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Lopes IA, Chicrala GM, Soares MQS, Capelozza ALA. Evaluation of the Nasopalatine Canal of Patients With and Without Cleft Lip and Palate in CBCT Exams. Cleft Palate Craniofac J 2024; 61:610-619. [PMID: 36278685 DOI: 10.1177/10556656221134146] [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] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To identify and compare the morphology and dimensions of the nasopalatine canal (NPC) of individuals with and without cleft lip and palate using Conical Beam Computed Tomography (CBCT) images and to relate the results to the type of cleft and tooth absences in the region. SETTING This is a cross-sectional, analytical study with a retrospective sample. PATIENTS, PARTICIPANTS 100 CBCT exams from patients with cleft lip and palate and 100 CBCT exams from patients without cleft lip and palate were used. INTERVENTIONS The NPC was evaluated for its morphology and measurements in the coronal, sagittal, and axial reformatting of CBCT exams. RESULTS It was obtained as a result that in the group of patients with a cleft, the shapes of funnel, banana, and needle of the NPC were more frequent than in the control group. Patients with cleft lip and palate had significantly a larger nasopalatine foramen and a larger NPC diameter, besides a significantly shorter NPC, compared to controls. In both groups, edentulous patients had less anterior maxillary bone thickness, when compared to patients with maxillary anterior teeth. Patients with clefts had a bone thickness buccal to the NPC less than in the control group. CONCLUSIONS This study confirms the anatomical variability of NPC in patients with cleft lip and palate. This finding reinforces the need for thorough surgical planning of the anterior region of the maxilla, in CBCT exams, by the dentist.
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Affiliation(s)
- Ivna Albano Lopes
- Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gabriela Moura Chicrala
- Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mariana Quirino Silveira Soares
- Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Campinas, Brazil
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Chatzipetros E, Tsiklakis K, Donta C, Damaskos S, Angelopoulos C. Morphological Assessment of Nasopalatine Canal Using Cone Beam Computed Tomography: A Retrospective Study of 124 Consecutive Patients. Diagnostics (Basel) 2023; 13:diagnostics13101787. [PMID: 37238271 DOI: 10.3390/diagnostics13101787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
This study aimed to assess and analyze the morphology and dimensions of the nasopalatine canal (NPC), as well as the adjacent buccal osseous plate (BOP), and to investigate the effect of gender, edentulism, NPC types, absence of maxillary central incisors (ACI) and age on the NPC and BOP, using cone beam computed tomography (CBCT). A total of 124 CBCT examinations (67 female and 57 male patients) were retrospectively included and evaluated. The assessment of the dimensions of the NPC, as well as the dimensions of the adjacent BOP, was performed by three Oral and Maxillofacial Radiologists on reconstructed sagittal and coronal CBCT sections under standardized conditions. Regarding the dimensions of the NPC and the adjacent BOP, the mean values were significantly higher among males than females. Furthermore, edentulous patients showed a significant reduction in BOP dimensions. Additionally, NPC types showed a significant effect on the length of the NPC, and the ACI had a significant effect on reducing BOP dimensions. Age had a significant effect on the diameter of the incisive foramen, with the mean values generally increasing with an increasing age. CBCT imaging of this anatomical structure contributes significantly to its full assessment.
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Affiliation(s)
- Emmanouil Chatzipetros
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, 115 27 Athens, Greece
| | - Kostas Tsiklakis
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, 115 27 Athens, Greece
| | - Catherine Donta
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, 115 27 Athens, Greece
| | - Spyros Damaskos
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, 115 27 Athens, Greece
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str., Goudi, 115 27 Athens, Greece
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Prado GM, Fontenele RC, Costa ED, Freitas DQ, Oliveira ML. Morphological and topographic evaluation of the mandibular canal and its relationship with the facial profile, skeletal class, and sex. Oral Maxillofac Surg 2023; 27:17-23. [PMID: 35304654 DOI: 10.1007/s10006-022-01058-x] [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: 03/07/2021] [Accepted: 03/13/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to evaluate the morphology and topography of the mandibular canal in patients with different facial profiles, skeletal classes, and sexes. METHODS Cone-beam computed tomography volumes of 103 patients were classified according to facial profile and skeletal class. Two examiners classified the mandibular canal into a linear, spoon-shaped, elliptical arc, or turning curvature and measured four related linear distances. The most frequent mandibular canal curvature was identified and multi-way ANOVA with Tukey's test compared the linear measurements between facial types, skeletal class, and sexes (α = 0.05). Kappa and intraclass correlation coefficients were used to assess the reproducibility of qualitative and quantitative variables, respectively. RESULTS The examiners showed excellent reproducibility. The four curvatures of the mandibular canal were found, but the spoon-shaped and elliptical arch were the most frequent. No significant differences were observed for most of the linear measurements between the different facial profiles, skeletal classes, and sexes (p > 0.05). CONCLUSION Spoon-shaped and elliptical arch are the most frequent curvatures of the mandibular canal; furthermore, its morphology and topography seem to be little influenced by the facial profile, skeletal class, and sex.
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Affiliation(s)
- Gustavo Moraes Prado
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil
| | - Rocharles Cavalcante Fontenele
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil
| | - Eliana Dantas Costa
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil.,Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Cafe Ave, Ribeirao Preto, SP, Brazil
| | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, 901, Limeira Ave, Piracicaba, SP, Brazil.
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Does the angulation between the maxillary central incisors and the nasopalatine canal differ among sagittal and vertical skeletal patterns? A CBCT study. Int Orthod 2022; 20:100636. [DOI: 10.1016/j.ortho.2022.100636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/20/2022] [Accepted: 03/26/2022] [Indexed: 11/23/2022]
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The Role of Morphometric Characteristics of Anterior Maxilla in Planning the Interventions Accompanied by Orthodontic Teeth Movement – An Overview. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The anterior maxilla or premaxilla is part of the upper jaw and the most significant content of this region, from the aspect of orthodontic therapy, are the incisor teeth. The frequency of complications during orthodontic movement of the upper incisors refers to a more detailed evaluation of the anatomical structures of the premaxilla. The aim of this study was to investigate morphological and morphometric characteristics of the anterior maxilla by cone beam computed tomography, which could be of interest for planning orthodontic teeth movement. By reviewing the available literature, we compared the values of the alveolar bone height, the distance between the alveolar crest and enamel – cement boundary, total alveolar bone width, the thickness of the buccal, and palatal plate, nasopalatine canal, and accessory canals of the anterior maxilla. The results of our study show changes in the labial and palatal aspects of the alveolar bone height during orthodontic interventions. Different results of the alveolar bone width are in correlation with gender, age, and type of orthodontic tooth movement. Distance between the nasopalatine canal and maxillary central incisors was estimated at the value from 4 to 6 mm, which is below the recommended value for maximum incisal retraction by Proffit. Research results show variations in shape, length, and diameter of the nasopalatine canal, which indicates individual varieties detected on cone beam computed tomography. Other anatomical structures and measures show an insignificant correlation with orthodontic teeth movement. According to the contradictory results of the available articles, it is required to achieve an individual approach to orthodontic interventions in the area of the anterior maxilla.
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Arnaut A, Milanovic P, Vasiljevic M, Jovicic N, Vojinovic R, Selakovic D, Rosic G. The Shape of Nasopalatine Canal as a Determining Factor in Therapeutic Approach for Orthodontic Teeth Movement-A CBCT Study. Diagnostics (Basel) 2021; 11:diagnostics11122345. [PMID: 34943581 PMCID: PMC8700672 DOI: 10.3390/diagnostics11122345] [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: 11/16/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 01/18/2023] Open
Abstract
The aim of this study was to evaluate the impact of the nasopalatine canal (NPC) shape and its morphometric characteristics on expected teeth movement by assessing the distance to maxillary central incisors (MCIs) according to NPC type. The retrospective study was performed on 133 CBCT images. The following parameters were obtained: the antero-posterior diameter (A-P) of the nasal foramen (NF), canal length, A-P and mediolateral diameter (M-L) of the incisive foramen (IF), and the distance between NPC and MCIs. With the exception of being hourglass-shaped, each NPC shape showed specific impacts of NPC shape on the relationship between NPC diameters at different sections and distances to MCIs. In banana-shaped NPC, a significant correlation was observed for A-P NF diameter, while in cylindrical-shaped NPC, a significant correlation was observed for NPC length. The increase in M-L IF, A-P IF, A-P NF, and NPC length in funnel-shaped NPC may be a risk factor for interventions that could result in teeth movement. According to the results, it seems that the proposed methodological approach for analysis of CBCT slices in the anterior maxilla may offer detailed information that could be an additional tool in planning the procedures that result in expected teeth movement.
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Affiliation(s)
- Aleksandra Arnaut
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (A.A.); (P.M.); (M.V.)
| | - Pavle Milanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (A.A.); (P.M.); (M.V.)
| | - Milica Vasiljevic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (A.A.); (P.M.); (M.V.)
| | - Nemanja Jovicic
- Department of Histology and Embryology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Radisa Vojinovic
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Dragica Selakovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Correspondence: (D.S.); (G.R.)
| | - Gvozden Rosic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Correspondence: (D.S.); (G.R.)
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Arnaut A, Milanovic P, Vasiljevic M, Jovicic N, Vojinovic R, Selakovic D, Rosic G. The Shape of Nasopalatine Canal as a Determining Factor in Therapeutic Approach for Orthodontic Teeth Movement—A CBCT Study. Diagnostics (Basel) 2021. [DOI: https://doi.org/10.3390/diagnostics11122345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to evaluate the impact of the nasopalatine canal (NPC) shape and its morphometric characteristics on expected teeth movement by assessing the distance to maxillary central incisors (MCIs) according to NPC type. The retrospective study was performed on 133 CBCT images. The following parameters were obtained: the antero-posterior diameter (A-P) of the nasal foramen (NF), canal length, A-P and mediolateral diameter (M-L) of the incisive foramen (IF), and the distance between NPC and MCIs. With the exception of being hourglass-shaped, each NPC shape showed specific impacts of NPC shape on the relationship between NPC diameters at different sections and distances to MCIs. In banana-shaped NPC, a significant correlation was observed for A-P NF diameter, while in cylindrical-shaped NPC, a significant correlation was observed for NPC length. The increase in M-L IF, A-P IF, A-P NF, and NPC length in funnel-shaped NPC may be a risk factor for interventions that could result in teeth movement. According to the results, it seems that the proposed methodological approach for analysis of CBCT slices in the anterior maxilla may offer detailed information that could be an additional tool in planning the procedures that result in expected teeth movement.
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Morphologic changes of the incisive canal and its proximity to maxillary incisor roots after anterior tooth movement. Am J Orthod Dentofacial Orthop 2021; 161:396-403.e1. [PMID: 34654602 DOI: 10.1016/j.ajodo.2020.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 08/01/2020] [Accepted: 08/01/2020] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The objectives were to evaluate the morphologic changes of the incisive canal (IC) and the influence of IC proximity to apical root resorption of maxillary central incisors after anterior tooth movement. METHODS Pretreatment and posttreatment cone-beam computed tomography images of adults (aged 18-47 years) were retrospectively evaluated. Subjects were divided into control group with minimal incisor movement (n = 32; maxillary incisor tip movement <2 mm) and maximum retraction group (n = 35; maxillary incisor tip movement >4 mm). The shape, direction, morphologic changes of the IC, the proximity of the central incisor root to IC, and the amount of apical root resorption associated with the proximity after orthodontic treatment were compared. RESULTS Changes in the shape of the IC were not observed in both control and retraction groups. However, 11.4% (4 of 35 subjects) in the retraction group indicated changes in the direction of the IC from slanted-straight to slanted-curved type after the direction of anterior retraction. The thickness of the cortical bone surrounding the IC and the distance between the incisor root and IC significantly decreased after orthodontic treatment in both groups (P <0.05). However, these changes were significantly greater in the retraction group than in control (P <0.0001). Contact or invasion of the incisor root to the IC was more prominent in the retraction group (42.8%-54.3%) than the control (10.9%-12.5%) (P <0.0001). The amount of root resorption indicated a tendency to increase in the order of separation, approximation, contact, and invasion in relation to IC. CONCLUSIONS Although remodeling of IC was evident in some patients, contact or invasion of the maxillary central incisor roots to IC was fairly high after maximum anterior retraction.
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Costa ED, de Oliveira Reis L, Gaêta-Araujo H, Martins LAC, Oliveira-Santos C, Freitas DQ. Comparison of distance of upper central incisor root and incisive canal in different sagittal and vertical skeletal patterns and sex: A retrospective CBCT study. Int Orthod 2021; 19:462-470. [PMID: 34312102 DOI: 10.1016/j.ortho.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION To evaluate the influence of sagittal and vertical skeletal patterns (skeletal classes and facial profiles), and sex on the distance between upper central incisors roots and incisive canal. MATERIAL AND METHODS Cone-beam computed tomography exams of 172 patients were classified into skeletal classes I, II, and III and according to the facial profile into mesofacial, brachyfacial, and dolichofacial. In sagittal reconstructions, linear measurements were done between central incisors roots and incisive canal at three levels: incisive foramen opening, intermediate region, and the region close to the apex of upper central incisors. In axial reconstructions, measurements of incisive canal width and distance between the roots were obtained. Analysis of Variance (three-way ANOVA) was used to evaluate measurement differences in relation to skeletal classes, facial profiles, and sex. RESULTS The distance between upper central incisors roots and incisive canal anterior region was little influenced by sagittal and vertical skeletal patterns and sex. Men had significantly greater incisive canal (mean=2.85mm; SD=1.18) width compared to women (mean=2.40mm; SD=1.04), regardless of skeletal class and facial profile (P<0.05). In general, inter-root distance between medial points of central incisors roots and incisive canal opening was greater in the region close to upper central incisors apex (mean=3.84mm; SD=1.44) than in incisive foramen opening (2.44mm; SD=1.04), (P<0.05). CONCLUSIONS The distance between upper central incisors roots and incisive canal is little influenced by sagittal and vertical skeletal patterns and sex.
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Affiliation(s)
- Eliana Dantas Costa
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil.
| | - Larissa de Oliveira Reis
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
| | - Hugo Gaêta-Araujo
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
| | - Luciano Augusto Cano Martins
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
| | - Christiano Oliveira-Santos
- University of São Paulo, Ribeirão Preto, Public Health and Forensic Dentistry, Department of Stomatology, Division of Oral Radiology, School of Dentistry of Ribeirão Preto, São Paulo, Brazil
| | - Deborah Queiroz Freitas
- University of Campinas, Piracicaba Dental School, Division of Oral Radiology, Department of Oral Diagnosis, Avenue Limeira 901, Areião, 13414-018 Piracicaba, Brazil
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Gender Differences in the Morphological Characteristics of the Nasopalatine Canal and the Anterior Maxillary Bone - CBCT Study. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2021-0029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The aim of this study was to investigate the gender differences in anatomical and morphometric characteristics of the nasopalatine canal–NPC and horizontal dimensions of the anterior maxilla by CBCT, which could be of interest for clinicians who perform implant surgery in this region. A retrospective quantitative study was conducted using CBCT images from the radiological database of the Department of Dentistry (Kragujevac) on a total of 113 participants (63 male and 50 female). The results of our study confirmed no gender difference in the distribution of NPC type, while the most frequent NPC type confirmed gender variations (cylindrical in females, funnel in males), but the lowest incidence of NPC type in both males and females was banana-type. The NPC length was significantly increased in males with no significant gender impact on medio-lateral (M-L) and antero-posterior (A-P) dimensions of the incisive foramen, as well as the A-P dimension of the nasal foramen. Linear regression analysis revealed the significant correlation between the M-L dimension of incisive foramen and the anterior maxilla diameter at all bone levels for males, and between the NPC length and the anterior maxilla diameter only in females at the level D. Also, both NPC type and gender significantly affected the correlations between the estimated parameters (females showed significant correlation only in funnel NPC type at the level D, while males showed significant correlation in both funnel NPC type at the level A, but also in hourglass-type at the level D). Those results imply significant gender impact in planning of various surgical interventions in the anterior maxilla region.
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Chung CJ, Nguyen T, Lee JH, Kim KH. Incisive canal remodelling following maximum anterior retraction reduces apical root resorption. Orthod Craniofac Res 2020; 24 Suppl 1:59-65. [PMID: 33369873 DOI: 10.1111/ocr.12464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The objectives were to visualize the incisive canal (IC) remodelling following maximum incisor retraction and to evaluate its impact on canal-invasion-associated apical root resorption. METHODS Pre- and post-treatment CBCT images of 34 adult orthodontic patients (age 18-47 years) with a large amount of maxillary incisor retraction (>4 mm) using temporary anchorage devices (TADs) were retrospectively evaluated. Maxillary regional superimpositions and 3D models of the IC along with central incisors were used to measure the changes in IC dimension, IC invasion by the roots and IC remodelling. In addition, the association of the amount of apical root resorption with the root-IC relationship and IC remodelling were evaluated. RESULTS IC invasion by the incisor roots following maximum retraction was seen in 53% (18 out of 34) of the cases. IC with larger volume and area showed more invasions compared with those with smaller volume and area (P < .01). The amount of root resorption was significantly higher with IC invasion than without invasion (2.39 mm vs 0.82 mm, P < .0001). IC remodelling following maximum retraction was seen in 24% of the subjects. IC remodelling group demonstrated less apical root resorption than the non-remodelling group (0.98 mm vs 3.27 mm, P < .0001). CONCLUSION IC with larger volume and surface area before treatment were more likely to show canal invasion by the incisor roots after maximum retraction. IC invasion resulted in apical root resorption. However, approximately one-fourth of cases showed remodelling of the IC, which reduced the amount of root resorption.
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Affiliation(s)
- Chooryung J Chung
- Department of Orthodontics, Gangnam Severance Hospital, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Tung Nguyen
- Department of Orthodontics, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
| | - Jee-Hyun Lee
- Department of Orthodontics, Gangnam Severance Hospital, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Gangnam Severance Hospital, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
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