients treated with maxillary protraction were selected and classified into two groups (SAMP: n = 19, mean age = 11.19 years; TBMP: n = 27, mean age = 11.21 years). Lateral cephalograms taken before treatment (T0), after the maxillary protraction (T1), and after the fixed appliance treatment (T2) were analysed and all variables were statistically tested to find difference between the two groups.
Results
Compared to the TBMP, the SAMP showed significant forward growth of maxilla (Co-A point and SN-Orbitale) and improvement in intermaxillary relationship (ANB, AB to mandible plane, and APDI) after the overall treatment (T0–T2), with no significant sagittal changes in maxilla or mandible throughout the fixed appliance treatment (T1–T2).
Limitations
In maxillary protraction, effects of skeletal anchorage were retrospectively compared with those of dental anchorage, not with Class I or III control.
Conclusions and implications
After maxillary protraction, skeletal and tooth-borne anchorage did not cause significant differences in the residual growth of maxilla throughout the phase II treatment. Orthopaedic effects with skeletal anchorage showed appropriate stability in maxilla and intermaxillary relationship even after fixed appliance treatment.
Collapse
Affiliation(s)
- Sang-Hoon Lee
- Department of Orthodontics, College of Dentistry, Dankook University, Cheonan, Chungnam, South Korea
| | | | - Dong-Hwa Chung
- Department of Orthodontics, College of Dentistry, Dankook University, Cheonan, Chungnam, South Korea
| | - Jin-Woo Lee
- Department of Orthodontics, College of Dentistry, Dankook University, Cheonan, Chungnam, South Korea
| | - Sang-Min Lee
- Department of Orthodontics, College of Dentistry, Dankook University, Cheonan, Chungnam, South Korea
| |
Collapse
|
12
|
Elnagar MH, Aronovich S, Kusnoto B. Digital Workflow for Combined Orthodontics and Orthognathic Surgery. Oral Maxillofac Surg Clin North Am 2019; 32:1-14. [PMID: 31699582 DOI: 10.1016/j.coms.2019.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article provides an overview of the digital workflow process for Combined orthodontics and Orthognathic surgery treatment starting from data acquisition (3-dimensional scanning, cone-beam computed tomography), data preparation, processing and Creation of a three-dimensional virtual augmented model of the head. Establishing a Proper Diagnosis and Quantification of the Dentofacial Deformity using 3D diagnostic model. Furthermore, performance of 3-dimensional Virtual orthognathic surgical treatment, and the construction of a surgical splint (via 3-dimensional printing) to allow transfer of the treatment plan to the actual patient during surgery.
Collapse
Affiliation(s)
- Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, 801 South Paulina Street, Room 131, Chicago, IL 60612-7211, USA.
| | - Sharon Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA
| | - Budi Kusnoto
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, 801 South Paulina Street, Room 131, Chicago, IL 60612-7211, USA
| |
Collapse
|
13
|
Abstract
As orthodontic treatment has advanced in complexity and in frequency, more recent techniques, using temporary skeletal anchorage, were developed to help correct more severe occlusal and dentofacial discrepancies that were treated with orthognathic surgery alone previously. These techniques have allowed the orthodontist to move teeth against a rigid fixation, allowing for more focused movements of teeth and for orthopedic growth modification. These types of treatments using rigid fixation have allowed for greater interaction between the orthodontist and the oral and maxillofacial surgeon, and have vastly enhanced the treatment planning for the orthodontist in today's society.
Collapse
Affiliation(s)
- Jason P Jones
- Department of Oral and Maxillofacial Surgery, UT Health San Antonio, 8210 Floyd Curl Drive, MC 8124, San Antonio, TX 78229, USA
| | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, 801 South Paulina Street, Room 131, M/C 841, Chicago, IL 60612-7211, USA.
| | - Daniel E Perez
- Department of Oral and Maxillofacial Surgery, UT Health San Antonio, 8210 Floyd Curl Drive, MC 8124, San Antonio, TX 78229, USA.
| |
Collapse
|
14
|
de Souza RA, Rino Neto J, de Paiva JB. Maxillary protraction with rapid maxillary expansion and facemask versus skeletal anchorage with mini-implants in class III patients: a non-randomized clinical trial. Prog Orthod 2019; 20:35. [PMID: 31475309 PMCID: PMC6717741 DOI: 10.1186/s40510-019-0288-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023] Open
Abstract
Background The use of skeletal anchorage devices for maxillary protraction in patients with class III malocclusion due to deficiency in the middle third of the face has been shown to be a promising approach to treatment of these patients. The aim of this study was to evaluate the treatment of class III patients with maxillary retrusion, using orthodontic mini-implants (MI) associated with intermaxillary elastics in comparison with the rapid maxillary expansion and facemask protocol (RME/FM). Methods In this prospective non-randomized clinical trial, the sample of 24 participants between 7 and 12 years of age (median age of 10.0 years and interquartile range = 3.0 years), at the stage prior to the pre-pubertal growth spurt, was divided in two groups. In group facemask (FM) (n = 12), the individuals received orthopedic treatment with RME/FM. In group MI (n = 12), two mini-implants were inserted in the region close to the maxillary first molar roots, and the other two in the region of the mandibular canines. Initial and final lateral teleradiographs were taken for cephalometric evaluation of all the cases. Statistical analysis included the Mann-Whitney, Wilcoxon, and Fisher’s exact tests. The level of significance was 5% (α = 0.05). Results Improvement was verified in the facial profile and occlusion of the participants, showing advancement of the maxilla in the two groups, with significant differences (P ≤ 0.05) between T0 and T1 in the following measurements: SNA, ANB, Wits, Co-A, Co-Gn, NAP, A-Npog, overjet, and molar relationship. There was no statistically significant intergroup difference (P > 0.05) in the cephalometric measurements evaluated, but the time of treatment was significant, and was faster for group MI. Conclusions The protocol with mini-implants may be an option for the correction of Class III due to maxillary deficiency.
Collapse
Affiliation(s)
- Ricardo Alves de Souza
- School of Dentistry, University of São Paulo, São Paulo, Brazil. .,Southwest Bahia State University, Jequié, Bahia, Brazil.
| | - José Rino Neto
- School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Orthodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Butantã, São Paulo, SP, 05508900, Brazil
| | - João Batista de Paiva
- School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Orthodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, Butantã, São Paulo, SP, 05508900, Brazil
| |
Collapse
|
15
|
Abstract
Three-dimensional (3D) imaging has advanced greatly and is used extensively in orthodontics. It is worth outlining and reviewing the developments of reverse engineering (RE) as its applications are growing more widespread and diverse. Data from an existing object are used to create a digital model. A traditional RE process is usually performed in these stages: (1) obtaining data, (2) restructuring the surfaces, and (3) creating a useful model. They are classified as (1) laser projection based and (2) fringe projection based. This digital technology has been used in creating 3D model scanning, 3D digital model superimposition, diagnostic setup, volumetric assessment of tooth wear, soft tissue facial analysis, incorporation of digital model to 3D facial image, lip position and smile reproducibility, analysis of tooth position after orthodontic treatment, and anthropometric measurements. This system has proven itself to have a varied probability of applications and researches in the field of orthodontics. Similar to every single system, even RE has its own benefits and shortcomings. The complexity of the process and high cost are the major disadvantages reported so far. Rapid advancement of this technology possibly will rapidly inverse the negative results that emerged previously. As a future work, innovative use of RE technology is necessary to make this system triumph in the field of orthodontics.
Collapse
|
16
|
Lo LJ, Weng JL, Ho CT, Lin HH. Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism. PLoS One 2018; 13:e0200589. [PMID: 30067766 PMCID: PMC6070212 DOI: 10.1371/journal.pone.0200589] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/01/2018] [Indexed: 01/27/2023] Open
Abstract
Both deep understanding and reliable prediction of postoperative soft tissue changes are crucial for planning orthognathic surgery. Instead of estimating soft tissue responses by measuring individual landmark changes, this study aimed to investigate the relationship (ratio) between soft and hard tissue movements in different facial regions through three-dimensional cone-beam computed tomography (CBCT). Preoperative and postoperative CBCT images were superimposed using the surface registration method on the basis of the cranial base, and 10 facial regions of interest were defined. Region-based volumetric subtractions between the preoperative and postoperative segments were performed. The volumetric differences and surface of each region were used to estimate the average movement. Correlation and regression analyses were performed to examine the relationships between the corresponding soft and hard tissue movements. An overall pattern of facial soft tissue movement was observed in patients with prognathism who underwent orthognathic surgery. The experiment results have shown that mean ratios for the average soft-to-hard tissue movements in the facial regions varied, which may not exactly be similar to the published reports because of the population biocharacteristics and study methods, but the trend is in agreement with the previous studies. Additionally, the prediction capability of the regression model was significantly high, ranging from 0.786 to 0.857, in upper lip, upper vermilion, and chin regions, thus demonstrating that the skin outline changes in these critical regions could be reliably predicted from the underlying bone movements. These results could likely be applied in future soft tissue simulation in orthognathic surgery.
Collapse
Affiliation(s)
- Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery, and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Jing-Ling Weng
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Ting Ho
- Department of Craniofacial Orthodontics, Department of Dentistry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsiu-Hsia Lin
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
| |
Collapse
|