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Lee CKJ, Yong CW, Saigo L, Ren YJ, Chew MT. Virtual surgical planning in orthognathic surgery: a dental hospital's 10-year experience. Oral Maxillofac Surg 2024; 28:729-738. [PMID: 37996564 DOI: 10.1007/s10006-023-01194-y] [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: 08/23/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE The primary objective of this study was to evaluate how the utilization of virtual surgical planning (VSP) and the epidemiological profile of patients undergoing orthognathic surgery (OGS) have changed in the past decade. METHODS The records of patients who had undergone orthognathic surgery at a national dental hospital were reviewed. Trends in VSP, epidemiological data, presentation of dentofacial deformity, and management details were recorded. RESULTS A total of 1184 patients were included in this study. The majority of the patients seeking treatment in this dental hospital were young Chinese adults with dentofacial deformities requiring bimaxillary surgeries. Most patients presented with a skeletal Class III pattern (79.0%), and asymmetry was diagnosed in 80.8% of all cases. CONCLUSION There was an initial slow pick-up rate for VSP, but this rapidly increased to a high adoption rate of 98.7-100% between 2019 and 2021. Together with an increasing body of evidence suggesting greater accuracy in VSP, utilization in this technology can be enhanced with greater familiarity with the technology and improvements in the VSP services.
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Affiliation(s)
- Cheryl Ker Jia Lee
- Level 5 Clinic, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore.
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9712, Groningen, CP, Netherlands.
| | - Chee Weng Yong
- National University of Singapore, Faculty of Dentistry, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Leonardo Saigo
- Level 5 Clinic, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore
| | - Yi Jin Ren
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9712, Groningen, CP, Netherlands
| | - Ming Tak Chew
- Level 5 Clinic, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore
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Lee KC, Park JH, Kim JC, Lee S, Moon D, Lee GH. Digital application of three-dimensional diagnosis and treatment with a virtual articulator. J ESTHET RESTOR DENT 2024; 36:710-722. [PMID: 38131436 DOI: 10.1111/jerd.13185] [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: 09/29/2023] [Revised: 11/03/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The purpose of this article was to introduce a method for the digital application of three-dimensional (3D) diagnosis and treatment with a virtual articulator and 3D data. CLINICAL CONSIDERATION With the use of cone-beam computed tomography (CBCT) and intraoral and facial scans, we can create a virtual articulator and evaluate the mandibular position in maximum intercuspation and centric-related occlusion for the patient with an unstable occlusion and temporomandibular disorders (TMD). Based on this, we treated a case using a digital mandibular position indicator (MPI) and fabricated a stabilization splint using a 3D printer. This approach eliminates the traditional impression or model mounting process and the analog face bow transfer. Furthermore, the design of the stabilization splint is accomplished using software. CONCLUSIONS The approach outlined in this article offers the potential for a digital diagnosis and treatment process by seamlessly integrating CBCT, intraoral scans, and facial scans with a high degree of accuracy. This may enhance precision in diagnosis and treatment planning, especially for patients with complicated TMD, in addition to facilitating effective communication with orthodontic patients who require thorough attention. CLINICAL SIGNIFICANCE Utilizing a virtual articulator and digital MPI for the occlusal evaluation of patients with TMD and unstable occlusion makes it possible to diagnose and analyze the occlusal condition accurately. This approach also allows for precision and efficiency in treatment.
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Affiliation(s)
- Kyungmin Clara Lee
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, USA
- Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jong-Cheol Kim
- Private Practice, Daegu, Korea
- Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Sangmi Lee
- Private Practice, Department of Orthodontics, School of Dentistry, Catholic University, Seoul, Korea
| | - Danal Moon
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
- Private Practice, Gwangju, Korea
| | - Gye-Hyeong Lee
- Department of Orthodontics, School of Dentistry, Chonnam National University, Gwangju, Korea
- Private Practice, Yeosu, Korea
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Strujak G, Marlière DAA, Medeiros YDL, Guariza Filho O, Carlini JL, Westphalen VPD. Virtual Versus Conventional Planning in Orthognathic Surgery: A Systematic Review and Meta-analysis. J Maxillofac Oral Surg 2024; 23:219-228. [PMID: 38601248 PMCID: PMC11001843 DOI: 10.1007/s12663-023-02091-3] [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: 09/05/2022] [Accepted: 12/06/2023] [Indexed: 04/12/2024] Open
Abstract
Objectives The purpose of this study was to compare the accuracy of hard tissues movements planned to result of the maxillary and mandibular positions between conventional surgical planning (CSP) and virtual surgical planning (VSP) in patients undergoing orthognathic surgery. Methods A systematic electronic search was carried out in six databases and gray literature with no restriction of publication date and language. Clinical observational studies that compared accuracy of maxillary position between CSP and VSP were included. Linear measurements of the mandible in the transverse plane and linear measurements of the maxilla in the vertical, horizontal and transverse planes were considered for analysis, comparing planned to postoperative outcomes of CSP and VSP. Cochrane tool was used to assess bias risk. A meta-analysis was performed to summarize similar results by using the Review Manager 5.3 software. Significance level was set at 5%. Results Six studies (2 RCT and 4 retrospective cohorts) were included according to inclusion and eligibility criteria, involving 255 patients. The inter-rater reliability of selection and eligibility was excellent (k = 0.8315 and k = 0.9329, respectively). Two studies presented that VSP seemed to have better results than CSP regarding linear measurements of the mandible in the transverse plane. Results from CSP and VSP were similar in accuracy for hard tissue in vertical plane of maxillary position (I2 = 0%; p = 0.17), although VSP was more accurate in horizontal plane (I2 = 0%; p = 0.02). Conclusion VSP presented better accuracy for transverse movements in mandible of asymmetric patients. VSP showed to be more accurate for movements in the horizontal plane, and qualitative analysis seemed to be more effective for transverse movements.
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Affiliation(s)
- Guilherme Strujak
- Department of Endodontics, School of Life Sciences, Pontifical Catholic University of Parana, Curitiba, Parana, Brazil
| | - Daniel Amaral Alves Marlière
- Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Limeira Avenue, 901, Areião, Piracicaba, São Paulo Brazil
| | | | - Odilon Guariza Filho
- Department of Orthodontics, Pontifical Catholic University of Parana, Curitiba, Parana Brazil
| | - João Luiz Carlini
- Department of Surgery, Federal University of Parana, Curitiba, Parana Brazil
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Altwaijri A. Minimally Invasive Approaches in Orthognathic Surgery: A Narrative Review of Contemporary Techniques and their Clinical Outcomes. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1652-S1656. [PMID: 38882864 PMCID: PMC11174174 DOI: 10.4103/jpbs.jpbs_1226_23] [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: 12/08/2023] [Revised: 01/02/2024] [Accepted: 01/07/2024] [Indexed: 06/18/2024] Open
Abstract
Maxillofacial surgery has evolved significantly, particularly in orthognathic procedures, shifting from invasive methods to minimally invasive techniques (MITs). Innovations, like 3D imaging, computer-aided simulations, piezoelectric surgery, and endoscopic assistance, have revolutionized patient care. These methods notably reduce bleeding, scarring, hospital stays, and recovery time, while enhancing surgical precision and outcomes. Our review focuses on modern MITs, including endoscopically assisted maxillomandibular advancement (EAMMA) and CAD/CAM technology. We conducted a thorough literature search, identifying 21 relevant articles from an initial pool of 423. The review evaluates the efficacy, complication rates, and long-term stability of these techniques, addressing challenges and future prospects. Emphasizing the significance of MI methods in orthognathic surgery, it advocates for further research and clinical adoption.
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Affiliation(s)
- Abdulrahman Altwaijri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Qassim, Saudi Arabia
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Ye H, Ye J, Wang S, Wang Z, Geng J, Wang Y, Liu Y, Sun Y, Zhou Y. Comparison of the accuracy (trueness and precision) of virtual dentofacial patients digitized by three different methods based on 3D facial and dental images. J Prosthet Dent 2024; 131:726-734. [PMID: 35369981 DOI: 10.1016/j.prosdent.2022.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM The accuracy of virtual dentofacial patients has been explored, but the accuracy of virtual patients established by using a straightforward and reliable method and the accuracy of different virtual patients are unclear. PURPOSE The purpose of this clinical study was to compare the accuracy of virtual dentofacial patients digitized by using registered-block impression, exposed anterior teeth, and cone beam computed tomography (CBCT) reconstruction methods based on 3-dimensional (3D) facial and dental images. MATERIAL AND METHODS From the 15 selected participants who needed CBCT scanning, 3 kinds of virtual dentofacial patients were established by using 3 registration methods based on digital dental casts: 3D facial images, CBCT data, and registered-block impression. Compared with actual measurement, 25 linear distances of all virtual dentofacial patients were selected and measured by using a software program, and 3 separate measurements were calculated by the same person. The 1-way analysis of variance (ANOVA) was used to compare the deviations among 3 kinds of virtual dentofacial patients (trueness) and the deviations within groups (precision). The 1-sample t test was used to compare the difference between the deviation and the ideal error of 0.00 (α=.05). RESULTS Compared with the actual measurement, the trueness of the average deviations for registered-block impression (1.02 ±1.24 mm) was better than that of exposed anterior teeth (2.35 ±1.71 mm) and CBCT reconstruction (2.86 ±1.61 mm). The precision of the average deviations for registered-block impression (1.29 ±1.43 mm) was better than that of exposed anterior teeth (2.00 ±1.72 mm) and CBCT reconstruction (2.12 ±1.94 mm). Significant differences in trueness and precision were found among the 3 groups of virtual dentofacial patients (P<.01). Significant differences among the deviations of all linear distances and the ideal error of 0.00 were observed for all groups of virtual dentofacial patients (P<.05). CONCLUSIONS The accuracy of registered-block impression was better than that of the exposed anterior teeth and CBCT reconstruction. The accuracy of exposed anterior teeth was lower than that of the other methods but could satisfy the requirements of clinical diagnostics and scientific methods. The accuracy of CBCT reconstruction was poor and could only be used for special situations that permitted low accuracy.
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Affiliation(s)
- Hongqiang Ye
- Associate Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Jiahui Ye
- Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Shimin Wang
- Dental Technician, Center of dental Laboratory, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Zixuan Wang
- Dental Technician, Center of dental Laboratory, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Jing Geng
- Graduate student, Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yiqing Wang
- Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yunsong Liu
- Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yuchun Sun
- Professor, Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yongsheng Zhou
- Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China.
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De Meurechy NKG, Decoste C, Mommaerts MY. On the use of intraoperative 3D-RX C-arm imaging in orthognathic surgery: a prospective non-consecutive case series study. Oral Maxillofac Surg 2024; 28:101-109. [PMID: 36279049 DOI: 10.1007/s10006-022-01119-1] [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: 06/09/2021] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
CONTEXT Segment and osteosynthesis malposition resulting in patients' complaints (mainly about asymmetries) are encountered in orthofacial/orthognathic surgery. OBJECTIVE, DESIGN, AND SETTING We planned to investigate the usefulness of intraoperative three-dimensional (3D) imaging concerning positioning and fixation of bone segments and osteosynthesis in orthognathic/orthofacial surgery. We performed a prospective study of non-consecutive cases. All patients receiving a bimaxillary osteotomy, genioplasty, and their combinations were included in the study from May 2016 to May 2020. Unilateral and bilateral sagittal split osteotomies were excluded. There were no gender and age limitations. All were intraoperatively examined using the BV Pulsera 3D-RX System (Philips Medical, Eindhoven, The Netherlands). The outcome variables were the percentage of revisions of segment positioning and osteosynthesis. Predictor variables were age, gender, type of surgery, timing (pre- and post-imaging), and surgeon experience (senior vs assistant). RESULTS Forty female and twenty-two male patients were included (mean age 25.25 years ± 7.52 and 29.1 years ± 12.6 respectively). We evaluated 27 genioplasties and 34 Le Fort "type-I" osteotomies. Indications for segment repositioning and redo-osteosynthesis increased after intraoperative imaging as compared to operator's clinical judgment before intraoperative imaging (95% confidence interval; p < .001 and p = .002 respectively). CONCLUSION Suboptimal positioning and fixation of bone segments or osteosynthesis were more apparent with 3D imaging. In addition, some satisfactory cases were also revised for an optimal outcome. As a result, surgeons were prompted to more revisions than judged necessary without intraoperative imaging.
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Affiliation(s)
- Nikolas K G De Meurechy
- European Face Centre, University Hospital Brussels, Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - Christopher Decoste
- European Face Centre, University Hospital Brussels, Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - Maurice Y Mommaerts
- European Face Centre, University Hospital Brussels, Laarbeeklaan 101, B-1090, Brussels, Belgium.
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Du W, Bi W, Liu Y, Zhu Z, Tai Y, Luo E. Machine learning-based decision support system for orthognathic diagnosis and treatment planning. BMC Oral Health 2024; 24:286. [PMID: 38419015 PMCID: PMC10902963 DOI: 10.1186/s12903-024-04063-6] [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: 06/06/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dento-maxillofacial deformities are common problems. Orthodontic-orthognathic surgery is the primary treatment but accurate diagnosis and careful surgical planning are essential for optimum outcomes. This study aimed to establish and verify a machine learning-based decision support system for treatment of dento-maxillofacial malformations. METHODS Patients (n = 574) with dento-maxillofacial deformities undergoing spiral CT during January 2015 to August 2020 were enrolled to train diagnostic models based on five different machine learning algorithms; the diagnostic performances were compared with expert diagnoses. Accuracy, sensitivity, specificity, and area under the curve (AUC) were calculated. The adaptive artificial bee colony algorithm was employed to formulate the orthognathic surgical plan, and subsequently evaluated by maxillofacial surgeons in a cohort of 50 patients. The objective evaluation included the difference in bone position between the artificial intelligence (AI) generated and actual surgical plans for the patient, along with discrepancies in postoperative cephalometric analysis outcomes. RESULTS The binary relevance extreme gradient boosting model performed best, with diagnostic success rates > 90% for six different kinds of dento-maxillofacial deformities; the exception was maxillary overdevelopment (89.27%). AUC was > 0.88 for all diagnostic types. Median score for the surgical plans was 9, and was improved after human-computer interaction. There was no statistically significant difference between the actual and AI- groups. CONCLUSIONS Machine learning algorithms are effective for diagnosis and surgical planning of dento-maxillofacial deformities and help improve diagnostic efficiency, especially in lower medical centers.
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Affiliation(s)
- Wen Du
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenjun Bi
- School of Electric Power Engineering, Nanjing Institute of Technology, Nanjing, China
| | - Yao Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Zhaokun Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yue Tai
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - En Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
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Grillo R, Borba AM, da Silva YS, Brozoski MA, Miloro M, Naclério-Homem MDG. Exploring the relationship between the number of systematic reviews and quality of evidence: an orthognathic surgery-based study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:101-112. [PMID: 38155010 DOI: 10.1016/j.oooo.2023.07.018] [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: 05/02/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE We analyzed the quality and quantity of systematic reviews (SRs) of orthognathic surgery, the most frequently published topic in maxillofacial surgery. STUDY DESIGN We searched the PubMed database for SRs of orthognathic surgery with no restriction on the language of publication date. We assessed the certainty of evidence presented according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and the Leiden Manifesto using the Grading of Recommendations Assessment, Development, and Evaluation approach. We analyzed the data using descriptive statistics, Pearson´s correlation test, and linear regression. RESULTS Of the 171 SRs evaluated, approximately one fifth presented evidence with a high level of certainty. The number of orthognathic surgery SRs has been increasing, and many SRs were published after very similar topics had already been published. There is no relationship between the impact factor and the certainty of evidence. CONCLUSIONS An excessive number of SRs of orthognathic surgery are published, and many SRs are superfluous, simply reporting previous findings. Clinicians should not base treatment decisions solely on the evidence presented in SRs, and journal editors and reviewers should evaluate these SRs more critically, particularly when they address topics that have already been covered in the literature.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis-Faculty of Dentistry of the University of São Paulo, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil.
| | - Alexandre Meireles Borba
- Research Program in Integrated Dental Sciences Department, Faculty of Dentistry of the University of Cuiabá, Cuiabá-MT, Brazil
| | | | - Mariana Aparecida Brozoski
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis-Faculty of Dentistry of the University of São Paulo, Brazil
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Maria da Graça Naclério-Homem
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis-Faculty of Dentistry of the University of São Paulo, Brazil
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Shah JK, Silverstein M, Cevallos P, Johnstone T, Wu R, Nazerali R, Bruckman K. Risk Factors for Hardware Removal Following Bimaxillary Surgery: A National Database Analysis. J Craniofac Surg 2024:00001665-990000000-01284. [PMID: 38231209 DOI: 10.1097/scs.0000000000009929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/06/2023] [Indexed: 01/18/2024] Open
Abstract
Orthognathic surgery typically relies on the rigid fixation of fracture fragments using metal hardware. Though hardware is usually intended to be implanted permanently, the removal of hardware (ROH) is sometimes indicated for a variety of reasons. The authors sought to identify risk factors for ROH following orthognathic surgery. The authors conducted a retrospective analysis of the Merative MarketScan Research Databases, 2007-2021 using Current Procedural Terminology (CPT) and International Classification of Disease (ICD-9 and ICD-10) codes to identify patients who underwent an index Le Fort 1 osteotomy and bilateral sagittal split osteotomy operation on the same day. Statistical analysis involved χ2, Shapiro-Wilk, Wilcoxon-Mann-Whitney, Poisson regression, and multivariable logistic regression tests. 4698 patients met the inclusion criteria. The mean age at surgery was 25 years, and 57% were female. ROH occurred in 5.9% of patients. The mean time to hardware removal was 190.5±172.4 days. In a multivariate logistic regression, increased odds of ROH were associated with older patient age [OR: 1.02 (1.01-1.03), P=0.046], sleep apnea [OR: 1.62 (1.13-2.32), P=0.018], and craniofacial syndrome and/or cleft diagnoses [OR: 1.88 (1.14-2.55), P<0.001]. In the same model, postoperative oral antibiotic prophylaxis was not associated with ROH (P=0.494). The incidence of all-cause complications [IRR: 1.03 (1.01-1.05), P<0.001] rose over the study period, while the incidence of ROH did not change significantly (P=0.281). Patients at elevated risk should be counseled on the increased possibility of a second operation for ROH before having orthognathic surgery to ensure expectations and health care utilization decisions align with the evidence.
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Affiliation(s)
- Jennifer K Shah
- Department of Surgery, Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Max Silverstein
- Department of Surgery, Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA
| | | | | | - Robin Wu
- Department of Surgery, Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA
| | - Rahim Nazerali
- Department of Surgery, Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA
| | - Karl Bruckman
- Department of Surgery, Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA
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Swaity A, Elgarba BM, Morgan N, Ali S, Shujaat S, Borsci E, Chilvarquer I, Jacobs R. Deep learning driven segmentation of maxillary impacted canine on cone beam computed tomography images. Sci Rep 2024; 14:369. [PMID: 38172136 PMCID: PMC10764895 DOI: 10.1038/s41598-023-49613-0] [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: 07/19/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024] Open
Abstract
The process of creating virtual models of dentomaxillofacial structures through three-dimensional segmentation is a crucial component of most digital dental workflows. This process is typically performed using manual or semi-automated approaches, which can be time-consuming and subject to observer bias. The aim of this study was to train and assess the performance of a convolutional neural network (CNN)-based online cloud platform for automated segmentation of maxillary impacted canine on CBCT image. A total of 100 CBCT images with maxillary canine impactions were randomly allocated into two groups: a training set (n = 50) and a testing set (n = 50). The training set was used to train the CNN model and the testing set was employed to evaluate the model performance. Both tasks were performed on an online cloud-based platform, 'Virtual patient creator' (Relu, Leuven, Belgium). The performance was assessed using voxel- and surface-based comparison between automated and semi-automated ground truth segmentations. In addition, the time required for segmentation was also calculated. The automated tool showed high performance for segmenting impacted canines with a dice similarity coefficient of 0.99 ± 0.02. Moreover, it was 24 times faster than semi-automated approach. The proposed CNN model achieved fast, consistent, and precise segmentation of maxillary impacted canines.
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Affiliation(s)
- Abdullah Swaity
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Prosthodontic Department, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Bahaaeldeen M Elgarba
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Prosthodontics, Tanta University, Tanta, Egypt
| | - Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Saleem Ali
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Restorative Dentistry Department, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Elena Borsci
- Oral Diagnostic Clinic, Karolinska Institute, Stockholm, Sweden
| | - Israel Chilvarquer
- Department of Oral Radiology, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.
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Markovic J, Peña-Cardelles JF, Pedrinaci I, Hamilton A, Gallucci GO, Lanis A. Considerations for predictable outcomes in static computer- aided implant surgery in the esthetic zone. J ESTHET RESTOR DENT 2024; 36:207-219. [PMID: 38018396 DOI: 10.1111/jerd.13171] [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: 08/14/2023] [Revised: 10/21/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To provide technical and clinical recommendations for implementing a digital workflow in Static Computer-Aided Implant Surgery in the anterior maxilla. CLINICAL CONSIDERATIONS An optimal 3D implant position is crucial for achieving satisfying results in implant rehabilitation in the esthetic area. Due to its complexity, implant placement in the esthetic zone should be executed with precision and predictability. Static Computer-Aided Implant Surgery requires thorough planning and detailed attention to every step of the digital workflow protocol. CONCLUSIONS Implant positioning in the esthetic zone using Static Computer-Aided Implant Surgery is a technique-sensitive procedure that requires precise execution of each step. This approach ensures accurate prosthetically driven 3D implant placement and prevents potential errors that could lead to inaccurate positioning. CLINICAL SIGNIFICANCE The proper implementation of Static Computer-Aided Implant Surgery may increase the level of agreement between the planned and definitive implant 3D positions in the esthetic zone, thus enhancing the esthetic outcomes of implant rehabilitation.
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Affiliation(s)
- Jovana Markovic
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Department for Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Juan Francisco Peña-Cardelles
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
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Chen D, Zhao W, Ren L, Tao K, Li M, Su B, Liu Y, Ban C, Wu Q. Digital PBL-CBL teaching method improves students' performance in learning complex implant cases in atrophic anterior maxilla. PeerJ 2023; 11:e16496. [PMID: 38077445 PMCID: PMC10710131 DOI: 10.7717/peerj.16496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background The clinical teaching of esthetic implant-supported restoration of the atrophic maxilla is challenging due to the complexity and unpredictability of bone and soft tissue augmentation. The traditional problem-based learning and case-based learning method (PBL-CBL method) with a full digital workflow (digital PBL-CBL method) provides the students a chance to view clinical cases in a more accurate and measurable way. The aim is to evaluate the effectiveness of the new digital PBL-CBL method in teaching complex implant cases in esthetic area. Materials & Methods A full digital workflow of dental implant therapy was established for patients with severely atrophic anterior maxilla. The digital data of cases done in the new workflow was used as teaching materials in digital PBL-CBL teaching. Fifty-four postgraduate students were randomly selected and divided into three groups, including traditional PBL-CBL group (students taught in a PBL-CBL method with no digital cases), digital PBL-CBL group (students taught in a PBL-CBL method with full digital cases) and control group (students taught in didactic teacher-centered method). After training for three months, a study of the students' opinions on the corresponding teaching method was carried out through a feedback questionnaire. A theory test was used to evaluate students' mastery of knowledge about tissue augmentation and esthetic implant restoration. A case analysis was used to determine whether students could apply the knowledge to problem solving. Results The digital PBL-CBL method resulted in a higher rate of satisfaction than the traditional PBL-CBL method and the didactic teacher-centered method in all items except for "This approach decreases extracurricular work". Case analysis scores of the digital PBL-CBL group were significantly higher than that of the traditional PBL-CBL group and the control group. For the theory test, the digital PBL-CBL group (61.00 ± 6.80) but not traditional PBL-CBL group (55.22 ± 9.86) obtained a significant higher score than the control group (45.11 ± 12.76), although no significant difference was found between the digital PBL-CBL group and the traditional PBL-CBL group. Conclusion Compared with other methods, students taught with the digital PBL-CBL method showed higher satisfaction and better performance in acquisition of academic knowledge and ability in solving practical clinical problems. The digital PBL-CBL method provided a promising alternative for teaching complex implant cases at the anterior maxilla.
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Affiliation(s)
- Dan Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Wenyan Zhao
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Li Ren
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Kunli Tao
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Miaomiao Li
- Dazhu Traditional Chinese Medicine Hospital, Chongqing, China
| | - Beiju Su
- Dazhu Traditional Chinese Medicine Hospital, Chongqing, China
| | - Yunfei Liu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chengzhe Ban
- Ruitai Stomatological Hospital, Chongqing, China
| | - Qingqing Wu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Wei X, Zheng J, Bu L, Luo Y, Qiu Y, Yang C. Digital template-guided genioplasty for patients with jaw deformity resulting from temporomandibular joint ankylosis: A comparison between single- and double-layer genioplasty. Int J Oral Maxillofac Surg 2023; 52:1057-1063. [PMID: 36990830 DOI: 10.1016/j.ijom.2023.03.003] [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: 04/21/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Abstract
The aim of this study was to compare single- and double-layer digital template-assisted genioplasty for the correction of jaw deformity resulting from temporomandibular joint ankylosis (TMJA). Thirteen patients with jaw deformity resulting from TMJA who underwent lateral arthroplasty, costochondral graft, or total joint replacement combined with single- or double-layer digital template-assisted genioplasty were included. Computed tomography data were obtained for the preoperative design. Digital templates were designed and manufactured using three-dimensional printing to assist with the chin osteotomy and repositioning in single- or double-layer genioplasty. Of the 13 patients included, seven underwent single-layer genioplasty and six underwent double-layer genioplasty. The digital templates precisely reflected the osteotomy planes and repositioning of the chin segments intraoperatively. The radiographic evaluation showed that the patients who underwent double-layer genioplasty exhibited more chin advancement (11.95 ± 0.92 mm vs 7.50 ± 0.89 mm; P < 0.001) with a slightly larger mean surface error (1.19 ± 0.14 mm vs 0.75 ± 0.15 mm; P < 0.001) than those who underwent single-layer genioplasty. This indicates that double-layer genioplasty better promoted chin advancement and improved the facial shape, but was accompanied by more surgical error compared with the preoperative design. Furthermore, hardly any nerve damage was observed. Digital templates are useful for assisting in surgical procedures.
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Affiliation(s)
- X Wei
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China
| | - J Zheng
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China
| | - L Bu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China
| | - Y Luo
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China
| | - Y Qiu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China
| | - C Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, and National Clinical Research Center of Stomatology, Shanghai, China.
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Keardkhong P, Chen YF, Yao CF, Chen YA, Liao YF, Chen YR. Comparison of regional soft tissue changes after bimaxillary rotational surgery between class III deformity with overbite and open bite: A 3D imaging analysis. Biomed J 2023; 46:100562. [PMID: 36184027 PMCID: PMC10498407 DOI: 10.1016/j.bj.2022.09.003] [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: 05/26/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This prospective study aimed to compare regional soft tissue changes between patients with class III overbite and open bite deformities treated with bimaxillary surgery involving clockwise and counter-clockwise mandibular setback, respectively. MATERIAL AND METHODS Class III deformity adults receiving Le Fort I and bilateral sagittal split osteotomies were grouped according to the incisal occlusion: overbite (n = 30) and open bite (n = 30). Combined cone-beam CT scans and 3D facial photographs preoperative and at least 1-year postoperative were taken to assess the soft tissue changes. RESULTS Postoperative changes for the overbite and open bite groups included anterior repositioning of nose (-0.8 ± 1.2 mm and -1.1 ± 1.1 mm, respectively) and cheek (-1.9 ± 1.3 mm and -1.7 ± 2.6 mm, respectively), posterior repositioning of chin (5.2 ± 4.0 mm and 4.9 ± 3.2 mm, respectively), and medial (-1.7 ± 2.0 mm and -1.9 ± 2.1 mm, respectively) and posterior (2.7 ± 1.4 mm and 2.8 ± 2.3 mm, respectively) repositioning of bilateral angles. Posterior (1.2 ± 2.0 mm and 5.1 ± 3.3 mm) and inferior (-1.4 ± 2.2 mm and -2.4 ± 2.7 mm) repositioning of upper lip and lower lip occurred in overbite group. Inferior (-2.3 ± 2.4 mm) and superior (3.7 ± 3.4 mm) repositioning of chin occurred in the overbite and open bite groups, respectively. CONCLUSIONS Treatment of class III overbite and open bite deformities with bimaxillary rotational surgery resulted in comparable regional soft tissue changes, except for upper lip, lower lip and chin.
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Affiliation(s)
- Piyanan Keardkhong
- Graduate Institute of Dental and Craniofacial Science, 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 at Linkou, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital at Taipei, Taipei, Taiwan
| | - Chuan-Fong Yao
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ying-An Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yu-Fang Liao
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Yu-Ray Chen
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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15
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Cen Y, Huang X, Liu J, Qin Y, Wu X, Ye S, Du S, Liao W. Application of three-dimensional reconstruction technology in dentistry: a narrative review. BMC Oral Health 2023; 23:630. [PMID: 37667286 PMCID: PMC10476426 DOI: 10.1186/s12903-023-03142-4] [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: 04/24/2023] [Accepted: 06/16/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Three-dimensional(3D) reconstruction technology is a method of transforming real goals into mathematical models consistent with computer logic expressions and has been widely used in dentistry, but the lack of review and summary leads to confusion and misinterpretation of information. The purpose of this review is to provide the first comprehensive link and scientific analysis of 3D reconstruction technology and dentistry to bridge the information bias between these two disciplines. METHODS The IEEE Xplore and PubMed databases were used for rigorous searches based on specific inclusion and exclusion criteria, supplemented by Google Academic as a complementary tool to retrieve all literature up to February 2023. We conducted a narrative review focusing on the empirical findings of the application of 3D reconstruction technology to dentistry. RESULTS We classify the technologies applied to dentistry according to their principles and summarize the different characteristics of each category, as well as the different application scenarios determined by these characteristics of each technique. In addition, we indicate their development prospects and worthy research directions in the field of dentistry, from individual techniques to the overall discipline of 3D reconstruction technology, respectively. CONCLUSIONS Researchers and clinicians should make different decisions on the choice of 3D reconstruction technology based on different objectives. The main trend in the future development of 3D reconstruction technology is the joint application of technology.
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Affiliation(s)
- Yueyan Cen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Xinyue Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Jialing Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Yichun Qin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Xinrui Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Shiyang Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Shufang Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China.
| | - Wen Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China.
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16
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Khanlar LN, Barmak AB, Oh Y, Mendha U, Yared S, Zandinejad A. Marginal and internal discrepancies associated with carbon digital light synthesis additively manufactured interim crowns. J Prosthet Dent 2023:S0022-3913(23)00259-7. [PMID: 37210221 DOI: 10.1016/j.prosdent.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/15/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Abstract
STATEMENT OF PROBLEM The carbon digital light synthesis (DLS) or continuous liquid interface production (CLIP) technology is an innovative additive manufacturing technology using oxygen-inhibited photopolymerization to create a continuous liquid interface of unpolymerized resin between the growing component and the exposure window. This interface eliminates the need for an incremental layer-by-layer approach, allowing for continuous creation and increased printing speed. However, the internal and marginal discrepancies associated with this new technology remain unclear. PURPOSE The purpose of this in vitro study was to evaluate the marginal and internal discrepancies by using the silicone replica technique of interim crowns fabricated by 3 different manufacturing technologies: direct light processing (DLP), DLS, and milling. MATERIAL AND METHODS A mandibular first molar was prepared, and a crown was designed with a computer-aided design (CAD) software program. The standard tessellation language (STL) file was used to create 30 crowns from the DLP, DLS, milling technologies (n=10). The gap discrepancy was determined using the silicone replica approach, with 50 measurements made with a ×70 microscope for each specimen for the marginal and internal gaps. The data were analyzed using 1-way ANOVA, followed by the Tukey HSD post hoc test (α=.05). RESULTS The DLS group had the least marginal discrepancy compared with the DLP and milling groups (P<.001). The DLP group showed the highest internal discrepancy followed by the DLS and milling groups (P=.038). No significant difference was found between DLS and milling in terms of internal discrepancy (P>.05). CONCLUSIONS The manufacturing technique had a significant effect on both internal and marginal discrepancies. The DLS technology showed the smallest marginal discrepancies.
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Affiliation(s)
- Leila Nasiry Khanlar
- Lecturer, AEGD Residency Program, Department of Comprehensive Dentistry, School of Dentistry, Texas A&M University, Dallas, Texas
| | - Abdul Basir Barmak
- Lecturer, AEGD Residency Program, Department of Comprehensive Dentistry, School of Dentistry, Texas A&M University, Dallas, Texas; Private practice, Arlington, Texas
| | - Youngju Oh
- Undergraduate student, Texas A&M University, School of Dentistry, Dallas, Texas
| | - Umar Mendha
- Undergraduate student, Texas A&M University, School of Dentistry, Dallas, Texas
| | - Sami Yared
- CEO and Founder, YDL Dental Laboratory, Dallas, Texas
| | - Amirali Zandinejad
- Associate Professor, Department of Comprehensive Dentistry, School of Dentistry, Texas A&M University, Dallas, Texas; Associate Professor, Clinical Research and Biostatistics, EIOH Medical Center, University of Rochester, Rochester, NY.
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Balel Y. The Last 40 Years of Orthognathic Surgery: A Bibliometric Analysis. J Oral Maxillofac Surg 2023:S0278-2391(23)00317-8. [PMID: 37075807 DOI: 10.1016/j.joms.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Bibliometric analyses provide information on the effectiveness, performance, trends, and various other characteristics of research by using mathematical and statistical analysis methods for data related to scientific publications. This study aims to determine the focus of studies in the field of orthognathic surgery, map it, and present the results in a simplified manner through a comprehensive bibliometric analysis of the relevant literature. METHODS In this bibliometric analysis study, orthognathic surgery publications from 1980 to 2022 were retrieved from the Web of Science Core Collection database. The independent variables were co-citations, while the outcome variables included cross-country collaboration analysis, keyword analysis, co-citation analysis, and cluster analysis of the co-citation network. Covariates were the number of publications, number of citations, year range, centrality value, and silhouette value. The bibliometric analysis was conducted using CiteSpace, VOSviewer, and R-Studio software. RESULTS A total of 7,135 publications and 75,822 references were included in the analysis, and the annual growth rate of publications was 9.52%. The co-citation clustering analysis revealed that the orthognathic surgery literature was organized into 16 subject headings. Patient satisfaction was found to be the most widely published topic. The youngest clusters, representing new topics in the field, were virtual planning and examination of condylar changes after orthognathic surgery. CONCLUSION Bibliometric analysis methods were used to evaluate the 40-year history of the orthognathic surgery literature. The analysis identified the most influential publications, the topics in which the literature is divided, and hot spots in the field. By conducting similar bibliometric research studies in the future, the progress and future direction of the literature can be monitored based on evidence.
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Affiliation(s)
- Yunus Balel
- Consultant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Tokat, Turkey.
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Surgical Precision Analysis of Orthognathic Surgery Combined With Invisible Orthodontic. J Craniofac Surg 2023; 34:e190-e195. [PMID: 36745135 DOI: 10.1097/scs.0000000000009120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/12/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study aimed to explore the changes in hard tissue after applying invisible orthodontic-orthognathic treatment and the digital design, and to explore the accuracy of the treatment effect of maxillofacial tissue after invisible orthodontic treatment and orthognathic treatment. METHODS From September 2020 to January 2022, 25 patients with class III skeletal malocclusion and 7 patients with class II skeletal malocclusion, were treated with invisible orthodontic treatment and orthognathic combined treatment. Orthodontic treatment with preoperative invisible orthodontic treatment followed by orthodontic surgery. All patients had cephalometric lateral films after surgery to analyze orthognathic surgery's goals and surgical effects of orthognathic surgery and the digital design. Measure the angle of the sella-nasion-A point angle, angle of sella-nasion-B point, ANB angle, maxillary convex angle, mandibular plane (MP) angle, 1-SN angle, 1-MP angle, etc, and compare surgery outcome with digital design. RESULT All patients were satisfied with the effect and no complications occurred. Angle of sella-nasion-A point, angle of sella-nasion-B point, ANB angle, maxillary convex angle, MP angle, 1-SN angle, and 1-MP angle had no significant difference between the postoperative effect and the purpose of digital design ( P >0.05), there was no apparent deviation between the upper and lower jaw and the chin ( P >0.05). CONCLUSION The combined invisible orthodontic treatment and orthognathic treatment are accurate and effective, and are worthy of promotion. It supplements traditional orthognathic therapy and is suitable for corresponding patients.
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Wu Y, Zeng C, Feng D, Chen Z, Fu Q, Liao W. Three-dimensional quantitative analysis of temporal region morphology in Chinese young adult. PeerJ 2023; 11:e14226. [PMID: 36751633 PMCID: PMC9899427 DOI: 10.7717/peerj.14226] [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: 03/07/2022] [Accepted: 09/21/2022] [Indexed: 02/05/2023] Open
Abstract
Background Temporal filling is commonly used to correct temporal depression. However, there is a lack of quantitative criteria for pre- and post-operative evaluations. The use of three-dimensional scanning may help improving the success of temporal filling by providing quantitative assessments. The study aimed to compare the results of qualitative morphological evaluation of the temporal region with a quantitative, numerical analysis of the temporal difference value (TDV). Methods We enrolled twenty-six male and forty-nine female volunteers aged 18 to 29 years. Facial images were acquired in OBJ format using 3dMD facial stereo-photography. The morphologies of the temporal regions were separately evaluated by four researchers in the form of two-dimensional (2D) images. Results were classified as either aesthetic or unaesthetic. The quantitative evaluation of the temporal region was then conducted. First, the temporal region was trimmed out from the original 3D image into a new OBJ file. Second, interpolation was used to construct a smooth, adapted surface. Third, a mathematical model of temporal region flatness denoted as the TDV, which was defined as the sum of the Euclidean distances of all 3D points between the constructed surface and the temporal-region OBJ file. The classification of each sample was compared with its TDV to verify the mathematical model's validity. The cutoff threshold and prediction accuracy of this mathematical model were calculated. Results The cutoff threshold between aesthetic and unaesthetic TDV was found to be 24.66 for males and 28.11 for females. The prediction accuracy rate was 0.73 for men and 0.73 for women. Conclusion The method has high overlap and good repeatability and minimizes the influence of subjective aesthetics on morphological judgment. TDV has a certain reference value for clinical temporal region evaluation.
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Affiliation(s)
- Yumeng Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chongmai Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Duanyu Feng
- School of Mathematics, Sichuan University, Sichuan University, Chengdu, Sichuan, China
| | - Zhilong Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qian Fu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wen Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan University, Chengdu, Sichuan, China
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20
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A Comparison of Teeth Measurements on Plaster and Digital Models. J Clin Med 2023; 12:jcm12030943. [PMID: 36769591 PMCID: PMC9918167 DOI: 10.3390/jcm12030943] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/13/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
(1) Background: Modern imaging methods and constantly developing technologies extend the range of diagnostic tools in medicine and in orthodontics. Thanks to them, scientists and doctors can use devices designed to diagnose 3D structures of the human body. The aim of the study was to assess the usefulness of digital orthodontic models as a diagnostic tool in the work of an orthodontist through a comparative analysis of the value of orthodontic measurements made on traditional plaster models and virtual models. (2) Methods: A total of 80 sets of models were made, including 40 sets of plaster models and 40 sets of digital models. A total of 48 diagnostic parameters were developed. They concerned dental parameters. (3) Results: Comparative analysis of crown height values on plaster and digital models showed statistically significant differences (p < 0.05) in 26 out of 48 dental parameters. (4) Conclusions: The differences between the measurements made with the software on the digital models and the measurements made with the traditional method of measurement using the digital caliper on the plaster models were small and clinically acceptable.
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21
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Gandedkar NH, Liou EJW. Complex case treatment: Is there a limit for Surgery-first approach? Semin Orthod 2023. [DOI: 10.1053/j.sodo.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Cao R, Chen B, Xu H, Cai Y, Liu W. Accuracy of three-dimensional optical devices for facial soft-tissue measurement in clinical practice of stomatology: A PRISMA systematic review. Medicine (Baltimore) 2022; 101:e31922. [PMID: 36451461 PMCID: PMC9704975 DOI: 10.1097/md.0000000000031922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The accuracy of 3-dimensional (3D) optical devices for facial soft-tissue measurement is essential to the success of clinical treatment in stomatology. The aim of the present systematic review was to summarize the accuracy of 3D optical devices used for facial soft-tissue assessment in stomatology. METHODS An extensive systematic literature search was performed in the PubMed/MEDLINE, Embase, Scopus and Cochrane Library databases for studies published in the English language up to May 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Peer-reviewed journal articles evaluating the facial soft-tissue morphology by 3D optical devices were included. The risk of bias was performed using the Quality Assessment Tool for Diagnostic Accuracy Studies-2 guidelines by the 2 reviewers. The potential publication bias was analyzed using the Review Manager software. RESULTS The query returned 1853 results. A total of 38 studies were included in this review. Articles were categorized based on the principle of devices: laser-based scanning, structured-light scanning, stereophotogrammetry and red, green, blue-depth camera. CONCLUSION Overall, the 3D optical devices demonstrated excellent accuracy and reliability for facial soft-tissue measurement in stomatology. red, green, blue-depth camera can collect accurate static and dynamic 3D facial scans with low cost and high measurement accuracy. Practical needs and availability of resources should be considered when these devices are used in clinical settings.
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Affiliation(s)
- Rongkai Cao
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Beibei Chen
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Hui Xu
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yiyi Cai
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Weicai Liu
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
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Alhossaini SJ, Neena AF, Issa NO, Abouelkheir HM, Gaweesh YY. Accuracy of markerless registration methods of DICOM and STL files used for computerized surgical guides in mandibles with metal restorations: An in vitro study. J Prosthet Dent 2022:S0022-3913(22)00636-9. [PMID: 36372586 DOI: 10.1016/j.prosdent.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 11/12/2022]
Abstract
STATEMENT OF PROBLEM Digital imaging and communications in medicine (DICOM) files together with surface scans must be accurately registered in virtual implant planning software programs to match real-life dimensions and ensure correct plan transfer through computer-aided manufactured surgical guides. PURPOSE The purpose of this in vitro study was to evaluate the accuracy of 3 different registration methods of DICOM data with and without metal restorations and a metal artifact reduction (MAR) tool for surface scans. MATERIAL AND METHODS Thirteen dentate mandibles were assigned to each group of this study (n=39). Baseplate wax was adapted to the bone surfaces of each mandible, and 5 radiopaque markers were attached. A desktop scanner was used to obtain control scans. The groups of metal-free mandibles (MFM) and mandibles with metal restorations (MRM) were scanned to obtain DICOM data without a MAR tool. Additional DICOM data for the MRM were obtained with the MAR tool (MRM-MAR). Point-based registration (PBR), best-fit registration (BFR), and automatic registration (AR) were used to align standard tessellation language (STL) and DICOM data, and 3 data sets were exported. Radiographic markers on each data set were compared with those on the control scan, and positional deviations were calculated and statistically evaluated with 1-way ANOVA followed by multiple pairwise comparisons, independent samples t test, and 2-way ANOVA (α=.05). RESULTS Within each group, PBR had the lowest deviation values with statistical significance in the MFM and the MRM-MAR groups (P<.001). AR showed failure in the MRM and the MRM-MAR groups. Statistically significant differences were found on comparing the average deviations among the 3 groups for PBR only (P<.001). No association was found between deviation values and the presence or absence of metal restoration, while a positive association was found with the type of registration method (P<.001). CONCLUSIONS PBR had the highest accuracy level compared with AR and BFR methods. An increase in the number of calculations resulted in more deviation values. The MAR tool had a positive effect on PBR in mandibles with metal restorations.
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Affiliation(s)
- Sara J Alhossaini
- Postgraduate student, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Akram F Neena
- Lecturer of Prosthodontics, Department of Prosthodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt.
| | - Noha O Issa
- Associate Professor of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Cairo, Cairo, Egypt
| | - Hassan M Abouelkheir
- Professor of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Yasmine Y Gaweesh
- Lecturer of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
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A Full Computerized Workflow for Planning Surgically Assisted Rapid Palatal Expansion and Orthognathic Surgery in a Skeletal Class III Patient. Case Rep Dent 2022; 2022:6413898. [PMID: 36312572 PMCID: PMC9605851 DOI: 10.1155/2022/6413898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023] Open
Abstract
In the present case report, we present and discuss the digital workflow involved in the orthodontic/orthognathic combined treatment of a skeletal malocclusion correction in a 17-year-old male patient affected by a skeletal class III, facial asymmetry, sagittal and transversal deficiency of the medium third of the skull, dental crowding, and bilateral cross-bite. The first stage of the treatment involved surgically assisted rapid palatal expansion and occlusal decompensation, using fixed self-ligating appliance. An orthodontic software package (i.e., Dolphin 3D Surgery module) was used to perform virtual treatment objective evaluation by integrating data from cone beam computer tomography acquisition, intraoral scan, and extraoral photographs. The software allowed a comprehensive evaluation of skeletal, dento-alveolar, and soft-tissue disharmonies, qualitative and quantitative simulation of surgical procedure according to skeletal and aesthetic objectives, and, consequently, the treatment of the malocclusion. Using a specific function of the software, the surgical splint was designed according to the pre-programmed skeletal movements, and subsequently, the physical splint was generated with a three-dimensional (3D) printing technology. Once a proper occlusal decompensation was reached, a Le Fort I osteotomy of the maxilla and a bilateral sagittal surgical osteotomy of the mandible were executed to restore proper skeletal relations. The whole treatment time was 8 months. The orthodontic/orthognathic combined treatment allowed to correct the skeletal and the dental imbalance, as well as the improvement of facial aesthetics. Accordingly, the treatment objectives planned in the virtual environment were achieved. Virtual planning offers new possibilities for visualizing the relationship between dental arches and surrounding bone and soft structures in a single virtual 3D model, allowing the specialists to simulate different surgical and orthodontic procedures to achieve the best possible result for the patient and providing an accurate and predictable outcome in the treatment of challenging malocclusions.
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Facial Scanning Accuracy with Stereophotogrammetry and Smartphone Technology in Children: A Systematic Review. CHILDREN 2022; 9:children9091390. [PMID: 36138698 PMCID: PMC9498045 DOI: 10.3390/children9091390] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/03/2022] [Accepted: 09/12/2022] [Indexed: 12/23/2022]
Abstract
The aim of the study was to systematically review and compare the accuracy of smartphone scanners versus stereophotogrammetry technology for facial digitization in children. A systematic literature search strategy of articles published from 1 January 2010 to 30 August 2022 was adopted through a combination of Mesh terms and free text words pooled through boolean operators on the following databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS, and OpenGrey. Twenty-three articles met the inclusion criteria. Stationary stereophotogrammetry devices showed a mean accuracy that ranged from 0.087 to 0.860 mm, portable stereophotogrammetry scanners from 0.150 to 0.849 mm, and smartphones from 0.460 to 1.400 mm. Regarding the risk of bias assessment, fourteen papers showed an overall low risk, three articles had unclear risk and four articles had high risk. Although smartphones showed less performance on deep and irregular surfaces, all the analyzed devices were sufficiently accurate for clinical application. Internal depth-sensing cameras or external infrared structured-light depth-sensing cameras plugged into smartphones/tablets increased the accuracy. These devices are portable and inexpensive but require greater operator experience and patient compliance for the incremented time of acquisition. Stationary stereophotogrammetry is the gold standard for greater accuracy and shorter acquisition time, avoiding motion artifacts.
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Plaster Casts vs. Intraoral Scans: Do Different Methods of Determining the Final Occlusion Affect the Simulated Outcome in Orthognathic Surgery? J Pers Med 2022; 12:jpm12081288. [PMID: 36013237 PMCID: PMC9409745 DOI: 10.3390/jpm12081288] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
A virtual occlusal adjustment in orthognathic surgery has many advantages; however, the haptic information offered by plaster casts is missing when using intraoral scans. Feeling the interferences may be helpful in defining the best possible occlusion. Whether the use of a virtual occlusal adjustment instead of the conventional approach has a significant effect on the postsurgical position of the jaws is a question that remains unanswered. This study compares a virtual method to the conventional method of defining the final occlusion. Twenty-five orthognathic patients were included. Bimaxillary and single-jaw orthognathic surgery (mandible only) was simulated. The two methods were compared regarding discrepancies in the simulated postsurgical position of the mandible, measured three-dimensionally using MeshLab (MeshLab 2020.12 3D). An analysis using SPSS revealed no significant differences between the tested methods (p-values: 0.580 to 0.713). The mean absolute discrepancies ranged from 0.14 mm to 0.72 mm, laying within the scope of the clinically acceptable inaccuracies of an osteosynthesis in orthognathic surgery. The lack of haptic information in virtual planning had no relevant influence on the definition of the final occlusion and the simulated postsurgical outcome. However, in individual cases, plaster models might still be helpful in finding the adequate occlusion, especially in the sagittal dimension and in cases of patients with an anterior open bite, but this remains to be tested.
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Preda F, Morgan N, Van Gerven A, Nogueira-Reis F, Smolders A, Wang X, Nomidis S, Shaheen E, Willems H, Jacobs R. Deep convolutional neural network-based automated segmentation of the maxillofacial complex from cone-beam computed tomography - A validation study. J Dent 2022; 124:104238. [PMID: 35872223 DOI: 10.1016/j.jdent.2022.104238] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES The present study investigated the accuracy, consistency, and time-efficiency of a novel deep CNN-based model for the automated maxillofacial bone segmentation from CBCT images. METHOD A dataset of 144 scans was acquired from two CBCT devices and randomly divided into three subsets: training set (n= 110), validation set (n= 10) and testing set (n=24). A three-dimensional (3D) U-Net (CNN) model was developed, and the achieved automated segmentation was compared with a manual approach. RESULTS The average time required for automated segmentation was 39.1 seconds with a 204-fold decrease in time consumption compared to manual segmentation (132.7 minutes). The model is highly accurate for identification of the bony structures of the anatomical region of interest with a dice similarity coefficient (DSC) of 92.6%. Additionally, the fully deterministic nature of the CNN model was able to provide 100% consistency without any variability. The inter-observer consistency for expert-based minor correction of the automated segmentation observed an excellent DSC of 99.7%. CONCLUSION The proposed CNN model provided a time-efficient, accurate, and consistent CBCT-based automated segmentation of the maxillofacial complex. CLINICAL SIGNIFICANCE Automated segmentation of the maxillofacial complex could act as a potent alternative to the conventional segmentation techniques for improving the efficiency of the digital workflows. This approach could deliver an accurate and ready-to-print three dimensional (3D) models that are essential to patient-specific digital treatment planning for orthodontics, maxillofacial surgery, and implant placement.
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Affiliation(s)
- Flavia Preda
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer33, BE-3000 Leuven, Belgium.
| | - Nermin Morgan
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer33, BE-3000 Leuven, Belgium; Department of Oral Medicine, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Dakahlia, Egypt
| | | | - Fernanda Nogueira-Reis
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer33, BE-3000 Leuven, Belgium; Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, Piracicaba, São Paulo 13414‑903, Brazil
| | | | - Xiaotong Wang
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer33, BE-3000 Leuven, Belgium
| | | | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer33, BE-3000 Leuven, Belgium
| | | | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer33, BE-3000 Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Box 4064, 141 04 Huddinge, Stockholm, Sweden
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Creation of Digital Virtual Patient by Integrating CBCT, Intraoral Scan, 3D Facial Scan: An Approach to Methodology for Integration Accuracy. J Craniofac Surg 2022; 33:e396-e398. [DOI: 10.1097/scs.0000000000008275] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lee SC, Hwang HS, Lee KC. Accuracy of deep learning-based integrated tooth models by merging intraoral scans and CBCT scans for 3D evaluation of root position during orthodontic treatment. Prog Orthod 2022; 23:15. [PMID: 35527317 PMCID: PMC9081076 DOI: 10.1186/s40510-022-00410-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
This study aimed to evaluate the accuracy of deep learning-based integrated tooth models (ITMs) by merging intraoral scans and cone-beam computed tomography (CBCT) scans for three-dimensional (3D) evaluation of root position during orthodontic treatment and to compare the fabrication process of integrated tooth models (ITMs) with manual method.
Material and methods
Intraoral scans and corresponding CBCT scans before and after treatment were obtained from 15 patients who completed orthodontic treatment with premolar extraction. A total of 600 ITMs were generated using deep learning technology and manual methods by merging the intraoral scans and CBCT scans at pretreatment. Posttreatment intraoral scans were integrated into the tooth model, and the resulting estimated root positions were compared with the actual root position at posttreatment CBCT. Discrepancies between the estimated and actual root position including average surface differences, arch widths, inter-root distances, and root axis angles were obtained in both the deep learning and manual method, and these measurements were compared between the two methods.
Results
The average surface differences of estimated and actual ITMs in the manual method were 0.02 mm and 0.03 mm for the maxillary and mandibular arches, respectively. In the deep learning method, the discrepancies were 0.07 mm and 0.08 mm for the maxillary and mandibular arches, respectively. For the measurements of arch widths, inter-root distances, and root axis angles, there were no significant differences between estimated and actual models both in the manual and in the deep learning methods, except for some measurements. Comparing the two methods, only three measurements showed significant differences. The procedure times taken to obtain the measurements were longer in the manual method than in the deep learning method.
Conclusion
Both deep learning and manual methods showed similar accuracy in the integration of intraoral scans and CBCT images. Considering time and efficiency, the deep learning automatic method for ITMs is highly recommended for clinical practice.
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Current Trends in Skeletal Borderline Patients: Surgical versus Orthodontic Treatment Decisions—What Is the Evidence? APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The aim is to assess the current evidence-based knowledge about treatment decisions for skeletal malocclusion in adult borderline patients. Methods: A literature search was conducted through three databases. Inclusion criteria were restricted to systematic reviews, prospective, retrospective, and control studies. Only articles comparing orthodontic camouflage and orthognathic surgical treatment for Class II and Class III malocclusions in adult patients were selected to be reviewed. Results: Seven articles concerning Class II and nine concerning Class III met the inclusion criteria. Scientific evidence was poor due to low methodological quality. Conclusions: Surgical treatment was found to better improve skeletal and soft-tissue cephalometric values, whereas camouflage treatment mainly involved dentoalveolar movements. Aesthetic changes, as perceived by the patient, were not significantly different in the two groups. Recently improved surgical techniques, differing from those described in the analyzed articles, may provide similar or more stable outcomes compared with orthodontic-only treatment. Although some cephalometric variables can be helpful, the most important parameters for treatment selection are the patient’s presenting complaint and their self-image perception. Further studies with larger sample sizes and similar pretreatment conditions, and considering patient self-evaluation of esthetics and function, should be undertaken.
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A comparison of the precision of 3D images of facial tissues from the forensic point of view. FORENSIC IMAGING 2022. [DOI: 10.1016/j.fri.2021.200471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Application of Three-Dimensional Digital Technology in Orthodontics: The State of the Art. Biomimetics (Basel) 2022; 7:biomimetics7010023. [PMID: 35225915 PMCID: PMC8883890 DOI: 10.3390/biomimetics7010023] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 12/10/2022] Open
Abstract
Three-dimensional technologies are one of the most recent and relevant advancements in the field of Dentistry. These systems, including intraoral scans, 3D imaging exams (CAT scan, CBCT and MRI), CAD/CAM 3D printing devices and 3D computer software, have enabled clinicians to greatly improve patient care along with reducing treatment planning time. The present descriptive study aims to explore possible applications of 3D technologies during the diagnosis, treatment plan, case monitoring and result assessment in orthodontics. The overall upgrade provided by these technologies can improve the clinicians’ workflow and effectiveness by simplifying conventional techniques considered to be especially arduous.
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Flügge T, Kramer J, Nelson K, Nahles S, Kernen F. Digital implantology—a review of virtual planning software for guided implant surgery. Part II: Prosthetic set-up and virtual implant planning. BMC Oral Health 2022; 22:23. [PMID: 35094677 PMCID: PMC8802526 DOI: 10.1186/s12903-022-02057-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Patient- and technology-related parameters influence the successful implementation of virtual implant planning and guided implant surgery. Besides data processing and computer aided design of drill guides as described in Part I, the possibilities and limitations for prosthetic set-up and virtual implant planning are essential (Part II). Methods The following software systems were examined using two different clinical situations for implant therapy: coDiagnostiX™, DentalWings, Canada (CDX); Simplant Pro™, Dentsply, Sweden (SIM); Smop™, Swissmeda, Switzerland (SMP); NobelClinician™, Nobel Biocare, Switzerland (NC); Implant Studio, 3Shape, Denmark (IST). Assessment criteria geared towards interfaces and integrated tools for prosthetic set-up and virtual implant planning. Results A software interface for an individual virtual prosthetic set-up was provided by two systems (CDX, IST), whereas the set-up of standardized teeth was provided by four systems (CDX, SIM, SMP, IST). Alternatively, a conventional set-up could be scanned and imported. One system could solely work with the digitization of a conventional set-up for virtual implant planning (NC). Stock abutments could be displayed for implant planning, but none of the tested software systems provided tools for the design of an individual abutment. All systems displayed three-dimensional reconstructions or two-dimensional cross-sections with varying orientation for virtual implant placement. The inferior alveolar nerve could be marked to respect a minimum distance between the nerve and the planned implant. Three implant planning systems provided a library to display more than 50 implant systems (CDX, SIM, IST), one system provided 33 implant systems (SMP) and one implant system provided 4 implant systems (NC). Conclusion Depending on the used software system, there are limited options for a virtual set-up, virtual articulators and the display of a virtual prosthetic set-up. The implant systems used by the clinician is important for the decision which software system to choose, as there is a discrepancy between available implant systems and the number of supported systems in each software. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02057-w.
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Yoshida S, Watanabe A, Sugahara K, Odaka K, Katakura A, Takano M. Osteotomy training for dental students using three-dimensional simulation software and maxillofacial three-dimensional-printed models. J Dent Educ 2022; 86:526-534. [PMID: 34978716 DOI: 10.1002/jdd.12860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/27/2021] [Accepted: 11/23/2021] [Indexed: 11/11/2022]
Abstract
PURPOSE/OBJECTIVES Simulated educational models of teeth, bones, and gums have been used for a long time in procedural skills training in dentistry. The advent of three-dimensional (3D) printing technologies and additive manufacturing has facilitated the production of more advanced 3D printed models that can be utilized for surgical and dental training together with other technologies (e.g., 3D scanners and image analysis software). METHODS We conducted training on osteotomy in the maxilla and mandible using maxillofacial simulation software (MSS) and a 3D-printed model for 5th-year undergraduate dental students (13 students in 2017 and 11 students in 2018 with more than half of their results). We compared the group (13 students) who performed osteotomy after participating in the simulation lecture with those (11 students) who performed osteotomy after performing self-simulation (they were instructed to bring their personal computers and install the MSS) using tests and questionnaires (pre- and post-curriculum). RESULTS The average test score was significantly higher in the group who performed osteotomy using the 3D-printed model after performing self-simulation; participants in this group had acquired a better understanding of the surgical procedure. Comparison using questionnaires showed a significant difference in the students' understanding of instruments and surgical techniques between both groups. CONCLUSION The MSS and 3D printed models are widely used clinically. Incorporating these in the curriculum will help accelerate student development. In addition, prompt education on the purpose and usefulness of these tools will not only facilitate simulation software and 3D-printed model-based treatment plan in the clinic but also promote further research.
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Affiliation(s)
- Shuji Yoshida
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Akira Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Keisuke Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Kento Odaka
- Department of Dental Radiology, Tokyo Dental College, Tokyo, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Masayuki Takano
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
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Norman N, Md Lepi J. Evolution of facial profile and soft tissue methods of orthodontic assessments: A narrative review. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_302_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Li J, Chen Z, Decker AM, Wang HL, Joda T, Mendonca G, Lepidi L. Trueness and Precision of Economical Smartphone-Based Virtual Facebow Records. J Prosthodont 2022; 31:22-29. [PMID: 33876857 PMCID: PMC8526632 DOI: 10.1111/jopr.13366] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2021] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To investigate the trueness and precision of virtual facebow records using a smartphone as a three-dimensional (3D) face scanner. MATERIAL AND METHODS Twenty repeated virtual facebow records were performed on two subjects using a smartphone as a 3D face scanner. For each subject, a virtual facebow was attached to his/her maxillary arch, and face scans were performed using a smartphone with a 3D scan application. The subject's maxillary arch intraoral scan was aligned to the face scan by the virtual facebow fork. This procedure was repeated 10 times for each subject. To investigate if the maxillary scan is located at the right position to the face, these virtual facebow records were superimposed to a cone-beam computed tomography (CBCT) head scan from the same subject by matching the face scan to the 3D face reconstruction from CBCT images. The location of maxillary arch in virtual facebow records was compared with its position in CBCT. The "trueness" of the proposed procedure is defined as the deviation between maxilla arch position in virtual facebow records and the CBCT images. The "precision" is defined as the deviation between each virtual facebow record. The linear deviation at left central incisor (#9), left first molar (#14), and right first molar (#3), as well as angular deviation of occlusal plane were analyzed with descriptive statistics. Differences between two objects were also explored with Mann Whitney U test. RESULTS The 20 virtual facebow records using the smartphone 3D scanner deviated from the CBCT measurements (trueness) by 1.14 ± 0.40 mm at #9, 1.20 ± 0.50 mm at #14, 1.12 ± 0.51 mm at the #3, and 1.48 ± 0.56° in the occlusal plane. The VFTs deviated from each other by 1.06 ± 0.50 mm at #9, 1.09 ± 0.49 mm at #14, 1.11 ± 0.58 mm at #3, and 0.81 ± 0.58° in the occlusal plane. When all sites combined, the trueness was 1.14 ± 0.40 mm, and the precision was 1.08 ± 0.52 mm. Out of eight measurements, three measurements were significantly different between subjects. Nevertheless, the mean difference was small. CONCLUSIONS Virtual facebow records made using smartphone-based face scan can capture the maxilla position with high trueness and precision. The deviation can be anticipated as around 1 mm in linear distance and 1° in angulation.
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Affiliation(s)
- Junying Li
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Ann M. Decker
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Gustavo Mendonca
- Department of Biologic & Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Luca Lepidi
- Department of Clinical and Experimental Medicine, University of Foggia School of Dentistry, Foggia, Italy
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de Waard O, Bruggink R, Baan F, Reukers HAJ, Bronkhorst EM, Kuijpers-Jagtman AM, Ongkosuwito EM. Operator Performance of the Digital Setup Fabrication for Orthodontic–Orthognathic Treatment: An Explorative Study. J Clin Med 2021; 11:jcm11010145. [PMID: 35011886 PMCID: PMC8745578 DOI: 10.3390/jcm11010145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to explore the operator performance of the fabrication of digital orthodontic setups integrated into cone beam computed tomography (CBCT) scans. Fifteen patients who underwent a combined orthodontic–orthognathic surgical treatment were included. The pre-treatment digital dental models and CBCT scans were fused, and four operators made virtual setups twice for all patients. Differences between the virtual setups were calculated by recording tooth crown movement from the pre-treatment model to the virtual setup. To examine performance, Pearson’s correlation coefficients, duplicate measurement errors, and inter-operator differences were calculated. For intra-operator performance, correlation values varied among tooth types, with mean correlation values from 0.66 to 0.83 for the maxilla and 0.70 to 0.83 for the mandible. For inter-operator performance, mean correlation values varied from 0.40 to 0.87 for the maxilla and from 0.44 to 0.80 for the mandible. Rotational mean differences exceeded the range of clinical acceptance (>2 degrees) at 18% for the maxilla and 20.8% for the mandible, and translational mean differences exceeded the range of clinical acceptance (0.6 mm) at 9.7% and 26% for the maxilla and mandible, respectively. The intra- and inter-operator performance of digital orthodontic setup construction for virtual three-dimensional orthognathic planning shows significant errors.
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Affiliation(s)
- Olivier de Waard
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (R.B.); (F.B.); (E.M.O.)
- Correspondence: ; Tel.: +31-24-3618824
| | - Robin Bruggink
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (R.B.); (F.B.); (E.M.O.)
- Radboudumc 3D Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Frank Baan
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (R.B.); (F.B.); (E.M.O.)
- Radboudumc 3D Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | | | - Ewald M. Bronkhorst
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, CH-3010 Bern, Switzerland
- Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Edwin M. Ongkosuwito
- Department of Dentistry—Orthodontics and Craniofacial Biology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands; (R.B.); (F.B.); (E.M.O.)
- Radboudumc 3D Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
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Gili T, Di Carlo G, Capuani S, Auconi P, Caldarelli G, Polimeni A. Complexity and data mining in dental research: A network medicine perspective on interceptive orthodontics. Orthod Craniofac Res 2021; 24 Suppl 2:16-25. [PMID: 34519158 PMCID: PMC9292769 DOI: 10.1111/ocr.12520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/23/2021] [Indexed: 12/19/2022]
Abstract
Procedures and models of computerized data analysis are becoming researchers' and practitioners' thinking partners by transforming the reasoning underlying biomedicine. Complexity theory, Network analysis and Artificial Intelligence are already approaching this discipline, intending to provide support for patient's diagnosis, prognosis and treatments. At the same time, due to the sparsity, noisiness and time-dependency of medical data, such procedures are raising many unprecedented problems related to the mismatch between the human mind's reasoning and the outputs of computational models. Thanks to these computational, non-anthropocentric models, a patient's clinical situation can be elucidated in the orthodontic discipline, and the growth outcome can be approximated. However, to have confidence in these procedures, orthodontists should be warned of the related benefits and risks. Here we want to present how these innovative approaches can derive better patients' characterization, also offering a different point of view about patient's classification, prognosis and treatment.
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Affiliation(s)
- Tommaso Gili
- Networks UnitIMT School for Advanced Studies LuccaLuccaItaly
- CNR‐ISC Unità SapienzaRomeItaly
| | - Gabriele Di Carlo
- Department of Oral and Maxillo‐Facial SciencesSapienza University of RomeRomeItaly
| | | | | | - Guido Caldarelli
- CNR‐ISC Unità SapienzaRomeItaly
- Department of Molecular Sciences and NanosystemsCa’Foscari University of VeniceVenezia MestreItaly
| | - Antonella Polimeni
- Department of Oral and Maxillo‐Facial SciencesSapienza University of RomeRomeItaly
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Type of mandibular asymmetry affects changes and outcomes of bimaxillary surgery for class III asymmetry. Clin Oral Investig 2021; 26:1077-1088. [PMID: 34338893 DOI: 10.1007/s00784-021-04092-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Various methods have been used to classify class III asymmetry. There is little information on the use of an asymmetry index to examine soft tissue changes and outcomes for patients with class III asymmetry. This study aimed to (1) evaluate soft tissue changes and outcomes for three types of mandibular asymmetry and (2) determine if measures are associated with type of asymmetry. MATERIALS AND METHODS Adults who consecutively underwent bimaxillary surgery using surgery-first approach for correction of class III asymmetry were divided into three groups based on type of mandibular asymmetry. This previously reported classification system is simple and mutually independent, categorizing mandibular asymmetry according to the amount and direction of ramus asymmetry relative to menton deviation: patients with a larger transverse ramus distance on the menton deviation side were divided into group 1 and group 2; group 1 (n = 45) exhibited a menton deviation larger than ramus discrepancy; group 2 (n = 11) exhibited a menton deviation less than ramus discrepancy; group 3 (n = 22) had larger transverse ramus distance contralateral to the side of the menton deviation. Soft tissue facial asymmetry indices, calculated from cone beam computed tomography images, assessed midline and contour asymmetry presurgery, changes postsurgery, and outcomes. RESULTS Compared with groups 1 and 2, the presurgery index for contour and midline asymmetry was smallest for group 3. All the three groups had significant improvement in midline asymmetry postsurgery, and outcome measures were good; there were no differences between groups. However, contour asymmetry only improved significantly for groups 1 and 2. The outcome for contour asymmetry was fair for groups 1 and 3 and poor for group 2. CONCLUSIONS Bimaxillary surgery significantly improved facial midline asymmetry. The type of mandibular asymmetry was associated with postsurgical changes and outcomes for contour asymmetry. CLINICAL RELEVANCE Understanding the types of mandibular asymmetry could help clinicians to develop treatment plans and predict treatment changes and outcomes.
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40
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Grillo R. Orthognathic Surgery: A Bibliometric Analysis of the Top 100 Cited Articles. J Oral Maxillofac Surg 2021; 79:2339-2349. [PMID: 34245705 DOI: 10.1016/j.joms.2021.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/19/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE An increasing number of articles on orthognathic surgery are published every year. This paper aims to provide a list of the top 100 cited articles on orthognathic surgery to help any professional level with interest in this topic and to map the trends of orthognathic surgery publications over time. METHODS A bibliographic search (retrospective study) following STROBE guidelines was performed on Google Scholar (GS) and Dimensions with the term "orthognathic surgery" in the title, abstract, and keywords. The number of citations, citations per year, authors, and publication year were evaluated. A ranking was created in GS citations order with the top 100 cited articles and variables discussed individually. A graphical illustration of keywords was created using VOSviewer. These steps are fundamental in creating this list and relating it to all published articles on the topic. RESULTS A helpful list of the top 100 articles was developed to help professionals in entirely different manners. Virtual planning and complications in orthognathic surgery were the most cited topics, with a 95% confidence interval (P < .05). Some curiosities are discussed, such as increasing interest in surgery first and the relation between airway/obstructive sleep apnea and orthognathic surgery. CONCLUSIONS Bibliometric and altmetric analysis for free using Google Scholar and Dimensions is laborious but possible. Bibliometrics is a powerful tool to become actualized at any health professional level, from students to academics; and could save considerable effort and time for parties interested in the topic. Appropriate keywords are a crucial step to wider article dissemination.
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Affiliation(s)
- Ricardo Grillo
- Assistant Professor, Department of Oral & Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil.
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41
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Ballo AM, Sim JW. A Novel Digital Implant Planning Workflow in Patients with Preexisting Metal Restorations: A Technical Report. J Prosthodont 2021; 30:632-635. [PMID: 33900660 DOI: 10.1111/jopr.13373] [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] [Accepted: 04/22/2021] [Indexed: 11/30/2022] Open
Abstract
A prosthetically-driven virtual implant plan is considered a challenging procedure depending on accurate registration of the three-dimensional optical surface scan and 3D volumetric rendering reconstructed from cone-beam computed tomography (CBCT) images. However, the presence of preexisting metal restorations may significantly negatively influence the registration process. This technical report describes a novel digital workflow to optimize the implant planning outcome for the partially edentulous patient with preexisting metal restorations by accurately aligning the standard triangle language data of the intraoral scanner with the CBCT rendering using a dual-scan technique and an appliance with radiographic markers.
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Affiliation(s)
- Ahmed M Ballo
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada.,Vancouver Academy of Digital Dentistry and Implantology (VADDI), Vancouver, BC, Canada
| | - Jae Won Sim
- Paul Ro Dental Laboratory, Burnaby, BC, Canada
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42
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Perrotti G, Baccaglione G, Clauser T, Scaini R, Grassi R, Testarelli L, Reda R, Testori T, Del Fabbro M. Total Face Approach (TFA) 3D Cephalometry and Superimposition in Orthognathic Surgery: Evaluation of the Vertical Dimensions in a Consecutive Series. Methods Protoc 2021; 4:mps4020036. [PMID: 34069808 PMCID: PMC8162563 DOI: 10.3390/mps4020036] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Cephalometry is fundamental in diagnosis, analysis, and planning of orthodontic-surgical treatment as it reveals skeletal relationship between the upper and lower jaw as well as facial aesthetic parameters. Nevertheless, 3D cephalometry has still not become the exam of choice in orthognathic treatment even though today CBCT (Cone Beam Computed Tomography) is routinely used in other branches of dentistry. Methods: In a sample of 13 patients undergoing bimaxillary orthognathic surgery a chin-vertex CBCT exam was prescribed prior to orthodontic treatment (OT) and 12 months after surgery (T1). The DICOM files uploaded to MaterialiseSimplant Ortho software pro 2.1 (Materialise Co., Leuven, Belgium) were analyzed following the multiplane 3D Total Face cephalometry protocol (TFA). Results: Results comparing pre-op and post-op TFA 3D cephalometry, were then evaluated considering reference values reported in literature. The CBCT, carried out pre- and post-surgery, were subsequently analyzed employing the superimposition method using cranial base as reference. The aim of this study is to evaluate the advantages and disadvantages of the two methods in orthognathic surgery. Conclusions: Multiplane 3D TFA allows the clinician to locate where major or minor skeletal discrepancies are found with respect to ideal parameters and is also useful in classifying skeletal intermaxillary relation. The superimposition method is highly intuitive but does not provide information on the quantity and location of osteotomic movement.
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Affiliation(s)
| | | | - Tommaso Clauser
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20126 Milan, Italy; (T.C.); (M.D.F.)
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (R.S.); (T.T.)
| | - Riccardo Scaini
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (R.S.); (T.T.)
| | - Roberta Grassi
- Department of Biomedical Sciences, Sassari University, 07100 Sassari, Italy;
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy;
- Correspondence:
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Tiziano Testori
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (R.S.); (T.T.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20126 Milan, Italy
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20126 Milan, Italy; (T.C.); (M.D.F.)
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (R.S.); (T.T.)
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Battistoni G, Cassi D, Magnifico M, Pedrazzi G, Di Blasio M, Vaienti B, Di Blasio A. Does Head Orientation Influence 3D Facial Imaging? A Study on Accuracy and Precision of Stereophotogrammetric Acquisition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084276. [PMID: 33920674 PMCID: PMC8073202 DOI: 10.3390/ijerph18084276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 11/18/2022]
Abstract
This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures of a mannequin head were obtained with a stereophotogrammetric system (Face Shape 3D MaxiLine). Image acquisition was performed with no rotations and with various pitch, roll, and yaw angulations. On 3D images, 14 linear distances were measured. Various indices were used to quantify error magnitude, among them the acquisition error, the mean and the maximum intra- and inter-operator measurement error, repeatability and reproducibility error, the standard deviation, and the standard error of errors. Two one-sided tests (TOST) were performed to assess the equivalence between measurements recorded in different head angulations. The maximum intra-operator error was very low (0.336 mm), closely followed by the acquisition error (0.496 mm). The maximum inter-operator error was 0.532 mm, and the highest degree of error was found in reproducibility (0.890 mm). Anthropometric measurements from alternative acquisition conditions resulted in significantly equivalent TOST, with the exception of Zygion (l)–Tragion (l) and Cheek (l)–Tragion (l) distances measured with pitch angulation compared to no rotation position. Face Shape 3D Maxiline has sufficient accuracy for orthodontic and surgical use. Precision was not altered by head orientation, making the acquisition simpler and not constrained to a critical precision as in 2D photographs.
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Affiliation(s)
- Giuditta Battistoni
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
- Correspondence: ; Tel.: +39-3403042386
| | - Diana Cassi
- Department of Surgical, Medical, Dental and Morphological Science with Interest in Transplant Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Marisabel Magnifico
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
| | - Giuseppe Pedrazzi
- Department of Medicine and Surgery, Unit of Neuroscience, Interdepartmental Centre of Robust Statistics (Ro.S.A.), University of Parma, 43126 Parma, Italy;
| | - Marco Di Blasio
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
| | - Benedetta Vaienti
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
| | - Alberto Di Blasio
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
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Aghazada H, Vernucci RA, Ramieri V, Cascone P, Barbato E, Silvestri A, Galluccio G. Assessment of maxillary canting on cone beam computed tomography and digital models: A retrospective study and proposal of a method. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:128-135. [PMID: 33774259 DOI: 10.1016/j.jormas.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The mounting of the plaster casts on articulator procedure is routinely performed in orthognathic surgery to assess canting of the maxillary occlusal plane, but the currently used protocols and reference plane could be source of errors which affect reliability. Nowadays the assessment of canting of the maxillary occlusal plane could be also performed with an entirely digital protocol. Aim of the study was to propose a method to evaluate canting in patients affected by Unilateral Condylar Hyperplasia, comparing the measurements performed on digital models matched on CBCT with those made on traditional articulator. MATERIALS AND METHODS A retrospective cross-sectional study was designed on 20 patients affected by vertical Unilateral Condylar Hyperplasia treated in the Units of Orthodontics and Maxillo-Facial Surgery. The canting of the maxillary occlusal plane was measured on plaster casts mounted on the conventional articulator and the measures were compared with those made on digital models matched on CBCT, according the protocol developed in our Unit. Molar, canine and basal difference were measured. To compare the two protocols and to test the agreement, we performed descriptive statistics, comparison between means and Bland Altman analysis. P value was set at 0.05. RESULTS Statistic comparison demonstrated agreement between measurements performed with the digital protocol and conventional physical method. CONCLUSION Measurements of canting with digital protocol are comparable to the physical standard method. A total digital protocol allows faster availability and storage of patient's data and better communication between orthodontist and maxillo-facial surgeon, especially in patients affected by three-dimensional malocclusions.
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Affiliation(s)
- Huseynagha Aghazada
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161 Rome, Italy
| | - Roberto Antonio Vernucci
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161 Rome, Italy.
| | - Valerio Ramieri
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161 Rome, Italy.
| | - Piero Cascone
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161 Rome, Italy.
| | - Ersilia Barbato
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161 Rome, Italy.
| | - Alessandro Silvestri
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161 Rome, Italy.
| | - Gabriella Galluccio
- Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Via Caserta, 6, 00161 Rome, Italy.
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45
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Harris BT, Yang CC, Morton D, Lin WS. Virtual facial simulation of prosthetic outcome for static computer-aided implant surgery and CAD-CAM prostheses. J ORAL IMPLANTOL 2021; 48:51-58. [PMID: 33690838 DOI: 10.1563/aaid-joi-d-19-00193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This clinical report describes a digital process of using a 3-dimensional (3D) virtual patient at an exaggerated smile view for the pre-treatment simulation of the prosthetic outcome. In addition, the virtual patient can be used to assist with the formulation of a prosthetically - driven surgical plan for static computer-aided implant surgery (s-CAIS) and the design of the computer-aided design and computer-aided manufacturing (CAD-CAM) prostheses.
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Affiliation(s)
| | | | | | - Wei-Shao Lin
- Indiana University Department of Prosthodontics 1121 W. Michigan Street UNITED STATES Indianapolis IN 46202-5186 Indiana University
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46
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Three-Dimensional Evaluation on Cortical Bone During Orthodontic Surgical Treatment. J Craniofac Surg 2021; 31:1637-1646. [PMID: 32502113 DOI: 10.1097/scs.0000000000006592] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Adult patients' severe malocclusions, especially the skeletal ones, cannot be exclusively solved by the orthodontic treatment and therefore a combined orthodontic-surgical treatment is necessary. Today, numerous software allows to plane and to visualize the final treatment results simulating the best therapeutic option. This is a retrospective experimental study that aims to analyze the changes in the buccal cortical bone in patients undergoing orthodontics surgeries and to evaluate the correlation between the dental movement and the changes in the relative bone cortex. The study sample consists of 32 subjects. By applying the CBCT radiographic examinations, the measurements were made in well-defined points of reference. The 3D study of the dental changes of position and the cortical buccal bone related variation, suggests how the determined orthodontic movement of the dental element does not achieve an easily predictable bone variation. Therefore, it also suggests that there is no direct proportionality relationship between the extent of bone apposition/reabsorption and dental movement.
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47
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Gaêta-Araujo H, Leite AF, Vasconcelos KDF, Jacobs R. Two decades of research on CBCT imaging in DMFR - an appraisal of scientific evidence. Dentomaxillofac Radiol 2021; 50:20200367. [PMID: 33555198 DOI: 10.1259/dmfr.20200367] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This article aims to appraise how scientific evidence related to CBCT has changed over the years, based on levels of evidence and diagnostic efficacy. METHODS A general search strategy was used in different databases (Pubmed, Embase, and Web of Science) to identify systematic reviews (SRs) on CBCT until November of 2020. The SRs included were divided according to different specialties of dentistry. A critical review of the articles was made, describing the level of evidence and efficacy. RESULTS In total, 75 articles were selected. There was an increase in the number of SRs on CBCT from 2014 onwards, as 83% of the SRs on this topic were published after 2013, and 72% between 2016 and to date. Twenty SRs (27%) performed meta-analysis. Only 28% of the SRs provided a detailed description of CBCT protocols. According to SR evidence, almost all specialties of dentistry have advanced concomitantly with the introduction of CBCT. The majority of SRs were related to clinical applications (level 2 of efficacy), followed by technical parameters (level 1 of efficacy). Only some CBCT models were mentioned in the SRs selected. CONCLUSION Over the course of 20 years, SRs related to CBCT applications for a broad range of dental specialties have been published, with the vast majority of studies at levels 1 and 2 of diagnostic efficacy. Not all CBCT models available on the market have been scientifically validated. At all times, one should remain cautious as such not to simply extrapolate in vitro results to the clinical setting. Also, considering the wide variety of CBCT devices and protocols, reported results should not be overstated or generalized, as outcomes often refer to specific CBCT devices and protocols.
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Affiliation(s)
- Hugo Gaêta-Araujo
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, 13414-903, Piracicaba, Sao Paulo, Brazil
| | - André Ferreira Leite
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dentistry, Faculty of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Karla de Faria Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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48
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Neo B, Lim L, Mohammed-Ali R. Time benefits of 3D planning in orthognathic surgery: a systematic review. Br J Oral Maxillofac Surg 2021; 60:120-127. [DOI: 10.1016/j.bjoms.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/16/2021] [Indexed: 10/22/2022]
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Hyer JN, Murta F, Juniat VAR, Ezra DG. Validating three-dimensional imaging for volumetric assessment of periorbital soft tissue. Orbit 2021; 40:9-17. [PMID: 31931650 DOI: 10.1080/01676830.2020.1711780] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 12/24/2019] [Indexed: 06/10/2023]
Abstract
Purpose: To evaluate the accuracy and interobserver variability of three-dimensional (3D) stereophotogrammetric imaging for volumetric assessment in the periorbital region and to propose a protocol for measurement. Methods: A cross-sectional study was performed. Fifty-eight normal adult subjects had photographs taken using the VECTRA M3 imaging system on two separate occasions at a single center teaching hospital. The primary study outcome measurement was mean volume change in the periorbital region, using different methods of image analysis with the following variables: registration method, eyes open or closed, eyelids measured separately or together, extension of area measured to include mid-face. Accuracy was defined as the agreement between paired images with no measured change in volume (0 mL). The agreement between two independent observers was assessed using Bland-Altman plots. Results: There was a statistically significant difference (P < .0001) between the different methods of measurement, with registration of images having the most effect (partial eta squared 0.229). A mean change in volume of 0.11 ± 0.13 mL was reported for the most accurate method. Agreement between observers was confirmed (highest Intraclass Correlation Coefficient 0.63). Conclusions: Assessment of volumetric change in the periorbital region using 3D image reconstruction is accurate with good interobserver repeatability and is suitable for clinical use. A protocol for data acquisition using the VECTRA M3 is proposed. 3D image reconstruction holds promise to enable diagnosis, treatment monitoring, and surgical outcome evaluation in ocular adnexal disease.
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Affiliation(s)
| | - Fabiola Murta
- Adnexal Department, Moorfields Eye Hospital , London, UK
| | | | - Daniel G Ezra
- Adnexal Department, Moorfields Eye Hospital , London, UK
- UCL Institute of Ophthalmology, NIHR Biomedical Research Centre for Ophthalmology , London, UK
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50
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Gao H, Yang Z, Lin WS, Tan J, Chen L. The Effect of Build Orientation on the Dimensional Accuracy of 3D-Printed Mandibular Complete Dentures Manufactured with a Multijet 3D Printer. J Prosthodont 2021; 30:684-689. [PMID: 33459450 DOI: 10.1111/jopr.13330] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To compare the dimensional accuracy of 3D-printed mandibular complete dentures with different build orientations. MATERIAL AND METHODS A mandibular complete denture was digitized as a virtual reference file. The reference file was 3D-printed at the 0°, 45°, and 90° build orientations with a MultiJet 3D printer (Projet MJP 3600 Dental, 3D systems, Rock Hill, SC). A total of 27 complete dentures were 3D-printed with 9 samples for each orientation. All printed dentures were digitized and separated into teeth, denture extension and intaglio test surfaces. The dimensional accuracy (in root mean square, RMS) was evaluated by comparing whole denture and 3 test surfaces with the reference file. One-way analysis of variance (ANOVA) and a Post-Hoc all pairs Bonferroni test were used to determine statistical differences (α = 0.05). RESULTS For the dimensional accuracy on whole denture, the 45° build orientation group showed the smallest RMS (0.170 ± 0.043 mm) than those of the 0° build orientation group (0.185 ± 0.060 mm, p < 0.001) and 90° build orientation group (0.183 ± 0.044 mm, p < 0.001). For the dimensional accuracy on the teeth, denture extension and intaglio test surfaces, the 45° build orientation group also show the smallest RMS values (0.140 ± 0.044 mm at teeth surface, 0.176 ± 0.058 mm at denture extension and 0.207 ± 0.006 mm at intaglio surface). The 0°and 90° build orientation groups had similar accuracy at the teeth (0.149 ± 0.056 mm versus 0.154 ± 0.056 mm, p = 0.164) and denture extension surfaces (0.200 ±0.025 mm vs 0.196 ± 0.013 mm, p = 1.000). However, 0° build orientation group (0.228 ± 0.010 mm) has significantly higher RMS values then those of 90° build orientation group (0.218 ± 0.057 mm) in the intaglio surface (p = 0.032). The teeth surfaces were most accurate in each build orientation groups, while the intaglio surfaces were least accurate. CONCLUSIONS The build orientation affected the dimensional accuracy of 3D-printed mandibular complete dentures, and the 45° build orientation resulted in the most accurate 3D-printed denture from a MultiJet 3D printer.
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Affiliation(s)
- Hanqi Gao
- Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Zhen Yang
- Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN
| | - Jianguo Tan
- Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Li Chen
- Department of Prosthodontics, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China
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