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Amin D, Nguyen N, Manhan AJ, Kim JH, Roser SM, Bouloux GF. Does a Point-of-Care 3-Dimensional Printer Result in a Decreased Length of Surgery for Orbital Fractures? J Oral Maxillofac Surg 2024:S0278-2391(24)00597-4. [PMID: 39069281 DOI: 10.1016/j.joms.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/07/2024] [Accepted: 07/05/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Utilization of point-of-care 3-dimensional printing (3DP) has decreased length of surgery in facial trauma. Little is known regarding 3DP's impact on length of surgery in orbital fracture. PURPOSE The purpose of this study was to compare length of surgery between 3DP/preadapted (3DPPA) orbital plates and intraoperative adapted plates (IOAP) for orbital fracture reconstruction. STUDY DESIGN, SETTING, SAMPLE This was a prospective, non-blinded, randomized clinical study of consecutive subjects with orbital fractures presented to Grady Memorial Hospital in Atlanta, Georgia, between January 2018 and June 2021. Subjects ≥ 18 years, unilateral fracture, no previous orbital surgery, and/or congenital craniofacial anomaly were included. We excluded subjects <18 years and bilateral fractures. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE Primary predictor variable was the treatment approach. Randomization software was used, and subjects were randomized to 3DPPA or IOAP groups. MAIN OUTCOME VARIABLE(S) Primary outcome variable was length of surgery in minutes. Secondary outcomes were the time required for plate insertion and fixation in minutes, operating room (OR) charges, and orbital volume (OV) calculation. COVARIATES Age, sex, race, etiology, laterality, location, dimension, indication for surgery, postoperative enophthalmos, and diplopia. ANALYSES Univariate and bivariate analyses were calculated. Statistical significance was P < .05. RESULTS Twenty-five subjects met the inclusion criteria. Mean ages in 3DPPA and conventional IOAP groups were 41.5 (±9) and 38.2 (±10, P = .31), respectively. The mean length of surgery was 32.6 (±13.7) in 3DPPA and 53.3 (±12.8, P < .001) in conventional IOAP. The mean time required for plate insertion and fixation was 15.8n (±14.4) in 3DPPA and 41.4 (±9.4, P < .001) in conventional IOAP. The mean OR charges were $1,072.5 (±524.6) in 3DPPA and $1,757.3 (±422.6, P ≤ 0.001) in conventional IOAP. The mean calculated OV of uninjured and reconstructed orbit for the 3DPPA was 23.5 (±3.2)cm3 and 23 (±3.5, P = .37)cm3, respectively. The mean calculated OV of uninjured and reconstructed orbit for conventional IOAP was 28.6 (±3.6)cm3 and 22.8 (±2.6, P < .001)cm3, respectively. CONCLUSION AND RELEVANCE Using 3DP to produce a model that enables preoperative plate bending/adaptation reduces the length of surgery, decreases OR charges, and results in predictable OV.
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Affiliation(s)
- Dina Amin
- Associate Professor, Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, NY.
| | - Nam Nguyen
- Resident-in-Training, Department of Surgery, University of Florida at Jacksonville, Jacksonville, FL
| | - Andrew J Manhan
- Resident-in-Training, Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA
| | - Joon He Kim
- Associate Professor, Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA
| | - Steven M Roser
- Professor of Surgery, Residency Program Director, Department of Surgery, Emory University School of Medicine Emory University, Atlanta, GA
| | - Gary F Bouloux
- Professor in Oral and Maxillofacial Surgery, Chief Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
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Watke MA. Prediction of exophthalmos by body mass index for craniofacial reconstruction: consequences for cold cases. Forensic Sci Med Pathol 2024; 20:335-350. [PMID: 37280468 DOI: 10.1007/s12024-023-00649-8] [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] [Accepted: 05/09/2023] [Indexed: 06/08/2023]
Abstract
It is inconvenient for a forensic practitioner to gather population-specific data before performing a facial reconstruction. The inconvenience may defeat the point of creating the reconstruction. The objective of this study was to evaluate a non-population-dependent method of determining exophthalmos. The protrusion of the eyeball is known to vary with the contents of the orbital cavity based on bony orbital resorption or increased or decreased fat contents, as well as according to relative eyeball size. Of use are available statistics on body mass index, and this is discussed within the context of eyeball protrusion. A weak positive correlation (0.3263) between the body mass index of the country where the study originated, and the degree of exophthalmos was found. The results suggest that eyeball protrusion rates can be established according to body mass index, and this framework may be more useful considering conventional police practices.
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Burashed H, Resnick CM, Ross EE, Mulliken JB, Padwa BL. Elastic Chain Premaxillary Retraction Appliance Does Not Increase Inter-Canthal Dimension in Patients with Bilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2024:10556656241241200. [PMID: 38515321 DOI: 10.1177/10556656241241200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE To determine if the elastic chain premaxillary retraction (ECPR) appliance increases inter-medial and inter-lateral canthal dimension in patients with bilateral complete cleft lip and palate (BCLP). DESIGN Retrospective cohort study. SETTING Specialized tertiary care facility. PATIENTS, PARTICIPANTS 126 patients with BCLP; 75 had ECPR, 51 had no pre-surgical manipulation. INTERVENTIONS Three-dimensional facial photographs were obtained prior to insertion of appliance (T0), post-appliance therapy prior to appliance removal/labial repair (T1), and several months after labial repair (T2) for a longitudinal ECPR group, and were obtained after age 4 years (T3) for a non-longitudinal ECPR group and for the non-ECPR group. MAIN OUTCOME MEASURES Inter-medial and inter-lateral canthal dimension (en-en, ex-ex) was determined for all groups/time-points. Measurements were compared between groups and to norms. RESULTS The mean en-en and ex-ex was 32.6 ± 3.2 mm and 84.4 ± 6.3 mm for the ECPR group and 33.5 ± 3.1 mm and 86.7 ± 7.2 mm for the non-ECPR group at T3. Inter-medial and inter-lateral canthal dimensions were significantly greater than normal (P < .05) in both groups; there was no significant difference between groups (P > .05). The mean en-en and ex-ex for the Longitudinal ECPR group was 27.5 ± 2.4 mm and 66.7 ± 3.7 mm at T0, 29.6 ± 2.4 mm and 70.4 ± 2.9 mm at T1, and 29.2 ± 2.3 mm and 72.3 ± 3.8 mm at T2. en-en and ex-ex increased significantly from T0-T1 (P < .05), decreased at T2 (P > .05) and was significantly larger than normal at all time-points (P < .05). CONCLUSIONS Inter-medial and inter-lateral canthal dimension increased after ECPR but returned to baseline growth trajectory. These dimensions were above normal at all time-points. There was no difference between those that did and did not have dentofacial orthopedic manipulation.
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Affiliation(s)
- Hamad Burashed
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Boston, MA, USA
| | - Cory M Resnick
- Harvard School of Dental Medicine, Boston, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Elizabeth E Ross
- Harvard School of Dental Medicine, Boston, USA
- Pediatric Dentistry, Boston Children's Hospital, Boston, MA, USA
| | - John B Mulliken
- Harvard School of Dental Medicine, Boston, USA
- Craniofacial Centre, Boston Children's Hospital, Boston, MA, USA
| | - Bonnie L Padwa
- Harvard School of Dental Medicine, Boston, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
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Rapid Maxillary Expansion (RME): An Otolaryngologic Perspective. J Clin Med 2022; 11:jcm11175243. [PMID: 36079172 PMCID: PMC9457357 DOI: 10.3390/jcm11175243] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 11/24/2022] Open
Abstract
Background. To evaluate the possible effects of Rapid Maxillary Expansion (RME), such as nasal breathing problems, middle ear function, Obstructive Sleep Apnea (OSA) in the otolaryngology field. RME has already been introduced in orthodontics to expand the maxilla of young patients affected by transversal maxillary constriction. Methods. A literature search was performed using different databases (Medline/PubMed, EMBASE, and CINAHL), from May 2005 to November 2021, according to the PRISMA guidelines. Results. The application of RME in children has shown good results on nasal function, reducing nasal resistances, independently from a previous adenotonsillectomy. These results are not only related to the increasing of nasal transverse diameters and volume, but also to the stiffening of airway muscles, enabling the nasal filtrum function and avoiding mouth opening, thereby decreasing respiratory infections. Positive effects have also been reported for the treatment of conductive hearing loss and of OSA, with the reduction of Apnea Hypopnea Index (AHI), possibly due to (i) an increased pharyngeal dimensions, (ii) a new tongue posture, and (iii) reduced nasal respiratory problems. Conclusions. Otolaryngologists should be aware of the indications and benefits of the RME treatment, considering its possible multiple beneficial effects.
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3D printing for orbital volume anatomical measurement. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:991-998. [PMID: 35779076 DOI: 10.1007/s00276-022-02968-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/20/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The aim was to develop a method for reproducible orbital volume (OV) measurement in vivo based on 3D printing. METHODS Twelve orbits were obtained from dry skulls of the Human Anatomy Department of Lille University. Computer tomography (CT) slice images of these orbits were transformed into stereo-lithography (STL) format and 3D-printed. Bone openings were closed using either putty and cellophane after printing (3D-Orb-1) or at the printing stage in silico using MeshMixer (3D-Orb-2). The results were compared with those of the conventional water-filling method as a control group (Anat-Orb). RESULTS The observers reported a mean orbital volume of 21.3 ± 2.1 cm3 for the open-skull method, 21.2 ± 2.4 cm3 for the non-sealed 3D-printing method, and 22.2 ± 2.0 cm3 for the closed-print method. Furthermore, the intraclass correlation coefficients (ICCs) showed excellent intra-rater agreement, i.e., an ICC of 0.994 for the first observer and 0.998 for the second, and excellent interobserver agreement (ICC: 0.969). The control and 3D-Orb-1 groups show excellent agreement (ICC: 0.972). The 3D-Orb-2 exhibits moderate agreement (ICC: 0.855) with the control and appears to overestimate orbital volume slightly. CONCLUSION Our 3D-printing method provides a standardized and reproducible method for the measurement of orbital volume.
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Amin D, Jeong J, Manhan AJ, Bouloux GF, Abramowicz S. Do Racial Differences in Orbital Volume Influence the Reconstruction of Orbital Trauma. J Oral Maxillofac Surg 2022; 80:121-126. [PMID: 34973720 DOI: 10.1016/j.joms.2021.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Successful orbital reconstruction relies on an accurate restoration of orbital volume (OV). The purpose of this study was to determine if the OV of African American (AA) subjects differs from that of Caucasian subjects. METHODS The authors implemented a retrospective observational study of successive subjects who received a maxillofacial computed tomography (CT) scan at a level I trauma center between 2017 and 2020. The primary predictor variable was race (AA/Caucasian). The primary outcome variable was orbital volume. Two independent examiners calculated OV with an open access OsiriX MD software version 10.0.5 (Pixmeo, Switzerland). Inter-rater reliability was calculated. Differences between races, genders, and sides were tested using independent samples t test with a significance of P < .05. RESULTS Sixty subjects (120 orbits) were included in the study. The mean age was 36.7 (SD ± 13.2) years with a range of 22 to 78 years. Gender distribution was equal with 30 male (50%) and 30 female (50%) subjects. Inter-examiner reliability was 0.973. The mean OV of AA and Caucasians was 22.38 and 23.23 cm3, respectively (P = .07). The mean OV of AA and Caucasian males was 23.92, and 24.17cm3, respectively (P = .71). The mean OV in AA and Caucasian females was 20.84 and 22.28cm3, respectively (P = .013). CONCLUSIONS African-American female subjects appear to have a smaller OV when compared with Caucasians which may influence orbital reconstruction. Laterality does not appear to be associated with any differences in OV.
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Affiliation(s)
- Dina Amin
- Assistant Professor in Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Director of Oral and Maxillofacial Surgery Outpatient Clinic, Grady Memorial Hospital, Atlanta, GA.
| | - James Jeong
- Resident-in-training, Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Andrew J Manhan
- Medical Student Researcher, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Gary F Bouloux
- Professor in Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Shelly Abramowicz
- Associate Professor in Oral and Maxillofacial Surgery and Pediatrics, Department of Surgery, Emory University School of Medicine, Chief of Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA
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Noh HK, Park HS. Does maxillary yaw exist in patients with skeletal Class III facial asymmetry? Am J Orthod Dentofacial Orthop 2021; 160:573-587. [PMID: 34332794 DOI: 10.1016/j.ajodo.2020.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study aimed to evaluate maxillary skeletal and dental yaw in patients with skeletal Class III facial asymmetry and investigate its correlation with menton deviation. METHODS Initial cone-beam computed tomography data from 60 patients with skeletal Class III malocclusion were used. There were 30 patients in both the symmetrical group (menton deviation <2 mm) and the asymmetrical group (menton deviation >4 mm). After reconstruction of 3-dimensional (3D) cone-beam computed tomography data, maxillary yaw and 3D positions of skeletal and dental landmarks were measured and compared between the groups. After that, correlations between menton deviation and the other variables were assessed. RESULTS No significant difference was noted in maxillary skeletal and dental yaw between the 2 groups. In the assessment of 3D positions, translation of the maxillary bone and maxillary dentition toward the menton deviation was observed (P <0.01). Maxillary skeletal and dental yaw was not significantly correlated with menton deviation in the asymmetrical group. CONCLUSIONS Maxillary skeletal and dental yaw was not evident in either group. Therefore, when planning maxillary surgery for patients with skeletal Class III facial asymmetry malocclusion, it may be appropriate to shift the focus of decompensation from maxillary yaw to maxillary translation.
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Affiliation(s)
- Hyung-Kyu Noh
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Hyo-Sang Park
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea.
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Brandner M, Strobl V, Bizjak B, Lindner S, Langmann A. Kraniomandibuläre Dysfunktion und Asthenopie – Literaturübersicht mit Fallbeispielen. SPEKTRUM DER AUGENHEILKUNDE 2021. [DOI: 10.1007/s00717-020-00476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Zusammenfassung
Hintergrund
Kann ein latentes Schielen (Heterophorie) nicht fusionell überwunden werden, treten asthenope Beschwerden wie intermittierende Doppelbilder, Blendempfindlichkeit, retrobulbäres Druckgefühl, Visusschwankungen und Kopfschmerzen auf. Häufig ist der zugrunde liegende Pathomechanismus unklar. Neben verschiedenen ophthalmologischen und neurologischen Erkrankungen wird auch die kraniomandibuläre Dysfunktion (CMD) als möglicher Auslöser einer Asthenopie beschrieben.
Material und Methode
Präsentation von 3 Fallbeispielen von Patientinnen mit CMD und Asthenopie und Literaturübersicht.
Resultate
Im Rahmen der Literaturrecherche wurden einige Arbeiten zur Anatomie und zu neurologischen Verschaltungen zwischen dem trigeminalen und dem okulomotorischen System gefunden, die über Veränderungen der Pupillenweite, der Konvergenz und der Stellung der Augen mögliche pathomechanische Zusammenhänge zwischen einer Malokklusion bzw. CMD und Heterophorie mit Asthenopie postulieren.
Schlussfolgerung
Bei Beschwerdepersistenz von asthenopen Beschwerden trotz optimaler orthoptischer Therapie kann eine weiterführende kieferorthopädische Abklärung in Betracht gezogen werden.
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Ziaul YH, Mahale A, Varghese S, Khanam F, AlFutaise M, Ahad MA, Edward DP, Khandekar RB. The Iris Thickness in a Healthy Saudi Population. Cureus 2021; 13:e12521. [PMID: 33564525 PMCID: PMC7863027 DOI: 10.7759/cureus.12521] [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] [Indexed: 11/05/2022] Open
Abstract
Purpose Iris thickness (IT), a known risk factor for angle closure glaucoma, has not been evaluated in the normal Saudi population. Methods Quantitative information on IT was evaluated in healthy Saudi eyes using anterior segment optical coherence tomography (ASOCT). IT and iris volume was measured with the room ‘light on’ (LON) and ‘light off’ (LOFF) using Image J software. IT in the nasal and temporal iris was measured at 500 µm (IT500) and 750 µm (IT750) from the scleral spur (SS). Differences in IT measurements by age, gender and type of refractive error were evaluated. Results We included 100 eyes of 50 healthy adult Saudis without ocular disease other than refractive errors. The mean age of 56 males and 44 females in the study group was 41.7 ± 14.5 years. The refractive status was as follows: emmetropia (35 eyes), mild/moderate myopia (33 eyes), high myopia (17 eyes) and hyperopia (15 eyes). The IT750 with LON was significantly more than IT500 both nasally (P = 0.03) and temporally (P < 0.001). The difference in IT750 and IT500 with LOFF was significantly more nasally (P = 0.03), temporally (P = 0.02), and with LON nasally (P = 0.005). IT was thicker in males when compared to females and variation of IT by refractive error was significant but not by age. The mean pupil diameter and anterior chamber depth decreased with age (P < 0.001). Anterior chamber width was not affected by age or illumination. Conclusion The baseline iris thickness in the Saudi eyes could be used to compare iris thickness in eyes with angle closure glaucoma among the Arab population.
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Affiliation(s)
- Yasir H Ziaul
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Alka Mahale
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Sejo Varghese
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Farheen Khanam
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | | | - Muhammad A Ahad
- Anterior Segment, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Deepak P Edward
- Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, USA
| | - Rajiv B Khandekar
- Epidemiology and Public Health, King Khalid Eye Specialist Hospital, Riyadh, SAU
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Lo Giudice A, Rustico L, Ronsivalle V, Nicotra C, Lagravère M, Grippaudo C. Evaluation of the changes of orbital cavity volume and shape after tooth-borne and bone-borne rapid maxillary expansion (RME). Head Face Med 2020; 16:21. [PMID: 32900389 PMCID: PMC7487642 DOI: 10.1186/s13005-020-00235-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/01/2020] [Indexed: 12/26/2022] Open
Abstract
Objective To assess and compare volumetric and shape changes of the orbital cavity in patients treated with tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). Study design Forty adolescents with bilateral maxillary cross-bite received tooth-borne (TB group = 20; mean age 14.27 ± 1.36 years) or bone-borne (BB group = 20; mean age of 14.62 ± 1.45 years) maxillary expander. Cone-beam computed tomography (CBCT) were taken before treatment (T1) and 6-month after the expander activation (T2). Volumetric and shape changes of orbital cavities were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT-derived models of pulp chamber. Student’s t tests were used to 1) compare T1 and T2 volumes of orbital cavities in TB and BB groups, 2) compare volumetric changes and the percentage of matching of 3D orbital models (T1-T2) between the two groups. Results Both TB and BB groups showed a slight increase of the orbital volume (0.64 cm3 and 0.77 cm3) (p < 0.0001). This increment were significant between the two groups (p < 0.05) while no differences were found in the percentage of matching of T1/T2 orbital 3D models (p > 0.05). The areas of greater changes were detected in the proximity of the frontozygomatic and frontomaxillary sutures. Conclusion TB-RME and BB-RME would not seem to considerably affect the anatomy or the volume of the orbital cavity in adolescents.
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Affiliation(s)
- Antonino Lo Giudice
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | | | - Vincenzo Ronsivalle
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | - Carmelo Nicotra
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | - Manuel Lagravère
- Orthodontic Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Cristina Grippaudo
- Dental and Maxillofacial Institute, Head and Neck Department, Fondazione Policlinico Gemelli IRCCS, Catholic University of Sacred Heart, 00168, Rome, Italy
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Vompi C, Serritella E, Galluccio G, Pistella S, Segnalini A, Giannelli L, Di Paolo C. Evaluation of Vision in Gnathological and Orthodontic Patients with Temporomandibular Disorders: A Prospective Experimental Observational Cohort Study. J Int Soc Prev Community Dent 2020; 10:481-490. [PMID: 33042891 PMCID: PMC7523923 DOI: 10.4103/jispcd.jispcd_273_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: 06/24/2019] [Accepted: 12/11/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives: Temporomandibular disorders (TMDs), orthodontic diseases, and vision dysfunctions seem to be strictly related. The purpose of this study was to prove the relationship, to evaluate the prevalence and the distribution of vision defects in dysfunctional and orthodontic patients, and to establish the type of the relationship. Materials and Methods: A total of 100 patients with TMDs were selected and studied through epidemiological analyses of the following factors: gnathological parameters (temporomandibular joint pathologies according to Diagnostic Criteria for Temporomandibular Disorders); occlusal and skeletal parameters (overjet, overbite, dental class, transversal discrepancies, and mandibular asymmetry); and orthoptic parameters (refractive defects and oculomotor diseases). A prospective experimental observational cohort study was conducted. A comparison with the average frequency of vision defects of the Italian population was performed. The prevalence of vision defects was evaluated. All gnathological and orthodontic parameters were associated with the orthoptic ones. A descriptive and statistical analysis of the data was carried out with the Statistical Package for the Social Sciences software; z test (P < 0.05), frequency analysis (frequency >50%), chi-square test, and Student’s t test (P < 0.05) were performed. The scientific consistency was evaluated by using the scientific criteria of Bradford Hill. Results: The comparison with the Italian population showed a higher frequency of refractive defects in the study sample (P < 0.001). The most frequent vision defects were phorias (92%) and tropia (3%). The increased frequency of ocular convergence reduction in the presence of disc displacement with reduction was significant (n = 28; 60%; P < 0.05). In the presence of asymmetry, low frequencies of astigmatism (n = 18; 30%) were observed compared to its absence (n = 22; 54%) (P < 0.05) and high frequencies of motor ocular deviations (n = 59; 100%) were observed compared to its absence (n = 36; 88%) (P < 0.05). In the presence of headache, low frequencies of emmetropia (n = 13; 22%) and higher frequencies of hyperopia (n = 18; 30%) were observed (P < 0.05). Two of five scientific criteria of Bradford Hill were met. Conclusion: It seems to emerge a possible positive relationship between TMD and vision defects. In particular, the most interesting associations were found between functional or skeletal orthognathic alterations and oculomotor dysfunctions. However, it was not possible to establish the type of relationship.
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Affiliation(s)
- Chiara Vompi
- Units of Gnathology, Department of Head and Neck, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Emanuela Serritella
- Units of Gnathology, Department of Head and Neck, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Gabriella Galluccio
- Units of Orthodontics, Department of Head and Neck, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Santino Pistella
- Units of Ophthalmology, Department of Head and Neck, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Alessandro Segnalini
- Units of Ophthalmology, Department of Head and Neck, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Carlo Di Paolo
- Units of Gnathology, Department of Head and Neck, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
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Evangelista K, Ferrari-Piloni C, Barros LAN, Avelino MAG, Helena Soares Cevidanes L, Ruellas ACDO, Valladares-Neto J, Silva MAG. Three-dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study. Orthod Craniofac Res 2020; 23:300-312. [PMID: 32022986 DOI: 10.1111/ocr.12370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/13/2020] [Accepted: 02/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate craniofacial asymmetry in children with transverse maxillary deficiency, with or without functional unilateral posterior crossbite (UPC), before and after rapid maxillary expansion (RME). SETTING AND SAMPLE POPULATION A sample of 51 children with cone beam computed tomography scans obtained before RME (T1) and a year after RME (T2). MATERIAL AND METHODS This prospective study consisted of 2 groups: 25 children with functional UPC (6.77 ± 1.5 years) and 26 children without UPC (7.41 ± 1.31 years). Linear and angular measurements were obtained from zygomatic, maxilla, glenoid fossa and mandible, using original and mirrored 3D overlapped models. All right and left side comparisons in both groups and intergroups asymmetries were compared using MANOVA and t test for independent samples, respectively, statistically significant at P < .05. RESULTS The UPC group showed no side differences, but mandibular horizontal rotation at T1, and this asymmetry was improved in T2. The non-UPC group showed at baseline significant lateral asymmetry in orbitale, position of palatine foramen, respectively, in average 2.95 mm and 1.16 mm, and 0.49 mm of average asymmetry in condylar height. The glenoid fossa was symmetric in both groups at T1 and T2. CONCLUSIONS Children with transverse maxillary deficiency showed slight morphological asymmetry, located in the mandible position in cases of UPC, and in the orbital and maxillary regions in cases without UPC. One year after RME, patients improved their craniofacial asymmetry, with significant changes in the mandible and correction of the mandibular rotation in patients who presented UPC.
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Abstract
OBJECTIVES Technological development and the need for electronic health records management resulted in the need for a computer with dedicated, commercial software in daily dental practice. The alternative for commercial software may be open-source solutions. Therefore, this study reviewed the current literature on the availability and use of open-source software (OSS) in dentistry. METHODS A comprehensive database search was performed on February 1, 2017. Only articles published in peer-reviewed journals with a focus on the use or description of OSS were retrieved. The level of evidence, according to Oxford EBM Centre Levels of Evidence Scale was classified for all studies. Experimental studies underwent additional quality reporting assessment. RESULTS The screening and evaluation process resulted in twenty-one studies from 1,940 articles found, with 10 of them being experimental studies. None of the articles provided level 1 evidence, and only one study was considered high quality following quality assessment. Twenty-six different OSS programs were described in the included studies of which ten were used for image visualization, five were used for healthcare records management, four were used for educations processes, one was used for remote consultation and simulation, and six were used for general purposes. CONCLUSIONS Our analysis revealed that the dental literature on OSS consists of scarce, incomplete, and methodologically low quality information.
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Cone-beam computed tomography of the orbit and optic canal volumes. J Craniomaxillofac Surg 2016; 44:1342-9. [DOI: 10.1016/j.jcms.2016.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/25/2016] [Accepted: 06/02/2016] [Indexed: 11/17/2022] Open
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Wu XB, Wang JQ, Zhao CP, Sun X, Shi Y, Zhang ZA, Li YN, Wang MY. Printed three-dimensional anatomic templates for virtual preoperative planning before reconstruction of old pelvic injuries: initial results. Chin Med J (Engl) 2015; 128:477-82. [PMID: 25673449 PMCID: PMC4836250 DOI: 10.4103/0366-6999.151088] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures. METHODS First, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8-17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure. RESULTS The accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6-9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3-29 months (median: 5 months). The fracture healing time was 9-17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The results were excellent in two cases, good in five, and poor in two based on the Majeed score. CONCLUSIONS The 3D printing planning technique for pelvic surgery was successfully integrated into a clinical workflow to improve patient-specific preoperative planning by providing a visual and haptic model of the injury and allowing patient-specific adaptation of each osteosynthesis implant to the virtually reduced pelvis.
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Affiliation(s)
| | - Jun-Qiang Wang
- Department of Orthopaedic Trauma, Beijing Jishuitan Hospital; Laboratory of Bone Tissue Engineering, Beijing Research Institute of Traumatology and Orthopaedics, Beijing 100035, China
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Vassar JW, Karydis A, Trojan T, Fisher J. Dentoskeletal effects of a temporary skeletal anchorage device-supported rapid maxillary expansion appliance (TSADRME): A pilot study. Angle Orthod 2015; 86:241-9. [PMID: 25993250 DOI: 10.2319/013015-76.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To quantitatively evaluate maxillary skeletal expansion using cone-beam computed tomography (CBCT) images and propose a novel way to quantify the dental tipping effects of temporary skeletal anchorage device-supported rapid maxillary expansion appliance (TSADRME). MATERIALS AND METHODS Images from 25 patients receiving rapid maxillary expansion with incorporated temporary skeletal anchorage devices (TSADs) before activation (T1) and after removal (T2) were analyzed to detect dentoskeletal changes. RESULTS A significant increase from T1 to T2 was found for all linear measurements except buccal maxillary width at the canines. The greatest buccal expansion was at the first molar, decreasing anteriorly. However, the greatest palatal expansion was at the first premolar. All younger subjects (8-16 years old) exhibited less dental tipping and greater expansion overall compared with the older subjects. There was great variability in dental tipping of first molars (mean = 4.31°), with some subjects demonstrating mild uprighting of these teeth. CONCLUSIONS The TSADRME appliance is an effective, clinically useful device that results in mild molar tipping and may positively affect expansion in the area of TSAD placement.
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Affiliation(s)
- Jason William Vassar
- a Resident, Department of Orthodontics, University of Tennessee Health Science Center, College of Dentistry, Memphis, Tenn
| | - Anastasios Karydis
- b Assistant Professor, Department of Periodontics, University of Tennessee Health Science Center, College of Dentistry, Memphis, Tenn
| | - Terry Trojan
- c Associate Professor and Department Chair, Department of Orthodontics, University of Tennessee Health Science Center, College of Dentistry, Memphis, Tenn
| | - Jack Fisher
- d Assistant Professor, Department of Orthodontics, University of Tennessee Health Science Center, College of Dentistry, Memphis, Tenn
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3D-assisted quantitative assessment of orbital volume using an open-source software platform in a Taiwanese population. PLoS One 2015; 10:e0119589. [PMID: 25774683 PMCID: PMC4361687 DOI: 10.1371/journal.pone.0119589] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 01/29/2015] [Indexed: 12/31/2022] Open
Abstract
Orbital volume evaluation is an important part of pre-operative assessments in orbital trauma and congenital deformity patients. The availability of the affordable, open-source software, OsiriX, as a tool for preoperative planning increased the popularity of radiological assessments by the surgeon. A volume calculation method based on 3D volume rendering-assisted region-of-interest computation was used to determine the normal orbital volume in Taiwanese patients after reorientation to the Frankfurt plane. Method one utilized 3D points for intuitive orbital rim outlining. The mean normal orbital volume for left and right orbits was 24.3±1.51 ml and 24.7±1.17 ml in male and 21.0±1.21 ml and 21.1±1.30 ml in female subjects. Another method (method two) based on the bilateral orbital lateral rim was also used to calculate orbital volume and compared with method one. The mean normal orbital volume for left and right orbits was 19.0±1.68 ml and 19.1±1.45 ml in male and 16.0±1.01 ml and 16.1±0.92 ml in female subjects. The inter-rater reliability and intra-rater measurement accuracy between users for both methods was found to be acceptable for orbital volume calculations. 3D-assisted quantification of orbital volume is a feasible technique for orbital volume assessment. The normal orbital volume can be used as controls in cases of unilateral orbital reconstruction with a mean size discrepancy of less than 3.1±2.03% in females and 2.7±1.32% in males. The OsiriX software can be used reliably by the individual surgeon as a comprehensive preoperative planning and imaging tool for orbital volume measurement and computed tomography reorientation.
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Bazargani F, Feldmann I, Bondemark L. Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones. Angle Orthod 2013; 83:1074-1082. [PMID: 23745976 PMCID: PMC8722830 DOI: 10.2319/020413-103.1] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 04/01/2013] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging. MATERIALS AND METHODS The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies. RESULTS The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive. CONCLUSIONS CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.
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Affiliation(s)
- Farhan Bazargani
- Senior Consultant, Department of Orthodontics, Postgraduate Dental Education Center, Örebro, Sweden
| | - Ingalill Feldmann
- Senior Consultant, Orthodontic Clinic, Public Dental Service, Gävleborg County Council and Centre for Research and Development, Uppsala University/Gävleborg County Council, Gävle, Sweden
| | - Lars Bondemark
- Professor and Chair, Department of Orthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Monaco A, Tepedino M, Sabetti L, Petrucci A, Sgolastra F. An adolescent treated with rapid maxillary expansion presenting with strabismus: a case report. J Med Case Rep 2013; 7:222. [PMID: 23971857 PMCID: PMC3849103 DOI: 10.1186/1752-1947-7-222] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 08/01/2013] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Few in vivo studies have investigated the effect of maxillary expansion on strabismus; however, some in vitro studies hypothesized that changes in the palatal width obtained with rapid maxillary expansion appliances could involve other bone structures that contain blood vessels and nerves conveying to the orbital cavity. The present case report seems to support that hypothesis, even if no analysis of pathogenetic mechanisms could be drawn. CASE PRESENTATION We present the case of a 14-year-old Caucasian girl affected by strabismus and referred for the treatment of a class III malocclusion with transverse maxillary deficiency, which was corrected by the application of a rapid maxillary expansion appliance (Haas type). At 2 months follow-up, the patient, who had not undergone any ophthalmologic treatment, was submitted to an ophthalmologic examination that revealed a marked change in the vision defect, which slightly relapsed at 6 months. CONCLUSIONS The results of our clinical evaluation showed a remarkable modification of the oculomotor system of our patient as an outcome of the rapid maxillary expansion.Further studies are needed to clarify these findings and to investigate the clinical implications of these observations.
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Affiliation(s)
- Annalisa Monaco
- Life Health and Environmental Science Department, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
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Volume reduction of cystic lesions after surgical decompression: a computerised three-dimensional computed tomographic evaluation. Clin Oral Investig 2012; 17:1701-8. [DOI: 10.1007/s00784-012-0869-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
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Wang JH, Kim JG, Ahn JH, Lim HC, Hoshino Y, Fu FH. Is femoral tunnel length correlated with the intercondylar notch and femoral condyle geometry after double-bundle anterior cruciate ligament reconstruction using the transportal technique? An in vivo computed tomography analysis. Arthroscopy 2012; 28:1094-103. [PMID: 22421566 DOI: 10.1016/j.arthro.2011.12.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 12/29/2011] [Accepted: 12/29/2011] [Indexed: 02/02/2023]
Abstract
PURPOSE To analyze femoral tunnel geometry using computed tomography (CT) imaging and evaluate the anatomic factors affecting femoral tunnel length after anterior cruciate ligament (ACL) reconstruction by the transportal technique. METHODS Twenty-nine patients underwent an anatomic double-bundle ACL reconstruction with a femoral tunnel drill by the transportal technique. CT imaging with OsiriX software (version 3.8; Pixmeo, Geneva, Switzerland) was used to measure femoral tunnel length (anteromedial [AM], posterolateral [PL], and central), femoral tunnel divergent angle, and femoral condyle size and intercondylar notch size parameters. Correlations between femoral tunnel length and femoral condyle size and intercondylar notch size parameters were analyzed. RESULTS The mean AM, PL, and central femoral tunnel lengths were 33.3 ± 3.9 mm, 33.6 ± 3.6 mm, and 34.3 ± 3.2 mm, respectively. A femoral tunnel length of less than 30 mm developed in 7 cases (24.1%) in the AM aspect and 4 cases (13.8%) in the PL aspect. The mean femoral tunnel divergent angle was 14.4° ± 4.1°. A positive correlation was found between AM, not PL or central, femoral tunnel length and medial femoral condyle anteroposterior (AP) distance (P = .01, r = 0.46), lateral femoral condyle AP distance (P = .01, r = 0.43), medial-to-lateral epicondylar distance (P = .03, r = 0.39), middle notch width (P = .009, r = 0.47), notch height (P = .001, r = 0.57), and notch area (P < .001, r = 0.58). CONCLUSIONS After double-bundle ACL reconstruction with the transportal technique through the accessory anteromedial portal, the AM and PL femoral tunnels showed mean tunnel length greater than 30 mm and a divergent angle. However, a femoral tunnel length of less than 30 mm developed in some cases. AM femoral tunnel length was correlated with femoral condyle size (medial femoral condyle AP distance, lateral femoral condyle AP distance, and medial-to-lateral epicondylar distance) and intercondylar notch size (notch width, notch height, and notch area). LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- Joon Ho Wang
- Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
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Giovinco NA, Dunn SP, Dowling L, Smith C, Trowell L, Ruch JA, Armstrong DG. A novel combination of printed 3-dimensional anatomic templates and computer-assisted surgical simulation for virtual preoperative planning in Charcot foot reconstruction. J Foot Ankle Surg 2012; 51:387-93. [PMID: 22366474 DOI: 10.1053/j.jfas.2012.01.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Indexed: 02/03/2023]
Abstract
Charcot foot syndrome (Charcot neuroarthropathy affecting the foot), particularly in its latter stages, may pose a significant technical challenge to the surgeon. Because of the lack of anatomic consistency, preoperative planning with virtual and physical models of the foot could improve the chances of achieving a predictable intraoperative result. In this report, we describe the use of a novel, inexpensive, 3-dimensional template printing technique that can provide, with just a normal printer, multiple "copies" of the foot to be repaired. Although we depict this method as it pertains to repair of the Charcot foot, it could also be used to plan and practice, or revise, 3-dimensional surgical manipulations of other complex foot deformities.
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