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Savoldi F, Dagassan-Berndt D, Patcas R, Mak WS, Kanavakis G, Verna C, Gu M, Bornstein MM. The use of CBCT in orthodontics with special focus on upper airway analysis in patients with sleep-disordered breathing. Dentomaxillofac Radiol 2024; 53:178-188. [PMID: 38265247 PMCID: PMC11003665 DOI: 10.1093/dmfr/twae001] [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: 09/05/2023] [Revised: 11/14/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
Applications of cone-beam CT (CBCT) in orthodontics have been increasingly discussed and evaluated in science and practice over the last two decades. The present work provides a comprehensive summary of current consolidated practice guidelines, cutting-edge innovative applications, and future outlooks about potential use of CBCT in orthodontics with a special focus on upper airway analysis in patients with sleep-disordered breathing. The present scoping review reveals that clinical applications of CBCT in orthodontics are broadly supported by evidence for the diagnosis of dental anomalies, temporomandibular joint disorders, and craniofacial malformations. On the other hand, CBCT imaging for upper airway analysis-including soft tissue diagnosis and airway morphology-needs further validation in order to provide better understanding regarding which diagnostic questions it can be expected to answer. Internationally recognized guidelines for CBCT use in orthodontics are existent, and similar ones should be developed to provide clear indications about the appropriate use of CBCT for upper airway assessment, including a list of specific clinical questions justifying its prescription.
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Affiliation(s)
- Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 8032, Switzerland
| | - Wing-Sze Mak
- Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong SAR
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Carlalberta Verna
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, 4058, Switzerland
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Nelke K, Morawska-Kochman M, Kowalski P, Dobrzyński M, Guziński M. A proposed protocol for correlation between bone density in hemimandibular hyperplasia radiography and histopathological findings - A retrospective study. J Craniomaxillofac Surg 2024; 52:196-202. [PMID: 38195296 DOI: 10.1016/j.jcms.2023.11.011] [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: 11/09/2022] [Revised: 09/07/2023] [Accepted: 11/23/2023] [Indexed: 01/11/2024] Open
Abstract
The role of low-dose computed tomography (LDCT) in surgical planning can be assessed based on the correlation among bone density (BD/HU), radiographic values, and the histopathological appearance of hyperplastic overgrowth in mandibular condyles (hemimandibular hyperplasia/osteochondroma). The aim of this study was to evaluate the correlation between LDCT indices of bone-density measurements in surgical planning and histopathological specimens. The patients incuded in this study underwent detailed radiological evaluation as preparation for further clinical procedures. Excised condyles were evaluated in terms of bone density index using LDCT, and then histopathologically to investigate the accuracy of surgical procedures and set the basis for future surgical planning. An index value between both condyles' bone densities represented the relative difference between the healthy condyle and the side with hemimandibular hyperplasia (HH). Patients with unilateral condylar hyperplasia (UCH) showed a statistical correlation between condyle heads with increased bone density (BD) and scintigraphic (SCI) values (p < 0.001). On the other hand, correlation between BD and histopathological studies alone was significant (p < 0.001). With the increase in BD measured in HU in UCH condyles, the overall value of fibrous cartilage layer thickness decreased (p < 0.001). Furthermore, histopathological evaluation indicated that increased bone density on the UCH side resulted in increased total thickness (p > 0.001). The proposed index measurements in the mandibular condyles based on LDCT/BD can be used to estimate the degree of required surgical resection. Results from LDCT radiographic studies correlate with histopathological specimens more than scintigraphy.
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Affiliation(s)
- Kamil Nelke
- Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland; Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland.
| | - Monika Morawska-Kochman
- Department of Otolaryngology, Head and Neck Surgery, Wrocław Medical University, Borowska 213, 50-556 Wroclaw, Poland
| | - Przemysław Kowalski
- Department of Clinical and Experimental Pathology, Wrocław Medical University, 50-556 Wrocław, Poland
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland
| | - Maciej Guziński
- Department of Radiology, Wrocław Medical University, Borowska 213, 50-556 Wrocław, Poland/
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Marghalani HYA. Volumetric comparison of mandibular condyles and mandibles in the different skeletal classes in the Saudi population. PeerJ 2024; 12:e16750. [PMID: 38188155 PMCID: PMC10771761 DOI: 10.7717/peerj.16750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024] Open
Abstract
Background Assessing the relationship between the condyle and mandible volume and the various skeletal classes is essential in orthodontic diagnosis. The current study evaluated this relationship using volumetric cone-beam computed tomography (CBCT), cephalometric methods, and the correlations between them. Materials and Methods The study examined 37 full-head CBCTs (74 condyles) from adults in the Saudi population. The condyle and mandible were separated from within the CBCT images. The volume of each segment was compared to measurements from multiple cephalometric analyses. Results The combined total condylar volume has a moderate correlation with the maxillomandibular differential in each of the genders and in the total sample. Mandibular volume has a significant correlation with the Wits appraisal (sagittal classification) in males. It was also significantly correlated with the vertical classification using gonial angles in females and in the total sample. Conclusion The relationship between mandible and condyle volume and cephalometric measurements is both dimensional and within the maxillomandibular complex rather than positional or related to the cranial base. Also, the correlation between the condylar and mandibular volumes and the sagittal and vertical dimensions in the orthodontic skeletal classes provides better insight into the mandibular complex.
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Affiliation(s)
- Hussain Y. A. Marghalani
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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4
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Vespasiano V, Mulder CS, Klop C, Koolstra JH, Nolte JW, Lobé NHJ, Beenen LFM, Becking AG. Mineralization and thickness of the condylar cortex in skeletal remains of children's mandibles: A preliminary study. Arch Oral Biol 2024; 157:105850. [PMID: 38007946 DOI: 10.1016/j.archoralbio.2023.105850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE To explore the relationship between the volumetric bone mineral density (vBMD), the thickness of the condylar cortex (Tcortex) and the hemimandibular volumes (Vhemimandible) of symmetrical and asymmetrical mandibles of children. DESIGN The data collection consisted of 92 archeological skeletal remains of children's mandibles between 1 and 12 years old. The mandibles were digitalized with a computed tomography (CT) scan, and three dimensional models were obtained. Vhemimandible was calculated using the optimal symmetry plane. The volumes were used to calculate the asymmetry index (AI). Mandibles with an AI of ≥ 3% (N = 9) and a sample of the most symmetrical mandibles (N = 9) were selected for this research. Three groups were created: a symmetrical, an asymmetrical and a pooled group. Micro-CT was used to measure the vBMD and Tcortex in four volumes of interest. The AI was calculated for these parameters as well. RESULTS Significant correlations were found between the vBMD and the Tcortex in the pooled group (P < .01) and between the AI of the vBMD and the AI of the Tcortex in the pooled (P < .01) and symmetrical group (P < .05). No significant correlations were found between the vBMD and the Vhemimandible and between the respective AIs. Between the Tcortex and the Vhemimandible a significant correlation was found in the pooled and asymmetrical group. CONCLUSION There is a relationship between the vBMD and the Tcortex. The correlations between the Tcortex and the Vhemimandible are insufficient to draw firm conclusions. A relationship between the vBMD and Vhemimandible was not confirmed in this study.
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Affiliation(s)
- V Vespasiano
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (location AMC) and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - C S Mulder
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (location AMC) and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - C Klop
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (location AMC) and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - J H Koolstra
- Department of Oral Cell Biology and Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands
| | - J W Nolte
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (location AMC) and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - N H J Lobé
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - L F M Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - A G Becking
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers (location AMC) and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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Espinosa S, Cortés R, Toro-Ibacache V. Single photon emission computed tomography (SPECT) diagnostic accuracy in active unilateral condylar hyperplasia: Retrospective study. J Craniomaxillofac Surg 2023; 51:467-474. [PMID: 37550116 DOI: 10.1016/j.jcms.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 05/30/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023] Open
Abstract
The aim of this study was to assess the diagnostic accuracy of single photon emission tomography (SPECT) in unilateral condylar hyperplasia (UCH). To this end, 3D morphometric changes of the mandibles in one year were assessed (T0 vs. T1) and compared over SPECT results in T1, in a sample of 40 patients. A contingency table was constructed based on these results for SPECT diagnostic accuracy evaluation, classifying patients as SPECT true-positive, true-negatives, false positives and false-negatives. Additionally, the morphometric analysis was used to describe the presentation of mandibular changes using principal component analysis (PCA) and non-parametric statistics. We obtained diagnostic accuracy results of sensitivity 81%, specificity 63%, positive predictor value (PPV) 59%, negative predictor value (NPV) 83% and accuracy 70%, showing that SPECT yields poor results regarding accuracy diagnostic performance. The morphometric analysis showed that individuals without progress of asymmetry and those with more progress differ particularly in a group of landmarks representing the mental region and the right mandibular body. Based on these landmarks, difference among the four SPECT-accuracy groups was statistically significant (p < 0.001), where the landmark showing the largest change within a year had a mean increase of 1.13 + 0.66 mm. Within the limitations of the study, it seems that SPECT alone is not suitable for making surgical decisions regarding condylectomy in active UCH. Follow up with morphological assessment methods are recommended for confirming an active UCH in combination with SPECT.
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Affiliation(s)
- S Espinosa
- Department of Oral and Maxillofacial Surgery, Hospital Sótero del Río, Santiago, Chile; Department of Oral and Maxillofacial Surgery, Clinica Indisa, Santiago, Chile.
| | - R Cortés
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - V Toro-Ibacache
- Laboratory for Craniofacial Research and Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile; Department of Maxillofacial Surgery, Hospital Clínico San Borja Arriarán, Santiago, Chile
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Shaffer SM, Naze GS. Evaluation and management of temporomandibular disorders. Part 1: an orthopedic physical therapy update on examination and clinical reasoning. J Man Manip Ther 2023; 31:133-142. [PMID: 36245265 PMCID: PMC10288910 DOI: 10.1080/10669817.2022.2123171] [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] [Indexed: 10/24/2022] Open
Abstract
Temporomandibular (TM) disorders afflict many people globally and, despite the presence of existing peer-reviewed material that assists conservative orthopedic providers, recent advances in knowledge indicate that updated resources are required for students, clinicians, and educators. This two-part series builds off previously published material to present newer supplementary information that can be useful during the evaluation and management processes. Content in Part 1 of this series includes a discussion about the factors that have been shown to contribute to TM disorders, an updated perspective of relevant pain science, a discussion of self-report outcome measures, and various different topics related to the examination of patients with TM disorders. Part 2 addresses information related to the temporomandibular joint disc, joint hypermobility, oral splints, and clinical reasoning. In combination with other available publications, this two-part series provides clinicians an opportunity to improve their delivery of effective and efficient clinical services for people diagnosed with TM disorders.
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Affiliation(s)
- Stephen M. Shaffer
- College of Education, Nursing, and Health Professions, Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA
| | - Garrett S. Naze
- Congdon School of Health Sciences, Department of Physical Therapy, High Point University, High Point, NC, USA
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Vespasiano V, Klop C, Mulder CS, Koolstra JH, Lobé NHJ, Beenen LFM, Nolte JW, Becking AG, Schreurs R, Maal TJJ, de Bakker BS. Normal variation of mandibular asymmetry in children. Orthod Craniofac Res 2023. [PMID: 36760175 DOI: 10.1111/ocr.12639] [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: 11/24/2022] [Revised: 01/11/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To explore the normal variation of asymmetry in mandibles of children in the age group of 1 to 12 years. MATERIALS AND METHODS The study group consisted of 92 cadaveric mandibles of children with a dental age of 1 to 12 years old in possession of ACTA (Academic Centre for Dentistry Amsterdam), Faculty of Dentistry, the Netherlands. 3D models of the mandibles were obtained from CT-scans and hemimandibular volumes of all mandibles were calculated. The condylar height, ramus height, mandibular body length and the gonial angle were bilaterally determined using a novel landmark-based method, and the degree of asymmetry was calculated. RESULTS No relationship was found between dental age and asymmetry of the studied parameters (P < .05). The highest degree of asymmetry was found in the ramus height, whereas the gonial angle presented the lowest degree of asymmetry. A positive correlation was found between the asymmetry of the hemimandibular volume vs the height of the ramus (P < .05) and the length of the mandibular body (P < .05). An inverse correlation was found between the asymmetry of the ramus height vs the condylar height (P < .05), mandibular body length (P < .05) and gonial angle (P < .05). CONCLUSIONS Mandibular asymmetries in children did occur (9.8% of the included mandibles presented with a relevant overall asymmetry of ≥3%) and were unrelated to age. The different segments of the mandible seem to compensate for each other, in order to maintain a functional equilibrium.
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Affiliation(s)
- Valeria Vespasiano
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Cornelis Klop
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Catharina S Mulder
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Jan H Koolstra
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nicolaas H J Lobé
- Department of Radiology and Nuclear Medicine, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Ludo F M Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Jitske W Nolte
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Alfred G Becking
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Ruud Schreurs
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), AZ, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery 3D Lab, Radboud University Medical Centre Nijmegen, GA, Nijmegen, The Netherlands
| | - Thomas J J Maal
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), AZ, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery 3D Lab, Radboud University Medical Centre Nijmegen, GA, Nijmegen, The Netherlands
| | - Bernadette S de Bakker
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC (location AMC), University of Amsterdam, AZ, Amsterdam, The Netherlands
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Chou ST, Tsai PL, Chen SC, Lin SH, Chen CM, Tseng YC. Condylar and ramus volume in asymmetric and symmetric skeletal class III malocclusion: A cone-beam computed tomography study. J Dent Sci 2023; 18:175-183. [PMID: 36643236 PMCID: PMC9831784 DOI: 10.1016/j.jds.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/19/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose Among the craniofacial structures, the mandible is the only bony structure with movable joints. Each part (including condyle process, coronoid process, and ramus) of mandible would interaction with the muscles and proceed different osteogenesis progress. The objective of this study was to evaluate the mandibles with symmetric and asymmetric skeletal Class III jaw relations by quantifying differences in the condyle process, coronoid process and ramus on CBCT (Cone-beam computer tomography) images. Our hypothesis was that CBCT would reveal no voluminal differences between deviated and non-deviated mandibular segments in asymmetric skeletal Class III. Materials and methods CBCT imagines were collected from dental department, KMUH and then divided into symmetric Class III group (Menton deviation < 4mm) and asymmetric Class III group (Menton deviation≧4mm). The mandibular structure would be segmented to ramus, condylar and coronoid process. Each volume was measured. Independent t test was used for comparison between groups, and paired t test was applied for comparison between both segmented parts within each group. Results Significant differences between deviation and non-deviation sides in the asymmetric group were found in condylar and ramus segments for volumetric quantitative measurements. There has no significant difference in ramus parts between groups. Significant greater condylar volume was found in non-deviation side of asymmetric group. Conclusion The results demonstrated that in the side with greater mandible growth potential, the condylar and the ramus volume would be greater as well. CBCT is a useful and accurate modality for quantification and evaluation of mandibular asymmetry.
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Affiliation(s)
- Szu-Ting Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pei-Lun Tsai
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Chieh Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shih-Hsuan Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yu-Chuan Tseng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,Department of Orthodontics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,Corresponding author. School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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van Riet TC, Klop C, Becking AG, Nolte JW. Management of Asymmetry. Oral Maxillofac Surg Clin North Am 2022; 35:11-21. [DOI: 10.1016/j.coms.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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10
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Kün-Darbois JD, Bertin H, Mouallem G, Corre P, Delabarde T, Chappard D. Bone characteristics in condylar hyperplasia of the temporomandibular joint: a microcomputed tomography, histology, and Raman microspectrometry study. Int J Oral Maxillofac Surg 2022; 52:543-552. [PMID: 36180268 DOI: 10.1016/j.ijom.2022.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 10/14/2022]
Abstract
Unilateral condylar hyperplasia (UCH) of the temporomandibular joint is a progressive deformation of the mandibular condyle of unknown origin. UCH is characterized by excessive growth of the condylar head and neck, leading to an increase in size and volume. The aim of this study was to investigate the characteristics of the bone in patients with UCH using microcomputed tomography (micro-CT), histology, and Raman microspectroscopy. The mandibular condyles of six patients with UCH were analysed using micro-CT, histology, and Raman microspectrometry and imaging, and the results were compared with those obtained for a normal control subject. Three-dimensional micro-CT models revealed focal abnormalities of the bone microarchitecture, with foci of osteosclerosis. Histological sections showed that these foci included islands of calcified cartilage matrix with live chondrocytes. Raman analysis revealed that the cartilage matrix was more heavily calcified than the bone matrix and that the cartilage could be identified by the phenylalanine (PHE) band of its matrix, as well as by its glycosaminoglycan (GAG) content. The persistence of foci of live and active chondrocytes within the bone matrix is intriguing and appears to be pathognomonic of UCH. These new findings on UCH could help to determine its pathophysiology and thus prevent this disease, which can lead to major facial deformity.
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Affiliation(s)
- J-D Kün-Darbois
- Université Angers, GEROM, IRIS-IBS Institut de Biologie en Santé, Angers, France; Service de Chirurgie Maxillo-faciale et Stomatologie, CHU d'Angers, Angers, France; Univ Angers, Nantes Université, Oniris, Inserm, RMeS, REGOS, SFR ICAT, F-49000 Angers, France
| | - H Bertin
- Service de Chirurgie Maxillo-faciale et Stomatologie, CHU de Nantes, Nantes, France; Univ Angers, Nantes Université, Oniris, Inserm, RMeS, REGOS, SFR ICAT, F-49000 Angers, France
| | - G Mouallem
- Service de Chirurgie Maxillo-faciale et Stomatologie, CHU de Nantes, Nantes, France
| | - P Corre
- Service de Chirurgie Maxillo-faciale et Stomatologie, CHU de Nantes, Nantes, France; Univ Angers, Nantes Université, Oniris, Inserm, RMeS, REGOS, SFR ICAT, F-49000 Angers, France
| | - T Delabarde
- Institut Médico-Légal de Paris, Paris, France
| | - D Chappard
- Université Angers, GEROM, IRIS-IBS Institut de Biologie en Santé, Angers, France; Univ Angers, Nantes Université, Oniris, Inserm, RMeS, REGOS, SFR ICAT, F-49000 Angers, France.
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11
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Reproducibility of 2D and 3D Ramus Height Measurements in Facial Asymmetry. J Pers Med 2022; 12:jpm12071181. [PMID: 35887678 PMCID: PMC9323863 DOI: 10.3390/jpm12071181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 12/03/2022] Open
Abstract
In our clinic, the current preferred primary treatment regime for unilateral condylar hyperactivity is a proportional condylectomy in order to prevent secondary orthognathic surgery. Until recently, to determine the indicated size of reduction during surgery, we used a ‘panorex-free-hand’ method to measure the difference between left and right ramus heights. The problem encountered with this method was that our TMJ surgeons measured differences in the amount to resect during surgery. Other 2D and 3D method comparisons were unavailable. The aim of this study was to determine the most reproducible ramus height measuring method. Differences in left/right ramus height were measured in 32 patients using three methods: one 3D and two 2D. The inter- and intra-observer reliabilities were determined for each method. All methods showed excellent intra-observer reliability (ICC > 0.9). Excellent inter-observer reliability was also attained with the panorex-bisection method (ICC > 0.9), while the CBCT and panorex-free-hand gave good results (0.75 < ICC < 0.9). However, the lower boundary of the 95% CI (0.06−0.97) of the inter-observer reliability regarding the panorex-free-hand was poor. Therefore, we discourage the use of the panorex-free-hand method to measure ramus height differences in clinical practice. The panorex-bisection method was the most reproducible method. When planning a proportional condylectomy, we advise applying the panorex-bisection method or using an optimized 3D-measuring method.
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Mallya SM, Ahmad M, Cohen JR, Kaspo G, Ramesh A. Recommendations for imaging of the temporomandibular joint. Position statement from the American Academy of Oral and Maxillofacial Radiology (AAOMR) and the American Academy of Orofacial Pain (AAOP). Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:639-648. [DOI: 10.1016/j.oooo.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/15/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
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Shetty SR, Al-Bayatti SW, Al Kawas S, Al-Rawi NH, Kamath V, Shetty R, Shetty S, Desai V, David L. A study on the association between the inferior nasal turbinate volume and the maxillary sinus mucosal lining using cone beam tomography. Heliyon 2022; 8:e09190. [PMID: 35368549 PMCID: PMC8968633 DOI: 10.1016/j.heliyon.2022.e09190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/12/2022] [Accepted: 03/21/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives The volume of the inferior turbinates (IT) and the lining of the maxillary sinuses are important parameters when assessing sino-nasal diseases. However, no radiographic studies have investigated the correlation between these parameters. The present study was conducted to analyze the association between IT volumes and thickness of maxillary sinus mucosal lining. Materials and methods A retrospective evaluation of the cone-beam computed tomography (CBCT) scans of 100 adult subjects was carried out by two radiologists. The scans were assigned to two groups (Group 1 & 2) based on the radiographic evidence of maxillary sinus lining in the CBCT scans. Group 1 consisted of 50 CBCT scans of subjects with no evidence of maxillary sinus mucosal lining, whereas Group 2 consisted of 50 subjects with evidence of maxillary sinus mucosal lining. The scans in the Group 2 were further sub-classified into five categories, based on the thickness of the maxillary sinus mucosal lining. Vesalius 3D software was used to evaluate the total volume of inferior nasal turbinates by the two radiologists and a mean volume was obtained for each study subject. Results The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologist was 0.87. Analysis of the results revealed that there was no significant gender-based difference (Group 1, P = 0.67 and Group 2, P = 0.95) in the total turbinate volume in either of the study groups. The total turbinate volume did not show any significant correlation (Group 1, r = 0.24 and Group 2, r = 0.12) with the age. There was a significant increase (P = 0.001) in the total turbinate volume of the subjects in Group 2 compared to Group 1. Regression analysis revealed that the thickness of sinus lining correlated significantly (P = 0.001) with the total turbinate volume. Conclusion An increase in the total turbinate volume has been associated with an increase in the thickness of the maxillary sinus mucosal lining. The data from this study will be useful for post-operative follow-up of inferior turbinates and maxillary sinus lining after the turbinate volume reduction procedures.
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Affiliation(s)
- Shishir Ram Shetty
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Corresponding author.
| | | | - Sausan Al Kawas
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | | | | | - Sunaina Shetty
- College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Vijay Desai
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Leena David
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Cavagnetto D, Abate A, Caprioglio A, Cressoni P, Maspero C. Three-dimensional volumetric evaluation of the different mandibular segments using CBCT in patients affected by juvenile idiopathic arthritis: a cross-sectional study. Prog Orthod 2021; 22:32. [PMID: 34595615 PMCID: PMC8484372 DOI: 10.1186/s40510-021-00380-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is currently no information on how different mandibular segments are affected by juvenile idiopathic arthritis. The aim of this paper is to assess volumetric differences of different mandibular segments in subjects with unilateral and bilateral JIA and to compare them with non-JIA control volumes. MATERIALS AND METHODS Forty subjects with unilateral TMJ involvement and 48 with bilateral TMJ involvement were selected for the case group and 45 subjects with no known rheumatic comorbidities for the control group. The mandible of each subject was divided according to a validated method into different paired volumes (hemimandible, condyle, ramus and hemibody). RESULTS The ANOVA test revealed a statistically significant difference in all the groups for condylar and ramus volumes, and the pairwise comparison evidenced a statistically significant higher condylar and ramus volume in the control group (1444.47 mm3; 5715.44 mm3) than in the affected side in the unilateral JIA group (929.46 mm3; 4776.31 mm3) and the bilateral JIA group (1068.54 mm3; 5715.44 mm3). Moreover, there was also a higher condylar volume in the unaffected side in the unilateral JIA group (1419.39 mm3; 5566.24 mm3) than in the bilateral JIA group and the affected side in the unilateral JIA group. CONCLUSIONS The affected side of unilateral JIA patients showed statistically significant lower volumes in the hemimandible, in the condyle and in the ramus. The largest total mandibular volume was observed in the control group, followed by the unilateral JIA group and, lastly, by the bilateral JIA group.
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Affiliation(s)
- Davide Cavagnetto
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.,Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Andrea Abate
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.,Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Alberto Caprioglio
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.,Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Paolo Cressoni
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy.,Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142, Milan, Italy. .,Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142, Milan, Italy.
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Using 3D Medical Modeling to Evaluate the Accuracy of Single-Photon Emission Computed Tomography (SPECT) Bone Scintigraphy in Diagnosing Condylar Hyperplasia. J Oral Maxillofac Surg 2021; 80:285.e1-285.e9. [PMID: 34648756 DOI: 10.1016/j.joms.2021.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the accuracy of single-photon emission computed tomography (SPECT) in diagnosing unilateral condylar hyperplasia (UCH) and to describe the condylar growth of patients with UCH. MATERIALS AND METHODS Using a retrospective study design, patients with UCH who had undergone SPECT and cone-beam computed tomography (CBCT) examinations at the same time were included in the study. We used 3D medical models based on CBCT data as the gold standard. The SPECT results were compared with the model data, and the sensitivity and specificity were calculated. To further describe the condylar growth activity, statistical analysis was performed, and the P value was set at 0.05. RESULTS The sample was composed of 75 patients. The sensitivity of SPECT was 55.3%, the specificity was 48.6%, and the area under the receiver operating characteristic curve was 0.53. There was no significant difference in sex between patients with and without active growth. CONCLUSION The sensitivity and specificity of SPECT are poor, and SPECT alone is not suitable for evaluating the active stage of condylar growth. 3D medical modeling has good prospects for application in the diagnosis of condylar hyperplasia.
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Gallagher AL, Ruellas ACDO, Benavides E, Soki FN, Aronovich S, Magraw CBL, Turvey T, Cevidanes L. Mandibular condylar remodeling characteristics after simultaneous condylectomy and orthognathic surgery. Am J Orthod Dentofacial Orthop 2021; 160:705-717. [PMID: 34353687 DOI: 10.1016/j.ajodo.2020.06.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The objectives of this study were to evaluate postsurgical condylar remodeling using a radiographical interpretation, quantify condylar volumetric asymmetry, and assess soft tissue symmetry after simultaneous unilateral high condylectomy and bimaxillary osteotomies. METHODS Sixteen patients diagnosed with unilateral condylar hyperplasia underwent unilateral high condylectomy and orthognathic surgery to correct skeletal and facial asymmetries. Cone-beam computed tomography scans were acquired before and 1-year after surgery. A radiographic consensus was evaluated for signs of reparative or degenerative changes. The condyles were mirrored and registered for assessment of volumetric and morphologic asymmetry. Soft tissue symmetry was evaluated by measurement of the distance of soft tissue pogonion from the skeletal midsagittal plane. RESULTS Patients who undergo unilateral high condylectomy and orthognathic surgery present radiographic signs suggestive of degenerative changes, including sclerosis, osteophytes, flattening, and erosion in both the surgical and nonsurgical condyles (P ≤0.01). There was an average volumetric improvement of 531.9 ± 662.3 mm3 1-year postsurgery (P = 0.006). Soft tissue symmetry improved in all patients, with an average improvement of 65.8% (4.0 mm ± 2.6 mm, P ≤ 0.01). There was no correlation between the change in condylar volumetric asymmetry and the stability of the soft tissue correction. CONCLUSIONS High condylectomy for the correction of a skeletal asymmetry in patients with condylar hyperplasia successfully reduces the volumetric asymmetry between the condyles. Postsurgical dysmorphic remodeling and degenerative changes were noted in both the surgical and nonsurgical condyles. Despite remarkable changes and remaining joint asymmetry, the soft tissue correction is stable 1-year postsurgery.
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Affiliation(s)
| | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Erika Benavides
- University of Michigan School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, Mich
| | - Fabiana Naomi Soki
- University of Michigan School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, Mich
| | - Sharon Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, Mich
| | | | - Timothy Turvey
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich.
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Yamaguchi T, Kim YI, Mohamed A, Hikita Y, Takahashi M, Haga S, Park SB, Maki K. Methods in Genetic Analysis for Evaluation Mandibular Shape and Size Variations in Human Mandible. J Craniofac Surg 2021; 33:e97-e101. [PMID: 33867516 DOI: 10.1097/scs.0000000000007686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT The human mandible has been investigated from both clinical and evolutionary perspectives. Recent advances in genome science have identified the genetic regulation of human mandibular shape and size. Identification of genes that regulate mandibular shape and size would not only enhance our understanding of the mechanisms of mandibular growth and development but also help define a strategy to prevent mandibular dysplasia. This review provides a comprehensive summary of why and how the mandible was evaluated in the human mandible genome study. The variation in human mandibular shape and size has been progressively clarified, not only by focusing on the mandible alone but also by using extremely diverse approaches. The methods of data acquisition for evaluating human mandibular shape and size variation are well established. Furthermore, this review explains how to proceed with future research.
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Affiliation(s)
- Tetsutaro Yamaguchi
- Department of Orthodontics, Kanagawa Dental University, Japan Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, South Korea Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan Department of Orthodontics, Suez Canal University, Ismailia, Egypt
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The Role of Three-Dimensional Printing Technology as an Additional Tool in Unilateral Condylar Hyperplasia Surgical Planning. J Craniofac Surg 2021; 31:e735-e738. [PMID: 33003058 DOI: 10.1097/scs.0000000000006733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study is to evaluate whether additive manufactory technology through the use of 3D mandible and skull cast models can provide additional support to the virtual surgical planning for patients affected by unilateral condylar hyperplasia (UCH). This study describes 2 patients affected by active UCH. Cone beam computed tomography (CBCT) scans were converted in STL files and then sent to a 3D printer that provided 3D cast models of patient's mandible and skull. Surgical planning was conducted performing linear measurement both on 3D virtual images and on 3D cast models. Proportional condylectomy was then simulated with the virtual software and on the 3D cast models as well. After 18 months, new CBCT scans of the patients were acquired and new 3D cast models were printed. Measurements performed on the 3D cast models were close and reliable if compared to measurements obtained on 3D virtual images. None of the patients underwent further surgeries obtaining stable results in terms of symmetry. 3D printing technologies have a relevant support for a more accurate planning and surgical treatment in UCH.
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Gateno J, Coppelson KB, Kuang T, Poliak CD, Xia JJ. A Better Understanding of Unilateral Condylar Hyperplasia of the Mandible. J Oral Maxillofac Surg 2020; 79:1122-1132. [PMID: 33493432 DOI: 10.1016/j.joms.2020.12.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/03/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Our current understanding of unilateral condylar hyperplasia (UCH) was put forth by Obwegeser. He hypothesized that UCH is 2 separate conditions: hemimandibular hyperplasia and hemimandibular elongation. This hypothesis was based on the following 3 assumptions: 1) the direction of overgrowth, in UCH, is bimodal-vertical or horizontal, with rare cases growing obliquely; 2) UCH can expand a hemimandible with and without significant condylar enlargement; and 3) there is an association between the condylar expansion and the direction of overgrowth-minimal expansion resulting in horizontal growth and significant enlargement causing vertical displacement. The purpose of this study was to test these assumptions. PATIENTS AND METHODS We analyzed the computed tomography scans of 40 patients with UCH. First, we used a Silverman Cluster analysis to determine how the direction of overgrowth is distributed in the UCH population. Next, we evaluated the relationship between hemimandibular overgrowth and condylar enlargement to confirm that overgrowth can occur independently of condylar expansion. Finally, we assessed the relationship between the degree of condylar enlargement and the direction of overgrowth to ascertain if condylar expansion determines the direction of growth. RESULTS Our first investigation demonstrates that the general impression that UCH is bimodal is wrong. The growth vectors in UCH are unimodally distributed, with the vast majority of cases growing diagonally. Our second investigation confirms the observation that UCH can expand a hemimandible with and without significant condylar enlargement. Our last investigation determined that in UCH, there is no association between the degree of condylar expansion and the direction of the overgrowth. CONCLUSIONS The results of this study disprove the idea that UCH is 2 different conditions: hemimandibular hyperplasia and hemimandibular elongation. It also provides new insights about the pathophysiology of UCH.
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Affiliation(s)
- Jaime Gateno
- Chairman, Oral and Maxillofacial Surgery Department, Houston Methodist Hospital, Houston, TX; Professor of Oral and Maxillofacial Surgery, Houston Methodist Academic Institute, Houston, TX; and Professor of Clinical Surgery (Oral and Maxillofacial), Weill-Cornell Medical College, New York, NY
| | - Kevin B Coppelson
- Former Advance Oral and Maxillofacial Surgery Fellow, Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital, Houston, TX
| | - Tianshu Kuang
- Research Assistant, Surgical Planning Laboratory, Houston Methodist Hospital, Houston, TX
| | - Cathy D Poliak
- Conoco-Phillips Instructional Assistant Professor of Data Science, Associate Director MSDS Program, Mathematics Department, University of Houston, Houston, TX
| | - James J Xia
- Director of the Surgical Planning Laboratory, Oral and Maxillofacial Surgery Department, Houston Methodist Research Institute; Professor of Oral and Maxillofacial Surgery, Houston Methodist Academic Institute, Houston, TX; and Professor of Surgery (Oral and Maxillofacial Surgery), Weill-Cornell Medical College, New York, NY.
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20
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Treatment of hemimandibular hyperplasia by computer-aided design and computer-aided manufacturing cutting and drilling guides accompanied with pre-bent titanium plates. J Craniomaxillofac Surg 2020; 48:1-8. [DOI: 10.1016/j.jcms.2019.01.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/16/2019] [Accepted: 01/25/2019] [Indexed: 11/20/2022] Open
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22
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A three-dimensional study of hemimandibular hyperplasia, hemimandibular elongation, solitary condylar hyperplasia, simple mandibular asymmetry and condylar osteoma or osteochondroma. J Craniomaxillofac Surg 2019; 47:1665-1675. [DOI: 10.1016/j.jcms.2019.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/02/2019] [Accepted: 08/08/2019] [Indexed: 11/21/2022] Open
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Efficacy of proportional versus high condylectomy in active condylar hyperplasia — A systematic review. J Craniomaxillofac Surg 2019; 47:1222-1232. [DOI: 10.1016/j.jcms.2019.03.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 02/14/2019] [Accepted: 03/21/2019] [Indexed: 11/19/2022] Open
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Duran GS, Di̇ndaroğlu F, Kutlu P. Hard- and soft-tissue symmetry comparison in patients with Class III malocclusion. Am J Orthod Dentofacial Orthop 2019; 155:509-522. [PMID: 30935606 DOI: 10.1016/j.ajodo.2018.05.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Our aim was to describe hard- and soft-tissue asymmetry in people who have a skeletal Class III malocclusion, and to compare with those without asymmetry. We also performed a regional analysis of a possible correlation between facial soft- and hard-tissue asymmetries. METHODS This retrospective study was performed with the use of the computed tomographic scans of 60 subjects. The skeletal Class III subjects were categorized into 2 subgroups: soft-tissue menton deviation ≤4 mm (n = 20) versus >4 mm (n = 20). The Class III groups were compared with a Class I symmetry group (n = 20). Hard and soft tissues were segmented into different morphologic areas and deviation calculated. Pearson correlation coefficients were obtained, and 1-way analysis of variance was conducted for statistical analysis. RESULTS The highest deviation in the hard tissues of the Class III asymmetry group was in the corpus region (5.55 ± 3.05 mm), with the second highest in the angulus region (4.70 ± 2.43 mm). The highest average deviation in the soft tissues was seen in the lower cheek (7.04 ± 3.46 mm). In the different study groups, the amounts of asymmetry measured in anatomic structures on the mandible were found to be highly correlated between neighboring structures. CONCLUSIONS Clinically and statistically significant differences were found in the anatomic regions located in the middle and lower thirds of the face. There was a medium or high correlation between condyle, coronoid process, ramus, and angulus regions. A low level of correlation was observed between middle face and mandibular asymmetries in hard-tissue upper cheek and lower cheek regions were correlated with different mandibular regions.
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Affiliation(s)
- Gökhan Serhat Duran
- Department of Orthodontics, Gülhane Faculty of Dentistry, Sağlık Bilimleri University, Etlik, Ankara, Turkey.
| | - Furkan Di̇ndaroğlu
- Department of Orthodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
| | - Pınar Kutlu
- Department of Orthodontics, Gülhane Faculty of Dentistry, Sağlık Bilimleri University, Etlik, Ankara, Turkey
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Geometrical parameters of the mandible in 3D CBCT imaging. Biocybern Biomed Eng 2019. [DOI: 10.1016/j.bbe.2018.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fariña R, Moreno E, Lolas J, Silva F, Martínez B. Three-dimensional skeletal changes after early proportional condylectomy for condylar hyperplasia. Int J Oral Maxillofac Surg 2019; 48:941-951. [PMID: 30755358 DOI: 10.1016/j.ijom.2019.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/17/2018] [Accepted: 01/21/2019] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to evaluate volumetric and dentoskeletal changes in 21 patients with active unilateral condylar hyperplasia (AUCH) after proportional condylectomy. A split-mouth design was used: control group healthy joints (HS, healthy side) and test group affected joints (AS, affected side) (21 per group). Cone beam tomography scans were obtained at T0 (preoperative), T1 (10days after the intervention), and T2 (approximately 12 months post-surgery). The condylar unit volume (CUV), articular cavity volume (ACV), and dentoalveolar units (DAUs) were measured. CUV showed a difference of 1.12cm3 between T0 and T1, increasing 0.4cm3 between T1 and T2 on AS. There was no difference between T0 and T2 on HS. ACV increased 0.65cm3 between T0 and T1 on AS, after which it decreased by 0.36cm3 at T2 (0.30cm3 larger than the initial articular cavity at T0). ACV showed no post-surgery differences on HS. Midline DAU showed extrusion of 0.20mm for maxilla and 0.52mm for mandible, while in the lateral area, maxilla was extruded by 0.3mm on HS and was intruded 0.12mm on AS. For the mandible, both sides showed extrusion (0.4-0.6mm). In the distal to canine and molar areas, intrusion of 0.2mm and 0.9mm, respectively, was observed on AS; there was extrusion of 0.6mm distal to the canine on HS. At the mandibular level, AS distal to the canine showed extrusion of 1mm, while intrusion of 0.2mm was observed in the molars. For HS, only extrusion at the molar level (0.2mm) was observed. In conclusion, after proportional condylectomy, a neocondyle forms within 12 months to equal the healthy contralateral side. The articular cavity, which is reduced in the initial stage, increases in size after surgery and the volume gradually approaches that of the healthy side. Dentoalveolar changes occur at the anterior and posterior levels, causing intrusion and extrusion of the interdental crests. An early proportional condylectomy as the sole surgical treatment for patients with AUCH allows normalization of the maxillomandibular relationship.
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Affiliation(s)
- R Fariña
- Department of Oral and Maxillofacial Surgery, Hospital del Salvador, Providencia, Región Metropolitana, Chile; Department of Oral and Maxillofacial Surgery, Hospital San Borja Arriarán, Santiago, Chile; Oral and Maxillofacial Surgery, Universidad de Chile, Santiago, Chile.
| | - E Moreno
- Department of Oral and Maxillofacial Surgery, Hospital del Salvador, Providencia, Región Metropolitana, Chile
| | - J Lolas
- Department of Oral and Maxillofacial Surgery, Hospital del Salvador, Providencia, Región Metropolitana, Chile
| | - F Silva
- Department of Oral and Maxillofacial Surgery, Hospital de Punta Arenas, Punta Arenas, Chile
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Espinosa S, Rabanal C, Toro-Ibacache V. Morphometric Characterization of Asymmetric Mandibles Due to Condylar Hyperactivity. J Oral Maxillofac Surg 2019; 77:1056-1067. [PMID: 30689968 DOI: 10.1016/j.joms.2018.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Mandibular asymmetry related to condylar hyperactivity (CH) presents a complex set of morphologic features that pose challenges for its correction. Using state-of-the-art morphometric techniques, this report provides a detailed and hierarchical description of the features present in CH-related asymmetric mandibles and offers new knowledge for the surgical treatment of CH. MATERIALS AND METHODS Sixty patients were included in the sample. Thirty had CH-related asymmetric mandibles and the other 30 had clinically symmetric mandibles. Twenty-eight 3-dimensional landmarks were placed on computed tomographically based reconstructions of each participant's mandible and analyzed using geometric morphometric analysis for the quantitative and qualitative comparison of their morphologic features. RESULTS All 60 participants exhibited asymmetry. However, those with CH exhibited a broad range of shapes and even shared several morphologic features with the controls. Mainly the ramus and then the body were the main contributors of the differences between groups. CONCLUSIONS There is considerable overlap of anatomic features characterizing symmetric and asymmetric mandibles; based on shape alone, the 2 groups can be easily misclassified. The ramus and body of the affected side in CH-related asymmetric mandibles were the main contributors to asymmetry of the structure. The chin, a usual diagnostic structure, did not greatly contribute to the structural asymmetry of the mandible.
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Affiliation(s)
- Sebastian Espinosa
- Attending Surgeon, Department of Oral and Maxillofacial Surgery, Hospital Sótero del Río, Santiago, Chile.
| | - Carolina Rabanal
- Attending Radiologist, Department of Oral and Maxillofacial Radiology, Hospital Sótero del Río, Santiago, Chile
| | - Viviana Toro-Ibacache
- Researcher, Centro de Análisis Cuantitativo en Antropología Dental, Facultad de Odontología, Universidad de Chile, Santiago, Chile; Researcher, Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
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Cone–beam computed tomographic analysis of maxillary and mandibular changes after high condylectomy combined with orthodontic treatment for active unilateral condylar hyperplasia. Br J Oral Maxillofac Surg 2018; 56:692-697. [DOI: 10.1016/j.bjoms.2018.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/13/2018] [Indexed: 11/22/2022]
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Nolte J, Schreurs R, Karssemakers L, Tuinzing D, Becking A. Demographic features in Unilateral Condylar Hyperplasia: An overview of 309 asymmetric cases and presentation of an algorithm. J Craniomaxillofac Surg 2018; 46:1484-1492. [DOI: 10.1016/j.jcms.2018.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/24/2018] [Accepted: 06/05/2018] [Indexed: 10/28/2022] Open
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Wu WJ, Huang MW, Zhang GH, Zhao D, Zheng L, Yu GY, Zhang JG. Mandibular growth in survivors of pediatric parotid gland carcinoma treated with interstitial brachytherapy. Pediatr Blood Cancer 2018; 65:e27223. [PMID: 29797637 DOI: 10.1002/pbc.27223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of the study was to present long-term results of mandibular growth in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy. PROCEDURE Twenty-five survivors of pediatric parotid gland carcinoma treated with iodine-125 seed interstitial brachytherapy were included for quantitative analysis, including three dimensional (3D) cephalometry and measurement of mandibular volume. RESULTS 3D cephalometry showed that the median fore-and-aft increments of the lengths of the condyle, the ramus, and the body of the mandible were 1.23, 0.19, and 1.66 mm for the affected side, respectively, and were 1.37, 1.95, and 3.42 mm for the unaffected side, respectively. The difference in increments of the ramus was statistically significant between the affected side and the unaffected side (P = 0.003; P < 0.05). Moreover, mandibular volume measurements showed that the median fore-and-aft increments of the volumes of the condyle, the ramus, and the body of the mandible were 290.62, 220.14, and 1706.40 mm3 for the affected side, respectively, and were 269.15, 370.40, and 1469.86 mm3 for the unaffected side, respectively. The difference in increments was statistically significant between the affected side and the unaffected side for the ramus (P = 0.005; P < 0.05) and the body (P = 0.043; P < .05). CONCLUSION Mandibular growth was affected by interstitial brachytherapy, especially for the ramus, in pediatric parotid gland carcinoma survivors treated with interstitial brachytherapy. Nevertheless, the impact was mild in these survivors.
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Affiliation(s)
- Wen-Jie Wu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Ming-Wei Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Guo-Hao Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Dan Zhao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Lei Zheng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Jian-Guo Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
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Jingqiu T, Jiaqian F, Yonghua L. [Characteristics of mandible and mandibular dentition in patients with near-normal occlusion and different vertical facial skeletal types]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 35:403-407. [PMID: 28853508 DOI: 10.7518/hxkq.2017.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective The aim of our work is to characterize individual normal occlusions to establish appropriate treatment standards for different vertical facial types. Methods A total of 30 patients with near-normal occlusion were grouped into high-angle group (eight cases), medium-angle group (12 cases), and low-angle group (10 cases) according to vertical facial skeletal type. Invivo5 software was used and digital imaging and communications in medicine data were rebuilt to measure the ∠L1/MP, ∠L6/MP, axis corner of L6, cant of occlusion plane, Balkwill angle, and Bonwill triangle of each group. Results Among the groups, the low-angle group had the smallest ∠L6/MP (P<0.05) and largest cant of occlusion. No significant difference was observed among the three groups with regard to the other parameters (P>0.05). Conclusion Patients with low-angle vertical facial skeletal type requires a modified treatment standard. In this group, the treatment standard must ensure that the cant of occlusion plane is more parallel to the Frankfurt horizontal plane compared with those of the other groups, and the axis of L6 is tilted distally relative to the mandibular plane.
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Affiliation(s)
- Tu Jingqiu
- Center of Stomatology, Xiangya Hospital of Central South University, Changsha 410013, China
| | - Fan Jiaqian
- Center of Stomatology, Xiangya Hospital of Central South University, Changsha 410013, China
| | - Lei Yonghua
- Center of Stomatology, Xiangya Hospital of Central South University, Changsha 410013, China
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Lima GM, Diodato S, Costabile E, Cicoria G, Civollani S, Marchetti C, Guidalotti PL, Pettinato C, Nanni C, Fanti S. Low dose radiation 18F-fluoride PET/CT in the assessment of Unilateral Condylar Hyperplasia of the mandible: preliminary results of a single centre experience. Eur J Hybrid Imaging 2018; 2:7. [PMID: 29782597 PMCID: PMC5954779 DOI: 10.1186/s41824-018-0025-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 01/15/2018] [Indexed: 11/13/2022] Open
Abstract
Background Unilateral condylar hyperplasia (UCH) of the mandible, or Hypercondylia, is a pathological condition that determines an abnormal growth of the affected condyle. Bone SPECT with Tc99m-diphosphonates is a successful tool in the diagnosis of UCH. EANM guidelines also suggest the use of 18F–NaF PET/CT, though it leads to a higher radiation exposure. Aim As UCH patients are young, we aimed to develop a low dose 18F–Fluoride PET/CT protocol and compare it to a standard injected activity scan, to assess if the image quality remains unchanged. Materials and methods We prospectively enrolled 20 patients (7 males, 13 females, mean age 23.2) with UCH, who underwent 18F–NaF PET/CT to assess the hypercondylia. We administered a low activity of 18F–NaF (2.9 MBq/kg) in 15 patients and a standard activity (5.3 MBq/kg) in 5 patients. Activity range was chosen according to 2015 EANM guidelines. To determine if the scans with low radiotracer activity were “diagnostic” such as those with standard activity, two expert nuclear medicine physicians, unaware of the administered activity, independently reviewed the scans and expressed a final qualitative judgment in terms of “diagnostic”/“non-diagnostic” scan. Furthermore, we compared the effective dose of a low injected activity PET/CT to the standard one and to a Bone SPECT performed with standard injected activity of Tc99m-diphosphonates. Results Reviewers classified 19 of 20 scans as “diagnostic”. Only one of them was classified as “non diagnostic” due to condylar arthrosis that disturbed the correct evaluation of condylar radiotracer uptake. The effective dose of a 18F–Fluoride PET/CT, in patient of 70 kg, is about 3.5 mSv in scans performed with 2.9 MBq/kg [0.017 mSv/MBq × 2.9 MBq/kg × 70 kg] and about 6.3 mSv in ones performed with 5.3 MBq/kg [0.017 mSv/MBq × 5.3 MBq/kg × 70 kg]. The effective dose of 99mTc-MDP bone SPECT is about 3.2 mSv [0.0043 mSv/MBq × 740 MBq of 99mTc-MDP]. Discussion 18F–NaF PET/CT performed with a low radiotracer activity allows a good assessment of UCH similar to that performed with an ordinary activity. The effective radiation dose of a low-injected activity PET/CT is significantly lower than an ordinary-injected activity and is not significantly higher than the most used Bone SPECT. Moreover PET/CT is performed in 1.5 h while Bone SPECT requires at least 3.5 h. Conclusions The 18F–Fluoride PET/CT procedure could be performed with 2.9 MBq/Kg (minimum 185 MBq, recommended at least 200 MBq) of 18F–NaF to minimize the effective radiation dose received, maintaining the quality of the scan. Further studies including a larger number of patients and clinical follow-up are needed to confirm our preliminary findings.
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Affiliation(s)
- G M Lima
- 1Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - S Diodato
- 1Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - E Costabile
- 2Maxillo-Facial Surgeon Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - G Cicoria
- 3Department of Medical Physics, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - S Civollani
- 3Department of Medical Physics, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - C Marchetti
- 2Maxillo-Facial Surgeon Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - P L Guidalotti
- 1Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - C Pettinato
- 3Department of Medical Physics, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - C Nanni
- 1Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - S Fanti
- 1Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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