1
|
Tseng YC, Wu TY, Lu CY, Chou ST, Lin SH, Chen CM. Investigating the postoperative soft tissue changes in different vertical facial divergent patients with mandibular prognathism. J Dent Sci 2024; 19:1443-1451. [PMID: 39035289 PMCID: PMC11259686 DOI: 10.1016/j.jds.2024.03.024] [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: 03/01/2024] [Revised: 03/27/2024] [Indexed: 07/23/2024] Open
Abstract
Background/purpose The extent of three-dimensional soft tissue changes in patients with varied facial skeletal patterns following mandibular setback surgery remains unclear. In this study, we aimed to investigate the postoperative changes in soft tissue chin thickness among mandibular prognathism patients, focusing on those presenting different divergence patterns, such as hyperdivergent and normodivergent patients. Materials and methods Cone-beam computed tomography images were obtained from 56 skeletal Class III patients who underwent only mandibular setback. Based on vertical craniofacial skeletal relationship, patients were divided into normodivergent group (27°37°) group. The three-dimensional displacements of Infradentale (Id), B point (B), and Pogonion (Pog), the soft tissue thickness of Id-Li (Labrale inferius), B-B' (soft tissue B point), and Pog-Pog' (soft tissue Pog point) were measured. Factors influencing the change in soft tissue thickness were investigated. Results Preoperative B-B' and Pog-Pog' thickness were significantly thinner in the hyperdivergent group than normodivergent group. Postoperative changes in B-B' and Pog-Pog' thickness were significantly larger in the hyperdivergent group than normodivergent group. A significant correlation was found between soft tissue thickness change (B-B' and Pog-Pog') and the preoperative soft tissue thickness and superior movement (B and Pog). Conclusion Hyperdivergent patients with skeletal class III have thinner preoperative soft tissue thickness (B-B' and Pog-Pog') than normodivergent patients in the preoperation. Postoperative changes in B-B' and Pog-Pog' thickness were significantly larger in the hyperdivergent group than normodivergent group. Postoperative superior movement of B and Pog correlated with postoperative change of soft tissue thickness.
Collapse
Affiliation(s)
- Yu-Chuan Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Orthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ting-Yu Wu
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Yu Lu
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Orthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Szu-Ting Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Orthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Hsuan Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Orthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
2
|
Alhazmi N, Alrasheed F, Alshayea K, Almubarak T, Alzeer B, Alorf MS, Alshanqiti A, Albalawi M. Facial Soft Tissue Characteristics Among Sagittal and Vertical Skeletal Patterns: A Cone-Beam Computed Tomography Study. Cureus 2023; 15:e44428. [PMID: 37791214 PMCID: PMC10543933 DOI: 10.7759/cureus.44428] [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] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
Background Facial esthetics depend on the skeletal and dental structures underlying variable facial soft tissue thickness. In this social context, determining the relationship between external soft tissue and underlying skeletal and dental hard tissue is essential for detailed orthodontic diagnosis and treatment planning. Objective This study aims to measure facial soft tissue thickness in different sagittal and vertical skeletal patterns. Methodology This is an observational study utilizing pre-existing cone-beam computed tomography (CBCT) images of 170 subjects (110 females and 60 males) with a mean age group of 37.45 ± 13.83 years. CBCT images were then classified sagittally based on the point A-Nasion-point B (ANB) angle from Steiner's analysis into skeletal Class I, Class II, and Class III. Furthermore, vertical patterns were grouped based on the Frankfort-mandibular plane angle (FMA) from Tweed's analysis into hyperdivergent, hypodivergent, and normodivergent facial types. One-way ANOVA was used to compare the means of facial soft tissue thickness between the skeletal groups, followed by Tukey's post-hoc test for individual comparison. Multinomial logistic regression analysis was used to test the association between gender, age, and skeletal groups. The significance level was 0.05. Results One-way ANOVA revealed statistically significant differences in both sagittal and vertical groups (p≤0.05). Tukey's post hoc analysis showed that the skeletal Class III group has increased soft tissue thickness in the subnasale, upper lip, and mention compared to Class I and Class II subjects. Moreover, the hypodivergent group demonstrated increased soft tissue thickness in gnathion and mentioned landmarks in relation to the other groups. Multinomial logistic regression analysis showed significant differences between groups according to both gender and sagittal skeleton patterns (p≤0.05), with males less likely to be in Class II. Conclusions Skeletal Class III and hypodivergent groups have thicker soft tissue in specific facial landmarks. Sexual dimorphism was marked in soft tissue measurements.
Collapse
Affiliation(s)
- Nora Alhazmi
- Preventive Dental Science, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research and Development, King Abdullah International Medical Research Center, Riyadh, SAU
- Dental Hospital, Ministry of National Guard for Health Affairs, Riyadh, SAU
| | - Faris Alrasheed
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research and Development, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Khalid Alshayea
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research and Development, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Talal Almubarak
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research and Development, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Bandir Alzeer
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research and Development, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Meshal S Alorf
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research and Development, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Abdulaziz Alshanqiti
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research and Development, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Maram Albalawi
- Biostatistics, King Abdullah International Medical Research Center, Riyadh, SAU
| |
Collapse
|
3
|
Nourmohammadi MJ, Ahmadi SAY, Rezaian J. Structural equation modelling to estimate facial soft tissue thickness parameters based on ethnicity, gender and body mass index: a secondary study on an Iranian dataset. Surg Radiol Anat 2023; 45:739-746. [PMID: 37087723 DOI: 10.1007/s00276-023-03147-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/24/2023]
Abstract
PURPOSE According to the anthropological importance of soft facial tissue thickness parameters, we aimed to find the association of these parameters with Lur and Arab ethnicities, gender and body mass index (BMI). Structural equation modeling (SEM) was used. METHODS As a secondary analysis, SEM was performed on a dataset of 100 participants. The participants were from Lur and Arab populations of Ahvaz province, Iran, from those who referred for magnetic resonance imaging (MRI) due to headache. RESULTS Multivariate regression illustrated that mental eminence (ME), chain-lip fold (CLF) and end of nasals (END) could not be predicted by the independent variables (p > 0.05). Right masseteric region (RMST) had the maximum predictability with R2 = 0.365, followed by middle philtrum (MID) with R2 = 0.358 (p < 0.001). With respect to our criterion to enter SEM, i.e. existing at least two significant covariates at significance level of 0.05, among staying parameters, only parameters of nasion (NA), MID, superior lip (SL), RMST and left masseteric region (LMST) remained. Among these cases, MID was the only parameter that its three covariates illustrated significant association. CONCLUSION MID parameter can be predicted by gender, BMI and Arab ethnicity. By carrying out such studies and creating database, such information can be used in plastic surgery, corpse identification, and facial reconstruction software in archeology.
Collapse
Affiliation(s)
| | - Seyyed Amir Yasin Ahmadi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Rezaian
- Research Office for the History of Persian Medicine, Department of Anatomical Sciences, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
| |
Collapse
|
4
|
Prado GM, Fontenele RC, Costa ED, Freitas DQ, Oliveira ML. Morphological and topographic evaluation of the mandibular canal and its relationship with the facial profile, skeletal class, and sex. Oral Maxillofac Surg 2023; 27:17-23. [PMID: 35304654 DOI: 10.1007/s10006-022-01058-x] [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: 03/07/2021] [Accepted: 03/13/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to evaluate the morphology and topography of the mandibular canal in patients with different facial profiles, skeletal classes, and sexes. METHODS Cone-beam computed tomography volumes of 103 patients were classified according to facial profile and skeletal class. Two examiners classified the mandibular canal into a linear, spoon-shaped, elliptical arc, or turning curvature and measured four related linear distances. The most frequent mandibular canal curvature was identified and multi-way ANOVA with Tukey's test compared the linear measurements between facial types, skeletal class, and sexes (α = 0.05). Kappa and intraclass correlation coefficients were used to assess the reproducibility of qualitative and quantitative variables, respectively. RESULTS The examiners showed excellent reproducibility. The four curvatures of the mandibular canal were found, but the spoon-shaped and elliptical arch were the most frequent. No significant differences were observed for most of the linear measurements between the different facial profiles, skeletal classes, and sexes (p > 0.05). CONCLUSION Spoon-shaped and elliptical arch are the most frequent curvatures of the mandibular canal; furthermore, its morphology and topography seem to be little influenced by the facial profile, skeletal class, and sex.
Collapse
Affiliation(s)
- Gustavo Moraes Prado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil
| | - Rocharles Cavalcante Fontenele
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil
| | - Eliana Dantas Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil.,Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Cafe Ave, Ribeirao Preto, SP, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil.
| |
Collapse
|
5
|
Hona TWPT, Stephan CN. Cephalometric landmark standards and recent trends in craniofacial identification (2018-22): Avoiding imposters by describing variant landmarks as supplemental. FORENSIC IMAGING 2022. [DOI: 10.1016/j.fri.2022.200525] [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]
|
6
|
Can Botulinum Toxin-A Contribute to Reconstructing the Physiological Homeostasis of the Masticatory Complex in Short-Faced Patients during Occlusal Therapy? A Prospective Pilot Study. Toxins (Basel) 2022; 14:toxins14060374. [PMID: 35737035 PMCID: PMC9227267 DOI: 10.3390/toxins14060374] [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: 04/25/2022] [Revised: 05/15/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023] Open
Abstract
The physiological homeostasis of the masticatory complex in short-faced patients is too robust to be disintegrated and reconstructed due to the powerful masseter muscle. This study innovatively introduced the botulinum toxin-A (BTX-A) into the field of dental occlusal treatment, providing a novel and minimally invasive therapy perspective for the two major clinical problems in these patients (low treatment efficiency and high rates of complications). In total, 10 adult patients with skeletal low angle seeking occlusal treatment (age: 27.0 ± 6.1 years; 4 males and 6 females) were administered 30−50 U of BTX-A in each masseter muscle and evaluated before and 3 months after injection based on cone-beam computed tomography (CBCT). We found a significant reduction in the thickness of the masseter muscle (MMT) (p < 0.0001). With regards to occlusion, we found a significant increase in the height of the maxillary second molar (U7-PP) (p < 0.05) with significantly flattened occlusal curves (the curve of Spee [COS] (p < 0.01), and the curve of Wilson [COW] (p < 0.05)). Furthermore, the variations in the temporomandibular joint exhibited a significant reduction in the anterior joint space (AJS) (p < 0.05) and superior joint space (SJS) (p < 0.05). In addition, the correlation analysis of the masticatory complex provided the basis for the following multiple regression equation: MMT = 10.08 − 0.11 COW + 2.73 AJS. The findings from our pilot study indicate that BTX-A, as a new adjuvant treatment attempt of occlusal therapy for short-faced patients, can provide a more favorable muscular environment for subsequent occlusal therapy through the adjustment of the biting force and may contribute to the reconstruction of healthier homeostasis of the masticatory complex. However, further research is required to establish the reliability and validity of these findings.
Collapse
|
7
|
Niño-Sandoval TC, Vasconcelos BC. Biotypic classification of facial profiles using discrete cosine transforms on lateral radiographs. Arch Oral Biol 2021; 131:105249. [PMID: 34543809 DOI: 10.1016/j.archoralbio.2021.105249] [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: 03/15/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of the study was to use discrete cosine transforms to graph soft tissue curves in lateral cephalometric radiographs and, with the obtained mathematical values, to group these curves by both traditional biotypes and cluster systems, in order to evaluate discriminatory capacity in terms of accuracy. DESIGN A sample of 625 lateral radiographs of adult patients (319 women and 306 men) was classified by facial biotype based on the ANB angle and mandibular plane angle. The curves of the facial profile were digitized with 50 equidistant points and discrete cosine transform was applied to analyze these curves mathematically for the determination of the accuracy of the classification of traditional biotypes. Phylogram cluster analysis was then performed for hierarchical grouping and accuracy was determined through cross-validation. RESULTS Grouping by biotype was performed for men and women separately. Although significant, accuracy did not surpass 71.4%. In the groups by clusters, significant results were achieved when performing four analyses for men and two for women. The best accuracy regarding classification power and qualitative distinction was 89.5% for men and 94% for women. CONCLUSIONS Discrete cosine transforms using a cluster system had greater discriminatory capacity in terms of accuracy compared to traditional grouping considering the ANB angle and mandibular plane angle. This exploration can be useful for the creation of a soft-tissue facial reconstruction software for the Latin American population.
Collapse
Affiliation(s)
- Tania Camila Niño-Sandoval
- University of Pernambuco - Santo Amaro Campus, Biological Sciences Institute, Specialization Course in Forensic Expertise, Recife, PE 50100-130, Brazil; University of Pernambuco, Pernambuco Dental School, Oswaldo Cruz University Hospital, Department of Oral and Maxillofacial Surgery and Traumatology, Recife, PE 50100-130, Brazil
| | - Belmiro C Vasconcelos
- University of Pernambuco, Pernambuco Dental School, Oswaldo Cruz University Hospital, Department of Oral and Maxillofacial Surgery and Traumatology, Recife, PE 50100-130, Brazil.
| |
Collapse
|
8
|
Midsagittal and bilateral facial soft tissue thickness: A cone-beam computed tomography assessment of Brazilian living adults. FORENSIC IMAGING 2021. [DOI: 10.1016/j.fri.2021.200444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|