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Li X, Zhang Z, Tang X, Li C, Liu W. Bone Density of the Condyle of Children with Craniofacial Microsomia and its Correlation with Condylar Resorption After Mandible Distraction Osteogenesis. Cleft Palate Craniofac J 2024; 61:1266-1274. [PMID: 36916235 DOI: 10.1177/10556656231163725] [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: 03/16/2023] Open
Abstract
OBJECTIVE To investigate condylar bone density (BD) in children with craniofacial microsomia (CFM) and identify factors that contribute to early stage condylar resorption (CR) after mandibular distraction osteogenesis (MDO). DESIGN Retrospective study. SETTING Craniofacial department of a plastic surgery hospital. PATIENTS Fifty-one children with CFM classified as Pruzansky IIa based on complete pre-(T0) and post-MDO (T1) computed tomography (CT) data. INTERVENTION AND MAIN OUTCOME MEASUREMENTS Mimic 21.0 (Materialise Inc., Belgium) was used to measure bilateral BD and condylar height (CH) and volume (CV) of affected side. Children were split into groups based on either affected side BD or the distraction length (DL,25 mm as cutoff) .Bilateral BD was compared using a paired t-test in each group. The CH and CV of affected side at T0 and T1 were compared. The relative values of the CH and CV (CH ratio) and the volume (CV ratio) of the affected side were compared across the groups. RESULTS The BD was lower on affected side than on unaffected side. Regarding BD, CH and CV decreased after MDO in group I, while the CH ratio and CV ratio of group I was lower than that of groups II and III. Regarding DL, the CV ratio was lower in Group L than Group S. CONCLUSIONS The condylar bone quality on affected side is compromised in type IIa CFM. A low BD in combination with a larger distraction distance may increase the risk of CR; therefore, MDO in patients with such characteristics should be postponed.
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Affiliation(s)
- Xiyuan Li
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zhiyong Zhang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaojun Tang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Chuan Li
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Wei Liu
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Niikura Y, Ishii T, Sakamoto Y, Ariizumi D, Sakamoto T, Sueishi K. Assessment and Identification of Improvement Areas for Facial Symmetry in Hemifacial Microsomia (Type IIB) Using Three-dimensional Measurements. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5877. [PMID: 38859809 PMCID: PMC11164012 DOI: 10.1097/gox.0000000000005877] [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: 01/08/2024] [Accepted: 04/17/2024] [Indexed: 06/12/2024]
Abstract
Background Surgical planning for hemifacial microsomia (HFM) patients often involves planning the amount of maxillary movement and mandibular bone distraction from three-dimensional (3D) volumetric images constructed from computed tomography scans. By representing anatomical indicators for facial symmetry in X, Y, and Z coordinates, we identified the more challenging areas in correcting facial asymmetry. Methods The study included five HFM patients with a mean age of 22.2 years, all diagnosed with HFM (type IIB). We established measurement points with high reproducible 3D coordinates on the 3D volumetric images obtained from computed tomography scans for before surgery, treatment objectives, and after surgery. We assessed the symmetry of measurement points between the affected side and nonaffected side at each time point. Results In the before-surgery group, significant differences were observed between the affected side and nonaffected side in X,Y (excluding Palatine foramen, upper molar, canine) and Z coordinates for measurement items. In the treatment objectives group, no differences were observed between the affected side and nonaffected side in X, Y, and Z coordinates, resulting in facial symmetry. In the after-surgery group, significant differences were observed in Y coordinates in the mental foramen area, and significant differences were observed in z axis measurement items in the canine and mental foramen areas. Conclusions It is evident that relying solely on a front view assessment is insufficient to achieve facial symmetry. Particularly, both anterior-posterior and vertical improvements in the area near the mental foramen on the affected side are necessary.
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Affiliation(s)
- Yoichiro Niikura
- From the Department of Orthodontics, Tokyo Dental College, Tokyo, Japan
| | - Takenobu Ishii
- From the Department of Orthodontics, Tokyo Dental College, Tokyo, Japan
- Department of Orthodontics, Tokyo Dental College Chiba Dental Centre, Chiba, Japan
| | - Yoshiaki Sakamoto
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Dai Ariizumi
- From the Department of Orthodontics, Tokyo Dental College, Tokyo, Japan
| | - Teruo Sakamoto
- Department of Orthodontics, Tokyo Dental College Chiba Dental Centre, Chiba, Japan
| | - Kenji Sueishi
- From the Department of Orthodontics, Tokyo Dental College, Tokyo, Japan
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Li X, Liu W, Tang X, Li C, Zhang Z. Three-dimensional Analysis of the Temporal Bone Morphology in Patients with Craniofacial Microsomia. Cleft Palate Craniofac J 2024; 61:584-591. [PMID: 36628544 DOI: 10.1177/10556656221149250] [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: 01/12/2023] Open
Abstract
OBJECTIVE To characterise the morphology of temporal bone in patients with craniofacial microsomia (CFM). DESIGN A retrospective study. SETTING A craniofacial centre. PATIENTS Ninety-four patients with unilateral craniofacial microsomia. INTERVENTIONS Mimics 21.0 (Materialise Inc., Belgium) was used to locate temporal bone landmarks on preoperative computed tomography data. The spatial Cartesian coordinate system was established in 3-matic 13.0 (Materialise Inc., Belgium). The coordinates of each landmark and the distances and angles between the landmarks were calculated. A classification system was used to quantify the severity of the zygomatic arch deformity. MAIN OUTCOME MEASURE(S) The bilateral differences in coordinates, linear and angular measurements, and the severity of temporal bone deformity (TTL δ, Psag δ, Paxiδ, and Tsag δ) among the groups were compared using the paired t-test and Kruskal-Wallis test, respectively. RESULTS Compared to those of the unaffected side, the landmarks of the inner ear and petrous part on the affected side showed a decrease in the Z-coordinate or an increase in the X-coordinate. A superolateral rotation tendency of the temporal bone on the affected side was found. There were no significant differences in the linear and angular measurements between the groups. The degree of zygomatic arch deformation was lower in the mild group; however, no significant difference was found between the moderate and severe groups. CONCLUSIONS In patients with CFM, asymmetry of the temporal bone and its inner organs (vestibulocochlear organ, facial nerve, and vessels) exists in multiple dimensions; its severity is not completely consistent with the degree of mandibular involvement.
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Affiliation(s)
- Xiyuan Li
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Wei Liu
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaojun Tang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Chuan Li
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zhiyong Zhang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Shu KY, Liu W, Zhao JL, Zhang ZY, Shan BG, Li XY, Ma LK. Condylar resorption post mandibular distraction osteogenesis in craniofacial microsomia: A retrospective study. J Craniomaxillofac Surg 2023; 51:675-681. [PMID: 37852887 DOI: 10.1016/j.jcms.2023.10.001] [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: 03/28/2022] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
The aim of this study was to investigate the characteristics of condylar resorption in craniofacial microsomia (CFM) patients following mandibular distraction osteogenesis (MDO). Patients with unilateral type-IIa and type-IIb CFM, who had completed MDO and mandibular distractor extraction (MDE), were recruited. The height and volume of the condyle were measured on three-dimension models created by the analysis of computed tomography (CT) data. Normality analysis was performed using the Shapiro-Wilk test. Data for the affected and unaffected sides were compared using the paired t-test or Wilcoxon signed-rank test. Data for both type-IIa and type-IIb CFM were compared using the independent-samples t-test or Mann-Whitney U test. The Pearson or Spearman correlation was used to determine the correlations of condylar resorption rate with related measurements. In total, 48 type-IIa and 48 type-IIb CFM patients were included. The condylar resorption rate in type-IIa CFM (0.35 ± 0.32) was significantly associated with the height of the condyle (r = 0.776, p < 0.001) and distraction distance (r = 0.447, p = 0.001), while the condylar resorption rate in type-IIb CFM (0.49 ± 0.46) was significantly associated with the height of the condyle (r = 0.924, p < 0.001). However, there was no significant difference in condylar resorption rate between type-IIa and type-IIb CFM (p = 0.075). In addition to occlusal changes, no other negative symptoms of the TMJ were observed with condylar resorption. Condylar resorption was evident in CFM patients following mandibular distraction osteogenesis, and the condylar resorption rate showed a relationship with distraction distance and condylar height.
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Affiliation(s)
- Kai-Yi Shu
- Department of Medical Cosmetology and Plastic Surgery, The Third People's Hospital of Chengdu, Chengdu, China
| | - Wei Liu
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiu-Li Zhao
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhi-Yong Zhang
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Ba-Ga Shan
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi-Yuan Li
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lun-Kun Ma
- Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhang M, Lyu L, Li J, Yan H, Zhu Y, Yu T, Wang Y, Zhao Y, Zhou Y, Liu D. Subjective evaluation of facial asymmetry with three-dimensional simulated images among the orthodontists and laypersons: a cross-sectional study. BMC Oral Health 2023; 23:500. [PMID: 37468873 DOI: 10.1186/s12903-023-03167-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/22/2023] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVES We used three-dimensional (3D) virtual images to undertake a subjective evaluation of how different factors affect the perception of facial asymmetry among orthodontists and laypersons with the aim of providing a quantitative reference for clinics. MATERIALS AND METHODS A 3D virtual symmetrical facial image was acquired using FaceGen Modeller software. The left chin, mandible, lip and cheek of the virtual face were simulated in the horizontal (interior/exterior), vertical (up/down), or sagittal (forward or backward) direction in 3, 5, and 7 mm respectively with Maya software to increase asymmetry for the further subjective evaluation. A pilot study was performed among ten volunteers and 30 subjects of each group were expected to be included based on 80% sensitivity in this study. The sample size was increased by 60% to exclude incomplete and unqualified questionnaires. Eventually, a total of 48 orthodontists and 40 laypersons evaluated these images with a 10-point visual analog scale (VAS). The images were presented in random order. Each image would stop for 30 s for observers with a two-second interval between images. Asymmetry ratings and recognition accuracy for asymmetric virtual faces were analyzed to explore how different factors affect the subjective evaluation of facial asymmetry. Multivariate linear regression and multivariate logistic regression models were used for statistical data analysis. RESULTS Orthodontists were found to be more critical of asymmetry than laypersons. Our results showed that observers progressively decreased ratings by 1.219 on the VAS scale and increased recognition rates by 2.301-fold as the degree of asymmetry increased by 2 mm; asymmetry in the sagittal direction was the least noticeable compared with the horizontal and vertical directions; and chin asymmetry turned out to be the most sensitive part among the four parts we simulated. Mandible asymmetry was easily confused with cheek asymmetry in the horizontal direction. CONCLUSIONS The degree, types and parts of asymmetry can affect ratings for facial deformity as well as the accuracy rate of identifying the asymmetrical part. Although orthodontists have higher accuracy in diagnosing asymmetrical faces than laypersons, they fail to correctly distinguish some specific asymmetrical areas.
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Affiliation(s)
- Mingjin Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Liang Lyu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jing Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huichun Yan
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yujia Zhu
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
- Center of Digital Dentistry/Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry Affiliation, Beijing, China
| | - Tingting Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yong Wang
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
- Center of Digital Dentistry/Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry Affiliation, Beijing, China
| | - Yijiao Zhao
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
- Center of Digital Dentistry/Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry Affiliation, Beijing, China
| | - Yanheng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
- Beijing Key Laboratory of Digital Stomatology, Beijing, China.
| | - Dawei Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
- Beijing Key Laboratory of Digital Stomatology, Beijing, China.
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Three-Dimensional Measurement of the Temporomandibular Joint in Pruzansky-Kaban Type IIa Hemifacial Microsomia. J Craniofac Surg 2023; 34:438-442. [PMID: 35864577 DOI: 10.1097/scs.0000000000008777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/11/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This observational retrospective cross-sectional study aimed to investigate the morphological characteristics of the temporomandibular joint (TMJ) in type IIa hemifacial microsomia (HFM). METHODS We recruited 88 patients with unilateral type IIa HFM. Data relating to the length, distance, and angle of the TMJ, were measured on 3-dimensional models created by the analysis of computed tomography data. Normality analysis was performed by using the Shapiro-Wilk test. Data were compared with the paired t test and Wilcoxon signed-rank test. RESULTS The height, long axis, and short axis of the affected condyle were significantly shorter than the unaffected side ( P <0.001); the ratios were 0.41±0.15, 0.75±0.20, and 0.95±0.24, respectively. The spaces between the condyle and the glenoid fossa were significantly larger in affected TMJs ( P <0.001). The ratio between the ipsilateral and contralateral anterior space in the sagittal plane was 4.62±2.59; this was significantly different than the ratio of inner space (1.50±1.70), superior space (1.70±0.97), and lateral space (1.28±0.62) in the coronal plane ( P <0.001) and the ratio of superior space (1.43±1.05) and posterior space (1.47±0.98) in the sagittal plane ( P <0.001); there were no statistical differences between the 5 spaces ( P >0.05). The breadth and depth of the glenoid fossa were significantly shorter in affected TMJs ( P <0.001), the ratio of the breadth in the affected and unaffected glenoid fossa was between 0.5 and 1 and the depth of the affected glenoid fossa was almost half of that on the unaffected side. The ratio between the ipsilateral and contralateral height of the condyle was significantly different when compared with the length of the mandibular ramus ( P <0.001). The ratio between the ipsilateral height of the condyle and the length of the mandibular ramus was significantly different when compared with that of the contralateral side ( P <0.001). The height of the affected condyle were significantly different ( P =0.005) among different ages. CONCLUSIONS We found that hypoplasia was more severe in terms of the height of the condyle than the long axis and short axis of the condyle. The degree of condyle deformity was more severe than the mandible. And the affected condyle still had growth potential in the vertical direction with age.
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Morphologic Changes of the Temporomandibular Joint in Pruzansky-Kaban Type IIa Hemifacial Microsomia Postmandibular Distraction Osteogenesis. J Craniofac Surg 2023; 34:591-596. [PMID: 36857566 DOI: 10.1097/scs.0000000000008854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/10/2022] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Mandibular distraction osteogenesis (MDO) is a powerful tool for the correction of hemifacial microsomia (HFM). The temporomandibular joint (TMJ) is the focus of attention in the diagnosis and treatment of HFM. This observational retrospective cross-sectional study aimed to investigate morphologic changes in TMJ post-MDO in type IIa HFM. METHODS We recruited 48 patients with unilateral type IIa HFM who had completed MDO and mandibular distractor extraction (MDE). Data relating to the length, distance, angle, and volume of the TMJ were measured on 3-dimension models created by the analysis of computed tomography data. Normality analysis was performed by using the Shapiro-Wilk test. Data were compared with the paired t test and Wilcoxon signed-ranks test. RESULTS The spaces between the affected condyle and the affected glenoid fossa before MDO were all significantly larger than before MDE (P<0.05). The breadth of the affected glenoid fossa before MDO was significantly longer than before MDE (P<0.001). The height of the affected condyle before MDO was significantly longer than before MDE (P<0.001). The volume of the affected condyle before MDO was significantly larger than before MDE (P<0.001). The ratio between the volume of the affected condyle and unaffected condyle before MDO was 0.20±0.13. The ratio between the volume of the affected condyle before MDE and MDO was 0.65±0.32. The resorption rate of the affected condyle post-MDO was 0.35±0.32. CONCLUSION Herein, we characterized anatomic changes of the TMJ in type- IIa HFM post-MDO. Condylar resorption and the compression of space between the condyle and the glenoid fossa on the affected side were 2 typical manifestations. Our findings enhanced the understanding of the application of MDO on HFM.
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Chen YF, Vinayahalingam S, Bergé S, Liao YF, Maal T, Xi T. Is the pattern of mandibular asymmetry in mild craniofacial microsomia comparable to non-syndromic class II asymmetry? Clin Oral Investig 2022; 26:4603-4613. [PMID: 35218426 PMCID: PMC9203369 DOI: 10.1007/s00784-022-04429-6] [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: 08/16/2021] [Accepted: 02/19/2022] [Indexed: 11/28/2022]
Abstract
Objectives To compare the characteristics of mandibular asymmetry in patients with unilateral craniofacial microsomia (CFM) and class II asymmetry. Materials and methods Pretreatment cone-beam computed tomography of consecutive adults with Pruzansky-Kaban type I and IIA CFM (CFM group) was analyzed by 3D cephalometry. Fourteen mandibular landmarks and two dental landmarks were identified. The mandibular size and positional asymmetry were calculated by using landmark-based linear and volumetric measurements, in terms of asymmetry ratios (affected/non-affected side) and absolute differences (affected − non-affected side). Results were compared with non-syndromic class II with matched severity of chin deviation (Class II group). Statistical analyses included independent t test, paired t test, chi-square test, and ANOVA. Results CFM group (n, 21; mean age, 20.4 ± 2.5 years) showed significantly larger size asymmetry in regions of mandibular body, ramus, and condyle compared to Class II group (n, 21; mean age, 27.8 ± 5.9 years) (p < 0.05). The curvature of mandibular body was asymmetric in CFM. Regarding the positional asymmetry of mandibular body, while a comparable transverse shift and a negligible yaw rotation were found among the two groups, the roll rotation in CFM was significantly greater as well as the occlusal (6.06° vs. 4.17°) and mandibular (7.84° vs. 2.80°) plane cants (p < 0.05). Conclusions Mild CFM showed significantly more severe size asymmetry and roll rotation in mandible than non-CFM class II asymmetry. Clinical relevance To improve the mandibular size and positional asymmetry in CFM, adjunct hard tissue augmentation or reduction in addition to OGS orthodontics with a meticulous roll and yaw planning is compulsory, which is expected to be distinct from treating non-CFM class II asymmetry.
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Affiliation(s)
- Yun-Fang Chen
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.,Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands
| | - Yu-Fang Liao
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Thomas Maal
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands.
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