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Lyu L, Zhang MJ, Wen AN, Wang S, Zhao YJ, Yong wang, Yu TT, Liu D. 3D facial mask for facial asymmetry diagnosis. Heliyon 2024; 10:e26734. [PMID: 38444476 PMCID: PMC10912245 DOI: 10.1016/j.heliyon.2024.e26734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
Objectives Facial asymmetry is a common problem seen in orthodontic clinics that may affect patient esthetics. In some instances, severe asymmetry that affects patient esthetics may cause psychological issues. An objective method is therefore required to help orthodontists identify asymmetry issues. Materials and methods We used three-dimensional (3D) facial images and landmark-based anthropometric analysis to construct a 3D facial mask to evaluate asymmetry. The landmark coordinates were transformed using a symmetric 3D face model to evaluate the efficacy of this method. Patients with facial asymmetry were recruited to conduct mirror and overlap analysis to form color maps, which were used to verify the utility of the novel soft tissue landmark-based method. Results The preliminary results demonstrated that the asymmetry evaluation method had a similar response rate compared to diagnosis using mirror and overlap 3D images, and could therefore identify 3D asymmetry problems. Conclusions By using 3D facial scans and 3D anthropometric analysis, we developed a preliminary evaluation method that provides objective parameters to clinically evaluate patient facial asymmetry and aid in the diagnosis of asymmetric areas. Clinical relevance This study presents a novel facial asymmetry diagnostic method that has the potential to aid clinical decisions during problem identification, treatment planning, and efficacy evaluation.
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Affiliation(s)
- Liang Lyu
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology, Beijing, China
- 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
| | - Ming-Jin Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology, Beijing, China
- 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
| | - Ao-Nan Wen
- 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
- National Center of Stomatology, Beijing, China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China
| | - Shuo Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology, Beijing, China
- 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
| | - Yi-Jiao Zhao
- 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
- National Center of Stomatology, Beijing, China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China
| | - Yong wang
- 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
- National Center of Stomatology, Beijing, China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing, China
| | - Ting-Ting Yu
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology, Beijing, China
- 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 & National Center of Stomatology, Beijing, China
- 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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España-Pamplona P, Zamora-Martinez N, Tarazona-Álvarez B, Pangrazio-Kulbersh V, Paredes-Gallardo V. Three-dimensional quantification of mandibular asymmetries in Caucasian adult patients with different sagittal and vertical skeletal patterns. A cone beam study using 3D segmentation and mirroring procedures. Head Face Med 2023; 19:54. [PMID: 38098053 PMCID: PMC10720065 DOI: 10.1186/s13005-023-00400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION An accurate identification of mandibular asymmetries is required by modern orthodontics and orthognathic surgery to improve diagnosis and treatment planning of such deformities. Although craniofacial deformities are very frequent pathologies, some types of asymmetries can be very difficult to assess without the proper diagnostic tools. The purpose of this study was to implement the usage of three-dimensional (3D) segmentation procedures to identify asymmetries at the mandibular level in adult patients with different vertical and sagittal patterns where the asymmetries could go unnoticed at the observational level. METHODS The study sample comprised 60 adult patients (33 women and 27 men, aged between 18 and 60 years). Subjects were divided into 3 sagittal and vertical skeletal groups. CBCT images were segmented, mirrored and voxel-based registered with reference landmarks using ITK-SNAP® and 3DSlicer® software's. 3D surface models were constructed to evaluate the degree of asymmetry at different anatomical levels. RESULTS There was a degree of asymmetry, with the left hemimandible tending to contain the right one (0.123 ± 0.270 mm (CI95% 0.036-0.222; p < 0.001). Although the subjects under study did not present significant differences between mandibular asymmetries and their sagittal or vertical skeletal pattern (p = 0.809 and p = 0.453, respectively), a statistically significant difference has been found depending on the anatomical region (p < 0.001; CI95%=1.020-1.021), being higher in the condyle, followed by the ramus and the corpus. CONCLUSIONS Although mandibular asymmetries cannot be correlated with vertical and sagittal skeletal patterns in symmetric patients, knowledge about 3D segmentation procedures and color maps can provide valuable information to identify mandibular asymmetries.
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Affiliation(s)
- Pilar España-Pamplona
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain.
| | - Natalia Zamora-Martinez
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
| | - Beatriz Tarazona-Álvarez
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
| | | | - Vanessa Paredes-Gallardo
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
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Vespasiano V, Klop C, Mulder CS, Koolstra JH, Lobé NHJ, Beenen LFM, Nolte JW, Becking AG, Schreurs R, Maal TJJ, de Bakker BS. Normal variation of mandibular asymmetry in children. Orthod Craniofac Res 2023. [PMID: 36760175 DOI: 10.1111/ocr.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/11/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To explore the normal variation of asymmetry in mandibles of children in the age group of 1 to 12 years. MATERIALS AND METHODS The study group consisted of 92 cadaveric mandibles of children with a dental age of 1 to 12 years old in possession of ACTA (Academic Centre for Dentistry Amsterdam), Faculty of Dentistry, the Netherlands. 3D models of the mandibles were obtained from CT-scans and hemimandibular volumes of all mandibles were calculated. The condylar height, ramus height, mandibular body length and the gonial angle were bilaterally determined using a novel landmark-based method, and the degree of asymmetry was calculated. RESULTS No relationship was found between dental age and asymmetry of the studied parameters (P < .05). The highest degree of asymmetry was found in the ramus height, whereas the gonial angle presented the lowest degree of asymmetry. A positive correlation was found between the asymmetry of the hemimandibular volume vs the height of the ramus (P < .05) and the length of the mandibular body (P < .05). An inverse correlation was found between the asymmetry of the ramus height vs the condylar height (P < .05), mandibular body length (P < .05) and gonial angle (P < .05). CONCLUSIONS Mandibular asymmetries in children did occur (9.8% of the included mandibles presented with a relevant overall asymmetry of ≥3%) and were unrelated to age. The different segments of the mandible seem to compensate for each other, in order to maintain a functional equilibrium.
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Affiliation(s)
- Valeria Vespasiano
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Cornelis Klop
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Catharina S Mulder
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Jan H Koolstra
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nicolaas H J Lobé
- Department of Radiology and Nuclear Medicine, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Ludo F M Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Jitske W Nolte
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Alfred G Becking
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Ruud Schreurs
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), AZ, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery 3D Lab, Radboud University Medical Centre Nijmegen, GA, Nijmegen, The Netherlands
| | - Thomas J J Maal
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), AZ, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery 3D Lab, Radboud University Medical Centre Nijmegen, GA, Nijmegen, The Netherlands
| | - Bernadette S de Bakker
- Department of Medical Biology, Section Clinical Anatomy & Embryology, Amsterdam UMC (location AMC), University of Amsterdam, AZ, Amsterdam, The Netherlands
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Kim HJ, Noh HK, Park HS. Use of a novel body mandibular plane (mental foramen-protuberance menti) in analyzing mandibular asymmetry compared with conventional border mandibular plane. Angle Orthod 2023; 93:490379. [PMID: 36689739 PMCID: PMC9933560 DOI: 10.2319/072522-513.1] [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: 07/01/2022] [Accepted: 12/01/2022] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES To compare a novel body mandibular horizontal plane (mental foramen-protuberance menti; Body-MHP) with the conventional border mandibular horizontal plane (gonion-menton [Me]; Border-MHP) to assess mandibular body inclination and dental compensation of skeletal Class III patients with and without facial asymmetry. MATERIALS AND METHODS Retrospective data obtained from diagnostic cone-beam computed tomography of 90 skeletal Class III patients (mean age, 21.67 ± 2.93 years; range, 15.0-30.6 years) were divided into symmetry (n = 30) and asymmetry groups (n = 60). The asymmetry group was subdivided into roll (n = 30) and non-roll types (n = 30). The differences in body inclination and dental measurements (distance and angle) according to two mandibular planes (Body-MHP and Border-MHP) were assessed in the groups and subgroups. RESULTS Mandibular body inclinations relative to the Body-MHP were not different in the roll-type asymmetric mandible between the sides, while those relative to the Border-MHP were different (P < .001). For the mandibular first molar positions relative to the Border-MHP, the differences in vertical distance between the sides were undermeasured and the inclination differences were overmeasured when compared relative to the Body-MHP. CONCLUSIONS The Body-MHP demonstrated better bilateral similarity in body inclination compared with the Border-MHP in patients with roll-type facial asymmetry. The novel body mandibular plane ensures an accurate diagnosis for tooth movement and jaw surgery, particularly in the roll-type asymmetric mandible.
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Kakehbaraei S, Arvanaghi R, Seyedarabi H, Esmaeili F, Zenouz AT. 3D tooth segmentation in cone-beam computed tomography images using distance transform. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ng WH, Goh BT, Lim AAT, Tan MH. Mandibular asymmetry: Is there a difference in the bone and soft tissue thickness between both sides? Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:e299-e306. [PMID: 36229374 DOI: 10.1016/j.oooo.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/02/2022] [Accepted: 05/13/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The asymmetric mandible presents the clinician with unique anatomic challenges in orthognathic surgery correction. This study aims to investigate these characteristics of the asymmetric mandible: mandible bone thickness, soft tissue thickness, and the proximity of the bone cortex to the inferior alveolar nerve (IAN) canal. STUDY DESIGN Three-dimensional virtual models were created of 35 participants of Asian descent with mandibular asymmetry. Mandibular bone thicknesses and soft tissue thicknesses were measured at certain landmarks. Statistical analysis of the thicknesses of both sides of the mandible was performed. Comparison of thicknesses between patients with minor and major asymmetry were also performed. RESULTS The bone was significantly thinner at the longer side at all 4 mandible landmarks (P < .001). The bone lateral to the IAN was significantly thinner at the longer side, as well (P < .001). The soft tissue thickness did not differ significantly across sides, except at 1 landmark. These findings were even more exaggerated in the major asymmetry group. CONCLUSIONS The longer side of the asymmetric mandible bone was thinner, and the bone lateral to the IAN was also thinner as a result. This asymmetric thinness was exaggerated in patients with severe asymmetry, which may predispose the longer side to IAN injury and unfavorable fractures. The differences in bone thickness in the asymmetric mandible may also result in residual postoperative asymmetry.
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Affiliation(s)
- Wee Hsuan Ng
- Discipline of Oral Maxillofacial Surgery, Department of Dentistry, Khoo Teck Puat Hospital, Singapore
| | - Bee Tin Goh
- Department of Oral & Maxillofacial Surgery, National Dental Centre Singapore, Singapore
| | - Asher Ah Tong Lim
- Department of Oral Maxillofacial Surgery, Faculty of Dentistry, National University Centre for Oral Health, Singapore
| | - Mei Hui Tan
- Department of Oral & Maxillofacial Surgery, National Dental Centre Singapore, Singapore.
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Fan Y, Zhang Y, Chen G, He W, Song G, Matthews H, Claes P, Pei Y, Zha H, Penington A, Kilpatrick N, Schneider P, Jiang R, Xu T. Automated assessment of mandibular shape asymmetry in 3-dimensions. Am J Orthod Dentofacial Orthop 2022; 161:698-707. [DOI: 10.1016/j.ajodo.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
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Pedersoli L, Dalessandri D, Tonni I, Bindi M, Isola G, Oliva B, Visconti L, Bonetti S. Facial Asymmetry Detected with 3D Methods in Orthodontics: A Systematic Review. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2111251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Historically, the development of two-dimensional (2D) imaging techniquesforerun that of three-dimensional (3D) ones. Some 2D methods are still considered valid and effective to diagnose facial asymmetry but 3D techniques may provide more precise and accurate measurements.
Objective:
The aim of this work is to analyze the accuracy and reliability of the imaging techniques available for the diagnosis of facial asymmetry in orthodontics and find the most reliable.
Methods:
A search strategy was implemented using PubMed (National Library of Medicine, NCBI).
Results:
A total of 3201 papers were identified in electronic searches. 90 articles, available in full text, were included in the qualitative synthesis consisting of 8 reviews on the diagnosis of facial asymmetry, 22 in vivo and in vitro studies on 2D methods and 60 in vivo and in vitro studies on 3D methods to quantify the asymmetry.
Conclusion:
2D techniques include X-ray techniques such as posterior-anterior cephalogram, which still represents the first level exam in the diagnosis of facial asymmetry. 3D techniques represent the second level exam in the diagnosis of facial asymmetry. The most current used techniques are CBCT, stereophotogrammetry, laser scanning, 3D optical sensors and contact digitization. The comparison between bilateral parameters (linear distances, angles, areas, volumes and contours) and the calculation of an asymmetry index represent the best choices for clinicians who use CBCT. The creation of a color-coded distance map seems to represent the most accurate, reliable and validated methods for clinicians who use stereophotogrammetry, laser scanning and 3D optical sensors.
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Three-Dimensional Quantification of Facial Morphology and Movements Using a Wearable Helmet. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2774713. [PMID: 35252441 PMCID: PMC8890869 DOI: 10.1155/2022/2774713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/26/2022] [Indexed: 11/17/2022]
Abstract
This work proposes a 3D normative database of facial ranges of motion in adults free from facial disorders. Ten facial movements were analyzed, each targeting the activity of specific muscle groups innervated by the facial nerve. The experimental protocol included a test-retest reliability positioning procedure of 25 skin markers based on clinical expertise in facial morphology. Three maximal voluntary contractions were recorded for each facial movement studied, using a 3D facial motion capture helmet. We included 53 adults free from facial disorders (26 men; age
), evaluated twice one week apart. The reliability of marker positioning was expressed as absolute measurement errors. The range of motion vectors of all markers from the best rest to the maximal voluntary contraction was calculated for each muscle group. Primary, secondary, and tertiary markers were extracted for each facial movement. 3D Procruste and asymmetry indices were developed. This allowed the identification of common thresholds of 10% for the asymmetry index and of 6 mm for the Procruste index, beyond which facial motions would be considered abnormally asymmetric. The normative database quantifies facial motions and allows assessment of the degree of clinical disorders by comparison. This protocol is currently being investigated in patients with chronic unilateral peripheral facial paresis.
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Evangelista K, Cardoso L, Toledo Í, Gasperini G, Valladares-Neto J, Cevidanes LHS, Ruellas ACDO, Silva MAG. Directions of mandibular canal displacement in ameloblastoma: A computed tomography mirrored-method analysis. Imaging Sci Dent 2021; 51:17-25. [PMID: 33828957 PMCID: PMC8007399 DOI: 10.5624/isd.20200132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/15/2020] [Accepted: 09/09/2020] [Indexed: 11/27/2022] Open
Abstract
Purpose This study was performed to investigate mandibular canal displacement in patients with ameloblastoma using a 3-dimensional mirrored-model analysis. Materials and Methods The sample consisted of computed tomographic scans of patients with ameloblastoma (n=10) and healthy controls (n=20). The amount of mandibular canal asymmetry was recorded as a continuous variable, while the buccolingual (yaw) and supero-inferior (pitch) directions of displacement were classified as categorical variables. The t-test for independent samples and the Fisher exact test were used to compare groups in terms of differences between sides and the presence of asymmetric inclinations, respectively (P<0.05). Results The length of the mandibular canal was similar on both sides in both groups. The ameloblastoma group presented more lateral (2.40±4.16 mm) and inferior (−1.97±1.92 mm) positions of the mental foramen, and a more buccal (1.09±2.75 mm) position of the middle canal point on the lesion side. Displacement of the mandibular canal tended to be found in the anterior region in patients with ameloblastoma, occurring toward the buccal and inferior directions in 60% and 70% of ameloblastoma patients, respectively. Conclusion Mandibular canal displacement due to ameloblastoma could be detected by this superimposed mirrored method, and displacement was more prevalent toward the inferior and buccal directions. This displacement affected the mental foramen position, but did not lead to a change in the length of the mandibular canal. The control group presented no mandibular canal displacement.
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Affiliation(s)
- Karine Evangelista
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | - Lincoln Cardoso
- University Clinical Hospital, Federal University of Goiás, Goiânia, Brazil
| | - Ítalo Toledo
- University Clinical Hospital, Federal University of Goiás, Goiânia, Brazil
| | - Giovanni Gasperini
- University Clinical Hospital, Federal University of Goiás, Goiânia, Brazil
| | - José Valladares-Neto
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | | | | | - Maria Alves Garcia Silva
- Department of Stomatological Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
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Feng B, Wang Y, Ouyang W, Yu M, Wang H. Construction and validity of a midsagittal plane based on the symmetry of a 3-dimensional model of the relevant cranial base. Am J Orthod Dentofacial Orthop 2020; 159:e49-e58. [PMID: 33357762 DOI: 10.1016/j.ajodo.2020.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/01/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The midsagittal plane (MSP) is the foundation for 3-dimensional (3D) cephalometric analyses. This article aimed to provide a protocol to construct a reliable and accurate MSP for 3D cephalometric craniofacial analysis. METHODS Cone-beam computed tomography data of 16 adult patients without obvious bilateral asymmetry were collected. The model of the anterior cranial base and sphenoid bone was constructed, and the candidate MSP was determined on the basis of the symmetry of this model. Intraclass correlation coefficients were used to assess intra- and interexaminer reliability of the candidate MSP. To investigate the accuracy of this candidate MSP, we constructed a true plane of symmetry of craniomaxillofacial structure and a control plane on the basis of 3 cranial midline points. We then compared these with the candidate MSP. RESULTS This candidate MSP resembled the true plane of symmetry with all the mean absolute errors <1 mm, and all the absolute errors for the candidate MSP were significantly smaller than the control plane (P ≤0.002). The relative intra- and interexaminer reliability for this candidate MSP was almost perfect (intraclass correlation coefficients >0.9). CONCLUSIONS The candidate MSP constructed using this method was thought to be reliable and accurate for 3D cephalometric analysis in patients without obvious cranial asymmetry.
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Affiliation(s)
- Bin Feng
- Department of Oral and Maxillofacial Radiology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yang Wang
- Department of Oral and Maxillofacial Radiology, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Wangtao Ouyang
- Department of Oral and Maxillofacial Radiology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Mengfei Yu
- Department of Oral and Maxillofacial Surgery and Implantology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China.
| | - Huiming Wang
- Department of Oral and Maxillofacial Surgery and Implantology, the Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China.
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Automatic detection of symmetry plane for computer-aided surgical simulation in craniomaxillofacial surgery. Phys Eng Sci Med 2020; 43:1087-1099. [PMID: 32776319 DOI: 10.1007/s13246-020-00909-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
Symmetry plane calculation is used in fracture reduction or reconstruction in the midface. Estimating a reliable symmetry plane without advanced anatomic knowledge is the most critical challenge. In this work, we developed a new automated method to find the mid-plane in CT images of an intact skull and a skull with a unilateral midface fracture. By use of a 3D point-cloud of a skull, we demonstrate that the proposed algorithm could find a mid-plane that meets clinical criteria. There is no need for advanced anatomical knowledge through the use of this algorithm. The algorithm used principal component analysis to find the initial plane. Then the rotation matrix, derived from an iterative closest point (ICP) registration method, is used to update the normal vector of the plane and find the optimum symmetry plane. A mathematical index, Hausdorff distance (HD), is used to evaluate the similarity of one mid-plane side in comparison to the contralateral side. HD decreased by 66% in the intact skull and 65% in a fractured skull and converged in just six iterations. High convergence speed, low computational load, and high accuracy suggest the use of the algorithm in the planning procedure. This easy-to-use algorithm with its advantages, as mentioned above, could be used as an operator in craniomaxillofacial software.
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Lum V, Goonewardene MS, Mian A, Eastwood P. Three-dimensional assessment of facial asymmetry using dense correspondence, symmetry, and midline analysis. Am J Orthod Dentofacial Orthop 2020; 158:134-146. [DOI: 10.1016/j.ajodo.2019.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 12/01/2019] [Accepted: 12/01/2019] [Indexed: 11/30/2022]
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Evangelista K, Valladares-Neto J, Garcia Silva MA, Soares Cevidanes LH, de Oliveira Ruellas AC. Three-dimensional assessment of mandibular asymmetry in skeletal Class I and unilateral crossbite malocclusion in 3 different age groups. Am J Orthod Dentofacial Orthop 2020; 158:209-220. [PMID: 32451206 DOI: 10.1016/j.ajodo.2019.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION This study aimed to evaluate the morphologic and positional features of the mandible in children, adolescents, and adults with skeletal Class I and unilateral posterior crossbite. METHODS The sample included cone-beam computerized tomography images of 76 subjects, divided in 3 groups: (1) children (aged 6.77 ± 1.5 years; n = 25), (2) adolescents (aged 14.3 ± 1.7 years; n = 26), and (3) adults (aged 32.66 ± 13.4 years; n = 25) with unilateral posterior crossbite. Condylar and mandibular linear distances and angles were performed using a mirrored 3-dimensional overlapped model. Intragroup asymmetries were determined by a comparison between crossbite and no crossbite sides. The differences between both sides of all measurements were compared among groups and correlated to mandibular horizontal rotation (yaw) and age. RESULTS The crossbite side showed shorter distances in the condyle and mandibular regions. Asymmetries were slightly but significantly greater in adults, as expressed by the lateromedial condylar distance, total ramus height, and mandibular length with an average 0.7 mm, 2.0 mm, and 1.5 mm, respectively. The mandibular yaw rotation was not correlated to age but moderately associated (r = 0.467) to asymmetry in mandibular length and total ramus height. CONCLUSIONS Patients with skeletal Class I and unilateral crossbite showed small mandibular asymmetries and these conditions were slightly greater in adults, specifically in lateromedial condylar distances and mandibular body and length.
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Affiliation(s)
- Karine Evangelista
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Brazil.
| | - José Valladares-Neto
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | - Maria Alves Garcia Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | | | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; Department of Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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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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Chen YF, Liao YF, Chen YA, Chen YR. Surgical-orthodontic treatment for class II asymmetry: outcome and influencing factors. Sci Rep 2019; 9:17956. [PMID: 31784585 PMCID: PMC6884499 DOI: 10.1038/s41598-019-54317-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022] Open
Abstract
The study aimed to evaluate the treatment outcome of bimaxillary surgery for class II asymmetry and find the influencing factors for residual asymmetry. Cone-beam computed tomographic images of 30 adults who had bimaxillary surgery were acquired, and midline and contour landmarks of soft tissue and teeth were identified to assess treatment changes and outcome of facial asymmetry. The postoperative positional asymmetry of each osteotomy segment was also measured. After surgery, the facial midline asymmetry of the mandible, chin, and lower incisors improved significantly (all p < 0.01). However, the residual chin deviation remained as high as 2.64 ± 1.80 mm, and the influencing factors were residual shift asymmetry of the mandible (p < 0.001), chin (p < 0.001), and ramus (p = 0.001). The facial contour asymmetry was not significantly improved after surgery, and the influencing factors were the initial contour asymmetry (p < 0.001), and the residual ramus roll (p < 0.001) or yaw (p < 0.01) asymmetry. The results showed that bimaxillary surgery significantly improved midline but not contour symmetry. The postoperative midline and contour asymmetry was mainly affected by the residual shift and rotational jaw asymmetry respectively.
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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.,Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Fang Liao
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. .,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan. .,Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan. .,Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Ying-An Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Ray Chen
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.,Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
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Cone-Beam Computed Tomography in Orthodontics. Dent J (Basel) 2019; 7:dj7030089. [PMID: 31480667 PMCID: PMC6784482 DOI: 10.3390/dj7030089] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/05/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.
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Charrier JB, Moreau N. [Secondary facial recontouring with micro-porous titanium implants]. ANN CHIR PLAST ESTH 2019; 64:511-518. [PMID: 31445778 DOI: 10.1016/j.anplas.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 11/16/2022]
Abstract
Facial recontouring has always been a longstanding objective of esthetic or reconstructive surgery. Most often it uses two types of surgical techniques: autologous and alloplastic. In that regard, different surgical techniques have been proposed to enhance facial recontouring. MATERIALS AND METHODS Through 5 clinical case reports and a literature review, this article explores the use of allopastic microporous titanium implants in secondary volumetric corrections of the face. RESULTS There is a current lack of evidence regarding the use of microporous titanium implants in volumetric corrections of the face, most papers reporting their use in post-traumatic or post-surgical cranio-facial defects repair. DISCUSSION Pros and cons of such implants are discussed in association with the usefulness of this surgical technique in daily surgical practice.
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Affiliation(s)
- J-B Charrier
- Chirurgie exclusive de la face, ex professeur des universités, pratique libérale, Paris, France.
| | - N Moreau
- Consultation de chirurgie orale, service de médecine bucco-dentaire, hôpital Bretonneau, AP-HP, 23, rue Joseph de Maistre, 75018 Paris, France; MCU-PH, Faculté de chirurgie dentaire, université Paris Descartes, 1, rue Maurice Arnoux, 92120 Montrouge France
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Anas IY, Bamgbose BO, Nuhu S. A comparison between 2D and 3D methods of quantifying facial morphology. Heliyon 2019; 5:e01880. [PMID: 31338446 PMCID: PMC6579906 DOI: 10.1016/j.heliyon.2019.e01880] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 12/04/2018] [Accepted: 05/30/2019] [Indexed: 11/19/2022] Open
Abstract
Objectives Currently, two & three-dimensional (2D & 3D) imaging techniques have largely replaced the direct anthropometric method in the assessment of facial morphology, but the difference between the two techniques was not quantified. Therefore, the aim of this study was to compare and quantify (the difference between) the two techniques. Materials and methods The faces of 150 subjects (75 males, 75 females) of northern Nigeria, predominantly Hausa ethnic group, were photographed (using digital camera) and scanned (using a 3D surface laser scanner). Facial dimensions were generated from the resulting virtual 2D and 3D models. Data were analyzed using R-statistic software & Paired sample t-test/Pearson correlation were conducted to compare the two methods and to quantify the level of closeness between the two measurements. Results Intraclass correlation coefficient (ICC) was very low (0.26) for the 3D and 2D measurements indicating the level of differences between the methods. Measurements taken with laser scanner were higher relative to the one taken by camera. The mean differences between the 3D and the 2D methods of quantifying facial morphology indicated a statistically significant positive difference. CONCLUSION: 2D and 3D anthropometry cannot be used interchangeably since there exists statistically significant variation between the two methods.
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Affiliation(s)
- IY Anas
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Bayero University Kano, Nigeria
- Corresponding author.
| | - BO Bamgbose
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, Bayero University, Nigeria
- Department of Oral and Maxillofacial Radiology, Aminu Kano Teaching Hospital, Nigeria
| | - Saleh Nuhu
- Department of Human Anatomy, Faculty of Basic Medical Sciences, Northwest University, Kano State, Nigeria
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Duran GS, Di̇ndaroğlu F, Kutlu P. Hard- and soft-tissue symmetry comparison in patients with Class III malocclusion. Am J Orthod Dentofacial Orthop 2019; 155:509-522. [PMID: 30935606 DOI: 10.1016/j.ajodo.2018.05.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Our aim was to describe hard- and soft-tissue asymmetry in people who have a skeletal Class III malocclusion, and to compare with those without asymmetry. We also performed a regional analysis of a possible correlation between facial soft- and hard-tissue asymmetries. METHODS This retrospective study was performed with the use of the computed tomographic scans of 60 subjects. The skeletal Class III subjects were categorized into 2 subgroups: soft-tissue menton deviation ≤4 mm (n = 20) versus >4 mm (n = 20). The Class III groups were compared with a Class I symmetry group (n = 20). Hard and soft tissues were segmented into different morphologic areas and deviation calculated. Pearson correlation coefficients were obtained, and 1-way analysis of variance was conducted for statistical analysis. RESULTS The highest deviation in the hard tissues of the Class III asymmetry group was in the corpus region (5.55 ± 3.05 mm), with the second highest in the angulus region (4.70 ± 2.43 mm). The highest average deviation in the soft tissues was seen in the lower cheek (7.04 ± 3.46 mm). In the different study groups, the amounts of asymmetry measured in anatomic structures on the mandible were found to be highly correlated between neighboring structures. CONCLUSIONS Clinically and statistically significant differences were found in the anatomic regions located in the middle and lower thirds of the face. There was a medium or high correlation between condyle, coronoid process, ramus, and angulus regions. A low level of correlation was observed between middle face and mandibular asymmetries in hard-tissue upper cheek and lower cheek regions were correlated with different mandibular regions.
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Affiliation(s)
- Gökhan Serhat Duran
- Department of Orthodontics, Gülhane Faculty of Dentistry, Sağlık Bilimleri University, Etlik, Ankara, Turkey.
| | - Furkan Di̇ndaroğlu
- Department of Orthodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
| | - Pınar Kutlu
- Department of Orthodontics, Gülhane Faculty of Dentistry, Sağlık Bilimleri University, Etlik, Ankara, Turkey
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Habibi Y, Habibi E, Al-Nawas B. Re-exposure in cone beam CT of the dentomaxillofacial region: a retrospective study. Dentomaxillofac Radiol 2019; 48:20180184. [PMID: 30540920 DOI: 10.1259/dmfr.20180184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
METHODS: In a retrospective cohort study CBCT images of 4986 patients from the patient database from the Department of Oral Radiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany were included and the rate of re-exposures was counted. Patients were stratified into those who received a scan with the small field-of-view CBCT or the large field-of-view CBCT. The effect of patient-related parameters as age and gender was implicated. As a further device-specific parameter, the statistical analysis included whether the selection of the field of view due to the device type had a significant influence on the occurrence of re-exposures. Furthermore, the rescans were analyzed with regard to their causes. RESULTS: In total, CBCT images of 82 (1.6%) patients had to be repeated. Looking at the two different devices, in 42 (1.3%) patients that received a scan with the large field-of-view CBCT and in 40 (2.3%) patients that received a scan with the small field-of-view CBCT respectively needed a retake. There was no statistically significant correlation between age and gender to retakes. For the small field-of-view-size significantly more retakes were observed than for the large one. With 46% motion artifacts were the most frequent causes for a re-exposure of the patient. CONCLUSIONS: Gender and age did not have an impact on the occurrence of re-exposures. Patients who received a scan with the small field-of-view CBCT were significantly more often rescanned than those with the large field-of-view CBCT.
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Affiliation(s)
- Yasamin Habibi
- 1 Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz , Germany
| | - Edriss Habibi
- 2 Department of Prosthodontics, University of Heidelberg, Dental School , Heidelberg , Germany
| | - Bilal Al-Nawas
- 1 Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz , Germany
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Cassi D, Battistoni G, Magnifico M, Di Blasio C, Pedrazzi G, Di Blasio A. Three-dimensional evaluation of facial asymmetry in patients with hemifacial microsomia using stereophotogrammetry. J Craniomaxillofac Surg 2019; 47:179-184. [DOI: 10.1016/j.jcms.2018.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 08/22/2018] [Accepted: 11/09/2018] [Indexed: 11/27/2022] Open
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Fan Y, Beare R, Matthews H, Schneider P, Kilpatrick N, Clement J, Claes P, Penington A, Adamson C. Marker-based watershed transform method for fully automatic mandibular segmentation from CBCT images. Dentomaxillofac Radiol 2018; 48:20180261. [PMID: 30379569 DOI: 10.1259/dmfr.20180261] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES: To propose a reliable and practical method for automatically segmenting the mandible from CBCT images. METHODS: The marker-based watershed transform is a region-growing approach that dilates or "floods" predefined markers onto a height map whose ridges denote object boundaries. We applied this method to segment the mandible from the rest of the CBCT image. The height map was generated to enhance the sharp decreases of intensity at the mandible/tissue border and suppress noise by computing the intensity gradient image of the CBCT itself. Two sets of markers, "mandible" and "background" were automatically placed inside and outside the mandible, respectively in a novel image using image registration. The watershed transform flooded the gradient image by dilating the markers simultaneously until colliding at watershed lines, estimating the mandible boundary. CBCT images of 20 adolescent subjects were chosen as test cases. Segmentation accuracy of the proposed method was evaluated by measuring overlap (Dice similarity coefficient) and boundary agreement against a well-accepted interactive segmentation method described in the literature. RESULTS: The Dice similarity coefficient was 0.97 ± 0.01 (mean ± SD), indicating almost complete overlap between the automatically and the interactively segmented mandibles. Boundary deviations were predominantly under 1 mm for most of the mandibular surfaces. The errors were mostly from bones around partially erupted wisdom teeth, the condyles and the dental enamels, which had minimal impact on the overall morphology of the mandible. CONCLUSIONS: The marker-based watershed transform method produces segmentation accuracy comparable to the well-accepted interactive segmentation approach.
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Affiliation(s)
- Yi Fan
- 1 Department of Dentistry, The University of Melbourne , Melbourne, VIC , Australia.,2 Facial Sciences , Murdoch Children's Research Institute, VIC , Australia
| | - Richard Beare
- 3 Developmental Imaging, Murdoch Children's Research Institute , Melbourne, VIC , Australia.,4 Department of Medicine, Monash University , Melbourne, VIC , Australia
| | - Harold Matthews
- 2 Facial Sciences , Murdoch Children's Research Institute, VIC , Australia.,5 Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital , Melbourne, VIC , Australia
| | - Paul Schneider
- 1 Department of Dentistry, The University of Melbourne , Melbourne, VIC , Australia
| | - Nicky Kilpatrick
- 2 Facial Sciences , Murdoch Children's Research Institute, VIC , Australia.,5 Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital , Melbourne, VIC , Australia
| | - John Clement
- 1 Department of Dentistry, The University of Melbourne , Melbourne, VIC , Australia.,2 Facial Sciences , Murdoch Children's Research Institute, VIC , Australia.,6 Cranfield Forensic Insititute, Cranfield University , England , UK
| | - Peter Claes
- 2 Facial Sciences , Murdoch Children's Research Institute, VIC , Australia.,7 Department of Electrical Engineering, KU Leuven , Leuven , Belgium.,8 Medical Imaging Research Center , Leuven , Belgium
| | - Anthony Penington
- 2 Facial Sciences , Murdoch Children's Research Institute, VIC , Australia.,5 Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital , Melbourne, VIC , Australia
| | - Christopher Adamson
- 3 Developmental Imaging, Murdoch Children's Research Institute , Melbourne, VIC , Australia
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Roque-Torres GD, Peyneau PD, Dantas da Costa E, Bóscolo FN, Maria de Almeida S, Ribeiro LW. Correlation between midline deviation and condylar position in patients with Class II malocclusion: A cone-beam computed tomography evaluation. Am J Orthod Dentofacial Orthop 2018; 154:99-107. [DOI: 10.1016/j.ajodo.2017.10.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 12/26/2022]
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26
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Paknahad M, Shahidi S, Bahrampour E, Beladi AS, Khojastepour L. Cone Beam Computed Tomographic Evaluation of Mandibular Asymmetry in Patients with Cleft Lip and Palate. Cleft Palate Craniofac J 2018; 55:919-924. [DOI: 10.1597/15-280] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: The purpose of the present study was to compare mandibular vertical asymmetry in patients with unilateral and bilateral cleft lip and palate and subjects with normal occlusion. Materials and Methods: Cone beam computed tomography scans of three groups consisting of 20 patients with unilateral cleft lip and palate, 20 patients affected by bilateral cleft lip and palate, and a control group of 20 subjects with normal occlusion were analyzed for this study. Condylar, ramal, and condylar plus ramal asymmetry indices were measured for all subjects using the method of Habets et al. Kruskal-Wallis and Mann-Whitney tests were used to determine any significant differences between the groups for all indices at the 95% level of confidence. Results: There were no significant differences regarding sex for all mandibular asymmetry indices in all three groups. All Asymmetry indices (condylar, ramal, and condylar plus ramal asymmetry) were significantly higher in the unilateral cleft group compared with the other two groups. Conclusion: Cone beam computed tomography images showed that patients with cleft lip and palate suffered from mandibular asymmetry. Subjects with unilateral cleft lip and palate had a more asymmetric mandible compared with the bilateral cleft lip and palate and control groups. Therefore, the mandible appears to be the leading factor in facial asymmetry in subjects with unilateral cleft lip and palate.
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27
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Bai L, Li L, Su K, Bleyer A, Zhang Y, Ji P. 3D reconstruction images of cone beam computed tomography applied to maxillofacial fractures: A case study and mini review. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2018; 26:115-123. [PMID: 29480233 DOI: 10.3233/xst-17342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Maxillofacial injuries can be complex and are clinically important due to their functional and cosmetic significance. Maltreated and missed fractures might cause deformity of the face; thus, accurate evaluation of the fracture provided by X-ray images is critical. In this study, we explore the application of cone-beam computed tomography (CBCT) for diagnosis of severe maxillofacial traumas. A patient with a complex fracture that affects the maxilla, mandible, wall of the maxillary sinus, zygoma, zygomatic arch and nasal bone was diagnosed using 3D reconstruction of CBCT images. This diagnostic approach provides detailed information obtained by static images and a systematic model with unique advantages for the following pre-surgical evaluation, surgical treatment and prognostic assessment of complex maxillofacial fractures.
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Affiliation(s)
- Liyun Bai
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Linlin Li
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Kexin Su
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Anthony Bleyer
- Division of Nephrology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA
| | - Yuanyuan Zhang
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA
| | - Ping Ji
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Scarfe WC, Azevedo B, Toghyani S, Farman AG. Cone Beam Computed Tomographic imaging in orthodontics. Aust Dent J 2017; 62 Suppl 1:33-50. [PMID: 28297089 DOI: 10.1111/adj.12479] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the last 15 years, cone beam computed tomographic (CBCT) imaging has emerged as an important supplemental radiographic technique for orthodontic diagnosis and treatment planning, especially in situations which require an understanding of the complex anatomic relationships and surrounding structures of the maxillofacial skeleton. CBCT imaging provides unique features and advantages to enhance orthodontic practice over conventional extraoral radiographic imaging. While it is the responsibility of each practitioner to make a decision, in tandem with the patient/family, consensus-derived, evidence-based clinical guidelines are available to assist the clinician in the decision-making process. Specific recommendations provide selection guidance based on variables such as phase of treatment, clinically-assessed treatment difficulty, the presence of dental and/or skeletal modifying conditions, and pathology. CBCT imaging in orthodontics should always be considered wisely as children have conservatively, on average, a three to five times greater radiation risk compared with adults for the same exposure. The purpose of this paper is to provide an understanding of the operation of CBCT equipment as it relates to image quality and dose, highlight the benefits of the technique in orthodontic practice, and provide guidance on appropriate clinical use with respect to radiation dose and relative risk, particularly for the paediatric patient.
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Affiliation(s)
- W C Scarfe
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - B Azevedo
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - S Toghyani
- Division of Radiology and Imaging Sciences, Department of Surgical and Hospital Dentistry, The University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - A G Farman
- University of Louisville School of Dentistry and Independent Consultant in Oral and Maxillofacial Radiology, Chicago, Illinois, USA
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Enhanced Surgical Outcomes in Patients With Skeletal Class III Facial Asymmetry by 3-Dimensional Surgical Simulation. J Oral Maxillofac Surg 2017; 76:1073-1083. [PMID: 29031529 DOI: 10.1016/j.joms.2017.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/12/2017] [Accepted: 09/12/2017] [Indexed: 01/17/2023]
Abstract
PURPOSE With the advance of image fusion techniques, the creation of 3-dimensional (3D) virtual head and 3D surgical simulations has provided previews of surgical procedures. The aim of this study was to investigate the surgical outcomes in patients receiving orthognathic surgery (OGS) with the guidance of 3D computer-assisted surgical simulation. PATIENTS AND METHODS The study included 34 consecutive patients (15 men and 19 women; age, 18.1 to 33.0 yr) with skeletal Class III facial asymmetry who underwent bimaxillary OGS. One-week postoperative cone-beam computed tomographic craniofacial images (Ta) were constructed and superimposed on preoperative simulated virtual images (Ts) at the cranial base and surfaces of the frontal and periorbital regions. The 3D cephalometric landmarks were measured relative to 3 reference planes. The outcomes among different experience levels of surgeons also were compared. RESULTS Although the mean values between Ta and Ts were small, statistical differences were observed in the center of maxillary and mandibular incisors and the B point relative to the midline and in the maxillary first molar in vertical distances, sagittal dentoskeletal dimensions, and pitch angles. The root mean square deviations (RMSDL) of measurement variables relative to center landmark accuracy were 1.5 and less than 2 mm at the maxilla and mandible, respectively. RMSDL greater than 2 mm was located at the maxillary first molar in the vertical distance and in the sagittal dimension at the anterior nasal spine and B point. Variables related to centering the midline structures were highly inter-related. The roll angle deviation was associated with centering the midline landmarks. The yaw angle deviation was not associated with midline correction. CONCLUSION With guidance from 3D surgical simulation, surgeons could achieve similar outcomes to correct facial asymmetry regardless of their years of practice.
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Nur Yilmaz RB, Germeç Çakan D, Arun T. Authors’ response. Am J Orthod Dentofacial Orthop 2016; 150:910-911. [DOI: 10.1016/j.ajodo.2016.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 08/23/2016] [Accepted: 08/31/2016] [Indexed: 11/25/2022]
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Thiesen G, Kim KB. Criteria for determining facial asymmetries. Am J Orthod Dentofacial Orthop 2016; 150:910. [DOI: 10.1016/j.ajodo.2016.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 08/09/2016] [Accepted: 08/31/2016] [Indexed: 10/20/2022]
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Li Y, Sun J, Zhang Y, Li W, Hu B, Song J. 3D reconstruction images of cone beam computed tomography in dental medicine application: A case study and mini-review. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2016; 24:673-680. [PMID: 27567751 DOI: 10.3233/xst-160596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Dental cone beam computed tomography (CBCT) is a new approach in diagnosis and predication of various dental diseases, including trauma, congenital defects, tumors and inflammatory. In this study, we reported the outcome of CBCT for a complicated case of malocclusion, accompanied with tooth loss and periodontitis. A combined application of CBCT with 3D-static images and rotated reconstruction images is reviewed as a systematic model in diagnosis, treatment and progonsis of a complex malocclusion.
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Affiliation(s)
- Yaming Li
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jicheng Sun
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yuanyuan Zhang
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA
| | - Wenyang Li
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Bo Hu
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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3-Dimensional CBCT analysis of mandibular asymmetry in unilateral condylar hyperplasia. J Craniomaxillofac Surg 2016; 44:1970-1976. [PMID: 27818059 DOI: 10.1016/j.jcms.2016.09.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 08/12/2016] [Accepted: 09/26/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Three-dimensional quantification of asymmetry in UCH has not been reported yet, but would be useful for diagnosing and evaluating the degree of deformity in this disease. It enables profound decision-making and timing of surgery. Unilateral condylar hyperplasia (UCH) can subjectively be classified in hemimandibular elongation (HE), hemimandibular hyperplasia (HH) and a combination of these two (hybrid form). The main purpose of this study was to quantify mandibular asymmetry in UCH patients with a reliable and reproducible method. Secondly, it was evaluated whether the existing classification can be confirmed. MATERIALS AND METHODS 37 UCH-patients with progressive mandibular asymmetry, supported by a positive bone scan and/or such clinical progression that condylectomy was performed, were included in this retrospective study. A group of healthy subjects, matched for age and gender, was used as the control group. Cone-beam computed tomography (CBCT) scans were imported in Maxilim® software. Each mandibular half was divided into three skeletal segments (condyle, ramus, and body). Linear and volumetric measurements were calculated for these skeletal units on the affected and unaffected side, for both patients and controls. RESULTS Significant differences between affected and unaffected sides in the patient group were found in condylar, ramus, and body segments for linear (p < 0.01) as well as for volumetric quantitative measurements (p < 0.0040). A mean linear difference between affected and unaffected sides in the condylar region of the UCH patient group was found of 3.6 mm (sd 2.9) versus 0.2 mm (sd 1.5) in controls. For volumetric measurements there was a mean difference between the left and right condyle of 718 mm3 (sd 638) in the patient group versus 8 mm3 (sd 225) difference in the control group. The condyle was the most affected segment. Differences between sides were significantly larger in the patient group than in the control group (p < 0.001). It was not possible to objectify differences between HE and HH. CONCLUSION CBCT is a useful and accurate modality for quantification and evaluation of mandibular asymmetry in UCH. It enables objective monitoring. The existing classification in HE and HH could not be confirmed.
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Three-dimensional evaluation of morphologic tooth symmetry in various malocclusions. Am J Orthod Dentofacial Orthop 2016; 150:459-66. [DOI: 10.1016/j.ajodo.2016.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 11/21/2022]
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Lin H, Zhu P, Lin Q, Huang X, Xu Y, Yang X. Comprehensive Analysis of Mandibular Residual Asymmetry after Bilateral Sagittal Split Ramus Osteotomy Correction of Menton Point Deviation. PLoS One 2016; 11:e0161601. [PMID: 27571364 PMCID: PMC5003338 DOI: 10.1371/journal.pone.0161601] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/08/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose Facial asymmetry often persists even after mandibular deviation corrected by the bilateral sagittal split ramus osteotomy (BSSRO) operation, since the reference facial sagittal plane for the asymmetry analysis is usually set up before the mandibular menton (Me) point correction. Our aim is to develop a predictive and quantitative method to assess the true asymmetry of the mandible after a midline correction performed by a virtual BSSRO, and to verify its availability by evaluation of the post-surgical improvement. Patients and Methods A retrospective cohort study was conducted at the Hospital of Stomatology, Sun Yat-sen University (China) of patients with pure hemi-mandibular elongation (HE) from September 2010 through May 2014. Mandibular models were reconstructed from CBCT images of patients with pre-surgical orthodontic treatment. After mandibular de-rotation and midline alignment with virtual BSSRO, the elongation hemi-mandible was virtually mirrored along the facial sagittal plane. The residual asymmetry, defined as the superimposition and boolean operation of the mirrored elongation side on the normal side, was calculated, including the volumetric differences and the length of transversal and vertical asymmetry discrepancy. For more specific evaluation, both sides of the hemi-mandible were divided into the symphysis and parasymphysis (SP), mandibular body (MB), and mandibular angle (MA) regions. Other clinical variables include deviation of Me point, dental midline and molar relationship. The measurement of volumetric discrepancy between the two sides of post-surgical hemi-mandible were also calculated to verify the availability of virtual surgery. Paired t-tests were computed and the P value was set at .05. Results This study included 45 patients. The volume differences were 407.8±64.8 mm3, 2139.1±72.5 mm3, and 422.5±36.9 mm3; residual average transversal discrepancy, 1.9 mm, 1.0 mm, and 2.2 mm; average vertical discrepancy, 1.1 mm, 2.2 mm, and 2.2 mm (before virtual surgery). The post-surgical volumetric measurement showed no statistical differences between bilateral mandibular regions. Conclusions Mandibular asymmetry persists after Me point correction. A 3D quantification of mandibular residual asymmetry after Me point correction and mandible de-rotation with virtual BSSRO sets up a true reference mirror plane for comprehensive asymmetry assessment of bilateral mandibular structure, thereby providing an accurate guidance for orthognathic surgical planning.
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Affiliation(s)
- Han Lin
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ping Zhu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Qiuping Lin
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoqiong Huang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yue Xu
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- * E-mail:
| | - Xiaoping Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Solem RC, Ruellas A, Ricks-Oddie JL, Kelly K, Oberoi S, Lee J, Miller A, Cevidanes L. Congenital and acquired mandibular asymmetry: Mapping growth and remodeling in 3 dimensions. Am J Orthod Dentofacial Orthop 2016; 150:238-51. [PMID: 27476356 DOI: 10.1016/j.ajodo.2016.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Disordered craniofacial development frequently results in definitive facial asymmetries that can significantly impact a person's social and functional well-being. The mandible plays a prominent role in defining facial symmetry and, as an active region of growth, commonly acquires asymmetric features. Additionally, syndromic mandibular asymmetry characterizes craniofacial microsomia (CFM), the second most prevalent congenital craniofacial anomaly (1:3000 to 1:5000 live births) after cleft lip and palate. We hypothesized that asymmetric rates of mandibular growth occur in the context of syndromic and acquired facial asymmetries. METHODS To test this hypothesis, a spherical harmonic-based shape correspondence algorithm was applied to quantify and characterize asymmetries in mandibular growth and remodeling in 3 groups during adolescence. Longitudinal time points were automatically registered, and regions of the condyle and posterior ramus were selected for growth quantification. The first group (n = 9) had a diagnosis of CFM, limited to Pruzansky-Kaban type I or IIA mandibular deformities. The second group (n = 10) consisted of subjects with asymmetric, nonsyndromic dentofacial asymmetry requiring surgical intervention. A control group (n = 10) of symmetric patients was selected for comparison. A linear mixed model was used for the statistical comparison of growth asymmetry between the groups. RESULTS Initial mandibular shape and symmetry displayed distinct signatures in the 3 groups (P <0.001), with the greatest asymmetries in the condyle and ramus. Similarly, mandibular growth had unique patterns in the groups. The dentofacial asymmetry group was characterized by significant asymmetry in condylar and posterior ramal remodeling with growth (P <0.001). The CFM group was characterized by asymmetric growth of the posterior ramus (P <0.001) but relatively symmetric growth of the condyles (P = 0.47). CONCLUSIONS Forms of CFM are characterized by active and variable growth of the dysplastic side, which has a distinct pattern from other disorders of mandibular growth.
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Affiliation(s)
- R Christian Solem
- Lecturer, Section of Orthodontics, University of California, Los Angeles, Calif.
| | - Antonio Ruellas
- Associate professor, Federal University of Rio de Janerio, Rio de Janerio, Brazil; postdoctoral fellow, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Joni L Ricks-Oddie
- Statistical consultant, Institute for Digital Research and Education, University of California, Los Angeles, Calif
| | - Katherine Kelly
- Adjunct clinical assistant professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | | | | | - Arthur Miller
- Professor, School of Dentistry, University of California, San Francisco, Calif
| | - Lucia Cevidanes
- Assistant professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
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Patel A, Islam SMS, Murray K, Goonewardene MS. Facial asymmetry assessment in adults using three-dimensional surface imaging. Prog Orthod 2015; 16:36. [PMID: 26490376 PMCID: PMC4614853 DOI: 10.1186/s40510-015-0106-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 10/05/2015] [Indexed: 11/10/2022] Open
Abstract
Background The use of three-dimensional (3D) surface imaging is becoming more popular and accepted in the fields of Medicine and Dentistry. The present study aims to develop a technique to automatically localise and quantify soft-tissue asymmetry in adults using 3D facial scans. This may be applied as a diagnostic tool to monitor growth and dynamic changes and to evaluate treatment outcomes. Methods 3D facial surface data were captured from 55 adults comprising 28 symmetrical faces and 27 asymmetrical faces using a 3dMDface system. A landmark-independent method, which compared the original and the mirrored 3D facial data, was developed to quantify the asymmetry. A Weibull distribution-based probabilistic model was generated from the root-mean-square (RMS) error data for the symmetrical group to designate a level of asymmetry which represented a normal range. Results Statistically significant (p < 0.0001) differences in the RMS error values were found when comparing symmetrical with asymmetrical groups and a similarly significant difference was identified between the lower and the upper face of the asymmetrical group. Conclusions The proposed 3D imaging-based method of identifying and quantifying facial soft-tissue asymmetry was fast and effective. The Weibull distribution-based comparison of a person’s asymmetry with respect to a large sample of symmetrical faces may also be used to evaluate growth, soft-tissue compensations and surgical outcomes.
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Affiliation(s)
- Arti Patel
- Department of Orthodontics, School of Dentistry, The University of Western Australia, 35, Stirling Hwy, Crawley, Western Australia, 6009, Australia.
| | - Syed Mohammed Shamsul Islam
- Department of Orthodontics, School of Dentistry, The University of Western Australia, 35, Stirling Hwy, Crawley, Western Australia, 6009, Australia.
| | - Kevin Murray
- School of Mathematics and Statistics, The University of Western Australia, 35, Stirling Hwy, Crawley, Western Australia, 6009, Australia.
| | - Mithran S Goonewardene
- Department of Orthodontics, School of Dentistry, The University of Western Australia, 35, Stirling Hwy, Crawley, Western Australia, 6009, Australia.
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Tyan S, Park HS, Janchivdorj M, Han SH, Kim SJ, Ahn HW. Three-dimensional analysis of molar compensation in patients with facial asymmetry and mandibular prognathism. Angle Orthod 2015; 86:421-30. [PMID: 26192894 DOI: 10.2319/030915-142.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the characteristic transverse dental compensations in patients with facial asymmetry and mandibular prognathism and to compare features of dental compensations between two types of mandibular asymmetry using 3-dimensional (3D) cone-beam computed tomography (CBCT). MATERIALS AND METHODS Seventy-eight adult patients with skeletal Class I (control group; n = 33; 19 men and 14 women) or skeletal Class III with facial asymmetry (experimental group; n = 45; 23 men and 22 women) were included. The experimental group was subdivided into two groups according to the type of mandibular asymmetry: translation type (T-type; n = 20) and roll type (R-type; n = 19). CBCT images were acquired before orthodontic treatment and 3D analyses were performed. RESULTS The transverse dental distance was significantly different between the two groups only at the palatal root apex of the maxillary first molar (P < .05). In the experimental group, the first molar axes were compensated significantly on both arches except the maxillary nondeviated side. The vertical molar heights were different between the two groups only on the maxillary arch (P < .001). The R-type showed greater mandibular ramal length difference and menton deviation than the T-type (P < .001). In the R-type, transverse compensation of the maxillary first molars was more obvious than with the T-type, which resulted in canting in the maxillary occlusal plane. CONCLUSIONS Mandibular asymmetry with prognathism showed a characteristic transverse dental compensation pattern. The mandibular asymmetry type influenced the amount and direction of molar compensation on the maxillary arch.
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Affiliation(s)
- Svetlana Tyan
- a Graduate student, Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Hong-Sik Park
- b Resident, Department of Orthodontics, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Munkhshur Janchivdorj
- a Graduate student, Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Sun-Ho Han
- a Graduate student, Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Su-Jung Kim
- c Associate Professor, Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Hyo-Won Ahn
- d Assistant Professor, Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
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Liu Z, Shen S, Xia JJ, Wang X. A Modified Method of Proximal Segment Alignment After Sagittal Split Ramus Osteotomy for Patients With Mandibular Asymmetry. J Oral Maxillofac Surg 2015; 73:2399-2407. [PMID: 26026710 DOI: 10.1016/j.joms.2015.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 04/25/2015] [Accepted: 05/02/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate a modified method of aligning the proximal segment after bilateral sagittal split ramus osteotomy (BSSO) in the treatment of patients with facial asymmetry. PATIENTS AND METHODS Eleven patients with mandibular excess and facial asymmetries were enrolled in this prospective study. The surgery was planned according to a computer-aided surgical simulation protocol. In addition, the proximal segment on the hypoplastic side was intentionally flared out after the distal segment was rotationally set back. If the gap between the proximal and distal segments was too wide, then bone grafts were used. The surgery was completed according to the computerized plan. The proximal segment on the hypoplastic side was fixed with bicortical lag screws, and the proximal segment on the hyperplastic side was fixed with a 4-hole titanium miniplate. Postoperative evaluation was performed 6 months after surgery. Statistical analyses were performed. RESULTS All surgeries were completed uneventfully. Of the 11 patients, 4 also underwent genioplasty and 3 underwent bone grafting to fill in the gap and smooth the anterior step. The physicians and patients were satisfied with the surgical outcomes. Only 1 patient underwent a secondary revision using an onlay hydroxyapatite implant. Results of statistical analyses showed that the computerized surgical plan could be accurately transferred to the patients at the time of surgery and the surgical outcomes achieved with this modified method were better than with the routine method of aligning the proximal and distal segments in maximal contact. CONCLUSION The present modified method of aligning the proximal segment for BSSO can effectively correct mandibular asymmetry and obviate a secondary revision surgery.
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Affiliation(s)
- Zhixu Liu
- Resident, Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Researcher Assistant, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Shunyao Shen
- Resident, Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Researcher Assistant, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - James J Xia
- Guest Professor, Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Director of Surgical Planning Laboratory and Professor of Oral and Maxillofacial Surgery, Institute for Academic Medicine, Houston Methodist Hospital, Houston, TX; Professor of Surgery (Oral and Maxillofacial Surgery), Weill Medicine College, Cornell University, New York, NY
| | - Xudong Wang
- Professor and Acting Chair, Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Professor, Shanghai Key Laboratory of Stomatology, Shanghai, China
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Weissheimer A, Menezes LM, Koerich L, Pham J, Cevidanes LHS. Fast three-dimensional superimposition of cone beam computed tomography for orthopaedics and orthognathic surgery evaluation. Int J Oral Maxillofac Surg 2015; 44:1188-96. [PMID: 25935632 DOI: 10.1016/j.ijom.2015.04.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 02/18/2015] [Accepted: 04/06/2015] [Indexed: 11/16/2022]
Abstract
The aim of this study was to validate a method for fast three-dimensional (3D) superimposition of cone beam computed tomography (CBCT) in growing patients and adults (surgical cases). The sample consisted of CBCT scans of 18 patients. For 10 patients, as the gold standard, the spatial position of the pretreatment CBCT was reoriented, saved as a reoriented volume, and then superimposed on the original image. For eight patients, four non-growing and four growing, the pre- and post-treatment scans were superimposed. Fast voxel-based superimposition was performed, with registration at the anterior cranial base. This superimposition process took 10-15s. The fit of the cranial base superimposition was verified by qualitative visualization of the semi-transparent axial, sagittal, and coronal cross-sectional slices of all corresponding anatomical structures. Virtual 3D surface models of the skull were generated via threshold segmentation, and superimposition errors in the reoriented models and the results of treatment for the treated cases were evaluated by 3D surface distances on colour-coded maps. The superimposition error of the spatial reorientation and for growing and non-growing patients was <0.5mm, which is acceptable and clinically insignificant. The voxel-based superimposition method evaluated was reproducible in different clinical conditions, rapid, and applicable for research and clinical practice.
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Affiliation(s)
- A Weissheimer
- Department of Orthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - L M Menezes
- Department of Orthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - L Koerich
- International Dental Program, Virginia Commonwealth University, Richmond, VA, USA
| | - J Pham
- Advanced Orthodontic Program, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - L H S Cevidanes
- Department of Orthodontics at the University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Use of the Matching Optimal Symmetry Plane Method in Planning Surgical Correction of Facial Asymmetry—A Preliminary Report of 20 Patients. J Oral Maxillofac Surg 2014; 72:1180.e1-13. [DOI: 10.1016/j.joms.2014.02.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 12/24/2013] [Accepted: 02/05/2014] [Indexed: 11/17/2022]
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Systematic review of preoperative mandibular canal position as it relates to postoperative neurosensory disturbance following the sagittal split ramus osteotomy. Int J Oral Maxillofac Surg 2014; 43:1076-81. [PMID: 24837554 DOI: 10.1016/j.ijom.2014.03.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 02/06/2014] [Accepted: 03/31/2014] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to review the current literature for the relationship between the preoperative position of the mandibular canal on three-dimensional (3D) radiographic imaging and postoperative neurosensory disturbance (NSD) following a sagittal split ramus osteotomy (SSRO). A literature search was conducted using PubMed, EMBASE, and the Cochrane Database for articles published from 1 January 2000 through 31 December 2013. Studies that included preoperative 3D imaging and assessment of NSD after surgery were reviewed. Study sample characteristics and results were extracted. Of the 69 articles identified, seven met the inclusion and exclusion criteria. There was no standardization for measuring the canal position or for evaluating NSD. General consensus was that the less space between the mandibular canal and the outer border of the buccal cortex the more frequent the occurrence of NSD. Increased bone density also appeared to contribute to a higher incidence of NSD. Utilization of 3D images to locate and measure the position of the mandibular canal is not standardized. Advances in 3D imaging and evaluation tools allow for new methodologies to be developed. Early attempts are informative, but additional studies are needed to verify the relationship between the location of the nerve and NSD following surgery.
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Methods to quantify soft tissue-based cranial growth and treatment outcomes in children: a systematic review. PLoS One 2014; 9:e89602. [PMID: 24586904 PMCID: PMC3937373 DOI: 10.1371/journal.pone.0089602] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 01/23/2014] [Indexed: 12/20/2022] Open
Abstract
Context Longitudinal assessment of cranial dimensions of growing children provides healthcare professionals with information about normal and deviating growth as well as treatment outcome. Objective To give an overview of soft tissue–based methods for quantitative longitudinal assessment of cranial dimensions in children until age 6 years and to assess the reliability of these methods in studies with good methodological quality. Data source PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, and CINAHL were searched. A manual search was performed to check for additional relevant studies. Study selection Primary publications on facial growth and treatment outcomes in children younger than age 6 years were included. Data extraction Independent data extraction was performed by two observers. A quality assessment instrument was used to determine methodological quality. Methods used in studies with good methodological quality were assessed for reliability expressed as the magnitude of the measurement error and the correlation coefficient between repeated measurements. Results In total, 165 studies were included, forming three groups of methods: head circumference anthropometry, direct anthropometry, and 2D photography and 3D imaging techniques (surface laser scanning and stereophotogrammetry). In general, the measurement error was below 2 mm, and correlation coefficients were very good. Conclusion Various methods for measuring cranial dimensions have shown to be reliable. Stereophotogrammetry is the most versatile method for quantitative longitudinal assessment of cranial dimensions and shapes in children. However, direct anthropometry continues to be the best method for routine clinical assessments of linear cranial dimensions in growing children until age 6 years.
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Temporomandibular joint condylar changes following maxillomandibular advancement and articular disc repositioning. J Oral Maxillofac Surg 2013; 71:1759.e1-15. [PMID: 24040949 DOI: 10.1016/j.joms.2013.06.209] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 06/18/2013] [Accepted: 06/19/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate condylar changes 1 year after bimaxillary surgical advancement with or without articular disc repositioning using longitudinal quantitative measurements in 3-dimensional (3D) temporomandibular joint (TMJ) models. METHODS Twenty-seven patients treated with maxillomandibular advancement (MMA) underwent cone-beam computed tomography before surgery, immediately after surgery, and at 1-year follow-up. All patients underwent magnetic resonance imaging before surgery to assess disc displacements. Ten patients without disc displacement received MMA only. Seventeen patients with articular disc displacement received MMA with simultaneous TMJ disc repositioning (MMA-Drep). Pre- and postsurgical 3D models were superimposed using a voxel-based registration on the cranial base. RESULTS The location, direction, and magnitude of condylar changes were displayed and quantified by graphic semitransparent overlays and 3D color-coded surface distance maps. Rotational condylar displacements were similar in the 2 groups. Immediately after surgery, condylar translational displacements of at least 1.5 mm occurred in a posterior, superior, or mediolateral direction in patients treated with MMA, whereas patients treated with MMA-Drep presented more marked anterior, inferior, and mediolateral condylar displacements. One year after surgery, more than half the patients in the 2 groups presented condylar resorptive changes of at least 1.5 mm. Patients treated with MMA-Drep presented condylar bone apposition of at least 1.5 mm at the superior surface in 26.4%, the anterior surface in 23.4%, the posterior surface in 29.4%, the medial surface in 5.9%, or the lateral surface in 38.2%, whereas bone apposition was not observed in patients treated with MMA. CONCLUSIONS One year after surgery, condylar resorptive changes greater than 1.5 mm were observed in the 2 groups. Articular disc repositioning facilitated bone apposition in localized condylar regions in patients treated with MMA-Drep.
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Clinical recommendations regarding use of cone beam computed tomography in orthodontics. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:238-57. [DOI: 10.1016/j.oooo.2013.06.002] [Citation(s) in RCA: 221] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 06/03/2013] [Indexed: 12/13/2022]
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Lee ST, Mori Y, Minami K, An CH, Park JW, Kwon TG. Does skeletal surgery for asymmetric mandibular prognathism influence the soft tissue contour and thickness? J Oral Maxillofac Surg 2013; 71:1577-87. [PMID: 23800674 DOI: 10.1016/j.joms.2013.04.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 04/09/2013] [Accepted: 04/09/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the present study was to investigate whether asymmetric mandibular prognathism accompanies a fundamental difference in soft tissue thickness and whether asymmetric mandibular setback surgery would influence the contour and thickness of the soft tissue of the chin. MATERIALS AND METHODS The present retrospective study included skeletal class III patients with significant mandibular chin deviation greater than 6 mm at the pogonion, who had undergone cone-beam computed tomography before and 6 months after surgery during a 2-year period. The predictor variables were timing (pre- and postoperatively) and side (asymmetric vs contralateral). The outcome measures were the hard and soft tissue contours and soft tissue thickness of the chin at the infradentale, B-point, and pogonion level evaluated with reformatted computed tomography images. The study variables were statistically compared using regression model and correlation analysis. RESULTS The present study consisted of 20 patients (10 males and 10 females; average age 20.2 years; range, 18 to 25). Preoperatively, the chin deviation side showed a more prominent hard and soft tissue outline but had a thinner soft tissue thickness, which camouflaged the hard tissue asymmetry. After surgery, the hard and soft tissue outline was greatly improved, and the soft tissue thickness had become nearly symmetric. Most of the soft tissue thickness changes correlated negatively with the hard tissue changes. CONCLUSIONS Asymmetric mandibular prognathism accompanied the 3-dimensional soft tissue contour and thickness asymmetry. Because the soft tissue responds favorably after skeletal surgery, the correction of 3-dimensional asymmetry of bone should be emphasized in patients with asymmetric mandibular prognathism.
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Affiliation(s)
- Sung-Tak Lee
- Center for Orthognathic surgery, Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry, Daegu, Korea
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Hodges RJ, Atchison KA, White SC. Impact of cone-beam computed tomography on orthodontic diagnosis and treatment planning. Am J Orthod Dentofacial Orthop 2013; 143:665-74. [DOI: 10.1016/j.ajodo.2012.12.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 12/01/2012] [Accepted: 12/01/2012] [Indexed: 11/26/2022]
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Park KR, Park HS, Piao Z, Kim MK, Yu HS, Seo JK, Lee SH. Three-dimensional vector analysis of mandibular structural asymmetry. J Craniomaxillofac Surg 2013; 41:338-44. [PMID: 23347884 DOI: 10.1016/j.jcms.2012.11.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 11/26/2012] [Accepted: 11/26/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The three-dimensional (3D) asymmetric structure of the mandible makes it necessary to analyze both its size and angle. Currently the developing 3D analysis techniques are not able to perform the simultaneous linear and angular measurements. Our aim was to evaluate mandibular asymmetry using a vector-based system by constructing 3D vectors for the mandibular functional units. MATERIAL AND METHODS We analyzed the 3D computed tomography images of normal control (N = 27) and asymmetric mandibles (N = 40). We created 3D vectors for the condylar, coronoid, body, gonial, and symphyseal functional units and compared the corresponding pairs of 3D vectors by calculating vector operations. RESULTS The vector difference and other vector components represented the individual 3D architectural pattern and severity of the asymmetric mandible. The body unit contributed most to mandibular asymmetry followed by the condylar unit. CONCLUSIONS The results indicate that 3D vector analysis can improve our understanding of the 3D architecture of asymmetric mandibles. This type of 3D vector analysis can be a useful tool for the comprehensive evaluation of its asymmetric mandibular structure.
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Affiliation(s)
- Kyung-Ran Park
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
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Brons S, van Beusichem ME, Bronkhorst EM, Draaisma J, Bergé SJ, Maal TJ, Kuijpers-Jagtman AM. Methods to quantify soft-tissue based facial growth and treatment outcomes in children: a systematic review. PLoS One 2012; 7:e41898. [PMID: 22879898 PMCID: PMC3412871 DOI: 10.1371/journal.pone.0041898] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 06/28/2012] [Indexed: 01/03/2023] Open
Abstract
Context Technological advancements have led craniofacial researchers and clinicians into the era of three-dimensional digital imaging for quantitative evaluation of craniofacial growth and treatment outcomes. Objective To give an overview of soft-tissue based methods for quantitative longitudinal assessment of facial dimensions in children until six years of age and to assess the reliability of these methods in studies with good methodological quality. Data Source PubMed, EMBASE, Cochrane Library, Web of Science, Scopus and CINAHL were searched. A hand search was performed to check for additional relevant studies. Study Selection Primary publications on facial growth and treatment outcomes in children younger than six years of age were included. Data Extraction Independent data extraction by two observers. A quality assessment instrument was used to determine the methodological quality. Methods, used in studies with good methodological quality, were assessed for reliability expressed as the magnitude of the measurement error and the correlation coefficient between repeated measurements. Results In total, 47 studies were included describing 4 methods: 2D x-ray cephalometry; 2D photography; anthropometry; 3D imaging techniques (surface laser scanning, stereophotogrammetry and cone beam computed tomography). In general the measurement error was below 1 mm and 1° and correlation coefficients range from 0.65 to 1.0. Conclusion Various methods have shown to be reliable. However, at present stereophotogrammetry seems to be the best 3D method for quantitative longitudinal assessment of facial dimensions in children until six years of age due to its millisecond fast image capture, archival capabilities, high resolution and no exposure to ionizing radiation.
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Affiliation(s)
- Sander Brons
- Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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