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Muñoz G, Brito L, Olate S. Photographic Parameters in Three-Dimensional Facial Image Acquisition. A Scoping Review. J Craniofac Surg 2024; 35:e376-e380. [PMID: 38722365 DOI: 10.1097/scs.0000000000010120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 06/04/2024] Open
Abstract
OBJECTIVE Orthognathic surgery is a viable and reproducible treatment for facial deformities. Despite the precision of the skeletal planning of surgical procedures, there is little information about the relations between hard and soft tissues in three-dimensional (3D) analysis, resulting in unpredictable soft tissue outcomes. Three-dimensional photography is a viable tool for soft tissue analysis because it is easy to use, has wide availability, low cost, and is harmless. This review aims to establish parameters for acquiring consistent and reproducible 3D facial images. METHODS A scoping review was conducted across PubMed, SCOPUS, Scientific Electronic Library Online (SciELO), and Web of Science databases, adhering to "Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews" guidelines. Articles presenting 3D facial photographs in the diagnostic phase were considered. RESULTS A total of 79 articles were identified, of which 29 were selected for analysis. CONCLUSION The predominant use of automated systems like 3dMD and VECTRA M3 was noted. User positioning has highest agreement among authors. Noteworthy aspects include the importance of proper lighting, facial expression, and dental positioning, with observed discrepancies and inconsistencies among authors. Finally, the authors proposed a 3D image acquisition protocol based on this research findings.
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Affiliation(s)
- Gonzalo Muñoz
- Doctoral Program in Morphological Sciences, School of medicine, Universidad de La Frontera
- CEMyQ, Center of Excellence in Morphological and Surgical Studies, School of Medicine, Universidad de La Frontera
| | - Leonardo Brito
- Doctoral Program in Morphological Sciences, School of medicine, Universidad de La Frontera
- Undergraduate Dentistry, School of Dentistry, Universidad de La Frontera
- Research Group (GIPO), Faculty of Health Sciences (FACSA), Universidad Autónoma de Chile
| | - Sergio Olate
- CEMyQ, Center of Excellence in Morphological and Surgical Studies, School of Medicine, Universidad de La Frontera
- Division of Oral, Facial and Maxillofacial Surgery, School of dentistry, Universidad de La Frontera, Araucania, Chile
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Grillo R, Borba AM, da Silva YS, Brozoski MA, Miloro M, Naclério-Homem MDG. Exploring the relationship between the number of systematic reviews and quality of evidence: an orthognathic surgery-based study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:101-112. [PMID: 38155010 DOI: 10.1016/j.oooo.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE We analyzed the quality and quantity of systematic reviews (SRs) of orthognathic surgery, the most frequently published topic in maxillofacial surgery. STUDY DESIGN We searched the PubMed database for SRs of orthognathic surgery with no restriction on the language of publication date. We assessed the certainty of evidence presented according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and the Leiden Manifesto using the Grading of Recommendations Assessment, Development, and Evaluation approach. We analyzed the data using descriptive statistics, Pearson´s correlation test, and linear regression. RESULTS Of the 171 SRs evaluated, approximately one fifth presented evidence with a high level of certainty. The number of orthognathic surgery SRs has been increasing, and many SRs were published after very similar topics had already been published. There is no relationship between the impact factor and the certainty of evidence. CONCLUSIONS An excessive number of SRs of orthognathic surgery are published, and many SRs are superfluous, simply reporting previous findings. Clinicians should not base treatment decisions solely on the evidence presented in SRs, and journal editors and reviewers should evaluate these SRs more critically, particularly when they address topics that have already been covered in the literature.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis-Faculty of Dentistry of the University of São Paulo, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil.
| | - Alexandre Meireles Borba
- Research Program in Integrated Dental Sciences Department, Faculty of Dentistry of the University of Cuiabá, Cuiabá-MT, Brazil
| | | | - Mariana Aparecida Brozoski
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis-Faculty of Dentistry of the University of São Paulo, Brazil
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Maria da Graça Naclério-Homem
- Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis-Faculty of Dentistry of the University of São Paulo, Brazil
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Face Lift after Facial Feminization Surgery: Indications and Special Considerations. Plast Reconstr Surg 2022; 149:107-115. [PMID: 34936610 DOI: 10.1097/prs.0000000000008654] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY Iatrogenic jowling can be an unintended consequence of facial feminization surgery. Reduction of the mandible and chin without overlying changes to the soft tissue can lead to a redundant and deflated soft-tissue envelope, requiring a face lift to address jowling, cervicofacial laxity, and/or lower facial rhytids. Prospective quality-of-life outcomes data support this hypothesis, as patients who underwent mandible contouring with or without angle osteotomies were significantly more likely to express interest in face lift following facial feminization surgery on univariable analysis (90.0 percent versus 10.0 percent, p = 0.038). Patients with inherent skin laxity are at particularly high risk, such as those with advancing age, extrinsic skin damage (e.g., sun exposure, cigarette smoke), and history of massive weight loss. Before facial feminization surgery, the authors recommend comprehensive patient counseling that includes a discussion of the possible future need for a face lift, preferably around 1 year after facial feminization surgery. When performing a face lift after facial feminization surgery, technical considerations include those related to sequelae of prior facial surgery, anatomical differences between cismale and cisfemale facial soft tissue, and the mechanism of jowling after facial feminization surgery versus normal facial aging. The authors believe that these considerations can set more realistic expectations for facial feminization surgery patients, improve surgeons' ability to skillfully execute this procedure, and ultimately contribute to ongoing quality-of-life improvements in facial feminization surgery patients.
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Polyetheretherketone patient-specific implants (PPSI) for the reconstruction of two different mandibular contour deformities. Oral Maxillofac Surg 2021; 26:299-309. [PMID: 34328575 DOI: 10.1007/s10006-021-00984-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aims to prospect the soft and hard tissue changes after augmentation of two different local mandibular contour defects using polyetheretherketone (PEEK) patient-specific onlay implants. METHODS Six patients with disfiguring local mandibular deformities were included in this study (five males and one female) and received seven PEEK patient-specific implants (PSI), virtually designed and surgically settled to augment seven mandibular defects, three deficient chins, and four mandibular angels. The analysis of the soft and hard tissue changes utilized the superimposition of the preoperative and the 6-month postoperative sagittal and coronal CT views, after standardizing the radiographic interpretation. RESULTS The soft tissue gain for the chin was 6.8 mm ± 0.98 with a 45.8% increase versus 4.42 mm ± 0.41 with a 22.9% increase for the angle. The difference in the soft tissue gain between the two groups was statistically significant (P = 0.0001). Comparing the soft tissue gain to the planned implant thickness, the percentage of the soft tissue gain for the chin recorded 109.2% versus 65.57% for the angle. The difference between the two groups was also statistically significant (P < 0.0001). CONCLUSION PEEK patient-specific onlay implants represented an efficient and straightforward modality to augment local mandibular contour deformities with favorable esthetic outcomes; the total soft tissue profile gain of the chin region markedly exceeded that of the mandibular angle.
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Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Describe the evolution of three-dimensional computer-aided reconstruction and its current applications in craniofacial surgery. 2. Recapitulate virtual surgical planning, or computer-assisted surgical simulation, workflow in craniofacial surgery. 3. Summarize the principles of computer-aided design techniques, such as mirror-imaging and postoperative verification of results. 4. Report the capabilities of computer-aided manufacturing, such as rapid prototyping of three-dimensional models and patient-specific custom implants. 5. Evaluate the advantages and disadvantages of using three-dimensional technology in craniofacial surgery. 6. Critique evidence on advanced three-dimensional technology in craniofacial surgery and identify opportunities for future investigation. SUMMARY Increasingly used in craniofacial surgery, virtual surgical planning is applied to analyze and simulate surgical interventions. Computer-aided design and manufacturing generates models, cutting guides, and custom implants for use in craniofacial surgery. Three-dimensional computer-aided reconstruction may improve results, increase safety, enhance efficiency, augment surgical education, and aid surgeons' ability to execute complex craniofacial operations. Subtopics include image analysis, surgical planning, virtual simulation, custom guides, model or implant generation, and verification of results. Clinical settings for the use of modern three-dimensional technologies include acquired and congenital conditions in both the acute and the elective settings. The aim of these techniques is to achieve superior functional and aesthetic outcomes compared to conventional surgery. Surgeons should understand this evolving technology, its indications, limitations, and future direction to use it optimally for patient care. This article summarizes advanced three-dimensional techniques in craniofacial surgery with cases highlighting clinical concepts.
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İZGİ N, AKBULUT S, AKBULUT N. Soft Tissue Response after Maxillary Step Surgery with or without ANS Reduction. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.810461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Choi SH, Lee H, Hwang JJ, Jung HD, Hwang CJ, Cha JY. Differences in soft-tissue thickness changes after bimaxillary surgery between patients with vertically high angle and normal angle. Am J Orthod Dentofacial Orthop 2020; 159:30-40. [PMID: 33127204 DOI: 10.1016/j.ajodo.2019.10.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 01/14/2023]
Abstract
INTRODUCTION We evaluated soft-tissue thickness changes after bimaxillary surgery according to vertical facial patterns in patients with skeletal Class III malocclusion with mandibular prognathism. METHODS Forty-three Korean patients (16 men and 27 women; mean age, 22.6 ± 4.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into 2 groups: normal-angle group (N group) and high-angle group (H group), on the basis of the presurgical angle of the mandibular plane relative to the sella-nasion plane (SN-MP). Changes in hard-tissue landmarks and soft-tissue thickness before and after surgery were analyzed from reconstructed 3-dimensional cone-beam computed tomography images. Postoperative soft-tissue thickness in both groups was compared with that in 40 patients with normal skeletal Class I malocclusion in the reference group. RESULTS Group N (27°-37°) and group H (>37°) did not differ significantly in terms of sex and age before surgery. Preoperative pogonion (Pog) thickness was significantly less in group H (9.7 ± 1.6 mm) than in group N (10.8 ± 1.9 mm) (P = 0.042). Adjusted multiple linear regression analysis showed a weak positive linear relationship between the SN-MP before surgery and soft-tissue Pog thickness change (R2 of 0.361; P = 0.001) after surgery, but the area below the lower lips was not completely normalized despite surgery. CONCLUSIONS The thickness of the soft-tissue Pog may increase slightly after surgery in patients with skeletal Class III malocclusion with a higher preoperative mandibular plane angle, but normalization in the area cannot be completely achieved despite surgery.
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Affiliation(s)
- Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, and BK21 PLUS Project, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hyemin Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Hwi-Dong Jung
- Department of Oral and Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, and BK21 PLUS Project, Yonsei University College of Dentistry, Yonsei University, Seoul, South Korea.
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Seifi M, Jafarpour Boroujeni M, Tabrizi R, Tahmasbi S. Association between Lateral Cephalometric Changes in X-Y Coordinate System and Profile Changes among Skeletal Class III Patients after Orthognathic Surgery. World J Plast Surg 2020; 9:282-289. [PMID: 33330004 PMCID: PMC7734939 DOI: 10.29252/wjps.9.3.282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Since aesthetic issues are the most important causes of referring skeletal class III patients to surgeons, investigating the impact of orthognathic surgeries on improving patient profiles increases the quality of treatment and quality of life. METHODS In a retrospective observational-analytical study, 25 patients older than 18 years with class III skeletal malocclusion who had gone under both orthodontic and double-jaw orthognathic treatment were enrolled. Cephalometric imaging interval was before and at least 6 months after surgery. By defining a number of points and coordinate axes (X-Y), a criterion for comparing hard and soft tissue changes was obtained. These measurements were coordinated, linear and angular. The quantitative data were compared with data obtained using the Likert Scale Questionnaire by means of electronic "Google Forms" that was completed by orthodontists (n=5) and maxillofacial surgeons (n=5) to rank improvement in post-surgical profiles for both cephalometry and photography from poor to pleasant. Spearman Correlation Analysis was conducted between the quantitative and qualitative data. RESULTS Vertical changes of point B and horizontal changes of point PNS showed correlation with improvement of patient profile. Changes in N-Pog line (R=-0.4), mandibular plane angle (R=-0.4) and nasolabial angle (NLA) (R=0.38) were significantly correlated with improvement of profiles. CONCLUSION In orthognathic double-jaw surgery on patients with skeletal Class III, forward movement of maxilla, upward positioning of mandible (decreasing anterior facial height), decreasing mandibular plane angle and increasing nasolabial angle would result in a better profile.
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Affiliation(s)
- Massoud Seifi
- Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Jafarpour Boroujeni
- Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soodeh Tahmasbi
- Department of Orthodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Submandibular soft tissue changes after mandibular set-back surgery in skeletal Class III patients. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:301-309. [DOI: 10.1016/j.jormas.2019.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/09/2019] [Accepted: 05/20/2019] [Indexed: 11/19/2022]
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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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Assessing the Correlation between Skeletal and Corresponding Soft-Tissue Equivalents to Determine the Relationship between CBCT Skeletal/Dental Dimensions and 3D Radiographic Soft-Tissue Equivalents. Int J Dent 2018; 2018:8926314. [PMID: 30057609 PMCID: PMC6051110 DOI: 10.1155/2018/8926314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/30/2018] [Accepted: 06/02/2018] [Indexed: 11/17/2022] Open
Abstract
Objective Compare measurements of skeletal and dental areas on the CBCT to the corresponding soft-tissue measures taken from a 3D Facial Scanner. Methods 30 patients with CBCT and 3D Facial scanner photos were selected from the orthodontic program database. 30 different distance measurements were obtained from CBCT and facial scan. OrthoInsight software was used to obtain the measurements from the facial scan images, and AVIZO software was used for corresponding CBCT landmarks. The Euclidean distance formula was used to determine the distances for the corresponding x, y, and z coordinates of the CBCT. Reliability for CBCT and Facial Scanner was completed by calculating 30 distances for 10 patients, 3 times. Once reliability was determined, all 30 distances were calculated once for CBCT and facial scanner on each patient and descriptive statistics and paired t-test were applied. Results All distances measured presented excellent reliability, the lowest one being the left eye width for the facial scanner (ICC 0.847). The landmark with the highest mean error on the CBCT was 2.0 ± 1.6 mm on the z-axis for the spinal level landmark. The Facial Scanner's largest mean measurement error was 1.5 ± 0.9 mm for the distance of the left corner of the mouth to gonion. All data except width between outer eye corners were statistically significant (p < 0.05). The average differences between facial scan and CBCT measurements ranged between 0.77 mm (left canine to cheekbone) to 26.94 mm (left subnasale to gonion) and are thus comparable. All measurements show a reasonable standard deviation between 2.57 mm (left eye width) to 9.91 mm (left gnathion to EAM). Conclusion Distances obtained from CBCT and facial scan present mild differences giving the perspective of a relationship between them. Understanding this difference and relationship can make it plausible to expect certain underlying skeletal distances under soft-tissue structures.
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