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Ding M, Kang Y, Shan X, Cai Z. Soft tissue movements after mandibular reconstruction using the vascularized iliac flap: patterns and predictions. Clin Oral Investig 2024; 28:461. [PMID: 39083111 DOI: 10.1007/s00784-024-05709-z] [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: 12/12/2023] [Accepted: 05/06/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVES To investigate soft-to-hard tissue response following mandibular reconstruction and to develop a predictive model for projecting soft tissue movement. MATERIALS AND METHODS In this retrospective study, 18 patients receiving mandibular reconstruction using a vascularized iliac flap were enrolled. Various indicators for characterizing the movement of tissues were considered to identify the effective predictors for projecting soft tissue movements. Face-region-specific linear regression models for prediction were constructed and evaluated. RESULTS The arithmetic mean of hard tissue movement in an extended area had the strongest correlation with the movement of the focal soft tissue, while the arithmetic mean in a regional area (Ram) was a more effective predictor. The linear regression model using Ram, global extrema and distances between them as the predictors performed the best in the lower margin of the face, with an average error of 1.51 ± 1.38 mm. Soft tissue movement in the alveolar process was not correlated with the existence of dentition, only can be predicted by the soft tissue movement below it. The area of the masseter was strongly correlation with Ram, but no other factors. CONCLUSIONS An accurate prediction of soft tissue movements in the lower margin and the alveolar process of the face can be achieved by considering hard tissue and adjacent soft tissue movements. No effective predictor in the masseter area was identified. CLINICAL RELEVANCE We investigated the relationship between hard tissue movements and the soft tissue responses in the facial area. Through building predictive models for projecting postoperative soft tissue movements, we derive insights for the aesthetic outcome of face surgeries. CLINICAL TRIAL REGISTRATION This study was registered on the Chinese Clinical Trial Registry (registration number: ChiCTR2100054103).
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Affiliation(s)
- Mengkun Ding
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No. 22 South Avenue, Zhongguancun, Haidian District, Beijing, 100081, China
| | - Yifan Kang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No. 22 South Avenue, Zhongguancun, Haidian District, Beijing, 100081, China
| | - Xiaofeng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No. 22 South Avenue, Zhongguancun, Haidian District, Beijing, 100081, China
| | - Zhigang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No. 22 South Avenue, Zhongguancun, Haidian District, Beijing, 100081, China.
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Tipyanggul W, Changsiripun C, Chamnannidiadha N. A Comparison of Esthetic Preferences on Female Skeletal Class II Alterations among Laypeople of Different Facial Profiles. Eur J Dent 2024. [PMID: 39074835 DOI: 10.1055/s-0044-1788654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the influences of assessors' different personal profiles on the esthetic perception of Class II facial profile corrections and the agreement between profile and silhouette images. MATERIALS AND METHODS A profile photo of a female with skeletal Class II was digitally altered into three profile and three silhouette images (most pronounced Class II division 1 characteristic, more retruded upper lip position, and more protruded mandibular position). Ninety-six laypeople from three facial profile groups (straight, convex, and concave profiles) chose these images for facial attractiveness. Data were analyzed using an SPSS program. Cohen's kappa coefficient and intraclass correlation coefficients were applied to determine intraparticipant and intra-examiner reliabilities. Chi-square tests were used to test between-group preferences and the relationship of profile preference with other factors. Cohen's kappa coefficient was used to test the agreement in selecting profile and silhouette images (p = 0.05). RESULTS All groups favored profiles with a protruded mandibular position (11-degree facial contour angle [FCA] and 91-degree nasolabial angle [NLA]). Despite facial profile differences, preference remained consistent (p = 0.649). The convex group showed a stronger inclination toward an untreated-simulating profile (17-degree FCA and 91-degree NLA). Preferences were consistent regardless of sex (p = 0.198) and education (p = 0.105). The percentage of agreement between profile and silhouette images in the total sample was 67.71% (kappa = 0.386). All groups of participants chose the more retruded upper lip position (17-degree FCA and 107-degree NLA) profile in silhouette more than in photograph. CONCLUSION All groups preferred a mandibular advancement-simulating profile. Using the photographs or silhouettes to assess the esthetic preference resulted in a similar trend. However, the flatter profile was more preferred in silhouette than in photograph.
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Affiliation(s)
- Wiwan Tipyanggul
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand
| | - Chidsanu Changsiripun
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand
| | - Niramol Chamnannidiadha
- Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand
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Chen YH, Baan F, Bruggink R, Ko EWC, Bergé S, Xi T. Clockwise versus counterclockwise rotation in bimaxillary surgery: 3D analysis of facial soft tissue outcomes. Oral Maxillofac Surg 2024; 28:693-703. [PMID: 37981624 DOI: 10.1007/s10006-023-01196-w] [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: 09/27/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE This study aimed to compare facial 3D soft tissue changes in subjects with Class III deformities who underwent bimaxillary clockwise (CW) and counterclockwise (CCW) rotational orthognathic surgery. METHODS Asian Class III subjects who completed bimaxillary surgical orthodontic treatments were enrolled and categorized into CW and CCW groups based on maxillary occlusal plane alterations. Preoperative and 9-month follow-up cone-beam computed tomography (CBCT) and 3D stereophotogrammetry were obtained, superimposed, and quantified for skeletal movements and soft tissue changes in six facial regions. Inverse probability of treatment weighting (IPTW) adjusted for potential confounding factors. RESULTS Thirty-seven subjects were included (CW group, n = 20; CCW group, n = 17). Postsurgical chin volume significantly reduced in the CW group compared to the CCW group (mean difference 6362 mm3; p = 0.037), and intergonial width significantly decreased in the CW group (mean difference 6.2 mm; p = 0.005). The postoperative alar width increased by 1.04 mm and 1.22 mm in the CW and CCW groups, respectively (p = 0.70). However, these changes were not significantly correlated to the direction of MMC pitch. CONCLUSION Clockwise rotation of the bimaxillary complex demonstrated a significant advantage in reducing chin volume and intergonial width compared to counterclockwise rotation, leading to a reduced frontal lower face width among Asian Class III subjects.
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Affiliation(s)
- Yi-Hsuan Chen
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Frank Baan
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robin Bruggink
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ellen Wen-Ching Ko
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Geert Grooteplein 10, 6525, Ga, Nijmegen, The Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Center, Geert Grooteplein 10, 6525, Ga, Nijmegen, The Netherlands.
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Zhang C, Lu T, Wang L, Wen J, Huang Z, Lin S, Zhou Y, Li G, Li H. Three-dimensional analysis of hard and soft tissue changes in skeletal class II patients with high mandibular plane angle undergoing surgery. Sci Rep 2024; 14:2519. [PMID: 38291067 PMCID: PMC10827781 DOI: 10.1038/s41598-024-51322-1] [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: 11/13/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
This study aimed to study 3-dimensional (3D) changes of hard and soft tissues of skeletal class II patients after 2-jaw surgery and genioplasty. 32 adult patients diagnosed with mandibular hypoplasia who underwent 2-jaw surgery of maxillary impaction, mandibular advancement and genioplasty were enrolled. Cone-beam computed tomography and 3D stereophotogrammetry was conducted 1 week before and 6 months after surgery. Dolphin imaging software was used to establish a 3D digitizing model and 3D measurement system. Paired t-test was performed to compare the values before and after surgery. Pearson's correlation test assessed the degree of correlations between hard and soft tissue change. The mean impaction of the maxilla was 2.600 ± 3.088 mm at A. The mean advancement of the mandible was 7.806 ± 2.647 mm at B. There was a significant upward and forward movement for most landmarks of the nose and lip, while a significant decrease in nasal tip height (lateral view), upper lip height, and upper and lower vermilion height. The nose's width was significantly increased. For maxillary, Sn, Ac-r, Ac-l, and Ls demonstrated a significant correlation with A and U1 in the anteroposterior axis. However, there were no significant correlations among them in the vertical axis. For mandibular, Li demonstrated a significant correlation with L1 in the anteroposterior axis specifically for the mandible. Notably, correlations between the landmarks of the chin's hard and soft tissues were observed across all axes. The utilization of 3-D analysis facilitated a quantitative comprehension of both hard and soft tissues, thereby furnishing valuable insights for the strategic formulation of orthognathic treatment plans targeting patients with skeletal class II conditions.
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Affiliation(s)
- Caixia Zhang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Tong Lu
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Lichan Wang
- Nanjing Lishui Stomatological Hospital, Nanjing, China
| | - Juan Wen
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Ziwei Huang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Shuang Lin
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yiwen Zhou
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Guifeng Li
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
| | - Huang Li
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
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Kim K, Lim CY, Shin J, Chung MJ, Jung YG. Enhanced artificial intelligence-based diagnosis using CBCT with internal denoising: Clinical validation for discrimination of fungal ball, sinusitis, and normal cases in the maxillary sinus. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107708. [PMID: 37473588 DOI: 10.1016/j.cmpb.2023.107708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND AND OBJECTIVE The cone-beam computed tomography (CBCT) provides three-dimensional volumetric imaging of a target with low radiation dose and cost compared with conventional computed tomography, and it is widely used in the detection of paranasal sinus disease. However, it lacks the sensitivity to detect soft tissue lesions owing to reconstruction constraints. Consequently, only physicians with expertise in CBCT reading can distinguish between inherent artifacts or noise and diseases, restricting the use of this imaging modality. The development of artificial intelligence (AI)-based computer-aided diagnosis methods for CBCT to overcome the shortage of experienced physicians has attracted substantial attention. However, advanced AI-based diagnosis addressing intrinsic noise in CBCT has not been devised, discouraging the practical use of AI solutions for CBCT. We introduce the development of AI-based computer-aided diagnosis for CBCT considering the intrinsic imaging noise and evaluate its efficacy and implications. METHODS We propose an AI-based computer-aided diagnosis method using CBCT with a denoising module. This module is implemented before diagnosis to reconstruct the internal ground-truth full-dose scan corresponding to an input CBCT image and thereby improve the diagnostic performance. The proposed method is model agnostic and compatible with various existing and future AI-based denoising or diagnosis models. RESULTS The external validation results for the unified diagnosis of sinus fungal ball, chronic rhinosinusitis, and normal cases show that the proposed method improves the micro-, macro-average area under the curve, and accuracy by 7.4, 5.6, and 9.6% (from 86.2, 87.0, and 73.4 to 93.6, 92.6, and 83.0%), respectively, compared with a baseline while improving human diagnosis accuracy by 11% (from 71.7 to 83.0%), demonstrating technical differentiation and clinical effectiveness. In addition, the physician's ability to evaluate the AI-derived diagnosis results may be enhanced compared with existing solutions. CONCLUSION This pioneering study on AI-based diagnosis using CBCT indicates that denoising can improve diagnostic performance and reader interpretability in images from the sinonasal area, thereby providing a new approach and direction to radiographic image reconstruction regarding the development of AI-based diagnostic solutions. Furthermore, we believe that the performance enhancement will expedite the adoption of automated diagnostic solutions using CBCT, especially in locations with a shortage of skilled clinicians and limited access to high-dose scanning.
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Affiliation(s)
- Kyungsu Kim
- Medical AI Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea; Department of Data Convergence and Future Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Chae Yeon Lim
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Joongbo Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Myung Jin Chung
- Medical AI Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea; Department of Data Convergence and Future Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea; Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Gi Jung
- Medical AI Research Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea; Department of Data Convergence and Future Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Shi Y, Liu S, Shao X, Zong C, Bai S, Yang Y, Liu Y, Shang H, Tian L. Facial changes in patients with skeletal class III deformity after bimaxillary surgery: an evaluation based on three-dimensional photographs registered with computed tomography. Br J Oral Maxillofac Surg 2022; 60:1404-1410. [PMID: 36428154 DOI: 10.1016/j.bjoms.2022.05.014] [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: 01/19/2022] [Revised: 05/11/2022] [Accepted: 05/30/2022] [Indexed: 11/23/2022]
Abstract
The objective of this study was to evaluate facial soft and hard tissue changes, individually and relative to each other, in patients with skeletal class III deformity after bimaxillary surgery using three-dimensional (3D) photos obtained by white light scanning. Thirty patients with skeletal class III deformity who underwent bimaxillary surgery were selected. Each patient underwent white light scanning and spiral computed tomography (CT) within two weeks before (T0) and six months after surgery (T1). The 3D photos were registered with CT soft tissue models for T0 and T1, and the skeletal area unaffected by treatment (cranial base) was used to register T0 and T1. Then, the 3D colour-coded map was analysed to assess both skeletal and soft tissue changes between T0 and T1. Changes in the 3D coordinates of each anatomical landmark were analysed using the Student's t-test. Maxillary advancement by 2-3 mm and mandibular recession by 5-6 mm were observed; the mandible was shortened in the vertical direction. Compared with the preoperative values, the nasal columella was 0.51 mm shorter, the upper lip was 0.71 mm longer, the base of the alar cartilage was 1.38 mm wider, and the nasolabial angle became larger. The ratio of change in the position of soft tissue point Sn to hard tissue point A was 0.73:1, and that of soft tissue point Pg to hard tissue point Pog was 0.86:1. Images obtained by structured white light scanning registered with CT can be used as an alternative to study facial changes after orthognathic surgery.
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Affiliation(s)
- Yulin Shi
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
| | - Siying Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
| | - Xiaoxi Shao
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
| | - Chunlin Zong
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
| | - Shizhu Bai
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Digital stomatology Center, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
| | - Yong Yang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
| | - Yanpu Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China
| | - Hongtao Shang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
| | - Lei Tian
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China.
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Salim V, Peter E, Ani G S. What are the intra-arch risk factors for palatally displaced maxillary canine? - Results of a case-control study. J Orthod Sci 2022; 11:48. [PMID: 36411810 PMCID: PMC9674934 DOI: 10.4103/jos.jos_168_21] [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: 08/06/2021] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION This study aimed to identify the intra-arch risk factors for palatally displaced canine by comparing the maxillary transverse dimensions, palatal depth (PD), and arch length (AL) of the subjects with and without impacted canine using cone-beam computed tomography (CBCT). METHODS In this prospective case-control study, 79 CBCT images of gender- and skeletal feature-matched subjects (25 cases and 54 controls) were compared. Based on the CBCT images, maxillary transverse widths at four levels (molar basal, molar alveolar, premolar basal, and premolar alveolar), maxillary PD, and maxillary AL were measured. Group comparisons were assessed using analysis of variance (ANOVA), followed by post-hoc Scheffe's test, and risk factors were identified using univariate and multivariate logistic regression. RESULTS The impacted canine group showed significantly smaller molar alveolar width, premolar alveolar width, PD, and greater AL compared to the control group (P = 0.046, P < 0.001, P = 0.003, and P = 0.001, respectively). No significant difference was observed in the molar and premolar basal width measurements between the two groups. Multivariate analysis showed that impacted maxillary canine was influenced by premolar alveolar width (odds ratio (OR): 0.669), PD (OR: 0.532), and AL (OR: 1.739). CONCLUSION Intra-arch risk factors, such as reduced maxillary premolar transverse alveolar width, PD, and greater AL, are associated with palatally displaced canine.
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Affiliation(s)
- Varsha Salim
- Department of Orthodontics, Government Dental College, Kottayam, Kerala, India
| | - Elbe Peter
- Department of Orthodontics, Government Dental College, Kottayam, Kerala, India,Address for correspondence: Dr. Elbe Peter, Department of Orthodontics and Dentofacial Orthopedics, Government Dental College, Kottayam, Kerala- 686 008, India. E-mail:
| | - Suja Ani G
- Department of Orthodontics, Government Dental College, Kottayam, Kerala, India
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Ajmera DH, Singh P, Leung YY, Gu M. Three-dimensional evaluation of soft-tissue response to osseous movement after orthognathic surgery in patients with facial asymmetry: A systematic review. J Craniomaxillofac Surg 2021; 49:763-774. [PMID: 34016501 DOI: 10.1016/j.jcms.2021.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/16/2021] [Accepted: 04/20/2021] [Indexed: 11/26/2022] Open
Abstract
To systematically assess the current literature on soft-tissue response associated with osseous movement following orthognathic surgery in patients with facial asymmetry. Six electronic databases (PubMed, EMBASE (via Ovid), Medline (via Ovid), Cochrane Library, Scopus, and Web of Science) and gray literature were searched for studies evaluating hard- and soft-tissue responses three-dimensionally after orthognathic surgery, using MeSH terms and keywords. The methodological quality and level of evidence of the included studies were analyzed using EPHPP and GRADE, respectively. The primary search yielded 125 articles, and 10 articles that satisfied the predefined inclusion criteria were finally included. All the included articles evaluated soft-tissue response, with six of them additionally investigating the magnitude of this response. Soft tissues move with hard tissues horizontally and anteroposteriorly; however, soft-tissue movement is less than hard tissue movement. In addition, soft tissue movement is more pronounced in the lower central facial region. Six articles were judged as having 'strong' methodological quality, while the evidence was found to be of 'low' quality for the soft-tissue response and the magnitude of this response. Despite a low level of evidence, the review substantiates a favorable three-dimensional soft-tissue response following osseous surgery. The soft-tissue response is more pronounced horizontally, anteroposteriorly, and in the lower central facial region. Nevertheless, well-designed prospective studies with a higher level of evidence are needed.
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Affiliation(s)
- Deepal Haresh Ajmera
- Department of Orthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Pradeep Singh
- Department of Orthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Yiu Yan Leung
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Min Gu
- Department of Orthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
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Suzuki K, Nakano H, Yamada T, Mizobuchi S, Yasuda K, Albouga S, Inoue K, Matsumura M, Tajiri S, Mishima K, Mori Y, Ueno T. Establishment of a Method for Predicting a Posed Smile from a Straight Face. J HARD TISSUE BIOL 2021. [DOI: 10.2485/jhtb.30.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kei Suzuki
- Department of Oral Surgery, Osaka Medical College
| | | | - Tomohiro Yamada
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
| | | | - Kousuke Yasuda
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
| | - Safieh Albouga
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
| | - Kazuya Inoue
- Department of Oral Surgery, Osaka Medical College
| | | | - Shiho Tajiri
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
| | - Katsuaki Mishima
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yamaguchi University
| | - Yoshihide Mori
- Division of Oral and Maxillofacial Surgery, Department of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
| | - Takaaki Ueno
- Department of Oral Surgery, Osaka Medical College
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Cunha HS, da Costa Moraes CA, de Faria Valle Dornelles R, da Rosa ELS. Accuracy of three-dimensional virtual simulation of the soft tissues of the face in OrtogOnBlender for correction of class II dentofacial deformities: an uncontrolled experimental case-series study. Oral Maxillofac Surg 2020; 25:319-335. [PMID: 33161500 PMCID: PMC7648899 DOI: 10.1007/s10006-020-00920-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/30/2020] [Indexed: 11/30/2022]
Abstract
Purpose To assess whether virtual simulations of the projection of the soft tissues of the face after class II bimaxillary orthognathic surgery, generated from 3D reconstruction of preoperative computed tomography (CT) scans, differed significantly from the actual soft tissue profile obtained in the late postoperative period (beyond 6 months). Secondarily, to validate the accuracy of a free, open-source software suite for virtual soft tissue planning in orthognathic surgery. Methods Helical CT scans were obtained pre- and postoperatively from 16 patients with Angle class II malocclusion who underwent bimaxillary orthognathic surgery. A comparative study between soft tissue meshes constructed for surgical simulation (M1) and the actual meshes obtained from postoperative scans (M2) was then performed. To establish the accuracy of 3D facial soft tissue simulation in a free and open-source software suite (OrtogOnBlender-OOB), 17 predetermined anatomic landmarks were measured in M1 and M2 scans after alignment of cranial structures. Results The mean error between preoperative simulations and actual postoperative findings was < 2 mm for all anthropometric landmarks. The overall average error for the facial soft tissues was 1.07 mm. Conclusion Comparison between preoperative simulation (M1) and actual postoperative findings (M2) showed clinically relevant ability of the method to reproduce actual surgical movement reliably (< 2-mm error). OOB is capable of accurate soft tissue planning for orthognathic surgery, but mesh deformation methods still require improvement. Trial registration RBR-88jff9. Retrospectively registered at Brazilian Registry of Clinical trials-ReBec (http://www.ensaiosclinicos.gov.br) May 06, 2020.
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Affiliation(s)
- Hugo Santos Cunha
- Oral and Maxillofacial Surgery Unit, Hospital de Base do Distrito Federal, Brasília, DF, Brazil
| | | | | | - Everton Luis Santos da Rosa
- Oral and Maxillofacial Surgery Unit, Instituto de Gestão Estratégica de Saúde do Distrito Federal (IGESDF), Hospital de Base, SMHS - Área Especial, Q. 101 - Asa Sul, Brasília, DF, 70330-150, Brazil.
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Mai DDP, Stucki S, Gkantidis N. Assessment of methods used for 3-dimensional superimposition of craniofacial skeletal structures: a systematic review. PeerJ 2020; 8:e9263. [PMID: 32547877 PMCID: PMC7278889 DOI: 10.7717/peerj.9263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/09/2020] [Indexed: 01/08/2023] Open
Abstract
Background So far, several techniques have been recommended for the assessment of craniofacial changes through skeletal tissue superimposition, but the evidence that supports them remains unexplored. The purpose of the present study is to assess the available literature on skeletal-tissue superimpositions of serial craniofacial CT or CBCT images used to detect morphological changes. Materials and Methods Medline (via Pubmed), EMBASE, Google Scholar, Cochrane Library, Open Grey and Grey Literature Report were searched (last search: 17.11.2019) using specific terms that fulfilled the requirements of each database in the context of the study aim. Hand searches were also performed. The outcomes of interest were the accuracy, precision, or agreement between skeletal-tissue superimposition techniques to assess changes in the morphology of craniofacial structures. Studies of any design with sample size ≥3 were assessed by two authors independently. The study protocol was registered in PROSPERO (ID: CRD42019143356). Results Out of 832 studies, fifteen met the eligibility criteria. From the 15 included studies, 12 have shown high total risk of bias, one low risk of bias, and two studies have shown unclear risk of bias. Thirteen out of the 15 studies showed high applicability concerns, two unclear and no study had low applicability concerns. There was high heterogeneity among studies regarding the type of participants, sample size, growth status, machines, acquisition parameters, superimposition techniques, assessment techniques and outcomes measured. Fourteen of them were performed on Cone Beam Computed Tomography (CBCT) and one on Computed Tomography (CT) derived 3D models. Most of the studies (eleven) used voxel-based registration, one landmark-based registration and three studies compared different registration techniques, which include the surface-based registration. Concerning the area of interest, nine studies focused on the anterior cranial base and certain facial structures, four on maxillary structures and four on mandibular structures. Non-growing participants were included in six studies, growing in eight, whereas one study had both. Conclusion Most of the available studies had methodological shortcomings and high applicability concerns. At the moment, certain voxel-based and surface-based superimpositions seem to work properly and to be superior to landmark-based superimposition. However, further research in the field is required to develop and properly validate these techniques on different samples, through high quality studies with low applicability concerns.
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Affiliation(s)
- Daniel Dinh-Phuc Mai
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Sven Stucki
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
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12
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Oueis R, Waite PD, Wang J, Kau CH. Orthodontic-Orthognathic Management of a patient with skeletal class II with bimaxillary protrusion, complicated by vertical maxillary excess: A multi-faceted case report of difficult treatment management issues. Int Orthod 2019; 18:178-190. [PMID: 31668665 DOI: 10.1016/j.ortho.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 09/28/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
This case reports the unsuccessful first treatment and the subsequent retreatment of a 35-year old Asian female with a skeletal class II with bimaxillary protrusion, complicated by a deep bite and vertical maxillary excess. This case report highlights the multiple facets of a challenging treatment plan and discusses the ramifications of treatment when treatment does not go as planned. The initial treatment plan consisted of a surgical approach with a maxillary Le Fort I surgery to correct the malocclusion as per the patient's requests without mandibular surgery due to the inherent risk of paraesthesia. The second treatment plan consisted of a bimaxillary surgery with genioplasty. The surgical treatment utilized virtual surgical planning (VSP). The orthodontic treatment was concluded with a corrected overjet and overbite achieving optimum function and balancing the facial profile aesthetically. This case report highlights the need for clear communication of the treatment plan and also the unpredictability of certain treatment outcomes especially when the literature does not provide for definitive conclusions. In addition, it sheds light on the challenge of unpredictable response of soft tissue after surgical treatment and the importance of patient expectations of outcomes. It is hoped that the paper provides a platform for future discussions of difficult malocclusions.
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Affiliation(s)
- Rawan Oueis
- University of Alabama, School of Dentistry, Department of Orthodontics, 1919 7th Ave S, SDB 305, Q1 35294-0007 Birmingham, AL, USA
| | - Peter D Waite
- University of Alabama, School of Dentistry, Department of Oral and Maxillofacial Surgery, Birmingham, AL, USA
| | - Jue Wang
- University of Alabama, School of Dentistry, Department of Orthodontics, 1919 7th Ave S, SDB 305, Q1 35294-0007 Birmingham, AL, USA
| | - Chung H Kau
- University of Alabama, School of Dentistry, Department of Orthodontics, 1919 7th Ave S, SDB 305, Q1 35294-0007 Birmingham, AL, USA.
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13
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Oral health-related quality of life following orthognathic surgery for class III correction its relationship with cephalometric changes. Int J Oral Maxillofac Surg 2019; 48:1434-1439. [DOI: 10.1016/j.ijom.2019.03.899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/27/2019] [Accepted: 03/19/2019] [Indexed: 11/19/2022]
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14
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Anthropometric Facial Changes After Orthognathic Surgery and Their Relation With Oral Health Related Quality of Life. J Craniofac Surg 2019; 30:1118-1120. [PMID: 31166256 DOI: 10.1097/scs.0000000000005214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of the present study was to determine the impacts of orthognathic surgery on soft tissue on frontal and profile views and their relation with patient's quality of life. METHODS Twenty-nine patients with severe skeletal class III malocclusion who were candidate for bimaxillary orthognathic surgery consisted of 1-piece Lefort I surgery with bilateral sagittal split osteotomy were selected. Oral health was assessed by short from of Oral Health Impact Profile-14 questionnaire. Facial anthropometric measurements were conducted before starting any treatment and 6 months after orthognathic surgery according to Farkas anthropometric study. The correlation between facial changes due to treatment and oral health were tested by Pearson correlation analysis. RESULTS No significant differences were observed in Oral Health Impact Profile-14 scores with regard to genders. Decreased vermilion total upper lip height index correlates positively with feeling difficult to relax. Increasing in medial-lateral cutaneous upper lip height index correlates negatively with dissatisfaction with diet. Increased upper face-face height index correlates positively with feeling uncomfortable to eat any foods and feeling a bit irritable with other people. CONCLUSION Oral health-related quality of life can be affected not only by the objective aesthetic criterion but also by different factors like their attitude toward aesthetic, surgery side effects.
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15
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Badiali G, Marcelli E, Bortolani B, Marchetti C, Cercenelli L. An average three-dimensional virtual human skull for a template-assisted maxillofacial surgery. Int J Artif Organs 2019; 42:566-574. [PMID: 31117867 DOI: 10.1177/0391398819849075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Although many advances have been made in three-dimensional virtual planning in maxillofacial surgery, facial harmony is still difficult to achieve and is heavily dependent on the surgeon's experience. The aim of the study is to present a method to build up an average three-dimensional virtual human skull to be used as a reference template for bone repositioning and reconstruction during maxillofacial surgical interventions. METHODS A total of 20 patients (10 females and 10 males) were selected for the optimal outcome after orthognathic surgery. Postoperative cone-beam computed tomography scans were collected and processed in order to obtain three-dimensional digital models of each skull. For male and female subgroups, the three-dimensional skull models were registered and an average three-dimensional virtual skull model was computed. Deviation color maps were calculated to show differences between each postoperative skull model in the population and the obtained average three-dimensional skull. A clinical use case of genioplasty treatment assisted by the provided average three-dimensional skull template was presented. RESULTS The overall mean deviation from the average three-dimensional skull model was 1.3 ± 0.6 and 1.6 ± 0.5 mm in male and female subgroups, respectively. For both groups, the greatest deviations were at the area of the mandible, while almost no deviation was found at the zygomatic and orbital areas. In the presented use case, the female average three-dimensional skull model was effectively used for guiding surgical planning. CONCLUSION The presented method of obtaining an average three-dimensional virtual human skull may offer the interesting perspective of performing an innovative template-assisted maxillofacial surgery.
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Affiliation(s)
- Giovanni Badiali
- Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Sciences and S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emanuela Marcelli
- Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Barbara Bortolani
- Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudio Marchetti
- Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Sciences and S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Laura Cercenelli
- Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Sciences and S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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16
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Soft tissue assessment before and after mandibular advancement or setback surgery using three-dimensional images: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:1389-1397. [DOI: 10.1016/j.ijom.2018.05.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/18/2018] [Accepted: 05/28/2018] [Indexed: 11/19/2022]
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17
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Koerich L, Brunetto DP, Ohira ETB. The effect of hard tissue surgical changes on soft tissue displacement: a pilot CBCT study. Dental Press J Orthod 2018; 22:39-46. [PMID: 29160343 PMCID: PMC5730135 DOI: 10.1590/2177-6709.22.5.039-046.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 06/08/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION This pilot study had as main objective to test the reliability of a new method to evaluate orthognathic surgery outcomes and also, to understand the effect of hard tissue changes on soft tissue displacement. METHODS The sample consisted of eight patients that underwent bimaxillary advancement and had CBCT at two time points (before surgery and 6-8 months follow-up). Voxel-based cranial base superimposition was used to register the scans. A different technique of iterative closest point (ICP) was used to measure and correlate the changes. The average displacement of 15 areas (4 hard tissue and 11 soft tissue) were measured twice. RESULTS ICC was > 0.99 for all areas. Changes in the tip of the nose did not correlate with changes in any maxillary area, whereas soft tissue A point, A point and upper lips had correlation with several areas. The highest correlation for the maxilla was between the upper lip and the left/right supra cheilion (p< 0.001, r= 0.91 and p< 0.001, r= 0.93, respectively). In the mandible, the majority of the correlations involved soft tissue pogonion, pogonion and lower incisors, with the strongest one between pogonion and lower incisors (p< 0.001, r= 0.98). CONCLUSION With the proper case selection, ICP is a reliable method that can be used to assess three-dimensional changes.
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Affiliation(s)
- Leonardo Koerich
- Virginia Commonwealth University, International Dental Program (Richmond, USA)
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Cintra O, Grybauskas S, Vogel CJ, Latkauskiene D, Gama NA. Digital platform for planning facial asymmetry orthodontic-surgical treatment preparation. Dental Press J Orthod 2018; 23:80-93. [PMID: 30088569 PMCID: PMC6072444 DOI: 10.1590/2177-6709.23.3.080-093.sar] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/03/2018] [Indexed: 12/04/2022] Open
Abstract
Dentofacial deformities usually are surgically treated, and 3D virtual planning has been used to favor accurate outcomes. Cases reported in the present article show that orthognathic surgery carried out to correct facial asymmetries does not comprise only one treatment protocol. 3D virtual planning might be used for surgical planning, but it should also be used to diagnose the deformity, thus allowing for an analysis of the best-recommended possibilities for the orthodontic preparation that suits each individual case.
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Affiliation(s)
| | - Simonas Grybauskas
- Private practice (Vilnius, Lithuania).,Vilnius University Hospital Zalgirio Clinic, Department of Oral of Maxillofacial Surgery (Vilnius, Lithuania).,Lithuanian University of Health Sciences, Department of Plastic and Reconstructive Surgery (Kaunas, Lithuania)
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19
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Lo LJ, Weng JL, Ho CT, Lin HH. Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism. PLoS One 2018; 13:e0200589. [PMID: 30067766 PMCID: PMC6070212 DOI: 10.1371/journal.pone.0200589] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/01/2018] [Indexed: 01/27/2023] Open
Abstract
Both deep understanding and reliable prediction of postoperative soft tissue changes are crucial for planning orthognathic surgery. Instead of estimating soft tissue responses by measuring individual landmark changes, this study aimed to investigate the relationship (ratio) between soft and hard tissue movements in different facial regions through three-dimensional cone-beam computed tomography (CBCT). Preoperative and postoperative CBCT images were superimposed using the surface registration method on the basis of the cranial base, and 10 facial regions of interest were defined. Region-based volumetric subtractions between the preoperative and postoperative segments were performed. The volumetric differences and surface of each region were used to estimate the average movement. Correlation and regression analyses were performed to examine the relationships between the corresponding soft and hard tissue movements. An overall pattern of facial soft tissue movement was observed in patients with prognathism who underwent orthognathic surgery. The experiment results have shown that mean ratios for the average soft-to-hard tissue movements in the facial regions varied, which may not exactly be similar to the published reports because of the population biocharacteristics and study methods, but the trend is in agreement with the previous studies. Additionally, the prediction capability of the regression model was significantly high, ranging from 0.786 to 0.857, in upper lip, upper vermilion, and chin regions, thus demonstrating that the skin outline changes in these critical regions could be reliably predicted from the underlying bone movements. These results could likely be applied in future soft tissue simulation in orthognathic surgery.
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Affiliation(s)
- Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery, and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Jing-Ling Weng
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Ting Ho
- Department of Craniofacial Orthodontics, Department of Dentistry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsiu-Hsia Lin
- Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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20
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Three-Dimensional Analysis of Midfacial Soft Tissue Changes After Maxillary Posterior Impaction and Intraoral Vertical Ramus Osteotomy for Mandibular Setback in Class III Patients. J Craniofac Surg 2017; 28:1789-1796. [DOI: 10.1097/scs.0000000000003754] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Olate S, Zaror C, Mommaerts MY. A systematic review of soft-to-hard tissue ratios in orthognathic surgery. Part IV: 3D analysis - Is there evidence? J Craniomaxillofac Surg 2017; 45:1278-1286. [PMID: 28619465 DOI: 10.1016/j.jcms.2017.05.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/16/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to determine the soft-to-hard tissue ratio using 3D analysis in different types of orthognathic surgery. MATERIAL AND METHODS A systematic search for relevant studies published in different languages through December 2016 was performed in the Medline, Embase, Lilacs, Scopus, and Science Direct databases. Additional studies were identified by reference analysis. The methodological quality of the included studies was evaluated using the method proposed by the Effective Public Health Practice Project. The level of evidence was assessed using the Level of Evidence (LOE) scale from the Oxford Center for Evidence-Based Medicine. RESULTS A total of 11 articles with 461 patients were included in the review, comprising 5 retrospective study and 6 prospective studies. The latter included 5 studies that performed anatomical area analyses of postoperative soft tissue results in the context of software-based planned surgeries without regard to hard tissues and 6 articles that presented analyses related to soft tissue in the preoperative and postoperative stage with certain points to be considered in hard tissues. The analysis of bias in the articles revealed a weak methodology in all included studies, which made it impossible to perform any type of comparison. CONCLUSION Bias governs many of the published studies related to 3D analysis. There are no data that can be applied to determine the soft-to-hard tissue ratio using 3D analysis in orthognathic surgery.
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Affiliation(s)
- Sergio Olate
- European Face Centre (Head: Prof. Maurice Y. Mommaerts, MD, DMD, PhD, FEBOMFS, FICS, FAACS), Universitair Ziekenhuis, Vrije Universiteit Brussel, Brussels, Belgium; Division of Oral and Maxillofacial Surgery (Head: Prof. Sergio Olate, DDS, MSc, PhD), Universidad de La Frontera, Temuco, Chile; Center for Biomedical Research (Head. Prof. Mariano del Sol), Universidad Autónoma de Chile, Temuco, Chile
| | - Carlos Zaror
- Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO) (Head: Prof. Carlos Zaror, DDS, MSc), Universidad de La Frontera, Temuco, Chile
| | - Maurice Y Mommaerts
- European Face Centre (Head: Prof. Maurice Y. Mommaerts, MD, DMD, PhD, FEBOMFS, FICS, FAACS), Universitair Ziekenhuis, Vrije Universiteit Brussel, Brussels, Belgium.
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Abstract
INTRODUCTION 3D imaging possibilities raised up in the last few years in the orthodontic field. In 2016, it can be used for diagnosis improvement and treatment planning by using digital set up combined to CBCT. It is relevant for orthodontic mechanic updating by creating visible or invisible customised appliances. It forms the basis of numerous scientific researches. MATERIALS AND METHODS The author explains the progress 3D imaging brings to diagnosis and clinics but also highlights the requirements it creates. DISCUSSION The daily use of these processes in orthodontic clinical practices needs to be regulated regarding the benefit/risk ratio and the patient satisfaction. RESULTS The command of the digital work flow created by these technics requires habits modifications from the orthodontist and his staff.
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Gibelli D, De Angelis D, Poppa P, Sforza C, Cattaneo C. A View to the Future: A Novel Approach for 3D-3D Superimposition and Quantification of Differences for Identification from Next-Generation Video Surveillance Systems. J Forensic Sci 2016; 62:457-461. [DOI: 10.1111/1556-4029.13290] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 06/16/2016] [Accepted: 06/26/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Daniele Gibelli
- LABANOF; Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale e delle Assicurazioni; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; V. Mangiagalli, 37 20133 Milan Italy
- LAFAS, Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico, Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; V. Mangiagalli, 31 20133 Milan Italy
| | - Danilo De Angelis
- LABANOF; Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale e delle Assicurazioni; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; V. Mangiagalli, 37 20133 Milan Italy
| | - Pasquale Poppa
- LABANOF; Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale e delle Assicurazioni; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; V. Mangiagalli, 37 20133 Milan Italy
| | - Chiarella Sforza
- LAFAS, Laboratorio di Anatomia Funzionale dell’Apparato Stomatognatico, Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; V. Mangiagalli, 31 20133 Milan Italy
| | - Cristina Cattaneo
- LABANOF; Laboratorio di Antropologia e Odontologia Forense; Sezione di Medicina Legale e delle Assicurazioni; Dipartimento di Scienze Biomediche per la Salute; Università degli Studi di Milano; V. Mangiagalli, 37 20133 Milan Italy
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Lee ST, Choi NR, Song JM, Shin SH. Three-dimensional morphometric analysis of mandibule in coronal plane after bimaxillary rotational surgery. Maxillofac Plast Reconstr Surg 2016; 38:49. [PMID: 27995122 PMCID: PMC5122603 DOI: 10.1186/s40902-016-0096-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 11/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure. Methods To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (≥16) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (≤10). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (≥16). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained. Results Mean Go’Rt-Me’-Go’Lt angular measurement was 100.74 ± 2.14 in female patients and 105.37 ± 3.62 in male patients. These showed significant difference with control A group in both genders. Ratio of Go’Rt,Go’Lt-Me’ length to some linear measurements (ratio of Me’-Cd’RtCd’Lt to Me’-Go’RtGo’Lt, ratio of Me’-Go’ to Me’-Go’RtGo’Lt, ratio of Go’Rt-Go’Lt to Me’-Go’RtGo’Lt) showed significant difference with control A group in both genders. Conclusion This study was intended to find some standard measurement of mandible frontal view in 3D analysis of aesthetic patient. So, these potential measurement value may be helpful for orthognathic treatment planning to have more aesthetic and perspective outcomes.
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Affiliation(s)
- Sung-Tak Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea
| | - Na-Rae Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea
| | - Jae-Min Song
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea
| | - Sang-Hun Shin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, 626-870 Korea
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Ikeda R, Oberoi S, Wiley DF, Woodhouse C, Tallman M, Tun WW, McNeill C, Miller AJ, Hatcher D. Novel 3-dimensional analysis to evaluate temporomandibular joint space and shape. Am J Orthod Dentofacial Orthop 2016; 149:416-28. [PMID: 26926030 DOI: 10.1016/j.ajodo.2015.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to present and validate a novel semiautomated method for 3-dimensional evaluation of the temporomandibular joint (TMJ) space and condylar and articular shapes using cone-beam computed tomographic data. METHODS The protocol for 3-dimensional analysis with the Checkpoint software (Stratovan, Davis, Calif) was established by analyzing cone-beam computed tomographic images of 14 TMJs representing a range of TMJ shape variations. Upon establishment of the novel method, analysis of 5 TMJs was further repeated by several investigators to assess the reliability of the analysis. RESULTS Principal components analysis identified 3 key components that characterized how the condylar head shape varied among the 14 TMJs. Principal component analysis allowed determination of the minimum number of landmarks or patch density to define the shape variability in this sample. Average errors of landmark placement ranged from 1.15% to 3.65%, and none of the 121 landmarks showed significant average errors equal to or greater than 5%. Thus, the mean intraobserver difference was small and within the clinically accepted margin of error. Interobserver error was not significantly greater than intraobserver error, indicating that this is a reliable methodology. CONCLUSIONS This novel semiautomatic method is a reliable tool for the 3-dimensional analysis of the TMJ including both the form and the space between the articular eminence and the condylar head.
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Affiliation(s)
- Renie Ikeda
- Assistant clinical professor, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, Calif.
| | - Snehlata Oberoi
- Professor, Division of Craniofacial Anomalies, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, Calif
| | | | | | - Melissa Tallman
- Assistant professor, Department of Biomedical Sciences, Grand Valley State University, Allendale, Mich
| | - Wint Wint Tun
- Resident, Division of Orthodontics, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, Calif
| | - Charles McNeill
- Professor emeritus; director, Center for Orofacial Pain, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California at San Francisco, San Francisco, Calif
| | - Arthur J Miller
- Professor, Division of Orthodontics, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, Calif
| | - David Hatcher
- Professor, Division of Orthodontics, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco; private practice, DDI Imaging Center, Sacramento, Calif
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Ozsoy U, Sekerci R, Ogut E. Effect of sitting, standing, and supine body positions on facial soft tissue: detailed 3D analysis. Int J Oral Maxillofac Surg 2015; 44:1309-16. [PMID: 26116065 DOI: 10.1016/j.ijom.2015.06.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 04/22/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022]
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Ozsoy U, Sekerci R, Ogut E. Effect of sitting, standing, and supine body positions on facial soft tissue: detailed 3D analysis. Int J Oral Maxillofac Surg 2015; 44:1309-1316. [DOI: https:/doi.org/10.1016/j.ijom.2015.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
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"Direct DICOM Slice Landmarking" A Novel Research Technique to Quantify Skeletal Changes in Orthognathic Surgery. PLoS One 2015; 10:e0131540. [PMID: 26252768 PMCID: PMC4529249 DOI: 10.1371/journal.pone.0131540] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 06/03/2015] [Indexed: 12/02/2022] Open
Abstract
The limitations of the current methods of quantifying the surgical movements of facial bones inspired this study. The aim of this study was the assessment of the accuracy and reproducibility of directly landmarking of 3D DICOM images (Digital Imaging and Communications in Medicine) to quantify the changes in the jaw bones following surgery. The study was carried out on plastic skull to simulate the surgical movements of the jaw bones. Cone beam CT scans were taken at 3mm, 6mm, and 9mm maxillary advancement; together with a 2mm, 4mm, 6mm and 8mm “down graft” which in total generated 12 different positions of the maxilla for the analysis. The movements of the maxilla were calculated using two methods, the standard approach where distances between surface landmarks on the jaw bones were measured and the novel approach where measurements were taken directly from the internal structures of the corresponding 3D DICOME slices. A one sample t-test showed that there was no statistically significant difference between the two methods of measurements for the y and z directions, however, the x direction showed a significant difference. The mean difference between the two absolute measurements were 0.34±0.20mm, 0.22±0.16mm, 0.18±0.13mm in the y, z and x directions respectively. In conclusion, the direct landmarking of 3D DICOM image slices is a reliable, reproducible and informative method for assessment of the 3D skeletal changes. The method has a clear clinical application which includes the analysis of the jaw movements “orthognathic surgery” for the correction of facial deformities.
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Kapila SD, Nervina JM. CBCT in orthodontics: assessment of treatment outcomes and indications for its use. Dentomaxillofac Radiol 2015; 44:20140282. [PMID: 25358833 DOI: 10.1259/dmfr.20140282] [Citation(s) in RCA: 193] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications. This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic therapy and for research to decipher treatment outcomes and 3D craniofacial anatomy. The current diagnostic and treatment planning indications for CBCT include impacted teeth, cleft lip and palate and skeletal discrepancies requiring surgical intervention. The use of CBCT in these and other situations such as root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, asymmetries and alveolar boundary conditions should be justified on the basis of the merits relative to risks of imaging. CBCT has also been used to assess 3D craniofacial anatomy in health and disease and of treatment outcomes including that of root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion; airway morphology, vertical malocclusion and obstructive sleep apnoea; TMJ morphology and pathology contributing to malocclusion; and temporary anchorage devices. Finally, this article utilizes findings of these studies and current voids in knowledge to provide ideas for future research that could be beneficial for further optimizing the use of CBCT in research and the clinical practice of orthodontics.
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Affiliation(s)
- S D Kapila
- Department of Orthodontics and Pediatric Dentistry, The University of Michigan, Ann Arbor, MI, USA
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Sharples L, Glover M, Clutterbuck-James A, Bennett M, Jordan J, Chadwick R, Pittman M, East C, Cameron M, Davies M, Oscroft N, Smith I, Morrell M, Fox-Rushby J, Quinnell T. Clinical effectiveness and cost-effectiveness results from the randomised controlled Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea-hypopnoea (TOMADO) and long-term economic analysis of oral devices and continuous positive airway pressure. Health Technol Assess 2015; 18:1-296. [PMID: 25359435 DOI: 10.3310/hta18670] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obstructive sleep apnoea-hypopnoea (OSAH) causes excessive daytime sleepiness (EDS), impairs quality of life (QoL) and increases cardiovascular disease and road traffic accident risks. Continuous positive airway pressure (CPAP) treatment is clinically effective but undermined by intolerance, and its cost-effectiveness is borderline in milder cases. Mandibular advancement devices (MADs) are another option, but evidence is lacking regarding their clinical effectiveness and cost-effectiveness in milder disease. OBJECTIVES (1) Conduct a randomised controlled trial (RCT) examining the clinical effectiveness and cost-effectiveness of MADs against no treatment in mild to moderate OSAH. (2) Update systematic reviews and an existing health economic decision model with data from the Trial of Oral Mandibular Advancement Devices for Obstructive sleep apnoea-hypopnoea (TOMADO) and newly published results to better inform long-term clinical effectiveness and cost-effectiveness of MADs and CPAP in mild to moderate OSAH. TOMADO A crossover RCT comparing clinical effectiveness and cost-effectiveness of three MADs: self-moulded [SleepPro 1™ (SP1); Meditas Ltd, Winchester, UK]; semibespoke [SleepPro 2™ (SP2); Meditas Ltd, Winchester, UK]; and fully bespoke [bespoke MAD (bMAD); NHS Oral-Maxillofacial Laboratory, Addenbrooke's Hospital, Cambridge, UK] against no treatment, in 90 adults with mild to moderate OSAH. All devices improved primary outcome [apnoea-hypopnoea index (AHI)] compared with no treatment: relative risk 0.74 [95% confidence interval (CI) 0.62 to 0.89] for SP1; relative risk 0.67 (95% CI 0.59 to 0.76) for SP2; and relative risk 0.64 (95% CI 0.55 to 0.76) for bMAD (p < 0.001). Differences between MADs were not significant. Sleepiness [as measured by the Epworth Sleepiness Scale (ESS)] was scored 1.51 [95% CI 0.73 to 2.29 (SP1)] to 2.37 [95% CI 1.53 to 3.22 (bMAD)] lower than no treatment (p < 0.001), with SP2 and bMAD significantly better than SP1. All MADs improved disease-specific QoL. Compliance was lower for SP1, which was unpopular at trial exit. At 4 weeks, all devices were cost-effective at £20,000/quality-adjusted life-year (QALY), with SP2 the best value below £39,800/QALY. META-ANALYSIS A MEDLINE, EMBASE and Science Citation Index search updating two existing systematic reviews (one from November 2006 and the other from June 2008) to August 2013 identified 77 RCTs in adult OSAH patients comparing MAD with conservative management (CM), MADs with CPAP or CPAP with CM. MADs and CPAP significantly improved AHI [MAD -9.3/hour (p < 0.001); CPAP -25.4/hour (p < 0.001)]. Effect difference between CPAP and MADs was 7.0/hour (p < 0.001), favouring CPAP. No trials compared CPAP with MADs in mild OSAH. MAD and CPAP reduced the ESS score similarly [MAD 1.6 (p < 0.001); CPAP 1.6 (p < 0.001)]. LONG-TERM COST-EFFECTIVENESS An existing model assessed lifetime cost-utility of MAD and CPAP in mild to moderate OSAH, using the revised meta-analysis to update input values. The TOMADO provided utility estimates, mapping ESS score to European Quality of Life-5 Dimensions three-level version for device cost-utility. Using SP2 as the standard device, MADs produced higher mean costs and mean QALYs than CM [incremental cost-effectiveness ratio (ICER) £6687/QALY]. From a willingness to pay (WTP) of £15,367/QALY, CPAP is cost-effective, although the likelihood of MADs (p = 0.48) and CPAP (p = 0.49) being cost-effective is very similar. Both were better than CM, but there was much uncertainty in the choice between CPAP and MAD (at a WTP £20,000/QALY, the probability of being the most cost-effective was 47% for MAD and 52% for CPAP). When SP2 lifespan increased to 18 months, the ICER for CPAP compared with MAD became £44,066. The ICER for SP1 compared with CM was £1552, and for bMAD compared with CM the ICER was £13,836. The ICER for CPAP compared with SP1 was £89,182, but CPAP produced lower mean costs and higher mean QALYs than bMAD. Differential compliance rates for CPAP reduces cost-effectiveness so MADs become less costly and more clinically effective with CPAP compliance 90% of SP2. CONCLUSIONS Mandibular advancement devices are clinically effective and cost-effective in mild to moderate OSAH. A semi-bespoke MAD is the appropriate first choice in most patients in the short term. Future work should explore whether or not adjustable MADs give additional clinical and cost benefits. Further data on longer-term cardiovascular risk and its risk factors would reduce uncertainty in the health economic model and improve precision of effectiveness estimates. TRIAL REGISTRATION This trial is registered as ISRCTN02309506. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 67. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Linda Sharples
- University of Leeds Clinical Trials Research Unit, Leeds, UK
| | - Matthew Glover
- Health Economics Research Unit, Brunel University, Uxbridge, UK
| | | | - Maxine Bennett
- Medical Research Council Biostatistics Unit, Cambridge, UK
| | - Jake Jordan
- Health Economics Research Unit, Brunel University, Uxbridge, UK
| | - Rebecca Chadwick
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | - Marcus Pittman
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | - Clare East
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | - Malcolm Cameron
- Maxillofacial Unit, Addenbrooke's NHS Foundation Trust, Cambridge, UK
| | - Mike Davies
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | - Nick Oscroft
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | - Ian Smith
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | - Mary Morrell
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Timothy Quinnell
- Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
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The validity of using surface meshes for evaluation of three-dimensional maxillary and mandibular surgical changes. Int J Oral Maxillofac Surg 2015; 44:914-20. [PMID: 25752242 DOI: 10.1016/j.ijom.2015.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/21/2014] [Accepted: 02/04/2015] [Indexed: 11/20/2022]
Abstract
The three-dimensional (3D) changes in hard tissue position following orthognathic surgery have been reported using 3D cephalometry, changes in volume, principal component analysis, and changes based on the surface model of the hard tissue. The aim of this study was to determine the validity of using surface models as a method of assessing positional changes of the maxilla and mandible. The actual unidirectional movement of the maxilla (advancement or downgraft) and the mandible (advancement), together with bidirectional movement of the maxilla (simultaneous advancement and downgraft) were simulated on a plastic skull. Following cone beam computed tomography scanning of each surgical simulation, the actual surgical movement was compared to the analysis based on surface model movement using the mean absolute distance of all points, the 90th percentile, and the root mean square (RMS) distance. All three methods of assessment of analysis consistently underestimated the actual amount of surgical movement. The movement was approximately one-third to one-half of the actual surgical movement. The use of surface meshes and point-to-point measurements grossly underestimates the 3D changes in the maxilla and mandible in simulated surgical procedures. Currently there are limitations in fully describing the true positional changes of the maxilla or the mandible in three dimensions.
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Gkantidis N, Schauseil M, Pazera P, Zorkun B, Katsaros C, Ludwig B. Evaluation of 3-dimensional superimposition techniques on various skeletal structures of the head using surface models. PLoS One 2015; 10:e0118810. [PMID: 25706151 PMCID: PMC4338241 DOI: 10.1371/journal.pone.0118810] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 01/11/2015] [Indexed: 12/01/2022] Open
Abstract
Objectives To test the applicability, accuracy, precision, and reproducibility of various 3D superimposition techniques for radiographic data, transformed to triangulated surface data. Methods Five superimposition techniques (3P: three-point registration; AC: anterior cranial base; AC + F: anterior cranial base + foramen magnum; BZ: both zygomatic arches; 1Z: one zygomatic arch) were tested using eight pairs of pre-existing CT data (pre- and post-treatment). These were obtained from non-growing orthodontic patients treated with rapid maxillary expansion. All datasets were superimposed by three operators independently, who repeated the whole procedure one month later. Accuracy was assessed by the distance (D) between superimposed datasets on three form-stable anatomical areas, located on the anterior cranial base and the foramen magnum. Precision and reproducibility were assessed using the distances between models at four specific landmarks. Non parametric multivariate models and Bland-Altman difference plots were used for analyses. Results There was no difference among operators or between time points on the accuracy of each superimposition technique (p>0.05). The AC + F technique was the most accurate (D<0.17 mm), as expected, followed by AC and BZ superimpositions that presented similar level of accuracy (D<0.5 mm). 3P and 1Z were the least accurate superimpositions (0.79<D<1.76 mm, p<0.005). Although there was no difference among operators or between time points on the precision of each superimposition technique (p>0.05), the detected structural changes differed significantly between different techniques (p<0.05). Bland-Altman difference plots showed that BZ superimposition was comparable to AC, though it presented slightly higher random error. Conclusions Superimposition of 3D datasets using surface models created from voxel data can provide accurate, precise, and reproducible results, offering also high efficiency and increased post-processing capabilities. In the present study population, the BZ superimposition was comparable to AC, with the added advantage of being applicable to scans with a smaller field of view.
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Affiliation(s)
- Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
- * E-mail:
| | | | - Pawel Pazera
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Berna Zorkun
- Department of Orthodontics, Cumhuriyet University, Sivas, Turkey
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Björn Ludwig
- Private orthodontic office, Traben-Trarbach, Germany
- Department of Orthodontics, University of Saarland, Homburg/Saar, Germany
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Volumetric analysis of implanted biphasic calcium phosphate/collagen composite by three-dimensional cone beam computed tomography head model superimposition. J Craniomaxillofac Surg 2015; 43:167-74. [DOI: 10.1016/j.jcms.2014.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/17/2014] [Accepted: 11/04/2014] [Indexed: 11/18/2022] Open
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Liebregts J, Xi T, Timmermans M, de Koning M, Bergé S, Hoppenreijs T, Maal T. Accuracy of three-dimensional soft tissue simulation in bimaxillary osteotomies. J Craniomaxillofac Surg 2014; 43:329-35. [PMID: 25637495 DOI: 10.1016/j.jcms.2014.12.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/19/2014] [Accepted: 12/19/2014] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to evaluate the accuracy of an algorithm based on the mass tensor model (MTM) for computerized 3D simulation of soft-tissue changes following bimaxillary osteotomy, and to identify patient and surgery-related factors that may affect the accuracy of the simulation. Sixty patients (mean age 26.0 years) who had undergone bimaxillary osteotomy, participated in this study. Cone beam CT scans were acquired pre- and one year postoperatively. The 3D rendered pre- and postoperative scans were matched. The maxilla and mandible were segmented and aligned to the postoperative position. 3D distance maps and cephalometric analyses were used to quantify the simulation error. The mean absolute error between the 3D simulation and the actual postoperative facial profile was 0.81 ± 0.22 mm for the face as a whole. The accuracy of the simulation (average absolute error ≤2 mm) for the whole face and for the upper lip, lower lip and chin subregions were 100%, 93%, 90% and 95%, respectively. The predictability was correlated with the magnitude of the maxillary and mandibular advancement, age and V-Y closure. It was concluded that the MTM-based soft tissue simulation for bimaxillary surgery was accurate for clinical use, though patients should be informed of possible variation in the predicted lip position.
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Affiliation(s)
- Jeroen Liebregts
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
| | - Maarten Timmermans
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
| | - Martien de Koning
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
| | - Theo Hoppenreijs
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Wagenerlaan 55, 6815 AD, Arnhem, The Netherlands.
| | - Thomas Maal
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
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Yılmaz A, Polat-Özsoy Ö, Arman-Özçırpıcı A, Uçkan S. Short-Term Evaluation of Nasal Changes After Maxillary Surgery. Turk J Orthod 2014. [DOI: 10.13076/tjo-d-15-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Machado GL. CBCT imaging - A boon to orthodontics. Saudi Dent J 2014; 27:12-21. [PMID: 25544810 PMCID: PMC4273277 DOI: 10.1016/j.sdentj.2014.08.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 03/25/2014] [Accepted: 08/27/2014] [Indexed: 11/23/2022] Open
Abstract
The application of innovative technologies in dentistry and orthodontics has been very interesting to observe. The development of cone-beam computed tomography (CBCT) as a preferred imaging procedure for comprehensive orthodontic treatment is of particular interest. The information obtained from CBCT imaging provides several substantial advantages. For example, CBCT imaging provides accurate measurements, improves localization of impacted teeth, provides visualization of airway abnormalities, it identifies and quantifies asymmetry, it can be used to assess periodontal structures, to identify endodontic problems, to plan placement sites for temporary skeletal anchorage devices, and to view condylar positions and temporomandibular joint (TMJ) bony structures according to the practitioner’s knowledge at the time of orthodontic diagnosis. Moreover, CBCT imaging involves only a minimal increase in radiation dose relative to combined diagnostic modern digital panoramic and cephalometric imaging. The aim of this article is to provide a comprehensive overview of CBCT imaging, including its technique, advantages, and applications in orthodontics.
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Correlation Analysis of Three-Dimensional Changes of Hard and Soft Tissues in Class III Orthognathic Surgery Patients Using Cone-Beam Computed Tomography. J Craniofac Surg 2014; 25:1530-40. [DOI: 10.1097/scs.0000000000000620] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Clinical recommendations regarding use of cone beam computed tomography in orthodontics. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:238-57. [DOI: 10.1016/j.oooo.2013.06.002] [Citation(s) in RCA: 221] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 06/03/2013] [Indexed: 12/13/2022]
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Franco AA, Cevidanes LHS, Phillips C, Rossouw PE, Turvey TA, Carvalho FDAR, Paula LKD, Quintão CCA, Almeida MAO. Long-term 3-dimensional stability of mandibular advancement surgery. J Oral Maxillofac Surg 2013; 71:1588-97. [PMID: 23769460 DOI: 10.1016/j.joms.2013.04.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/03/2013] [Accepted: 04/08/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate 3-dimensional changes in the position of the condyles, rami, and chin from 1 to 3 years after mandibular advancement surgery. MATERIALS AND METHODS This prospective observational study used pre- and postoperative cone-beam computed tomograms of 27 subjects with skeletal Class II jaw relation and normal or deep overbite. An automatic technique of cranial base superimposition was used to assess positional and bone remodeling changes that were visually displayed and quantified using 3-dimensional color maps. Analysis of covariance with presence of genioplasty, age at time of surgery, and gender as explanatory variables was used to estimate and test adjusted mean changes for each region of interest. RESULTS The chin rotated downward and backward 1 to 3 years after surgery. Changes of at least 2 mm were observed in 17% of cases. Mandibular condyles presented with displacements or bone remodeling of at least 2 mm on the anterior surface (21% of cases on the left side and 13% on the right), superior surface (8% on right and left sides), and lateral poles (17% on left side and 4% on right). Posterior borders of the rami exhibited symmetric lateral or rotational displacements in 4% of cases. CONCLUSION In the hierarchy of surgical stability, mandibular advancement surgery is considered one of the most stable surgical procedures. However, 1 to 3 years after surgery, approximately 20% of patients had 2- to 4-mm changes in horizontal and vertical chin positions or changes in condylar position and adaptive bone remodeling.
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Affiliation(s)
- Alexandre A Franco
- Department of Orthodontics, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Hodges RJ, Atchison KA, White SC. Impact of cone-beam computed tomography on orthodontic diagnosis and treatment planning. Am J Orthod Dentofacial Orthop 2013; 143:665-74. [DOI: 10.1016/j.ajodo.2012.12.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 12/01/2012] [Accepted: 12/01/2012] [Indexed: 11/26/2022]
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Makdissi J. L’utilisation du conebeam en orthodontie : la situation actuelle. Int Orthod 2013. [DOI: 10.1016/j.ortho.2012.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kim BR, Oh KM, Cevidanes LH, Park JE, Sim HS, Seo SK, Reyes M, Kim YJ, Park YH. Analysis of 3D Soft Tissue Changes After 1- and 2-Jaw Orthognathic Surgery in Mandibular Prognathism Patients. J Oral Maxillofac Surg 2013; 71:151-61. [DOI: 10.1016/j.joms.2012.02.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 02/07/2012] [Accepted: 02/07/2012] [Indexed: 10/28/2022]
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Oh KM, Seo SK, Park JE, Sim HS, Cevidanes LHS, Kim YJR, Park YH. Post-operative soft tissue changes in patients with mandibular prognathism after bimaxillary surgery. J Craniomaxillofac Surg 2012; 41:204-11. [PMID: 23058178 DOI: 10.1016/j.jcms.2012.09.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 09/01/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022] Open
Abstract
PURPOSE The objective of this study was to evaluate the three-dimensional soft tissue changes observed over time after bimaxillary surgery for mandibular prognathism using cone-beam computed tomography (CBCT) superimposed imaging. MATERIALS AND METHODS CBCT scans were obtained for 25 patients before bimaxillary surgery (T0), at 2 months after surgery (T1) and at 6 months after surgery (T2). Cephalometric variables from the reoriented volumetric images were measured and compared at T0, T1, and T2. The quantitative surface displacement in the middle and the lower third of the facial soft tissue using CMF tools was assessed by superimposing the T0 and T1 or T0 and T2 3D images. RESULTS The soft tissue in middle third of face moved forward at T1 and significantly moved backward from T1 to T2 (Ch-Al, p < 0.001; Al, p < 0.05; Pn, p < 0.05). Most of the soft tissue changes from T1 to T2 were not correlated with the hard tissue changes (p > 0.05), while the cheeks were positively correlated with the soft tissue around them (Exo-Al, p < 0.01; Ch-Al, p < 0.01). CONCLUSION Post-operative soft tissue changes occurred in the middle third of the face and are considered to be more complex than the changes in the lower third of face. Therefore, soft tissue assessment at least 6 months after surgery is desirable.
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Affiliation(s)
- Kyung-Min Oh
- Department of Orthodontics, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Gil-dong 445, Gangdong-gu, Seoul 134-701, Republic of Korea
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Aydil B, Özer N, Marşan G. Facial soft tissue changes after maxillary impaction and mandibular advancement in high angle class II cases. Int J Med Sci 2012; 9:316-21. [PMID: 22745571 PMCID: PMC3384840 DOI: 10.7150/ijms.4247] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 06/03/2012] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to determine the vertical and anteroposterior alterations in the soft, the dental and the skeletal tissues associated with the facial profile after Le Fort I maxillary impaction in conjunction with sagittal split osteotomy for mandibular advancement performed in patients with a high angle Class II skeletal deformity.The study population consists of 21 patients (11 females and 10 males, mean age 24.5±1.6 years) who underwent Le Fort I maxillary impaction in conjunction with sagittal split osteotomy for mandibular advancement. Lateral cephalograms were obtained prior to the surgery and 1.3±0.2 years postoperatively. Wilcoxon test was performed to compare the pre- and postsurgical cephalometric measurements. Pearson correlation test was carried out to determine the relative changes in skeletal, dental and the facial soft tissues.The insignificant decrease in the nasolabial angle was correlated with the significant decrease in the vertical position of the nose due to the nasal protraction noticed after bimaxillary surgery. The retraction of both the upper lip and the upper incisors was correlated with the insignificant decrease in the columella-lobular angle. The insignificant decrease in both the vertical height of the mandibular B point and the lower incisors was correlated with the insignificant decrease in vertical height of the soft tissue pogonion, attributable to the resulting superior movement of the soft tissues of the chin and the counter clockwise rotation of the mandible after maxillary impaction and bilateral sagittal split osteotomy, respectively.Le Fort I maxillary impaction in conjunction with mandibular sagittal split osteotomy for mandibular advancement significantly affected the vertical and anteroposterior positions of the maxilla and the mandible, respectively. When performed in combination, these surgical techniques may efficiently alter the position of upper incisor and the nasal position in both vertical and anteroposterior directions. Bimaxillary orthognathic surgery seems to be an efficient method for obtaining satisfactory results in the appearance of the soft, the dental and the skeletal tissues associated with the facial profile in patients with high angle Class II skeletal deformity.
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Affiliation(s)
- Barış Aydil
- Istanbul University, Faculty of Dentistry, Department of Maxillofacial Surgery, Istanbul, Turkey.
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