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Hikosaka Y, Koizumi S, Kim YI, Adel M, Nadim M, Hikita Y, Yamaguchi T. Comparison of Mandibular Volume and Linear Measurements in Patients with Mandibular Asymmetry. Diagnostics (Basel) 2023; 13:diagnostics13071331. [PMID: 37046549 PMCID: PMC10093347 DOI: 10.3390/diagnostics13071331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/26/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
In patients with mandibular asymmetry, the volume of the mandible divided by the mandibular median plane is significantly larger on the non-deviated (N-Dev) side than on the deviated (Dev) side. However, it has been reported that there is no significant difference between the volumes of the N-Dev and Dev sides when the mandibular ramus and body are divided. The purpose of this study was to investigate which region is responsible for the volume difference between the N-Dev and Dev sides. Cone Beam Computed Tomography (CBCT) images of patients with mandibular asymmetry were analyzed by measuring the volume, and linear analysis of the mandibular body, ramus, and condyle on the N-Dev and Dev side was performed. In this study, CBCT images of 37 patients (8 Japanese, 16 Korean, and 13 Egyptian) aged ≥ 18 years with mandibular asymmetry (men: 20, women: 17) were used to evaluate mandibular asymmetry. In patients with mandibular asymmetry, the N-Dev side showed significantly larger values than the Dev side for both volume and linear condyle, ramus, and mandibular body measurements. These results do not differ according to sex or ethnicity. Therefore, it is suggested that the N-Dev side of mandibular asymmetry is large without any regional specificity in pathophysiology.
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Affiliation(s)
- Yuki Hikosaka
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan
| | - So Koizumi
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan
| | - Yong-Il Kim
- Department of Orthodontics, Pusan National University Dental Hospital, Yangsan 50612, Republic of Korea
| | - Mohamed Adel
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA
| | - Mohamed Nadim
- Department of Orthodontics, Suez Canal University, Ismailia 41522, Egypt
| | - Yu Hikita
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan
| | - Tetsutaro Yamaguchi
- Department of Orthodontics, School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan
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Jo H, Ohe JY, Lee JW, Lee BS, Jung J. Posterior bending osteotomy: An effective measure to secure facial symmetry in orthognathic surgery. J Craniomaxillofac Surg 2021; 49:538-544. [PMID: 33581956 DOI: 10.1016/j.jcms.2021.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/30/2020] [Accepted: 01/31/2021] [Indexed: 11/28/2022] Open
Abstract
This study aimed to compare the effectiveness of posterior bending osteotomy and grinding techniques for orthognathic surgery in patients with facial asymmetry. Patients who had undergone Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, and who presented with a menton shift and setback difference exceeding 4 mm, were enrolled. Cone-beam computed tomography was performed before surgery (T0), immediately after surgery (T1), and 6 months after surgery (T2). Overall, 38 patients were included and divided into posterior bending osteotomy (n = 23) and grinding (n = 15) groups. Significant differences were observed between the posterior bending osteotomy and grinding groups on the treated side. In the grinding group, the gonion on the treated side was displaced slightly outward, resulting in a significant difference between both sides (non-treated side: 50.52 ± 4.20 [T0] and 48.67 ± 4.37 [T2]; treated side: 50.88 ± 4.55 [T0] and 51.00 ± 3.95 [T2]; p = 0.038). In the posterior bending osteotomy group, bilateral inward movements of the gonion were observed, and the distance from the midsagittal plane to the gonion did not differ significantly between the sides (non-treated side: 46.74 ± 4.41 [T0] and 45.54 ± 3.95 [T2]; treated side: 47.43 ± 4.93 [T0] and 45.18 ± 3.52 [T2]; p = 0.224). The yawing movement of the proximal segment was greater in the grinding group than in the posterior bending osteotomy group (non-treated side: p = 0.839; treated side: p = 0.025). Posterior bending osteotomy is recommended over the grinding method for patients with severe facial asymmetry, in order to ensure a symmetric and esthetic facial profile by allowing passive adaptation between the mandibular segments.
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Affiliation(s)
- Hyunmi Jo
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea; Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Baek-Soo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Junho Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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Wolanski RB, Gasparello GG, Miyoshi CS, Guimarães LK, Saga AY, Tanaka OM. Evaluation of the perception of smile esthetics, in frontal view, with mandibular laterognatism, through the eye-tracking technique. J Orthod Sci 2020; 9:7. [PMID: 33110766 PMCID: PMC7585464 DOI: 10.4103/jos.jos_66_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/26/2020] [Accepted: 03/06/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To evaluate the perception of esthetics and the attractiveness of the smile, in frontal view, with mandibular asymmetry, through the eye-tracking. MATERIALS AND METHODS OGAMA software and The Eye Tribe Tracker hardware were used to obtain eye tracking in certain areas of interest on the face. To simulate asymmetry, Photoshop® image editing software was used to create a vertical reference line to the midline of the face and make it symmetrical with control of the angulation relative to another horizontal reference line passing through the vertices. Then, the lower third of the face added asymmetries or deviations, starting from zero, with increments of 2 by 2 degrees up to 6 degrees. The study included 60 laypeople, 30 males and 30 females, without any knowledge about the study, showing good vision, and not having used drugs with the possibility of influencing cognitive or motor skills. RESULTS From the heat map in cases of mandibular asymmetry, it is possible to visualize that for both sexes the evaluators evaluated with a certain degree of similarity mainly when the deviations presented with 6 degrees. The trajectory of the male and female gaze in cases with asymmetry shows that in cases with a magnitude of 6 degrees, the raters traced mainly in the region of the mouth with little transition in the eye region and mainly in the areas of interest considered as "other." In the images presented with a magnitude of up to 4 degrees, they were traced in the general image. CONCLUSIONS The perception of laypeople from mandibular asymmetry to the right in females presented a higher perception when compared to males with mandible asymmetry to the left.
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Affiliation(s)
- Rafael B Wolanski
- Undergraduation Student in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Gil G Gasparello
- Undergraduation Student in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Caio S Miyoshi
- Phd Postgraduate Student in Orthodontics, School of Life Sciences, Pontificia Universidade Católica do Paraná, Curitiba, Brazil
| | - Lara K Guimarães
- Phd Postgraduate Student in Orthodontics, School of Life Sciences, Pontificia Universidade Católica do Paraná, Curitiba, Brazil
| | - Armando Y Saga
- Professor of Residency in Orthodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Orlando M Tanaka
- Full Professor, Graduate Dentistry Program in Orthodontics, School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba, Brazil
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Bispo de Carvalho Barbosa P, de Andrade Vieira W, de Macedo Bernardino Í, Costa MM, Pithon MM, Paranhos LR. Aesthetic facial perception and need for treatment in simulated laterognathism in male faces of different ethnicities. Oral Maxillofac Surg 2019; 23:407-413. [PMID: 31187286 DOI: 10.1007/s10006-019-00784-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 05/30/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to compare the aesthetic perception and treatment need in individuals of different ethnicities with various degrees of laterognathism assessed by orthodontists, oral and maxillofacial surgeons, and laypersons. METHODS Three male descendants of different ethnicities were assessed, in which the mandibular deviation was manipulated digitally in different angulations (from 0 to 8°). The assessment was performed by three groups (orthodontists, maxillofacial surgeons, and laypersons (n = 20)), and it consisted of scoring the degree of pleasantness of the images presented in a numerical scale and indicating or not a corrective treatment for the respective image. RESULTS The higher the degree of deviation, the lower the scores assigned to the image (p < 0.05). Laypersons assigned the highest scores, with a significant difference between laypersons and oral and maxillofacial surgeons (p < 0.05). In terms of treatment need according to the group of evaluators, there were no statistically significant differences among them (p > 0.05). Moreover, the increase in degree of deviation increased the perception of treatment need (p < 0.05). The African faces received the highest scores, with significant differences from the Caucasian faces (p < 0.05). The overall tendency was higher treatment indication for the Caucasian faces, with statistically significant differences from the African faces (p < 0.05). CONCLUSION The greater the mandibular deviation, the lower the aesthetic pleasantness. Laypersons are less critical regarding the assessment of mandibular deviation. There was no difference for treatment indication by the different groups of evaluators. In addition, ethnicity may influence the perception and treatment indication.
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Affiliation(s)
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, Piracicaba Dental School, State University of Campinas, UNICAMP, Av. Limeira, 901, Piracicaba, SP, 13414-903, Brazil
| | - Ítalo de Macedo Bernardino
- Department of Dentistry, State University of Paraíba, Rua Baraúnas, 351, Campina Grande, PB, 58429-500, Brazil
| | - Marcio Magno Costa
- School of Dentistry, Area of Removable Prosthesis and Dental Materials, Federal University of Uberlandia, Campus Umuarama, Av. Pará, 1720, Uberlândia, MG, 38405-320, Brazil
| | - Matheus Melo Pithon
- Postgraduate Program in Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, R. Prof. Rodolpho Paulo Rocco, 325, Rio de Janeiro, RJ, 21941-617, Brazil
| | - Luiz Renato Paranhos
- School of Dentistry, Area of Preventive and Social Dentistry, Federal University of Uberlandia, Campus Umuarama, Av. Pará, 1720, Bloco 2G, sala 1, Uberlândia, MG, 38405-320, Brazil.
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Oueis R, Waite PD, Wang J, Kau CH. Orthodontic-Orthognathic Management of a patient with skeletal class II with bimaxillary protrusion, complicated by vertical maxillary excess: A multi-faceted case report of difficult treatment management issues. Int Orthod 2019; 18:178-190. [PMID: 31668665 DOI: 10.1016/j.ortho.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 09/28/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
This case reports the unsuccessful first treatment and the subsequent retreatment of a 35-year old Asian female with a skeletal class II with bimaxillary protrusion, complicated by a deep bite and vertical maxillary excess. This case report highlights the multiple facets of a challenging treatment plan and discusses the ramifications of treatment when treatment does not go as planned. The initial treatment plan consisted of a surgical approach with a maxillary Le Fort I surgery to correct the malocclusion as per the patient's requests without mandibular surgery due to the inherent risk of paraesthesia. The second treatment plan consisted of a bimaxillary surgery with genioplasty. The surgical treatment utilized virtual surgical planning (VSP). The orthodontic treatment was concluded with a corrected overjet and overbite achieving optimum function and balancing the facial profile aesthetically. This case report highlights the need for clear communication of the treatment plan and also the unpredictability of certain treatment outcomes especially when the literature does not provide for definitive conclusions. In addition, it sheds light on the challenge of unpredictable response of soft tissue after surgical treatment and the importance of patient expectations of outcomes. It is hoped that the paper provides a platform for future discussions of difficult malocclusions.
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Affiliation(s)
- Rawan Oueis
- University of Alabama, School of Dentistry, Department of Orthodontics, 1919 7th Ave S, SDB 305, Q1 35294-0007 Birmingham, AL, USA
| | - Peter D Waite
- University of Alabama, School of Dentistry, Department of Oral and Maxillofacial Surgery, Birmingham, AL, USA
| | - Jue Wang
- University of Alabama, School of Dentistry, Department of Orthodontics, 1919 7th Ave S, SDB 305, Q1 35294-0007 Birmingham, AL, USA
| | - Chung H Kau
- University of Alabama, School of Dentistry, Department of Orthodontics, 1919 7th Ave S, SDB 305, Q1 35294-0007 Birmingham, AL, USA.
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