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Supmaneenukul Y, Khemla C, Parakonthun K. Soft tissue compensation evaluation in patients with facial asymmetry using cone-beam computed tomography combined with 3D facial photographs. Heliyon 2024; 10:e27720. [PMID: 38496872 PMCID: PMC10944279 DOI: 10.1016/j.heliyon.2024.e27720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024] Open
Abstract
Objectives This study aimed to evaluate bilateral soft tissue, hard and soft-tissue thickness at various anatomical levels in patients with facial asymmetries. Moreover, we attempted to find out correlation between soft-tissue compensation and severity of asymmetry by using cone-beam computed tomography (CBCT) combined with 3D facial photographs. Study design Based on menton deviation (MD), twenty-four subjects were divided into: mild-asymmetry group (n=12) and moderate-to-severe-asymmetry group (n = 12). CBCT images were superimposed with 3D facial photographs. Distance from the midsagittal plane to the outermost point of soft-tissue and hard-tissue were measured and calculated soft-tissue thickness. Comparison of soft-tissue thickness between deviated and contralateral side at any anatomical levels were performed within group, and correlation between bilateral soft-tissue thickness subtractions (soft-tissue compensation) and MD values was evaluated. Results Within group, Soft- and hard-tissue distances were greater in deviated side than contralateral side at any levels. In moderate-to-severe group, significant differences were found at gonion and body of mandible level, whereas soft-tissue thickness was only found to be higher on deviated side at the level of mandibular ramus. Soft tissue compensation was negatively correlated with MD value at level of mandibular ramus (R = -0.5, P < 0.05). Conclusions Asymmetry was found to be larger in the lower third of the face and was notably remarkable in the moderate-to-severe group. Soft-tissue thickness was thicker on the deviated side of the mandibular ramus. Thus, the soft-tissue compensation seems to be minimized in patients with more severe asymmetry.
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Affiliation(s)
- Yannapat Supmaneenukul
- Residency Training in Orthodontics, Orthodontic Division, Department of Pedodontics and Preventive Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok, 10110, Thailand
| | - Chinnachote Khemla
- Oral Surgery Section, Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, 10110, Thailand
| | - Kulthida Parakonthun
- Orthodontic Division, Department of Pedodontics and Preventive Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok, 10110, Thailand
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Kazimierczak N, Kazimierczak W, Serafin Z, Nowicki P, Jankowski T, Jankowska A, Janiszewska-Olszowska J. Skeletal facial asymmetry: reliability of manual and artificial intelligence-driven analysis. Dentomaxillofac Radiol 2024; 53:52-59. [PMID: 38214946 PMCID: PMC11003660 DOI: 10.1093/dmfr/twad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/29/2023] [Accepted: 11/11/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES To compare artificial intelligence (AI)-driven web-based platform and manual measurements for analysing facial asymmetry in craniofacial CT examinations. METHODS The study included 95 craniofacial CT scans from patients aged 18-30 years. The degree of asymmetry was measured based on AI platform-predefined anatomical landmarks: sella (S), condylion (Co), anterior nasal spine (ANS), and menton (Me). The concordance between the results of automatic asymmetry reports and manual linear 3D measurements was calculated. The asymmetry rate (AR) indicator was determined for both automatic and manual measurements, and the concordance between them was calculated. The repeatability of manual measurements in 20 randomly selected subjects was assessed. The concordance of measurements of quantitative variables was assessed with interclass correlation coefficient (ICC) according to the Shrout and Fleiss classification. RESULTS Erroneous AI tracings were found in 16.8% of cases, reducing the analysed cases to 79. The agreement between automatic and manual asymmetry measurements was very low (ICC < 0.3). A lack of agreement between AI and manual AR analysis (ICC type 3 = 0) was found. The repeatability of manual measurements and AR calculations showed excellent correlation (ICC type 2 > 0.947). CONCLUSIONS The results indicate that the rate of tracing errors and lack of agreement with manual AR analysis make it impossible to use the tested AI platform to assess the degree of facial asymmetry.
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Affiliation(s)
| | - Wojciech Kazimierczak
- Kazimierczak Private Dental Practice, 85-009 Bydgoszcz, Poland
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-067 Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-067 Bydgoszcz, Poland
| | - Paweł Nowicki
- Kazimierczak Private Dental Practice, 85-009 Bydgoszcz, Poland
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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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Alqhtani N, Alshammery D, AlOtaibi N, AlZamil F, Allaboon A, AlTuwaijri D, Baseer MA. Correlations Between Mandibular Asymmetries and Temporomandibular Disorders: A Systematic Review. J Int Soc Prev Community Dent 2021; 11:481-489. [PMID: 34760791 PMCID: PMC8533045 DOI: 10.4103/jispcd.jispcd_130_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/09/2021] [Accepted: 05/13/2021] [Indexed: 12/14/2022] Open
Abstract
Objective This systematic review aimed to investigate the correlation between mandibular asymmetry and temporomandibular disorders (TMDs). Materials and Methods A systematic search of the published literature was performed in electronic databases such as PubMed (MEDLINE), Scopus, Web of Science, Cochrane, Google Scholar, Clinicaltrials.gov, and Saudi Digital Library. Gray literature was searched through System for Information on Grey Literature through OpenGrey. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed in the investigation. The focussed question according to PICO format was: "does the mandibular asymmetry contribute to temporomandibular disorders"? Eligibility criteria included clinical trials (CTs), observation studies, cross-sectional and cohort studies in English that investigated mandibular asymmetries and TMD among patients. Blind and duplicate study selection, data extraction, and risk of bias assessment were carried out. Results The initial search resulted in 1906 articles, of which 11 (8 CTs, 1 cross-sectional, 1 retrospective, and 1 observational) studies were selected for qualitative synthesis after fulfilling the eligibility criteria. Conclusion Most of the studies included in this review showed either very high risk or high risk of bias. Despite the low certainty of evidence, the current study indicated a likely relationship between mandibular asymmetries and TMDs.
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Affiliation(s)
- Nasser Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Deema Alshammery
- Department of Preventive Dental Science, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Nawaf AlOtaibi
- Dental Student, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Faisal AlZamil
- Dental Student, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Aljowhara Allaboon
- Dental Student, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Dana AlTuwaijri
- Dental Student, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Mohammad Abdul Baseer
- Department of Preventive Dental Science, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
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Quantitative Asymmetry Assessment between Virtual and Mixed Reality Planning for Orthognathic Surgery—A Retrospective Study. Symmetry (Basel) 2021. [DOI: 10.3390/sym13091614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Orthognathic surgical planning compromises three clinical needs: occlusal balancing, symmetry, and harmony, which may result in multiple outcomes. Facial symmetry is the ultimate goal for patients and practitioners. Pure virtual planning and mixed reality planning were two innovative technologies in clinical practices compared to conventional model surgery used for decades. We proposed quantitative asymmetry assessment methods in both mandibular contour (in 2D) and a midface and mandible relationship in 3D. A computerized optimal symmetry plane, being the median plane, was applied in both planning methods. In the 3D asymmetry assessment between two planning methods, the deviation angle and deviation distance between midface and mandible were within 2° and 1.5 mm, respectively. There was no significant difference, except the symmetry index of the anterior deviation angle between the virtual and mixed reality planning in the 3D asymmetry assessment. In the mandible contour assessment, there was no significant difference between the virtual and mixed reality planning in asymmetry assessment in the frontal and frontal downward inclined views. Quantitative outcomes in 3D asymmetry indices showed that mixed reality planning was slightly more symmetric than virtual planning, with the opposite in 2D contouring.
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Cone-beam Computed Tomography-based three-dimensional cephalometric analysis of mandible symmetry and the occlusal plane of adult patients with high-angle skeletal class III malocclusion and jaw deformity. Arch Oral Biol 2021; 127:105157. [PMID: 34015688 DOI: 10.1016/j.archoralbio.2021.105157] [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: 01/06/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To use cone beam computed tomography (CBCT) scans to analyze mandibular symmetry, the occlusal plane and their correlations in patients with high-angle skeletal class III malocclusion and jaw deformity. DESIGN Reconstructed images simulated of CBCT data of 20 adult patients with high-angle skeletal class III malocclusion and jaw asymmetry (Experimental group) and 20 adult patients of skeletal class I with normal faces (Control group) were measured with a three-dimensional (3D) geometric morphological measurement system. Related landmarks, lines and planes were marked and relevant distances and angles of 3D craniofacial structures were measured. The Student t-test was performed to assess symmetry. With the help of the Pearson correlation and Linear regression, we explored the correlations and other relationships among them. RESULTS Compared with control group, the symmetrical differences in experimental group were concentrated in condyle, coracoid process, mandibular angle, mandibular first molar area and the chin (P < 0.05). A strong positive correlation was found between the degree of mandibular deviation and the inclination of the occlusal plane in the coronal position (r = 0.860, P < 0.001) and a linear relationship between them was found: Y = 1.300 + 0.419X (the inclination of occlusal plane was Y, and the mandibular deviation was X). CONCLUSIONS Certain characteristics of mandibular symmetry and the occlusal plane were found in patients with high-angle skeletal class III malocclusion and jaw asymmetry. These findings provide references for doctors to pay attention to the degree and location of mandibular asymmetry and to determine the occlusal plane.
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Currò G, Bilello G, Messina P, Scardina GA. Transverse Asymmetries of the Maxilla Even in Healthy and Apparently Symmetrical Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E446. [PMID: 33429919 PMCID: PMC7826829 DOI: 10.3390/ijerph18020446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 11/17/2022]
Abstract
In the formulation of an orthodontic treatment plan, the three-dimensional analysis of the dental arches represents a fundamental moment for the evaluation of all the morphological parameters necessary in order to have a correct and complete diagnosis. In this regard, the study of the dental arches on the horizontal plane is sometimes neglected or not thorough enough. When evaluating the transverse dimensions of the dental upper arche, the presence of an asymmetry is frequently found, and it means that an hemiarch is larger than the other. Furthermore, any variation in one of the three planes of space always involves an alteration also on the other two planes in order to have compensation. The morphology of a bone segment depends on various factors, mainly genetical, acquired and environmental. Regarding the environmental factors, the function determines the morphology, but this in turn determines the function. In the case of unilateral mastication, the upper maxilla will be asymmetrical, so growing patients will have compensation on other skull bones. From these considerations arises the need for a careful study of the horizontal plane of the maxilla in the presence of a malocclusion during diagnostic evaluations. These asymmetries, however, must be evaluated and quantified in the diagnostic phase in order to formulate a correct plan of treatment. The aim of this work is to demonstrate that there are almost always transverse asymmetries of the maxilla, albeit of a slight entity, even in healthy and apparently symmetrical subjects.
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Affiliation(s)
| | | | | | - Giuseppe Alessandro Scardina
- Department of Surgical, Oncological and Stomatological Disciplines (DiChirOnS), University of Palermo, 90133 Palermo, Italy; (G.C.); (G.B.); (P.M.)
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