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Dresner R, Mehta S, Upadhyay M, El-Bialy T, Kuo CL, Tadinada A, Yadav S. Positional, morphologic, and volumetric differences in TMJ in unilateral posterior crossbites and controls: A retrospective CBCT study. Int Orthod 2024; 22:100889. [PMID: 38833956 DOI: 10.1016/j.ortho.2024.100889] [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: 02/20/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate if there are any morphologic, positional, and volumetric differences in the temporomandibular joint (TMJ) of patients with unilateral posterior crossbite (UPC) compared to controls. Another objective was to analyse the discrepancy in the TMJ between the crossbite versus non-crossbite side in UPC versus right and left sides in controls. Additionally, this study aimed to evaluate the differences in the bone density at the masseteric insertion site at the angle of mandible in the UPC group and control group. MATERIAL AND METHODS One hundred and thirty-two CBCTs were analysed with 66 patients in UPC group and 66 patients in control group (non-crossbite). Temporomandibular joint spaces - Anterior joint space (AJS), Superior joint space (SJS), Posterior joint space (PJS), Medial joint space (MJS), Middle joint space (MiJS), and Lateral joint space (LJS) were measured. Additionally, bone density at angle of mandible and volume of mandibular condyle were evaluated. The measurements were compared between the groups as well as between the crossbite and non-crossbite sides within the UPC group and between right and left sides within the control group. Furthermore, the associations between UPC and changes in TMJ regarding joint space availability, bone density, condylar head volume, and the effects of sex and age were evaluated using regression analysis. RESULTS It was observed that UPC group showed a greater condylar volume, than the control group. Additionally, a larger mean discrepancy was observed between the crossbite side and non-crossbite side within the UPC group concerning condylar volume than controls. Concerning age, condylar volume was observed to be larger in adults than children. Adults showed significantly greater bone density and condylar volume than adolescents. Concerning sex, it was observed that males showed a larger SJS (right), MiJS, LJS, and bone density at the mandibular angle than females. CONCLUSION There is a difference in the TMJ parameters particularly condylar volume in patients with UPC compared to controls.
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Affiliation(s)
| | - Shivam Mehta
- Department of Orthodontics, Texas A&M University School of Dentistry Dallas, 75246 Texas, USA.
| | - Madhur Upadhyay
- Division of Orthodontics, Department of Craniofacial Sciences, Health Center Farmington, University of Connecticut, 06030 Connecticut, USA
| | - Tarek El-Bialy
- Division of Orthodontics, Department of Craniofacial Sciences, Faculty of Medicine and Dentistry, 7-020D Katz Group Centre for Pharmacy and Health Research, University of Alberta, T6G 2E1 Edmonton, Alberta, Canada
| | - Chia-Ling Kuo
- Department of Public Health Sciences, University of Connecticut, Health Center, CT 06030 Farmington, USA
| | - Aditya Tadinada
- Section of Oral and Maxillofacial Radiology, Department of Craniofacial SciencesUniversity of Connecticut, Health Center, CT 06030 Farmington, USA
| | - Sumit Yadav
- Henry and Anne Cech Orthodontic Foundation, UNMC College of Dentistry and Children's Hospital and Medical Center Lincoln, Omaha, NE, USA
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Karabiber G, Yılmaz HN. Three-dimensional evaluation of the temporomandibular joints after unilateral surgically assisted rapid maxillary expansion in adults: A preliminary retrospective study. J Oral Rehabil 2023; 50:1432-1438. [PMID: 37614097 DOI: 10.1111/joor.13576] [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: 11/24/2022] [Revised: 04/21/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Unilateral surgically assisted rapid maxillary expansion (U-SARME) is a successful method for correction of true unilateral posterior crossbite (TUPC). OBJECTIVES This retrospective preliminary study aimed to evaluate the position and morphology of condyles in TUPC cases and the effects of U-SARME on condyle with the help of cone beam computed tomography (CBCT). METHODS Fifteen patients (mean age: 18.69 ± 1.59 years) who were diagnosed as TUPC and undergone U-SARME were selected. Preoperative (T0) and after 6-month retention (T1) DICOM data of CBCT images were evaluated with MIMICs version 19.0 software. Condylar morphology (medio-lateral and antero-posterior dimensions) and position (anterior, posterior, medial and lateral joint spaces, frontal/axial axis angles, the ratio of posterior to anterior joint space and the percentage of posterior to anterior joint space) were evaluated. Student's t-test was used for intergroup (crossbite, normal) comparisons. Paired-samples t-test was used for intra-group comparisons (p = .05). RESULTS There were no positional or dimensional asymmetry of the condyles between crossbite and normal sides initially and after expansion. Regarding T0-T1 changes, while significant increase was determined in medial (0.3 ± 0.29 mm; p = .001) and superior (0.39 ± 0.7 mm; p = .045) joint spaces on crossbite side, posterior (0.79 ± 0.99 mm; p = .008), superior (0.5 ± 0.79 mm; p = .029) and lateral joint spaces (0.31 ± 0.54 mm; p = .042) presented significant increases on normal side. However, no significant changes were found between crossbite and normal sides at T0 and T1. CONCLUSIONS Condyles were symmetrical in true unilateral posterior crossbite cases and the symmetry were not disrupted following U-SARME.
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Affiliation(s)
- Gülden Karabiber
- Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Hanife Nuray Yılmaz
- Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Augdal TA, Angenete OW, Shi XQ, Säll M, Fischer JM, Nordal E, Rosendahl K. Cone beam computed tomography in the assessment of TMJ deformity in children with JIA: repeatability of a novel scoring system. BMC Oral Health 2023; 23:12. [PMID: 36627622 PMCID: PMC9830735 DOI: 10.1186/s12903-022-02701-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The temporomandibular joint (TMJ) is frequently involved in juvenile idiopathic arthritis (JIA). Diagnostic imaging is necessary to correctly diagnose and evaluate TMJ involvement, however, hitherto little has been published on the accuracy of the applied scoring systems and measurements. The present study aims to investigate the precision of 20 imaging features and five measurements based on cone beam computed tomography (CBCT). METHODS Imaging and clinical data from 84 participants in the Norwegian study on juvenile idiopathic arthritis, the NorJIA study, were collected. Altogether 20 imaging features and five measurements were evaluated independently by three experienced radiologists for intra- and interobserver agreement. Agreement of categorical variables was assessed by Fleiss', Cohen's simple or weighted Kappa as appropriate. Agreement of continuous variables was assessed with 95% limits of agreement as advised by Bland and Altman. RESULTS "Overall impression of TMJ deformity" showed almost perfect intraobserver agreement with a kappa coefficient of 0.81 (95% CI 0.69-0.92), and substantial interobserver agreement (Fleiss' kappa 0.70 (0.61-0.78)). Moreover, both "flattening" and "irregularities" of the eminence/fossa and condyle performed well, with intra- and interobserver agreements of 0.66-0.82 and 0.55-0.76, respectively. "Reduced condylar volume" and "continuity" of the fossa/eminence had moderate intra- and interobserver Kappa values, whereas continuity of the condyle had Kappa values above 0.55. Measurements of distances and angles had limits of agreement of more than 15% of the sample mean. CONCLUSIONS We propose a CBCT-based scoring system of nine precise imaging features suggestive of TMJ deformity in JIA. Their clinical validity must be tested.
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Affiliation(s)
- Thomas A. Augdal
- grid.412244.50000 0004 4689 5540Section of Paediatric Radiology, University Hospital of North Norway, Postboks 100, 9038 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oskar W. Angenete
- grid.52522.320000 0004 0627 3560Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Faculty of Medicine and Health Sciences, Institute for Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Xie-Qi Shi
- grid.7914.b0000 0004 1936 7443Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway ,grid.32995.340000 0000 9961 9487Department of Oral and Maxillofacial Radiology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Mats Säll
- grid.52522.320000 0004 0627 3560Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Johannes M. Fischer
- grid.7914.b0000 0004 1936 7443Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ellen Nordal
- grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.412244.50000 0004 4689 5540Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway
| | - Karen Rosendahl
- grid.412244.50000 0004 4689 5540Section of Paediatric Radiology, University Hospital of North Norway, Postboks 100, 9038 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Alsawaf DH, Almaasarani SG, Hajeer MY, Rajeh N. The effectiveness of the early orthodontic correction of functional unilateral posterior crossbite in the mixed dentition period: a systematic review and meta-analysis. Prog Orthod 2022; 23:5. [PMID: 35156156 PMCID: PMC8841381 DOI: 10.1186/s40510-022-00398-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/05/2022] [Indexed: 12/15/2022] Open
Abstract
Objective This systematic review and meta-analysis aimed to critically appraise the available evidence of the effectiveness of early intervention of functional unilateral posterior crossbites (FPXB) between the ages of 6 and 12 years. Materials and methods Electronic search in four databases (PubMed, Scopus, Embase, and Google Scholar) for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) was performed between 1st January 1990 and 31st October 2021. Methodological index for non-randomized studies (MINORS) for CCTs and Cochrane's risk of bias tool for RCTs were applied. The certainty of the evidence was evaluated according to the grading of recommendations, assessment, development, and evaluation (GRADE) approach. Results Nine studies (6 RCTs and 3 CCTs) were included in this review, and six of them were appropriate for quantitative synthesis. The meta-analysis revealed that the quad-helix (QH) was more effective than expansion plates (EP) in increasing the intermolar width (WMD = 1.25; 95% CI 0.75, 1.75; P < 0.001), and decreasing treatment time (WMD = − 3.36; 95% CI − 4.97, − 1.75; P < 0.001). The relapse rate at 5.6 years post-treatment was greater in the QH group than in the EP group (RR = 3.00); however, the difference was statistically insignificant. There was no significant difference between the QH and the EP in other outcome measures. When assessing the rapid maxillary expansion (RME), only one RCT compared the RME with an untreated control group and reported a significant increase in the maxillary intermolar and intercanine width (P < 0.001, P = 0.002, respectively) and a significant decrease in lower midline deviation (P < 0.001). Conclusion There is weak to moderate evidence that the treatment of functional posterior crossbite (FPXB) by the QH increased the maxillary intermolar width and the success rate and decreased the treatment duration compared to the EP. The relapse percentage was greater in the QH group. There is very weak evidence that the mandibular midline correction rate did not differ significantly between the QH and the EP modalities. The RME using the Hyrax appliance corrected the FPXB successfully; however, the strength of evidence in this regard is very low. As the quality of evidence ranged from very low to moderate in this review, we confirm the need for more RCTs with different expansion appliances in the early treatment of FPXB. Supplementary Information The online version contains supplementary material available at 10.1186/s40510-022-00398-4.
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Leonardi RM, Aboulazm K, Giudice AL, Ronsivalle V, D'Antò V, Lagravère M, Isola G. Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique. Clin Oral Investig 2021; 25:1775-1785. [PMID: 32743674 DOI: 10.1007/s00784-020-03480-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment. MATERIALS AND METHODS Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a "best-fit" algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student's t tests. RESULTS A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001). CONCLUSIONS Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant. CLINICAL RELEVANCE Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings.
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Affiliation(s)
- Rosalia Maria Leonardi
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy.
| | - Khaled Aboulazm
- Department of Orthodontics, School of Dentistry, Pharos University, Alexandria, Egypt
| | - Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo D'Antò
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, Naples, Italy
| | - Manuel Lagravère
- Department of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Gaetano Isola
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
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Almaqrami BS, Alhammadi MS, Tang B, ALyafrusee ES, Hua F, He H. Three-dimensional morphological and positional analysis of the temporomandibular joint in adults with posterior crossbite: A cross-sectional comparative study. J Oral Rehabil 2021; 48:666-677. [PMID: 33586221 DOI: 10.1111/joor.13156] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 01/06/2021] [Accepted: 02/03/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this study was to three-dimensionally (3D) evaluate the morphological and positional features of the temporomandibular joint (TMJ) in adults with unilateral and bilateral posterior crossbite compared with aligned control subjects. MATERIALS AND METHODS This cross-sectional comparative study analysed cone beam computed tomography (CBCT) images of 90 adult subjects' divided into three equal groups: bilateral posterior crossbite (BCG), unilateral posterior crossbite (UCG) and control group (CG). 3D measurements of the TMJ included the following: (a) position, angulation and inclination of the mandibular condyles; (b) centralisation of the condyles in their respective mandibular fossae; and (c) volumetric measurements of the TMJ spaces. Intra- and intergroup differences were identified using the paired Student's t test and an analysis of variance (ANOVA) followed by Tukey's post hoc test, respectively. RESULTS Regarding the intra-group side-based comparisons, there were significant differences in the anterior and superior joint spaces and the anteroposterior condylar joint position in the UCG. Intergroup comparisons revealed significant differences in the vertical condylar inclination, medial condylar position, condylar width and height, and volumetric joint space between the unaffected side of the UCG and left sides of the other groups. There were significant differences in the anteroposterior condylar inclination, medial condylar position, condylar width and height, anterior, posterior, superior and volumetric joint spaces, and anteroposterior condylar joint position between the crossbite side of the UCG and the right sides of the other groups. CONCLUSION Skeletal crossbite accompanied with characteristic morphological and positional TMJ features associated with unilateral posterior crossbite and are associated with side-specific TMJ asymmetry.
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Affiliation(s)
- Bushra Sufyan Almaqrami
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Maged Sultan Alhammadi
- Division of Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, Faculty of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Bojun Tang
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Enas Senan ALyafrusee
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Yemen.,Orthodontic Department, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Fang Hua
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Center for Evidence-Based Stomatology, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Hong He
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Leonardi R, Muraglie S, Lo Giudice A, Aboulazm KS, Nucera R. Evaluation of mandibular symmetry and morphology in adult patients with unilateral posterior crossbite: a CBCT study using a surface-to-surface matching technique. Eur J Orthod 2020; 42:650-657. [PMID: 31995170 DOI: 10.1093/ejo/cjz106] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate mandibular morphology in adults affected by posterior unilateral crossbite (PUXB) and to evaluate the hemi mandibular volumes from the crossbite (CB) and non-CB sides of the same patients. METHODS Thirty-eight cone beam computed tomography (CBCT) images were consecutively recruited and the Digital Imaging and Communications in Medicine (DICOM)-formatted scans were volume rendered into a surface three-dimensional (3D) mesh model and volumes to obtain the 3D model of the mandibular bone. To achieve the surface point-to-point analysis of the mandibular models, a reverse engineering software was used. The same procedure was performed for an age-matched control group (19 CBCT images). RESULTS Total mandibular volume showed a difference of 2.46 cm3 between patients and controls, which was not statistically significant. A mean difference of 1.53 cm3 was found comparing the hemi mandibular volumes from the CB and non-CB sides of PUXB patients, this difference was statistically significant (P ≤ 0.01). Findings for the surface-to-surface deviation analysis, demonstrated a higher percentage of mismatch in patients PUXB, over 10% at 0.5 mm tolerance level. LIMITATIONS Limitations are related to the intrinsic surfaces matching methodology, that make difficult to evaluate discrepancies among different mandibular anatomical units. CONCLUSION Adult patients affected by PUXB show a greater mandibular structural asymmetry compared to controls because of a lower matching percentage obtained from the surface-to-surface matching technique. IMPLICATIONS Treatment of adult patients affected by PUXB should take into consideration the possibility of a mild mandibular asymmetry mainly localized at the condyle and gonial angle levels.
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Affiliation(s)
- Rosalia Leonardi
- Department of Orthodontics, School of Dentistry, University of Catania, Italy
| | - Simone Muraglie
- Department of Orthodontics, School of Dentistry, University of Catania, Italy
| | - Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, University of Catania, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Italy
| | - K S Aboulazm
- Department of Orthodontics, School of Dentistry, Pharos University, Alexandria, Egypt
| | - R Nucera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Italy
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De Grauwe A, Ayaz I, Shujaat S, Dimitrov S, Gbadegbegnon L, Vande Vannet B, Jacobs R. CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment. Eur J Orthod 2020; 41:381-389. [PMID: 30351398 PMCID: PMC6686083 DOI: 10.1093/ejo/cjy066] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. OBJECTIVE The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. SEARCH METHODS MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. SELECTION CRITERIA The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. DATA COLLECTION AND ANALYSIS Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. CONCLUSIONS CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. REGISTRATION None. CONFLICT OF INTEREST None to declare.
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Affiliation(s)
- Annelore De Grauwe
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Irem Ayaz
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Ortún-Terrazas J, Cegoñino J, Illipronti-Filho E, Pérez del Palomar A. Analysis of temporomandibular joint dysfunction in paediatric patients with unilateral crossbite using automatically generated finite element models. Comput Methods Biomech Biomed Engin 2020; 23:627-641. [DOI: 10.1080/10255842.2020.1755275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - José Cegoñino
- Department of Mechanical Engineering, University of Zaragoza, Zaragoza, Spain
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10
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Ortún-Terrazas J, Fagan MJ, Cegoñino J, Illipronti-Filho E, Pérez Del Palomar A. Towards an early 3D-diagnosis of craniofacial asymmetry by computing the accurate midplane: A PCA-based method. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 191:105397. [PMID: 32092615 DOI: 10.1016/j.cmpb.2020.105397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/11/2020] [Accepted: 02/13/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Craniofacial asymmetry is a common growth disorder often caused by unilateral chewing. Although an early orthodontic treatment would avoid surgical procedures later in life, the uncertainty of defining the accurate sagittal midplane potentially leads to misdiagnosis and therefore inaccurate orthodontic treatment plans. This novel study aims to 3D-diagnose craniofacial complex malformations in children with unilateral crossbite (UXB) considering a midplane which compensates the asymmetric morphology. METHODS The sagittal midplane of 20 children, fifteen of whom exhibited UXB, was computed by a PCA-based method which compensates the asymmetry mirroring the 3D models obtained from cone-beam computed tomography data. Once determined, one side of the data was mirrored using the computed midplane to visualize the malformations on the hard and soft tissues by 3D-computing the distances between both halves. Additionally, 31 skull's landmarks were manually placed in each model to study the principal variation modes and the significant differences in the group of subjects with and without UXB through PCA and Mann-Whitney U test analyses respectively. RESULTS Morphological 3D-analysis showed pronounced deformities and aesthetic implications for patients with severe asymmetry (jaw deviation > 0.8 mm) in whole craniofacial system, while initial signs of asymmetry were found indistinctly in the mandible or maxilla. We detected significant (p < 0.05) malformations for example in mandibular ramus length (0.0086), maxillary palate width (0.0481) and condylar head width (0.0408). Craniofacial malformations increased the landmarks' variability in the group of patients with UXB over the control group requiring 8 variation modes more to define 99% of the sample' variability. CONCLUSIONS Our findings demonstrated the viability of early diagnosis of craniofacial asymmetry through computing the accurate sagittal midplane which compensates the individual's asymmetrical morphology. Furthermore, this study provides important computational insights into the determination of craniofacial deformities which are caused by UXB, following some empirical findings of previous clinical studies. Hence, this computational approach can be useful for the development of new software in craniofacial surgery or for its use in biomedical research and clinical practice.
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Affiliation(s)
- Javier Ortún-Terrazas
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain.
| | - Michael J Fagan
- Medical and Biological Engineering, School of Engineering and Computer Science, University of Hull, Hull, United Kingdom
| | - Jose Cegoñino
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Edson Illipronti-Filho
- School of Dentistry, Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil
| | - Amaya Pérez Del Palomar
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
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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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12
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Frapier L, Massif L. Interaction des troubles transversaux unilateraux avec le sens sagittal : conduite à tenir. Int Orthod 2017; 15:332-364. [DOI: 10.1016/j.ortho.2017.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Frapier L, Massif L. Interaction between unilateral transverse disorders and the sagittal dimension: What measures are needed? Int Orthod 2017; 15:332-364. [DOI: 10.1016/j.ortho.2017.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Temporomandibular Joint Anatomy Assessed by CBCT Images. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2916953. [PMID: 28261607 PMCID: PMC5312052 DOI: 10.1155/2017/2916953] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/28/2016] [Indexed: 11/18/2022]
Abstract
Aim. Since cone beam computed tomography (CBCT) has been used for the study of craniofacial morphology, the attention of orthodontists has also focused on the mandibular condyle. The purpose of this brief review is to summarize the recent 3D CBCT images of mandibular condyle. Material and Methods. The eligibility criteria for the studies are (a) studies aimed at evaluating the anatomy of the temporomandibular joint; (b) studies performed with CBCT images; (c) studies on human subjects; (d) studies that were not clinical case-reports and clinical series; (e) studies reporting data on children, adolescents, or young adults (data from individuals with age ≤ 30 years). Sources included PubMed from June 2008 to June 2016. Results. 43 full-text articles were initially screened for eligibility. 13 full-text articles were assessed for eligibility. 11 articles were finally included in qualitative synthesis. The main topics treated in the studies are the volume and surface of the mandibular condyle, the bone changes on cortical surface, the facial asymmetry, and the optimum position of the condyle in the glenoid fossa. Conclusion. Additional studies will be necessary in the future, constructed with longitudinal methodology, especially in growing subjects. The limits of CBCT acquisitions are also highlighted.
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Comparative Evaluation of Condylar Volume Between Patients With Unilateral Condylar Hyperplasia and Class III Dentofacial Deformity. J Oral Maxillofac Surg 2017; 75:180-188. [DOI: 10.1016/j.joms.2016.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 09/07/2016] [Accepted: 09/07/2016] [Indexed: 11/18/2022]
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16
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Tagkli A, Paschalidi P, Katsadouris A, Tsolakis A. Relationship between orthodontics and temporomandibular disorders. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Since the end of the 20th century, the problems of the temporomandibular disorders (TMDs) have aroused interest to the orthodontists. The aim of this literature review is to present the contemporary evidence concerning the association between the presence of malocclusions and the occurrence of signs and symptoms of the TMJ. In addition, additional variables, which may affect the TMJs of a patient during the orthodontic treatment are pointed out. It is evident that there is an increased number of patients who are seeking for orthodontic treatment, not only in order to enhance their facial aesthetics and the function of mastication system, but also to relieve the symptoms of the temporomandibular joint (TMJ). There are multiple etiological factors that have been associated with the TMDs and they may be manifested by pain and/or sounds of TMJ. In addition, during the clinical examination it can be detected a deviation from the normal function of the mandible.
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