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Ajmera DH, Singh P, Leung YY, Khambay BS, Gu M. Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry: a systematic review : Establishment of the mid-sagittal reference plane: a systematic review. Clin Oral Investig 2024; 28:242. [PMID: 38575839 PMCID: PMC10995046 DOI: 10.1007/s00784-024-05620-7] [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: 05/09/2022] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To systematically review the literature for mid-sagittal plane establishment approaches to identify the most effective method for constructing the mid-sagittal plane for the evaluation of facial asymmetry. MATERIALS AND METHODS Six electronic databases (PubMed, Medline (via Ovid), EMBASE (via Ovid), Cochrane Library, Web of Science, and Scopus) and grey literature were searched for the studies that computed the mid-sagittal reference plane three-dimensionally, using a combination of MeSH terms and keywords. The methodological quality and the level of evidence for the included studies were analyzed using QUADAS-2 and GRADE, respectively. RESULTS The preliminary search yielded 6746 records, of which 42 articles that met the predefined inclusion criteria were included in the final analysis. All the included articles reported the construction of the mid-sagittal reference plane (MSP) using varied methods. The risk of bias and concerns regarding the applicability of the included studies were judged to be 'low'. The level of evidence was determined to be 'low' for the effectiveness of the technique and 'moderate' for the ease of clinical applicability. CONCLUSION Despite methodological heterogeneity, this review substantiates the comparable efficacy of cephalometric and morphometric MSP construction methods. A fully automated morphometric MSP holds promise as a viable option for routine clinical use. Nevertheless, future prospective studies with an emphasis on the impact, accuracy, and clinical applicability of MSP construction techniques in cases of facial asymmetry are required. CLINICAL RELEVANCE The present review will assist clinicians in selecting the most suitable method for MSP construction, leading to improved treatment planning and ultimately more favorable treatment outcomes.
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Affiliation(s)
- Deepal Haresh Ajmera
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Pradeep Singh
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yiu Yan Leung
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Balvinder S Khambay
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
- Orthodontics Department, School of Dentistry, University of Birmingham, Birmingham, UK.
- Discipline of Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
| | - Min Gu
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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Wang Y, Wu W, Christelle M, Sun M, Wen Z, Lin Y, Zhang H, Xu J. Automated localization of mandibular landmarks in the construction of mandibular median sagittal plane. Eur J Med Res 2024; 29:84. [PMID: 38287445 PMCID: PMC10823719 DOI: 10.1186/s40001-024-01681-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/17/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE To use deep learning to segment the mandible and identify three-dimensional (3D) anatomical landmarks from cone-beam computed tomography (CBCT) images, the planes constructed from the mandibular midline landmarks were compared and analyzed to find the best mandibular midsagittal plane (MMSP). METHODS A total of 400 participants were randomly divided into a training group (n = 360) and a validation group (n = 40). Normal individuals were used as the test group (n = 50). The PointRend deep learning mechanism segmented the mandible from CBCT images and accurately identified 27 anatomic landmarks via PoseNet. 3D coordinates of 5 central landmarks and 2 pairs of side landmarks were obtained for the test group. Every 35 combinations of 3 midline landmarks were screened using the template mapping technique. The asymmetry index (AI) was calculated for each of the 35 mirror planes. The template mapping technique plane was used as the reference plane; the top four planes with the smallest AIs were compared through distance, volume difference, and similarity index to find the plane with the fewest errors. RESULTS The mandible was segmented automatically in 10 ± 1.5 s with a 0.98 Dice similarity coefficient. The mean landmark localization error for the 27 landmarks was 1.04 ± 0.28 mm. MMSP should use the plane made by B (supramentale), Gn (gnathion), and F (mandibular foramen). The average AI grade was 1.6 (min-max: 0.59-3.61). There was no significant difference in distance or volume (P > 0.05); however, the similarity index was significantly different (P < 0.01). CONCLUSION Deep learning can automatically segment the mandible, identify anatomic landmarks, and address medicinal demands in people without mandibular deformities. The most accurate MMSP was the B-Gn-F plane.
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Affiliation(s)
- Yali Wang
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Weizi Wu
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Orthodontics, Affiliated Hospital of Stomatology, Anhui Medical University Hefei, 69 Meishan Road, Hefei, Anhui, China
| | - Mukeshimana Christelle
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Mengyuan Sun
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zehui Wen
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Orthodontics, Affiliated Hospital of Stomatology, Anhui Medical University Hefei, 69 Meishan Road, Hefei, Anhui, China
| | - Yifan Lin
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | - Hengguo Zhang
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Jianguang Xu
- Key Lab. of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Department of Orthodontics, Affiliated Hospital of Stomatology, Anhui Medical University Hefei, 69 Meishan Road, Hefei, Anhui, China.
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Evangelista K, Teodoro AB, Bianchi J, Cevidanes LHS, de Oliveira Ruellas AC, Silva MAG, Valladares-Neto J. Prevalence of mandibular asymmetry in different skeletal sagittal patterns. Angle Orthod 2022; 92:118-126. [PMID: 34546287 PMCID: PMC8691477 DOI: 10.2319/040921-292.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To analyze the prevalence of mandibular asymmetry in skeletal sagittal malocclusions. MATERIALS AND METHODS PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, LIVIVO and gray literature (OpenGrey, ProQuest, and Google Scholar) were electronically searched. Two independent investigators selected the eligible studies, and assessed risk of bias and certainty of evidence (GRADE). One reviewer independently extracted the data and the second reviewer checked this information. Any disagreement between the reviewers in each phase was resolved by discussion between them and/or involved a third reviewer for final decision. RESULTS Electronic search identified 5,132 studies, and 5 observational studies were included. Risk of bias was low in two studies, moderate in one, and high in two. The studies showed high heterogeneity. Mandibular asymmetry ranged from 17.43% to 72.95% in overall samples. Horizontal chin deviation showed a prevalence of 17.66% to 55.6% asymmetry in Class I malocclusions, and 68.98% in vertical asymmetry index. In Class II patients, prevalence of mandibular asymmetry varied from 10% to 25.5% in horizontal chin deviation, and 71.7% in vertical asymmetry index. The Class III sample showed a prevalence of mandibular asymmetry ranging from 22.93% to 78% in horizontal chin deviation and 80.4% in vertical asymmetry index. Patients seeking orthodontic or orthognathic surgery treatment showed greater prevalence of mandibular asymmetry. CONCLUSIONS Skeletal Class III malocclusion showed the greatest prevalence of mandibular asymmetry. Mandibular vertical asymmetry showed a marked prevalence in all malocclusions. However, conclusions should be interpreted with caution due to use of convenience samples and low-quality study outcomes.
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Apostolopoulos K, Palomo JM, Rizzante FAP, Pugliese F. A 3D mirroring and colormap asymmetry study of Class II subdivision patients. Orthod Craniofac Res 2021; 25:429-436. [PMID: 34863033 DOI: 10.1111/ocr.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients with Class II subdivision malocclusion present skeletal and dental asymmetries. The purpose of this study is to assess those asymmetries by 3D mirroring and colormap quantification. METHODS This study analyzed 50 initial CBCTs divided into two groups: Class I (control group) and Class II subdivision (study group) malocclusion patients. CBCTs were oriented and full skull was segmented generating a 3D model. The right side of the 3D models was mirrored, using a midsagittal plane as reference, resulting in a perfectly symmetric skull based on two right sides. Original and mirrored models were superimposed on the unchanged right half, and differences were quantified using a colormap. Eight regions of interest were assessed: gonion, mandibular front, maxillary front, zygomatic process, maxillary and mandibular canine and molar areas. RESULTS Statistically significant differences using the Mann-Whitney test were found in six of the eight evaluated areas when comparing the control to the study group. The maxillary skeletal areas did not show any difference between the groups. CONCLUSIONS Patients with Class II subdivision malocclusion show true skeletal and dental asymmetries when comparing right and left sides. The maxilla showed no significant skeletal asymmetry, but the maxillary teeth were positioned more mesially on the Class II side. The maxillary canine on the Class II side was also more bucally positioned. The mandible showed significant asymmetries with both skeletal and dental areas in the Class II side more distally and bucally positioned.
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Affiliation(s)
- Konstantinos Apostolopoulos
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fabio Antonio Piola Rizzante
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fernando Pugliese
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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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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Apostolopoulos K, Bous RM, ElNaghy R, Kumar AR, Valiathan M. Examining the variability of bone and soft tissue morphology in Hemifacial Microsomia: A case series of 8 patients. J Craniomaxillofac Surg 2021; 49:352-357. [PMID: 33612409 DOI: 10.1016/j.jcms.2021.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/08/2020] [Accepted: 02/07/2021] [Indexed: 11/28/2022] Open
Abstract
AIM OF THE STUDY Patients with Hemifacial Microsomia (HFM) exhibit highly variable skeletal and soft tissue asymmetries. The purpose of this study was to evaluate soft tissue discrepancies in patients with HFM and correlate them to the skeletal discrepancy. Eight patients were selected and studied retrospectively using 3-dimensional (3D) superimposition and color mapping of the soft and hard tissues. The skeletal and soft tissue facial structures were segmented and mirrored, resulting in a perfectly symmetric skull and face. Original and mirrored 3D models were superimposed. Differences between the affected and normal side were assessed in seven areas: frontal, endocanthion, exocanthion, malar, maxillary frontal, mandibular frontal and gonion area. The correlations between the skeletal and soft tissue asymmetry were evaluated by Pearson correlations. Hard tissue asymmetry ranged from 1.4 mm (Endocanthion) to 5.5 mm (Gonion), while soft tissue asymmetry ranged from 1.5 mm (Endocanthion) to 5.6 mm (Malar). Correlation between skeletal and soft tissue deficiency were highly variable, with the highest correlation at gonion and the lowest at exocanthion. Bone and soft tissue hypoplasia were highly correlated at the gonion and the malar area, while the remaining evaluated areas demonstrated poor correlation between skeletal and soft tissue asymmetries. Future studies will determine if target treatment can reliably improve bone and soft tissue hypoplasia in this area.
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Affiliation(s)
- Konstantinos Apostolopoulos
- Department of Craniofacial and Special Care Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Rany M Bous
- Department of Craniofacial and Special Care Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Rahma ElNaghy
- Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.
| | - Anand R Kumar
- Division of Plastic and Reconstructive Surgery, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Manish Valiathan
- Department of Craniofacial and Special Care Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
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Mai DDP, Stucki S, Gkantidis N. Assessment of methods used for 3-dimensional superimposition of craniofacial skeletal structures: a systematic review. PeerJ 2020; 8:e9263. [PMID: 32547877 PMCID: PMC7278889 DOI: 10.7717/peerj.9263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/09/2020] [Indexed: 01/08/2023] Open
Abstract
Background So far, several techniques have been recommended for the assessment of craniofacial changes through skeletal tissue superimposition, but the evidence that supports them remains unexplored. The purpose of the present study is to assess the available literature on skeletal-tissue superimpositions of serial craniofacial CT or CBCT images used to detect morphological changes. Materials and Methods Medline (via Pubmed), EMBASE, Google Scholar, Cochrane Library, Open Grey and Grey Literature Report were searched (last search: 17.11.2019) using specific terms that fulfilled the requirements of each database in the context of the study aim. Hand searches were also performed. The outcomes of interest were the accuracy, precision, or agreement between skeletal-tissue superimposition techniques to assess changes in the morphology of craniofacial structures. Studies of any design with sample size ≥3 were assessed by two authors independently. The study protocol was registered in PROSPERO (ID: CRD42019143356). Results Out of 832 studies, fifteen met the eligibility criteria. From the 15 included studies, 12 have shown high total risk of bias, one low risk of bias, and two studies have shown unclear risk of bias. Thirteen out of the 15 studies showed high applicability concerns, two unclear and no study had low applicability concerns. There was high heterogeneity among studies regarding the type of participants, sample size, growth status, machines, acquisition parameters, superimposition techniques, assessment techniques and outcomes measured. Fourteen of them were performed on Cone Beam Computed Tomography (CBCT) and one on Computed Tomography (CT) derived 3D models. Most of the studies (eleven) used voxel-based registration, one landmark-based registration and three studies compared different registration techniques, which include the surface-based registration. Concerning the area of interest, nine studies focused on the anterior cranial base and certain facial structures, four on maxillary structures and four on mandibular structures. Non-growing participants were included in six studies, growing in eight, whereas one study had both. Conclusion Most of the available studies had methodological shortcomings and high applicability concerns. At the moment, certain voxel-based and surface-based superimpositions seem to work properly and to be superior to landmark-based superimposition. However, further research in the field is required to develop and properly validate these techniques on different samples, through high quality studies with low applicability concerns.
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Affiliation(s)
- Daniel Dinh-Phuc Mai
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Sven Stucki
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
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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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Vandekerckhove D, Deibel D, Vinayahalingam S, Claeys G, Kwon TG, Bergé S, Xi T. Median Lingual Foramen, a new midmandibular cephalometric landmark. Orthod Craniofac Res 2020; 23:357-361. [PMID: 32096318 PMCID: PMC7496480 DOI: 10.1111/ocr.12372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/03/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Abstract
Purpose In asymmetrical mandibles, it is often challenging to identify the mandibular midline. The median lingual foramen (MLF) is located at the midline of the anterior mandible. The purpose of this study is to evaluate the reproducibility of identifying the MLF compared to conventional landmarks on cone beam computed tomography's (CBCT's) to mark the mandibular midline. Material and Methods Ten symmetrical class II, 10 symmetrical class III, ten asymmetrical class II and 10 asymmetrical class III patients were included. On CBCTs, the cephalometric landmarks menton, pogonion, genial tubercle and MLF were identified twice by two observers. Results A high intra‐ and interobserver reproducibility was found for all landmarks, the highest being the MLF. The gain in accuracy is 0.998 mm, 0.824 mm and 0.361 mm compared to pogonion, genial tubercle and menton, respectively (P‐value <.05). Conclusion MLF is a reliable and reproducible landmark to indicate the midline of the mandible, particularly in Class II asymmetric mandibles.
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Affiliation(s)
- David Vandekerckhove
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Dionne Deibel
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Gilles Claeys
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tae-Geon Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Kwon SM, Hwang JJ, Jung YH, Cho BH, Lee KJ, Hwang CJ, Choi SH. Similarity index for intuitive assessment of three-dimensional facial asymmetry. Sci Rep 2019; 9:10959. [PMID: 31358850 PMCID: PMC6662710 DOI: 10.1038/s41598-019-47477-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 07/18/2019] [Indexed: 12/21/2022] Open
Abstract
Evaluation of facial asymmetry generally involves landmark-based analyses that cannot intuitively assess differences in three-dimensional (3D) stereoscopic structures between deviation and non-deviation sides. This study tested a newly developed similarity index that uses a mirroring technique to intuitively evaluate 3D mandibular asymmetry, and characterised the resulting lower facial soft tissue asymmetry. The similarity index was used to evaluate asymmetry before and after surgery in 46 adult patients (27 men, 19 women; age, 22 ± 4.8 years) with skeletal Class III malocclusion and facial asymmetry who underwent conventional bimaxillary orthognathic surgery. Relative to the midsagittal plane used as the reference plane, the non-overlapping volume of the mandible significantly decreased, and the similarity index significantly increased after surgery. Similarity indexes of the mandible and lower facial soft tissue were strongly negatively correlated with non-overlapping volumes of each measurement. Differences in bilateral hemi-mandibular and hemi-lower facial soft tissue surface and volume measurements before surgery were significantly negatively correlated with similarity indexes of the mandible before and after surgery. This newly developed similarity index and non-overlapping volume using a mirroring technique can easily and intuitively evaluate overall 3D morphological discrepancies, especially 3D mandibular asymmetry, before and after surgery in skeletal Class III patients with facial asymmetry.
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Affiliation(s)
- Sun Mi Kwon
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jae Joon Hwang
- Department of Oral and Maxillofacial Radiology, Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Yun-Hoa Jung
- Department of Oral and Maxillofacial Radiology, Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Leonardi R, Muraglie S, Bennici O, Cavallini C, Spampinato C. Three-dimensional analysis of mandibular functional units in adult patients with unilateral posterior crossbite: A cone beam study with the use of mirroring and surface-to-surface matching techniques. Angle Orthod 2019; 89:590-596. [PMID: 31013132 DOI: 10.2319/081718-607.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To use three-dimensional (3D) mirroring and surface-to-surface techniques to determine any differences in mandibular functional unit shape and morphology between the crossbite side and non-crossbite side in adult patients with posterior unilateral crossbite who had not received any corrective treatment for malocclusion. MATERIALS AND METHODS Cone-beam computed tomography (CBCT) records from 24 consecutive adult white patients (mean age, 27.5 years; range 22.6-39.7 years; 14 women and 10 men) seeking treatment for maxillary transverse deficiency were assessed in this study. The control group comprised CBCT scans from age- and sex-matched patients. Segmentation masks were generated to obtain 3D surface mesh models of the mandibles and analyze the six skeletal functional units, which were further analyzed with reverse engineering software. RESULTS Statistically significant differences in the mean surface distance when comparing the study sample and the control sample were found at the condylar process, mandibular ramus, angular process (P ≤ .0001), and alveolar process (P ≤ .01); no statistically significant differences were found for the coronoid process, the chin, and the mandibular body (P ≥ .5). CONCLUSIONS The condylar, angular, and alveolar processes plus the mandibular ramus appear to play a more dominant role than did the body, the coronoid, and the chin units in the asymmetry of the mandible in patients with unilateral crossbite.
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Stamatakis HC, Steegman R, Dusseldorp J, Ren Y. Head positioning in a cone beam computed tomography unit and the effect on accuracy of the three-dimensional surface mode. Eur J Oral Sci 2018; 127:72-80. [DOI: 10.1111/eos.12582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Harry C. Stamatakis
- Department of Orthodontics; University of Groningen; University Medical Centre Groningen; Groningen the Netherlands
| | - Ralph Steegman
- Department of Orthodontics; University of Groningen; University Medical Centre Groningen; Groningen the Netherlands
| | - Joost Dusseldorp
- Department of Orthodontics; University of Groningen; University Medical Centre Groningen; Groningen the Netherlands
| | - Yijin Ren
- Department of Orthodontics, W. J. Kolff Institute of Biomedical Engineering and Materials Science; University of Groningen; University Medical Centre Groningen; Groningen the Netherlands
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Three-dimensional evaluation of mandibular asymmetry: a new classification and three-dimensional cephalometric analysis. Int J Oral Maxillofac Surg 2018; 47:1043-1051. [DOI: 10.1016/j.ijom.2018.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 02/01/2018] [Accepted: 03/20/2018] [Indexed: 11/21/2022]
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15
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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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16
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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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Plane-to-plane analysis of mandibular misalignment in patients with facial asymmetry. Am J Orthod Dentofacial Orthop 2018; 153:70-80. [DOI: 10.1016/j.ajodo.2017.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/19/2022]
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18
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Martini M, Klausing A, Messing-Jünger M, Lüchters G. The self-defining axis of symmetry: A new method to determine optimal symmetry and its application and limitation in craniofacial surgery. J Craniomaxillofac Surg 2017; 45:1558-1565. [DOI: 10.1016/j.jcms.2017.06.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/01/2017] [Accepted: 06/27/2017] [Indexed: 11/17/2022] Open
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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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Junqueira CHZ, Janson G, Junqueira MHZ, Mendes LM, Favilla EE, Garib DG. Comparison between full face and hemifacial CBCT cephalograms in clinically symmetrical patients: a pilot study. Dental Press J Orthod 2016; 20:83-9. [PMID: 25992992 PMCID: PMC4445230 DOI: 10.1590/2176-9451.20.2.083-089.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/02/2014] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: One of the advantages of cone-beam computed tomography (CBCT) is the possibility
of obtaining images of conventional lateral cephalograms derived from partial or
complete reconstruction of facial images. OBJECTIVE: This study aimed at comparing full face, right and left hemifacial CBCT
cephalograms of orthodontic patients without clinical facial asymmetry. METHODS: The sample comprised nine clinically symmetrical patients who had pretreament
full face CBCT. The CBCTs were reconstructed so as to obtain full face, right and
left hemifacial cephalograms. Two observers, at two different times, obtained
linear and angular measurements for the images using Dolphin 3D software.
Dependent and independent t-tests were used to assess the reproducibility of
measurements. Analysis of Variance and Kruskal-Wallis tests were used to compare
the variables obtained in the CBCT derived cephalometric views. RESULTS: There was good reproducibility for CBCT scans and no statistically significant
differences between measurements of full face, right and left hemifacial CBCT
scans. CONCLUSIONS: Cephalometric measurements in full face, right and left hemifacial CBCT scans in
clinically symmetrical patients are similar.
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Affiliation(s)
| | - Guilherme Janson
- Department of Orthodontics, College of Dentistry, Universidade de São Paulo, Bauru, São Paulo, Brazil
| | | | | | | | - Daniela Gamba Garib
- Department of Orthodontics, College of Dentistry, Universidade de São Paulo, Bauru, São Paulo, Brazil
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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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Fang JJ, Tu YH, Wong TY, Liu JK, Zhang YX, Leong IF, Chen KC. Evaluation of mandibular contour in patients with significant facial asymmetry. Int J Oral Maxillofac Surg 2016; 45:922-31. [DOI: 10.1016/j.ijom.2016.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 12/22/2015] [Accepted: 02/15/2016] [Indexed: 11/29/2022]
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Soft tissue coverage on the segmentation accuracy of the 3D surface-rendered model from cone-beam CT. Clin Oral Investig 2016; 21:921-930. [PMID: 27206862 PMCID: PMC5360826 DOI: 10.1007/s00784-016-1844-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 05/02/2016] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of this study is to investigate the effect of soft tissue presence on the segmentation accuracy of the 3D hard tissue models from cone-beam computed tomography (CBCT). MATERIALS AND METHODS Seven pairs of CBCT Digital Imaging and Communication in Medicine (DICOM) datasets, containing data of human cadaver heads and their respective dry skulls, were used. The effect of the soft tissue presence on the accuracy of the segmented models was evaluated by performing linear and angular measurements and by superimposition and color mapping of the surface discrepancies after splitting the mandible and maxillo-facial complex in the midsagittal plane. RESULTS The linear and angular measurements showed significant differences for the more posterior transversal measurements on the mandible (p < 0.01). By splitting and superimposing the maxillo-facial complex, the mean root-mean-square error (RMSE) as a measurement of inaccuracy decreased insignificantly from 0.936 to 0.922 mm (p > 0.05). The RMSE value for the mandible, however, significantly decreased from 1.240 to 0.981 mm after splitting (p < 0.01). CONCLUSIONS The soft tissue presence seems to affect the accuracy of the 3D hard tissue model obtained from a cone-beam CT, below a generally accepted level of clinical significance of 1 mm. However, this level of accuracy may not meet the requirement for applications where high precision is paramount. CLINICAL RELEVANCE Accuracy of CBCT-based 3D surface-rendered models, especially of the hard tissues, are crucial in several dental and medical applications, such as implant planning and virtual surgical planning on patients undergoing orthognathic and navigational surgeries. When used in applications where high precision is paramount, the effect of soft tissue presence should be taken into consideration during the segmentation process.
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Gkantidis N, Schauseil M, Pazera P, Zorkun B, Katsaros C, Ludwig B. Evaluation of 3-dimensional superimposition techniques on various skeletal structures of the head using surface models. PLoS One 2015; 10:e0118810. [PMID: 25706151 PMCID: PMC4338241 DOI: 10.1371/journal.pone.0118810] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 01/11/2015] [Indexed: 12/01/2022] Open
Abstract
Objectives To test the applicability, accuracy, precision, and reproducibility of various 3D superimposition techniques for radiographic data, transformed to triangulated surface data. Methods Five superimposition techniques (3P: three-point registration; AC: anterior cranial base; AC + F: anterior cranial base + foramen magnum; BZ: both zygomatic arches; 1Z: one zygomatic arch) were tested using eight pairs of pre-existing CT data (pre- and post-treatment). These were obtained from non-growing orthodontic patients treated with rapid maxillary expansion. All datasets were superimposed by three operators independently, who repeated the whole procedure one month later. Accuracy was assessed by the distance (D) between superimposed datasets on three form-stable anatomical areas, located on the anterior cranial base and the foramen magnum. Precision and reproducibility were assessed using the distances between models at four specific landmarks. Non parametric multivariate models and Bland-Altman difference plots were used for analyses. Results There was no difference among operators or between time points on the accuracy of each superimposition technique (p>0.05). The AC + F technique was the most accurate (D<0.17 mm), as expected, followed by AC and BZ superimpositions that presented similar level of accuracy (D<0.5 mm). 3P and 1Z were the least accurate superimpositions (0.79<D<1.76 mm, p<0.005). Although there was no difference among operators or between time points on the precision of each superimposition technique (p>0.05), the detected structural changes differed significantly between different techniques (p<0.05). Bland-Altman difference plots showed that BZ superimposition was comparable to AC, though it presented slightly higher random error. Conclusions Superimposition of 3D datasets using surface models created from voxel data can provide accurate, precise, and reproducible results, offering also high efficiency and increased post-processing capabilities. In the present study population, the BZ superimposition was comparable to AC, with the added advantage of being applicable to scans with a smaller field of view.
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Affiliation(s)
- Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
- * E-mail:
| | | | - Pawel Pazera
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Berna Zorkun
- Department of Orthodontics, Cumhuriyet University, Sivas, Turkey
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Björn Ludwig
- Private orthodontic office, Traben-Trarbach, Germany
- Department of Orthodontics, University of Saarland, Homburg/Saar, Germany
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Sanders DA, Chandhoke TK, Uribe FA, Rigali PH, Nanda R. Quantification of skeletal asymmetries in normal adolescents: cone-beam computed tomography analysis. Prog Orthod 2014; 15:26. [PMID: 24935152 PMCID: PMC4047766 DOI: 10.1186/s40510-014-0026-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 01/16/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The detection and quantification of skeletal asymmetries is a fundamental component to diagnosis and treatment planning in orthodontics. The purpose of this study was to identify and quantify the characteristics of facial and dental asymmetries in a normal, adolescent population using 3D imaging. METHODS Thirty consecutive Class I patients (mean age 14.32 years, SD 1.67) meeting the inclusion criteria were analyzed by three-dimensional cone-beam computed tomography (CBCT). Dental, maxillary, mandibular, and cranial base variables were measured with Dolphin 3D. CBCT analysis consisted of the localization of 34 anatomical landmarks. All reference points were digitized in 3D and analyzed using 67 skeletal and dental measurements. Student's t tests for paired samples were used with a significance level of p < 0.05. RESULTS Minor right-left discrepancies were noted in all planes. The most anterior point of the glenoid fossa and most condylar points were positioned more superior and lateral on the right side, compared to the left side. Porion was also located more superiorly on the right side relative to the left side. The posterior nasal spine was found to be located to the right of the midsagittal plane. Slight dental midline discrepancies were found, and the dental arch lengths were slightly longer on the left side compared to the right. The height of the ramus, in both 3D and 2D, and the inclination of the ramus were greater on the right than that on the left side. CONCLUSIONS The findings of this study suggest minor asymmetries exist and are likely a common occurrence in the normal human craniofacial complex. Additionally, a natural compensatory mechanism may exist which controls the size and shape of specific tissues in order to maintain functional symmetry.
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Affiliation(s)
| | - Taranpreet K Chandhoke
- Division of Orthodontics, Department of Craniofacial Sciences, University of Connecticut, School of Dental Medicine, 263 Farmington Avenue, Farmington CT 06030, USA.
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Murdoch-Kinch CA. Craniofacial Anomalies. Oral Radiol 2014. [DOI: 10.1016/b978-0-323-09633-1.00032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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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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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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Makdissi J. L’utilisation du conebeam en orthodontie : la situation actuelle. Int Orthod 2013. [DOI: 10.1016/j.ortho.2012.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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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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Almăşan OC, Băciuţ M, Hedeşiu M, Bran S, Almăşan H, Băciuţ G. Posteroanterior cephalometric changes in subjects with temporomandibular joint disorders. Dentomaxillofac Radiol 2012; 42:20120039. [PMID: 23253565 DOI: 10.1259/dmfr.20120039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of the study was to establish the changes in posteroanterior cephalometric variables in subjects with temporomandibular joint disorders (TMDs). METHODS Posteroanterior cephalograms of 61 subjects (age range 16-36.6 years, standard deviation 4.88 years) were used to determine cephalometric differences. Subjects were classified according to the Research Diagnostic Criteria for Temporomandibular Joint Disorders into three groups: unilateral TMD, bilateral TMD and no TMD. 14 linear and angular measurements were assessed on the posteroanterior cephalogram. For assessing facial asymmetry, the asymmetry index for bilateral measurements was calculated between the right and the left side. In cases with unilateral TMD, the asymmetry index was calculated using the difference between the unaffected and affected side. The differences among multiple groups were analysed using the one-way analysis of variance test and Scheffé post hoc test. RESULTS 47 subjects were females (77%) and 14 were males (23%). 19 subjects had unilateral TMDs and 16 subjects had bilateral TMDs. The asymmetry index of the distance from the horizontal plane to the antegonion was higher in subjects with unilateral TMD than in patients with bilateral or no TMD (p < 0.05). Also, the asymmetry index of the distances from the vertical plane to the condyle (p = 0.05), gonion (Go) (p = 0.0004), antegonion (p = 0.002) and chin (Ch) (p = 0.02) was higher in subjects with unilateral TMDs. The asymmetry index of the O point-Go-Go' and O point-Ch-Ch' angles differed significantly in subjects with unilateral TMDs (p < 0.05). CONCLUSIONS Unilateral TMDs are associated with changes in posteroanterior cephalometric measurements. The assessment of posteroanterior cephalometric variables could be used as a key factor for evaluating the presence of TMDs.
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Affiliation(s)
- O C Almăşan
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
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Yan G, Sugita Y, Wang X, Takayama M, Jinno M, Nakano K, Kawakami T, Yang M, Lu L. The Value of 3-Dimensional Computed Tomography for Jaws Osteotomies. J HARD TISSUE BIOL 2012. [DOI: 10.2485/jhtb.21.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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