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Yelken Kendirci M, Ertürk AF, Özcan I, Kendirci AŞ, Akgül T. The role of scoliosis on temporomandibular joint disease: a cross-sectional study based on ultrasonography. Clin Radiol 2024; 79:e417-e423. [PMID: 38143227 DOI: 10.1016/j.crad.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/05/2023] [Accepted: 11/19/2023] [Indexed: 12/26/2023]
Abstract
AIM To investigate the relationship between temporomandibular disorders (TMD) and the stomatognathic system and spine through a multidisciplinary approach, utilising ultrasound to assess the temporomandibular joint. MATERIALS AND METHODS Between October 2020 and January 2021, 50 patients aged 12-18 years with adolescent idiopathic scoliosis and 50 healthy individuals were enrolled. All participants underwent clinical examinations based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. Additionally, ultrasound evaluations were performed of the temporomandibular joint and masseter muscles. Subsequently, the data from both groups were compared and analysed. RESULTS The mean age of participants was 14.69 ± 2.73 years in the scoliosis group (SG) and 14.68 ± 1.81 years in the control group (CG). Among scoliosis patients, a moderate negative correlation was observed between the Cobb angle (indicative of curvature severity) and mouth opening (p=0.023; r=-0.320). Furthermore, the incidence of TMD was significantly higher in the scoliosis group compared to the control group (p<0.001). Additionally, it was found that a 1-unit increase in joint space elastography value led to a 4.81-fold higher likelihood of diagnosing disc displacement with reduction (p=0.009; 95% CI: 1.47-15.73). CONCLUSION This pioneering study, the first of its kind to explore the connection between scoliosis and ultrasound-based temporomandibular joint screening, suggests that scoliosis may be a predisposing factor for TMD. Moreover, the present findings underscore the importance of joint elastography as a valuable quantitative tool in TMD diagnosis.
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Affiliation(s)
- M Yelken Kendirci
- Biruni University Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, İstanbul, Turkey.
| | - A F Ertürk
- Biruni University Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, İstanbul, Turkey
| | - I Özcan
- Biruni University Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, İstanbul, Turkey
| | - A Ş Kendirci
- Istanbul University, Istanbul Medical Faculty, Orthopaedics and Traumatology Department, İstanbul, Turkey
| | - T Akgül
- Istanbul University, Istanbul Medical Faculty, Orthopaedics and Traumatology Department, İstanbul, Turkey
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Loewe C, Pflaum J, Wanke EM, Erbe C, Holzgreve F, Groneberg DA, Ohlendorf D. Association between constitution, axiography, orthodontic cast analysis, and upper body posture in women aged 31 to 40 years. Clin Oral Investig 2023:10.1007/s00784-023-05030-1. [PMID: 37126145 DOI: 10.1007/s00784-023-05030-1] [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: 01/24/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Whether it is primarily the spine that reacts with pain to the negative consequences of everyday stress and possibly the temporomandibular system as a result (ascending chain), or whether incorrect stress in the dental area has an influence on body geometry (descending chain), is still a controversially discussed topic. The aim of this study is to investigate possible relationships between constitutional, axiographic, and dental parameters with upper body posture. MATERIAL AND METHODS A total of 106 subjectively healthy women between 31 and 40 years of age voluntarily participated in this study. Data collection was done by filling out a questionnaire with constitutional and anamnestic parameters and by evaluating orthodontic casts, axiographic measurements, and video raster stereographic measurements. These data were analyzed using correlations and group comparisons, with the significance level set at p ≤ 0.05. RESULTS Positive correlations were shown between the constitutional factors of body weight and BMI and the lumbar bending angle (p = 0.01), the kyphosis angle (p = 0.001), and lordosis angle (weight p = 0.05; BMI p = 0.03). In the cast analysis, regardless of the direction of the midline shift (left/right/none), a left lateral tilt can be seen which is greatest at 2.12° with a left midline shift. In addition, the elevated pelvic side correlates with the side of the displacement of the jaw, with the stronger manifestation being on the left side. With a vertical anterior bite in the normal range, the kyphosis angle is 48.09°, while with a deep bite, it is 60.92°, and with an open bite, it is 62.47°; thus, the group in the normal range differs significantly (p = 0.01) from the other two. The greater the protrusion, the smaller the sagittal plane angles (kyphosis angle, lumbar bending angle, each p = 0.03), and the more dorsal the posture (p = 0.04). The lordosis angle differs significantly (p = 0.001) between the group of subjects with a protrusion in the normal range (52.34°) and the group with an increased advancement of the mandible (41.79°). CONCLUSION There is a correlation between body weight, BMI, midline shift, and protrusion, as well as the vertical anterior step and upper body posture in women between 31 and 40 years of age. Interdisciplinary functional examinations of the temporomandibular musculature, and also sustained orthodontic treatment, can contribute to an improvement in upper body posture.
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Affiliation(s)
- C Loewe
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt Am Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt Am Main, Germany
| | - J Pflaum
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt Am Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt Am Main, Germany
| | - E M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt Am Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt Am Main, Germany
| | - C Erbe
- Department of Orthodontics, School of Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - F Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt Am Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt Am Main, Germany
| | - D A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt Am Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt Am Main, Germany
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt Am Main, Theodor-Stern-Kai 7, Building 9A, 60590, Frankfurt Am Main, Germany.
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Arai S, Kato C, Watari I, Ono T. Does Orthodontic Treatment Change the Preferred Chewing Side of Patients with Malocclusion? J Clin Med 2022; 11:jcm11216343. [PMID: 36362571 PMCID: PMC9657436 DOI: 10.3390/jcm11216343] [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: 09/28/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 11/29/2022] Open
Abstract
Whether orthodontic treatment can change the preferred chewing side (PCS) is unknown. This study examined (1) if the PCS changes after orthodontic treatment and (2) which factors contribute to this change. Two hundred fifty patients who visited the orthodontic clinic at Tokyo Medical and Dental University Hospital between 2017 and 2020 were included in the study. Mandibular kinesiograph (MKG) was taken at pre- and post-treatment, and PCS was determined. Patients who showed a change in PCS to the opposite side and those who showed no change in PCS at post-treatment were pooled into the PCS-changed and PCS-unchanged groups, respectively. The demographic, clinical, and cephalometric parameters were compared between the groups. Significant factors associated with changes in were of age < 20 years at the beginning of orthodontic treatment (odds ratio (OR), 2.00), maximum lateral mandibular movement to PCS ≥ 10.0 mm at pre-treatment (OR, 6.51), and change in occlusal canting of ≥1.0° (OR, 2.72). The predicted probability of change in PCS was 13.2%, 36.0%, and 67.5% for no factor, one factor, and two factors associated with PCS change, respectively. Orthodontic treatment may change PCS due to patient age, maximum lateral mandibular movement to PCS, and change in occlusal canting.
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Zhang H, Ma J, Zhang Z, Feng Y, Cai C, Wang C. Occlusal deviations in adolescents with idiopathic and congenital scoliosis. Korean J Orthod 2022; 52:165-171. [PMID: 35535016 PMCID: PMC9117788 DOI: 10.4041/kjod21.259] [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: 10/14/2021] [Revised: 01/01/2022] [Accepted: 01/05/2022] [Indexed: 11/10/2022] Open
Abstract
Objective This cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations. Methods Fifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test. Results In comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients. Conclusions Patients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.
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Affiliation(s)
- Hao Zhang
- State Key Laboratory of Military Stomatology National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Jingbo Ma
- Department of Thoracic Surgery, The Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Zhicheng Zhang
- Department of Orthopedics, The Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Yafei Feng
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chuan Cai
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Chao Wang
- Department of Stomatology, The Seventh Medical Center of PLA General Hospital, Beijing, China
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Wen JX, Yang HH, Han SM, Cao L, Wu HZ, Yang C, Li H, Chen LL, Li NN, Yu BH, Gao BL, Wu WJ. Trunk balance, head posture and plantar pressure in adolescent idiopathic scoliosis. Front Pediatr 2022; 10:979816. [PMID: 36340704 PMCID: PMC9627203 DOI: 10.3389/fped.2022.979816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/26/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The relationship of trunk balance with head posture and plantar pressure is unknown in patients with adolescent idiopathic scoliosis (AIS). OBJECTIVE To investigate the relationship of trunk balance with head posture and plantar pressure by analyzing the imaging data of patients with AIS. MATERIALS AND METHODS This retrospective study was performed on 80 AIS patients who had whole spine frontal and lateral radiographs, and the imaging parameters were measured and analyzed. RESULTS The coronal trunk imbalance rate was 67.5%, the trunk offset direction was towards left in 65 cases and right in 15 cases, and the head offset direction was towards left in 66 cases and right in 14 cases. The sagittal trunk imbalance rate was 57.25%. The distance of apical vertebrae and head offset in the coronal trunk balance group was significantly (P < 0.05) smaller than that in the imbalance group. The apical vertebrae offset distance and head offset distance were positively correlated with the tilt angle of trunk (r = 0.484 and 0.642, respectively, P < 0.05). The difference in the percentage of pressure load on the left and right foot was significantly (P < 0.05) greater in the coronal imbalance group than that in the balance group.The center of pressure (COP) sway area was significantly (P < 0.05) larger in the overall trunk imbalance group (both coronal and sagittal imbalance) than in the balanced group. CONCLUSION Most AIS patients have trunk imbalance which is severer on the coronal than on the sagittal plane. AIS patients with trunk imbalance show more significant local deformities, greater head offset, greater COP sway area, and decreased head and standing stability.
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Affiliation(s)
- Jin-Xu Wen
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Hui-Hui Yang
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Shu-Man Han
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Lei Cao
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Hui-Zhao Wu
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Chen Yang
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Han Li
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Lin-Lin Chen
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Nuan-Nuan Li
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Bao-Hai Yu
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Bu-Lang Gao
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Wen-Juan Wu
- Department of Radiology, Third Hospital of Hebei Medical University Shijiazhuang, China
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Bilateral Sagittal Split Mandibular Ramus Osteotomy Alters the Temporomandibular Joint. J Craniofac Surg 2021; 32:e598-e600. [PMID: 34387266 DOI: 10.1097/scs.0000000000007898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT In this retrospective analysis, we examined temporomandibular joint space volume and condyle position in 10 patients undergoing bilateral sagittal split mandibular ramus osteotomy plus Le Fort I osteotomy to correct mandibular asymmetry. Cone beam computed tomography was used to map temporomandibular joint prior to (T0), immediately after (T1), and at 1 year after surgery (T2). In the deviated side, we detected significant lateral shift of the condyle in 5 patients at T1, and the shift disappeared at T2. In the non-deviated side, we detected significant medial shift of the condyle in all 10 patients at T1; the shift continued in 9 patients at T2. Temporomandibular joint space volume increased significantly at T1 and returned to presurgical volume at T2. In conclusion, there is significant shift in position of condyle in majority of the patients after bilateral sagittal split mandibular ramus osteotomy. The most consistent and persisting change was medial shift on the nondeviated side.
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Kerbrat A, Schouman T, Decressain D, Rouch P, Attali V. Interaction between posture and maxillomandibular deformity: a systematic review. Int J Oral Maxillofac Surg 2021; 51:104-112. [PMID: 34120792 DOI: 10.1016/j.ijom.2021.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/05/2021] [Accepted: 05/07/2021] [Indexed: 11/24/2022]
Abstract
Maxillomandibular deformity (MMD) and body posture appear to be correlated. However, no systematic literature review of the available evidence to support this correlation has been performed to date. The aim of this study was to conduct a systematic literature review on posture and MMD. This systematic literature review was registered in the PROSPERO database. Systematic searches of the MEDLINE, Scopus, Cochrane Library, and Web of Science databases were performed. In total, 13 clinical studies were included. Nine found a significant association between MMD and body posture or body balance: two studies showed a correlation between increased cervical lordosis and skeletal class III MMD, two studies showed an interaction between mandibular deviation and scoliosis, four studies demonstrated a significant association between lumbar column and pelvis anatomy and MMD, and one study found a correlation between displacement of the centre of mass and MMD. However, the level of evidence is low; the methods used to evaluate body posture and MMD were inconsistent. Orthognathic surgery could modify body posture. Although there seems to be an interaction between body posture and facial deformity, the number of studies is too small and the level of evidence too low to strongly support this association.
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Affiliation(s)
- A Kerbrat
- Service de Chirurgie Maxillo-Faciale, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France; Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France.
| | - T Schouman
- Service de Chirurgie Maxillo-Faciale, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France; Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - D Decressain
- Service de Chirurgie Maxillo-Faciale, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - P Rouch
- Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - V Attali
- Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France; Groupe Hospitalier Universitaire APHP - Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
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Sofyanti E, Auerkari EI, Boel T, Soegiharto BM. Vertical Mandibular and Trunk Symmetry in Indonesian Orthodontic Patients. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sofyanti E, Boel T, Sihombing ARN. The correlation between back posture and sagittal jaw position in adult orthodontic patients. J Taibah Univ Med Sci 2020; 16:63-69. [PMID: 33603633 PMCID: PMC7858012 DOI: 10.1016/j.jtumed.2020.10.009] [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: 07/17/2020] [Revised: 10/07/2020] [Accepted: 10/11/2020] [Indexed: 11/29/2022] Open
Abstract
Objective A debate remains in evidence-based medicine about the reciprocal interchange between dental occlusion and body postural therapy. Back posture deformity has been found to be related to trunk asymmetry as one characteristic of scoliosis that is commonly reported in occlusal development issue. This study aims to determine the correlation between back posture and sagittal jaw position in adult orthodontic patients treated at the dental hospital of Universitas Sumatera Utara. Methods This observational study was conducted on orthodontic patients who had routine orthodontic control between October 2019 and February 2020. The sagittal jaw relationship on pre-treatment cephalometry lateral-based on Steiner analysis was done with OrthoVision software. The back posture that related to cervical, thoracic, and lumbar measurement was performed using scoliometer plastic economy (Baseline®). Results From 128 patients, aged between 18 and 30 years, we found 72 patients with Class I, 41 patients with Class II, and 15 patients with Class III skeletal malocclusion. There were no significant differences of trunk asymmetry based on sagittal jaw relationship (p = 0.651). Additionally, there was no significant correlation between back posture and sagittal jaw position in Class II and Class III patients (r = 0.112, p > 0.05). Conclusion In this study, the sagittal jaw relationship had poor correlation to back posture in orthodontic adult patients due to a compensatory mechanism. The presence of temporomandibular dysfunction, sella-nasion-B point, and head posture are specific variables in a particular dento-skeletal type that should be considered in further studies.
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Affiliation(s)
- Ervina Sofyanti
- Department of Orthodontics, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia
| | - Trelia Boel
- Department of Dentomaxillofacial and Radiography, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia
| | - Anrice R N Sihombing
- Orthodontics Specialist Program, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia
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Lin H, He Y, Feng Y, Huang F. Comparison of condylar morphology changes and position stability following unilateral and bilateral sagittal split mandibular ramus osteotomy in patients with mandibular prognathism. Head Face Med 2019; 15:18. [PMID: 31296246 PMCID: PMC6622001 DOI: 10.1186/s13005-019-0202-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 07/01/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Unilateral sagittal split ramus osteotomy (USSRO) is not widely used given the postoperative instability caused by the inevitable rotation of the mandibular segment during surgery. However, the influence of mandibular movement on the condylar morphology and position stability has not been completely explored. The aim of the study was to quantitatively evaluate the effect of USSRO on the condylar surface morphology changes and postoperative stability in patients with mandibular lateral prognathism and compare these findings with the classic bilateral sagittal split ramus osteotomy (BSSRO). PATIENTS/METHODS This was a retrospective study involving 134 patients with mandibular lateral prognathism who received USSRO (n = 56) and BSSRO (n = 78) surgery. Here, cone beam computed tomography (CBCT) was performed before surgery (T0), immediately after surgery (T1), and 1 year postoperatively (T2). Differences of condylar sizes, condylar surface deviation, and mandibular positioning parameters (dental midline deviation, SNB, SN-MP) were calculated from T0 to T2. Comparisons were performed at the deviated side or nondeviated side of condyles between the USSRO and BSSRO groups. The relation between the dental midline deviation and condylar surface morphology changes from T0 to T2 were investigated. RESULTS Condylar surface morphology changes at the deviated side of temporomandibular joint (TMJ) before and 1 year after the surgery were significantly different between the USSRO and BSSRO groups. The dental midline deviation was related to the changes of condylar volume, surface size and surface deviation at the deviated side of TMJ in patients following USSRO. No significant difference was noted between the USSRO and BSSRO groups for postoperative condylar surface morphology changes at the nondeviated side. In both groups, significant differences between T0 and T1 and no significant difference between T1 and T2 were noted for all of the mandibular positioning parameters. CONCLUSIONS Both BSSRO and USSRO exhibit favorable postoperative stability in the correction of mandibular prognathism. After USSRO surgery, condylar surface changes occurred at the deviated side of the TMJ, and the dental midline deviation was closely related to the changes of condylar surface morphology. USSRO represents a stable alternative for minor asymmetric mandibular prognathism correction with the advantages of reduced operating time and surgical trauma.
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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
| | - Yifan He
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yifan Feng
- Department of Prothodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Fang Huang
- Department of Paediatric Dentistry, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Fang Huang, No.56 Lingyuan Xi Road, Guangzhou, Guangdong Province, People's Republic of China, 510055.
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Primozic J, Perinetti G, Zhurov A, Richmond S, Ovsenik M, Antolic V, Primozic J. Three-dimensional assessment of back symmetry in subjects with unilateral functional crossbite during the pre-pubertal growth phase: a controlled study. Eur J Orthod 2019; 41:250-257. [PMID: 30102316 DOI: 10.1093/ejo/cjy053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND/OBJECTIVES Since a high prevalence of back anomalies has been reported among subjects with crossbite, the aim was to assess the degree of back symmetry among subjects with (crossbite) and without (control) unilateral functional crossbite during the pre-pubertal growth phase. METHODS A group of 70 subjects (36 boys, 34 girls; 6.8 ± 1.2 years) in the primary or mixed dentition phase were included. Clinical assessment of head posture, shoulder, scapula and hip height were performed with the subject standing, and differences between the left and right side greater than 5 mm recorded. Asymmetry of the scapula and trunk prominence greater than 8 mm was recorded along with the prominence of thoracic and lumbar paravertebral musculature during the forward-bending test. Back symmetry was assessed qualitatively and quantitatively on colour deviation maps of superimposed mirrored three-dimensional back scans at a tolerance level of 2 mm. RESULTS No significant differences were observed between the groups regarding the frequency of clinically assessed back anomalies. The percentage of back symmetry was slightly lower in the crossbite than that in the control group (71.4 ± 13.3% and 79.2 ± 12.1%, respectively). A significant association (P < 0.05) was seen between scapula plane inclination (OR = 3.41) and scapula prominence inequalities (OR = 3.29) and unilateral functional crossbite, while hip height inequalities (OR = 0.94) were more frequent in the control group. No associations were detected between the side of crossbite and side of prominence of back parameters. LIMITATIONS The use of different thresholds for clinical (5-8 mm) and three-dimensional (2 mm) symmetry assessment. CONCLUSIONS Although some degree of back asymmetry was detected in the crossbite group during the pre-pubertal growth phase, this asymmetry does not appear to be clinically relevant.
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Yu M, Diao Y, Sun Y, Zhang F, Pan S, Chen X, Zhou F, Zhao Y, Xu N. Evaluation of a combined approach to the correction of congenital cervical or cervicothoracic scoliosis. Spine J 2019; 19:803-815. [PMID: 30447326 DOI: 10.1016/j.spinee.2018.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND CONTEXT An anteroposterior combined approach has been used for the treatment of congenital cervical or cervicothoracic scoliosis. However, its outcomes and surgical risks have not been clarified. PURPOSE We analyzed the characteristics of congenital cervical and cervicothoracic scoliosis and evaluated the outcomes of an anteroposterior combined approach for its treatment. STUDY DESIGN We carried out a retrospective clinical study of prospectively collected data. PATIENT SAMPLE Sixteen patients were treated between 2009 and 2013. Their average age was 9.2years. OUTCOME MEASURES Radiographic and surgical outcomes were measured and recorded. We compared morphological parameters and preoperative and postoperative results. METHODS All patients underwent surgery with a combined approach. The following radiographic parameters were measured: head tilt (HT), mandible incline (MI), shoulder balance (SB), structural and compensatory curves, cervical lordosis, C7 central sacral vertical line (C7-CSVL) ratio, C7 sagittal vertical axis (C7-SVA) ratio, C2-C7 SVA ratio, the angle between the upper endplate of the T2 vertebra and a horizontal line (T2 tilt), gravity line ratio. Demographic and surgical data were also collected. RESULTS On average, the duration of follow-up was 68.0 months, surgical blood loss was 675mL, and the duration of surgery was 400.5 minutes. The average correction rate was 64.9% in the structural curve and 29.5% in the compensatory curve. Statistical analysis showed that MI significantly correlated with HT and SB (p<.05). The C7-CSVL ratio correlated with the HT, MI, and SB (p<.05). The C7-SVA ratio correlated with the structural curve and cervical lordosis (p<.05), and the gravity line ratio correlated with the structural and compensatory curve, cervical lordosis, and C7-SVA ratio (p<.05). Moreover, there were correlations between the structural and compensatory curves as well as between the structural curve and cervical lordosis (p<.05). There were significant differences before and after surgery in HT, MI, and structural and compensatory curves. Four patients developed nerve root palsy after surgical correction and totally recovered by 6 months of follow-up. CONCLUSION The combined approach is an effective surgical option for congenital cervical or cervicothoracic scoliosis. The resection of the hemivertebra cannot only improve head-neck aesthetic appearance but can also maintain the growth potential of the neck.
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Affiliation(s)
- Miao Yu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Yinze Diao
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Yu Sun
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China.
| | - Fengshan Zhang
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Shengfa Pan
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Xin Chen
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Feifei Zhou
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Yanbin Zhao
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
| | - Nanfang Xu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing 100191, China
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Jaw asymmetry may cause bad posture of the head and the spine—A preliminary study. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2018. [DOI: 10.1016/j.ajoms.2018.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hitier M, Hamon M, Denise P, Lacoudre J, Thenint MA, Mallet JF, Moreau S, Quarck G. Lateral Semicircular Canal Asymmetry in Idiopathic Scoliosis: An Early Link between Biomechanical, Hormonal and Neurosensory Theories? PLoS One 2015; 10:e0131120. [PMID: 26186348 PMCID: PMC4506017 DOI: 10.1371/journal.pone.0131120] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 05/28/2015] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Despite its high incidence and severe morbidity, the physiopathogenesis of adolescent idiopathic scoliosis (AIS) is still unknown. Here, we looked for early anomalies in AIS which are likely to be the cause of spinal deformity and could also be targeted by early treatments. We focused on the vestibular system, which is suspected of acting in AIS pathogenesis and which exhibits an end organ with size and shape fixed before birth. We hypothesize that, in adolescents with idiopathic scoliosis, vestibular morphological anomalies were already present at birth and could possibly have caused other abnormalities. MATERIALS AND METHODS The vestibular organ of 18 adolescents with AIS and 9 controls were evaluated with MRI in a prospective case controlled study. We studied lateral semicircular canal orientation and the three semicircular canal positions relative to the midline. Lateral semicircular canal function was also evaluated by vestibulonystagmography after bithermal caloric stimulation. RESULTS The left lateral semicircular canal was more vertical and further from the midline in AIS (p = 0.01) and these two parameters were highly correlated (r = -0.6; p = 0.02). These morphological anomalies were associated with functional anomalies in AIS (lower excitability, higher canal paresis), but were not significantly different from controls (p>0.05). CONCLUSION Adolescents with idiopathic scoliosis exhibit morphological vestibular asymmetry, probably determined well before birth. Since the vestibular system influences the vestibulospinal pathway, the hypothalamus, and the cerebellum, this indicates that the vestibular system is a possible cause of later morphological, hormonal and neurosensory anomalies observed in AIS. Moreover, the simple lateral SCC MRI measurement demonstrated here could be used for early detection of AIS, selection of children for close follow-up, and initiation of preventive treatment before spinal deformity occurs.
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Affiliation(s)
- Martin Hitier
- Department of Otolaryngology—Head and Neck Surgery, CHU de Caen, Caen, F-14000, France
- Department of Anatomy, UNICAEN, Caen, 14032, France
- Department of Pharmacology and Toxicology; School of Medical Sciences and Brain Health Research Center, University of Otago, Dunedin, New Zealand
- U 1075 COMETE, INSERM, Caen, 14032, France
- * E-mail:
| | - Michèle Hamon
- Department of Neuroradiology, CHU de Caen, Caen, 14000, France
| | | | - Julien Lacoudre
- Department of Otolaryngology—Head and Neck Surgery, CHU de Caen, Caen, F-14000, France
| | | | | | - Sylvain Moreau
- Department of Otolaryngology—Head and Neck Surgery, CHU de Caen, Caen, F-14000, France
- Department of Anatomy, UNICAEN, Caen, 14032, France
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Mandibular asymmetry: a three-dimensional quantification of bilateral condyles. Head Face Med 2013; 9:42. [PMID: 24354862 PMCID: PMC3878129 DOI: 10.1186/1746-160x-9-42] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 12/17/2013] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The shape and volume of the condyle is considered to play an important role in the pathogenesis of the mandibular deviation. Curvature analysis is informative for objectively assess whether the shape of the condyles matches that of the glenoid fossa. In this study, a three-dimensional (3-D) quantification of bilateral asymmetrical condyles was firstly conducted to identify the specific role of 3-D condylar configuration for mandibular asymmetry. METHODS 55 adult patients, 26 males (26 ± 5 yrs) and 29 females (26 ± 5 yrs), diagnosed with mandibular asymmetry were included. The examination of deviation of chin point, deviation of dental midlines, inclination of occlusal plane, and depth of the mandibular occlusal plane were conducted. After the clinical investigation, computed tomography images from the patients were used to reconstruct the 3-D mandibular models. Then the condylar volume, surface size, surface curvature and bone mineral density were evaluated independently for each patient on non-deviated and deviated sides of temporomandibular joint. RESULTS Both the condylar surface size and volume were significantly larger on deviated side (surface size: 1666.14 ± 318.3 mm2, volume: 1981.5 ± 418.3 mm3). The anterior slope of the condyle was flatter (0.12 ± 0.06) and the posterior slope (0.39 ± 0.08) was prominently convex on the deviated side. The corresponding bone mineral density values were 523.01 ±118.1 HU and 549.07 ±120. 6 HU on anterior and posterior slopes. CONCLUSIONS The incongruence presented on the deviated side resulted in a reduction in contact areas and, thus, an increase in contact stresses and changes of bone density. All aforementioned results suggest that the difference existing between deviated and non-deviated condyles correlates with facial asymmetrical development. In mandibular asymmetry patients, the 3-D morphology of condyle on deviated side differ from the non-deviated side, which indicates the association between asymmetrical jaw function and joint remodeling.
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