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Ajmera DH, Singh P, Leung YY, Khambay BS, Gu M. Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry: a systematic review : Establishment of the mid-sagittal reference plane: a systematic review. Clin Oral Investig 2024; 28:242. [PMID: 38575839 PMCID: PMC10995046 DOI: 10.1007/s00784-024-05620-7] [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: 05/09/2022] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To systematically review the literature for mid-sagittal plane establishment approaches to identify the most effective method for constructing the mid-sagittal plane for the evaluation of facial asymmetry. MATERIALS AND METHODS Six electronic databases (PubMed, Medline (via Ovid), EMBASE (via Ovid), Cochrane Library, Web of Science, and Scopus) and grey literature were searched for the studies that computed the mid-sagittal reference plane three-dimensionally, using a combination of MeSH terms and keywords. The methodological quality and the level of evidence for the included studies were analyzed using QUADAS-2 and GRADE, respectively. RESULTS The preliminary search yielded 6746 records, of which 42 articles that met the predefined inclusion criteria were included in the final analysis. All the included articles reported the construction of the mid-sagittal reference plane (MSP) using varied methods. The risk of bias and concerns regarding the applicability of the included studies were judged to be 'low'. The level of evidence was determined to be 'low' for the effectiveness of the technique and 'moderate' for the ease of clinical applicability. CONCLUSION Despite methodological heterogeneity, this review substantiates the comparable efficacy of cephalometric and morphometric MSP construction methods. A fully automated morphometric MSP holds promise as a viable option for routine clinical use. Nevertheless, future prospective studies with an emphasis on the impact, accuracy, and clinical applicability of MSP construction techniques in cases of facial asymmetry are required. CLINICAL RELEVANCE The present review will assist clinicians in selecting the most suitable method for MSP construction, leading to improved treatment planning and ultimately more favorable treatment outcomes.
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Affiliation(s)
- Deepal Haresh Ajmera
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Pradeep Singh
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yiu Yan Leung
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Balvinder S Khambay
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
- Orthodontics Department, School of Dentistry, University of Birmingham, Birmingham, UK.
- Discipline of Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
| | - Min Gu
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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Ortún-Terrazas J, Cegoñino J, Pérez Del Palomar A. In silico approach towards neuro-occlusal rehabilitation for the early correction of asymmetrical development in a unilateral crossbite patient. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3688. [PMID: 36726272 DOI: 10.1002/cnm.3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/09/2023] [Accepted: 01/29/2023] [Indexed: 05/13/2023]
Abstract
Neuro-occlusal rehabilitation (N.O.R.) is a discipline of the stomatognathic medicine that defends early treatments of functional malocclusions, such as unilateral crossbite, for the correction of craniofacial development, avoiding surgical procedures later in life. Nevertheless, N.O.R.'s advances have not been proved analytically yet due to the difficulties of evaluate the mechanical response after the treatment. This study aims to evaluate computationally the effect of N.O.R.'s treatments during childhood. Therefore, bilateral chewing and maximum intercuspation occlusion were modelled through a detailed finite element model of a paediatric craniofacial complex, before and after different selective grinding-alternatives. This model was subjected to the muscular forces derived from a musculoskeletal model and was validated by the occlusal contacts recorded experimentally. This approach yielded errors below 2% and reproduced successfully the occlusal, muscular, functional and mechanical imbalance before the therapies. Treatment strategies balanced the occlusal plane and reduced the periodontal overpressure (>4.7 kPa) and the mandibular over deformation (>0.002 ε) on the crossed side. Based on the principles of the mechanostat theory of bone remodelling and the pressure-tension theory of tooth movement, these findings could also demonstrate how N.O.R.'s treatments correct the malocclusion and the asymmetrical development of the craniofacial complex. Besides, N.O.R.'s treatments slightly modified the stress state and functions of the temporomandibular joints, facilitating the chewing by the unaccustomed side. These findings provide important biomechanical insights into the use of N.O.R.'s treatments for the correction of unilateral crossbite, but also encourage the application of computing methods in biomedical research and clinical practise.
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Affiliation(s)
- Javier Ortún-Terrazas
- Escuela Superior de Ingeniería y Tecnología (ESIT), Universidad Internacional de La Rioja (UNIR), Logroño, La Rioja, Spain
- Instituto Tecnológico de Aragón (ITAINNOVA), Zaragoza, Zaragoza, Spain
| | - José Cegoñino
- Instituto Tecnológico de Aragón (ITAINNOVA), Zaragoza, Zaragoza, Spain
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Mangal U, Lee SM, Lee S, Cha JY, Lee KJ, Yu HS, Jung H, Choi SH. Reorientation methodology for reproducible head posture in serial cone beam computed tomography images. Sci Rep 2023; 13:3220. [PMID: 36828940 PMCID: PMC9958024 DOI: 10.1038/s41598-023-30430-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/22/2023] [Indexed: 02/26/2023] Open
Abstract
Low dose and accessibility have increased the application of cone beam computed tomography (CBCT). Often serial images are captured for patients to diagnose and plan treatment in the craniofacial region. However, CBCT images are highly variable and lack harmonious reproduction, especially in the head's orientation. Though user-defined orientation methods have been suggested, the reproducibility remains controversial. Here, we propose a landmark-free reorientation methodology based on principal component analysis (PCA) for harmonious orientation of serially captured CBCTs. We analyzed three serial CBCT scans collected for 29 individuals who underwent orthognathic surgery. We first defined a region of interest with the proposed protocol by combining 2D rendering and 3D convex hull method, and identified an intermediary arrangement point. PCA identified the y-axis (anterioposterior) followed by the secondary x-axis (transverse). Finally, by defining the perpendicular z-axis, a new global orientation was assigned. The goodness of alignment (Hausdorff distance) showed a marked improvement (> 50%). Furthermore, we clustered cases based on clinical asymmetry and validated that the protocol was unaffected by the severity of the skeletal deformity. Therefore, it could be suggested that integrating the proposed algorithm as the preliminary step in CBCT evaluation will address a fundamental step towards harmonizing the craniofacial imaging records.
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Affiliation(s)
- Utkarsh Mangal
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | | | - Seeyoon Lee
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | - Jung-Yul Cha
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | - Kee-Joon Lee
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | - Hyung-Seog Yu
- grid.15444.300000 0004 0470 5454Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | | | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, 03722, Korea.
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Condylar Asymmetry in Children with Unilateral Posterior Crossbite Malocclusion: A Comparative Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111772. [PMID: 36421221 PMCID: PMC9688623 DOI: 10.3390/children9111772] [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: 10/15/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
Unilateral posterior crossbite (UXB) is a common, severely asymmetric malocclusion, characterized by maxillary hypoplasia and masticatory dysfunction. The aim of this research is to evaluate the asymmetry of mandibular condyles and rami in children with UXB. This comparative cross-sectional study included 33 children with UXB (girls = 15, boys = 18; mean age ± SD = 8.0 ± 1.3 years.months]) and 33 age- and gender-matched controls (girls = 15, boys = 18; mean age ± SD = 8.4 ± 1.3 years.months]). Pre-treatment OPGs were analyzed by comparing the height of condyles and rami between the sides using the method by Habets et al. (1988); the result was considered significant if the degree of asymmetry was >6%. Children with UXB showed a significantly increased asymmetry of mandibular condyles (mean ± SD = 10.7% ± 9, p < 0.001), but not of rami (mean ± SD = 1.9% ± 2.3), compared to controls. The rami did not show significant asymmetry in either group. The presence of an increased condylar asymmetry index in a developing patient with unilateral posterior crossbite is a sign of altered skeletal growth and should be considered in the diagnostic process and treatment plan.
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Li Z, Li W, Yan W, Zhang R, Xie S. Data-driven learning to identify biomarkers in bipolar disorder. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107112. [PMID: 36156436 DOI: 10.1016/j.cmpb.2022.107112] [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: 04/16/2021] [Revised: 06/09/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Bipolar disorder (BD) is one of the primary causes of disability globally and can be easily misdiagnosed as schizophrenia or major depression due to their similar symptoms. Hence, it is of great significance to explore the pathogenesis of BD. Statistical analysis is currently the most common method for exploring the neuropathological mechanisms of psychiatric disorders. However, this method only considers the relationship between groups and does not reflect the individual-level diagnosis. Therefore, we developed machine learning algorithms to measure pathological brain changes in psychiatric disorders. METHODS An autoencoder and a feature selection method are proposed to identify the abnormal structural patterns of BD in this study. The autoencoder was constructed using structural imaging data from 1113 healthy controls, which aims to define the normal range of anatomical deviations to distinguish healthy individuals from BD patients. The biomarkers of BD were identified by the reconstruction errors in each brain region. The proposed feature selection (FS)-select framework aimed to determine the optimal FS method and identify the most reproducible feature associated with BD. RESULTS We found that the left orbital region of the middle frontal gyrus had the greatest difference between healthy controls and BD patients using a trained autoencoder. The most reproducible feature was the left orbital region of the middle frontal gyrus by FS-select framework when using the different cross-validation strategies. CONCLUSIONS A consistent result was obtained from the above two proposed methods wherein a significant difference between healthy controls and BD patients was identified in the left orbital region of the middle frontal gyrus.
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Affiliation(s)
- Zhuangzhuang Li
- College of Telecommunication and Information Engineering, Nanjing University of Posts and Telecommunications, Nanjing 210023, China
| | - Wenmei Li
- School of Geographic and Biologic Information, Nanjing University of Posts and Telecommunications, Nanjing 210023, China.
| | - Wei Yan
- Department of Psychiatry affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
| | - Rongrong Zhang
- Department of Psychiatry affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Shiping Xie
- Department of Psychiatry affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China
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Xu L, Xiong Y, Guo J, Tang W, Wong KKL, Yi Z. An intelligent system for craniomaxillofacial defecting reconstruction. INT J INTELL SYST 2022. [DOI: 10.1002/int.23006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Lei Xu
- Machine Intelligence Laboratory, College of Computer Science Sichuan University People's Republic of China
| | - Yutao Xiong
- Department of Oral and Maxillofacial Surgery, West China College of Stomatology Sichuan University Chengdu People's Republic of China
| | - Jixiang Guo
- Machine Intelligence Laboratory, College of Computer Science Sichuan University People's Republic of China
| | - Wei Tang
- Department of Oral and Maxillofacial Surgery, West China College of Stomatology Sichuan University Chengdu People's Republic of China
| | - Kelvin K. L. Wong
- The University of Adelaide Adelaide Australia
- School of Computer Science and Engineering Central South University Changsha People's Republic of China
| | - Zhang Yi
- Machine Intelligence Laboratory, College of Computer Science Sichuan University People's Republic of China
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Ortún-Terrazas J, Fagan MJ, Cegoñino J, Illipronti-Filho E, Del Palomar AP. Biomechanical evaluation of the unilateral crossbite on the asymmetrical development of the craniofacial complex. A mechano-morphological approach. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 217:106703. [PMID: 35217305 DOI: 10.1016/j.cmpb.2022.106703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/27/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE The occlusion effect on the craniofacial development is a controversial topic that has attracted the interest of many researchers but that remains unclear, mainly due to the difficulties on measure its mechanical response experimentally. This mechano-morphological relationship of the craniofacial growth is often explained by the periosteal and capsular matrices of the functional matrix hypothesis (FMH); however, its outcomes have not been analytically demonstrated yet. This computational study aims, therefore, to analytically demonstrate the mechano-morphological relationship in the craniofacial development of children with unilateral crossbite (UXB) using the finite element (FE) method. METHODS The craniofacial complex asymmetry of ten children, five of whom exhibit UXB, was 3D-analysed and compared with the biomechanical response computed from a FE analysis of each patient's occlusion. Due to the complexity of the geometry and the multitude of contacts involved, the inherent limitations of the model were evaluated by comparing computed occlusal patterns with those recorded by an occlusal analysis on 3D printed copies. RESULTS Comparison's outcomes proved the reliability of our models with just a deviation error below 6% between both approaches. Out of validation process, computational results showed that the significant elongation of mandibular branch in the contralateral side could be related to the mandibular shift and increase of thickness on the crossed side, and particularly of the posterior region. These morphological changes could be associated with periodontal overpressure (>4.7 kPa) and mandibular over deformation (0.002 ε) in that side, in agreement with the periosteal matrix's principles. Furthermore, the maxilla's transversal narrowing and the elevation of the maxillary and zygomatic regions on the crossed side were statistically demonstrated and seem to be related with their respective micro displacements at occlusion, as accounted by their specific capsule matrices. Our results were consistent with those reported clinically and demonstrated analytically the mechano-morphological relationship of children's craniofacial development based on the FMH's functional matrices. CONCLUSIONS This study is a first step in the understanding of the occlusion's effect on the craniofacial development by computational methods. Our approach could help future engineers, researchers and clinicians to understand better the aetiology of some dental malocclusions and functional disorders improve the diagnosis or even predict the craniofacial development.
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Affiliation(s)
- Javier Ortún-Terrazas
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain.
| | - Michael J Fagan
- Medical and Biological Engineering, School of Engineering and Computer Science, University of Hull, Hull, United Kingdom
| | - José Cegoñino
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Edson Illipronti-Filho
- School of Dentistry, Department of Stomatology, University of São Paulo, São Paulo, Brazil
| | - Amaya Pérez Del Palomar
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
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Pinheiro M, Willaert R, Khan A, Krairi A, Van Paepegem W. Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions. Sci Rep 2021; 11:14034. [PMID: 34234245 PMCID: PMC8263622 DOI: 10.1038/s41598-021-93564-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/22/2021] [Indexed: 01/01/2023] Open
Abstract
Temporomandibular joint (TMJ) replacement with an implant is only used when all other conservative treatments fail. Despite the promising short-term results, the long-term implications of TMJ replacement in masticatory function are not fully understood. Previous human and animal studies have shown that perturbations to the normal masticatory function can lead to morphological and functional changes in the craniomaxillofacial system. A clearer understanding of the biomechanical implications of TMJ replacement in masticatory function may help identify design shortcomings that hinder their long-term success. In this study, patient-specific finite element models of the intact and implanted mandible were developed and simulated under four different biting tasks. In addition, the impact of re-attaching of the lateral pterygoid was also evaluated. The biomechanics of both models was compared regarding both mandibular displacements and principal strain patterns. The results show an excessive mediolateral and anteroposterior displacement of the TMJ implant compared to the intact joint in three biting tasks, namely incisor (INC), left moral (LML), and right molar (RML) biting. The main differences in principal strain distributions were found across the entire mandible, most notably from the symphysis to the ramus of the implanted side. Furthermore, the re-attachment of the lateral pterygoid seems to increase joint anteroposterior displacement in both INC, LML and RML biting while reducing it during LGF. Accordingly, any new TMJ implant design must consider stabilising both mediolateral and anteroposterior movement of the condyle during biting activities and promoting a more natural load transmission along the entire mandible.
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Affiliation(s)
- Manuel Pinheiro
- Department of Materials, Textiles and Chemical Engineering, Mechanics of Materials and Structures (MMS), Ghent University, Ghent, Belgium.
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium
| | - Afaq Khan
- Materials Innovation Institute (M2i), Delft, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Anouar Krairi
- Materials Innovation Institute (M2i), Delft, The Netherlands
| | - Wim Van Paepegem
- Department of Materials, Textiles and Chemical Engineering, Mechanics of Materials and Structures (MMS), Ghent University, Ghent, Belgium
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Ortún-Terrazas J, Cegoñino J, Illipronti-Filho E, Pérez del Palomar A. Analysis of temporomandibular joint dysfunction in paediatric patients with unilateral crossbite using automatically generated finite element models. Comput Methods Biomech Biomed Engin 2020; 23:627-641. [DOI: 10.1080/10255842.2020.1755275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - José Cegoñino
- Department of Mechanical Engineering, University of Zaragoza, Zaragoza, Spain
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