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Meng WY, Ma YQ, Shi B, Liu RK, Wang XM. The comparison of biomechanical effects of the conventional and bone-borne palatal expanders on late adolescence with unilateral cleft palate: a 3-dimensional finite element analysis. BMC Oral Health 2022; 22:600. [PMID: 36514035 PMCID: PMC9745990 DOI: 10.1186/s12903-022-02640-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients with unilateral cleft lip and palate were associated with different nasomaxillary complex from the normal population. Although the biomechanical effects of conventional rapid palatal expansion (Hyrax expansion) and bone-borne rapid palatal expansion (micro-implant-assisted expansion) in non-cleft patients have been identified by multiple studies, little is known in patients with unilateral cleft lip and palate. The purpose of this study was to investigate and compare the biomechanical effects of the conventional and bone-borne palatal expanders in a late adolescence with unilateral cleft lip and palate. METHODS A cone beam CT scan of a late adolescence with unilateral cleft lip and palate was selected to construct the three-dimensional finite element models of teeth and craniofacial structures. The models of conventional and born-borne palatal expanders were established to simulate the clinical maxillary expansion. The geometric nonlinear theory was applied to evaluate the Von Mises stress distribution and displacements in craniofacial structures and teeth. RESULTS Bone-borne palatal expander achieved more transverse movement than conventional palatal expander in the whole mount of craniofacial regions, and the maximum amount of expansion was occurred anteriorly along the alveolar ridge on cleft-side. The expanding force from born-borne palatal expander resulted in more advancement in nasomaxillary complex than it in conventional palatal expander, especially in the anterior area of the minor segment of maxilla. Stresses from the both expanders distributed in similar patterns, but larger magnitudes and ranges were generated using the bone-borne expander around the maxillary buttresses and pterygoid plates of sphenoid bone. The maximum expanding stresses from born-borne palatal expander were concentrated on palatal slope supporting minscrews, whereas those from conventional palatal expander were concentrated on the anchoring molars. In addition, the buccal tipping effect of teeth generated using the bone-borne expander was less than it using the conventional palatal expander. CONCLUSION Bone-borne expander generated enhanced skeletal expansion at the levels of alveolar and palate in transversal direction, where the miniscrews contributed increased expanding forces to maxillary buttresses and decreased forces to buccal alveolar. Bone-borne expanders presented a superiority in correcting the asymmetric maxilla without surgical assistant in late adolescence with unilateral cleft lip and palate.
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Affiliation(s)
- Wen-yu Meng
- grid.412643.60000 0004 1757 2902Department of Ultrasound Imaging, The First Hospital of Lanzhou University, 730000 Lanzhou, The People’s Republic of China
| | - Yan-qing Ma
- grid.32566.340000 0000 8571 0482Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing (NO: 20JR10RA653 - ZDKF20210401), School of Stomatology, Lanzhou University, No. 199, Donggang West Road, Gansu Province 730000 Lanzhou, People’s Republic of China ,grid.32566.340000 0000 8571 0482Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000 Gansu Province People’s Republic of China
| | - Bing Shi
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 The People’s Republic of China
| | - Ren-kai Liu
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 The People’s Republic of China ,grid.413200.40000 0001 1276 6562Department of Orthodontics and Pediatric Dentistry, West China Stomatological Hospital, West China College of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041 People’s Republic of China
| | - Xiao-ming Wang
- grid.32566.340000 0000 8571 0482Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing (NO: 20JR10RA653 - ZDKF20210401), School of Stomatology, Lanzhou University, No. 199, Donggang West Road, Gansu Province 730000 Lanzhou, People’s Republic of China ,grid.32566.340000 0000 8571 0482Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000 Gansu Province People’s Republic of China
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Huqh MZU, Abdullah JY, Wong LS, Jamayet NB, Alam MK, Rashid QF, Husein A, Ahmad WMAW, Eusufzai SZ, Prasadh S, Subramaniyan V, Fuloria NK, Fuloria S, Sekar M, Selvaraj S. Clinical Applications of Artificial Intelligence and Machine Learning in Children with Cleft Lip and Palate-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710860. [PMID: 36078576 PMCID: PMC9518587 DOI: 10.3390/ijerph191710860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/22/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE The objective of this systematic review was (a) to explore the current clinical applications of AI/ML (Artificial intelligence and Machine learning) techniques in diagnosis and treatment prediction in children with CLP (Cleft lip and palate), (b) to create a qualitative summary of results of the studies retrieved. MATERIALS AND METHODS An electronic search was carried out using databases such as PubMed, Scopus, and the Web of Science Core Collection. Two reviewers searched the databases separately and concurrently. The initial search was conducted on 6 July 2021. The publishing period was unrestricted; however, the search was limited to articles involving human participants and published in English. Combinations of Medical Subject Headings (MeSH) phrases and free text terms were used as search keywords in each database. The following data was taken from the methods and results sections of the selected papers: The amount of AI training datasets utilized to train the intelligent system, as well as their conditional properties; Unilateral CLP, Bilateral CLP, Unilateral Cleft lip and alveolus, Unilateral cleft lip, Hypernasality, Dental characteristics, and sagittal jaw relationship in children with CLP are among the problems studied. RESULTS Based on the predefined search strings with accompanying database keywords, a total of 44 articles were found in Scopus, PubMed, and Web of Science search results. After reading the full articles, 12 papers were included for systematic analysis. CONCLUSIONS Artificial intelligence provides an advanced technology that can be employed in AI-enabled computerized programming software for accurate landmark detection, rapid digital cephalometric analysis, clinical decision-making, and treatment prediction. In children with corrected unilateral cleft lip and palate, ML can help detect cephalometric predictors of future need for orthognathic surgery.
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Affiliation(s)
- Mohamed Zahoor Ul Huqh
- Orthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Johari Yap Abdullah
- Craniofacial Imaging Lab, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Ling Shing Wong
- Faculty of Health and Life Sciences, INTI International University, Nilai 71800, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
| | - Nafij Bin Jamayet
- Division of Clinical Dentistry (Prosthodontics), School of Dentistry, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia
| | - Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Qazi Farah Rashid
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Adam Husein
- Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Wan Muhamad Amir W. Ahmad
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Sumaiya Zabin Eusufzai
- Department of Biostatistics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Malaysia
| | - Somasundaram Prasadh
- National Dental Center Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore
| | | | | | | | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh 30450, Malaysia
| | - Siddharthan Selvaraj
- Faculty of Dentistry, AIMST University, Bedong 08100, Malaysia
- Correspondence: (J.Y.A.); (L.S.W.); (S.S.)
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Lee H, Nguyen A, Hong C, Hoang P, Pham J, Ting K. Biomechanical effects of maxillary expansion on a patient with cleft palate: A finite element analysis. Am J Orthod Dentofacial Orthop 2017; 150:313-23. [PMID: 27476365 DOI: 10.1016/j.ajodo.2015.12.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 12/01/2015] [Accepted: 12/01/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the effects of rapid palatal expansion on the craniofacial skeleton of a patient with unilateral cleft lip and palate (UCLP) and to predict the points of force application for optimal expansion using a 3-dimensional finite element model. METHODS A 3-dimensional finite element model of the craniofacial complex with UCLP was generated from spiral computed tomographic scans with imaging software (Mimics, version 13.1; Materialise, Leuven, Belgium). This model was imported into the finite element solver (version 12.0; ANSYS, Canonsburg, Pa) to evaluate transverse expansion forces from rapid palatal expansion. Finite element analysis was performed with transverse expansion to achieve 5 mm of anterolateral expansion of the collapsed minor segment to simulate correction of the anterior crossbite in a patient with UCLP. RESULTS High-stress concentrations were observed at the body of the sphenoid, medial to the orbit, and at the inferior area of the zygomatic process of the maxilla. The craniofacial stress distribution was asymmetric, with higher stress levels on the cleft side. When forces were applied more anteriorly on the collapsed minor segment and more posteriorly on the major segment, there was greater expansion of the anterior region of the minor segment with minimal expansion of the major segment. CONCLUSIONS The transverse expansion forces from rapid palatal expansion are distributed to the 3 maxillary buttresses. Finite element analysis is an appropriate tool to study and predict the points of force application for better controlled expansion in patients with UCLP.
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Affiliation(s)
- Haofu Lee
- Assistant professor, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Alan Nguyen
- Dental student, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Christine Hong
- Assistant professor, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Paul Hoang
- Orthodontic resident, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - John Pham
- Dental student, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif
| | - Kang Ting
- Professor and chair, Department of Orthodontics, School of Dentistry, University of California at Los Angeles, Los Angeles, Calif.
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Aikawa T, Haraguchi S, Tanaka S, Uematsu S, Ishibashi M, Kogo M, Iida S. Rotational movement of the anterior maxillary segment by hybrid distractor in patients with cleft lip and palate. ACTA ACUST UNITED AC 2010; 110:292-300. [DOI: 10.1016/j.tripleo.2010.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 01/04/2010] [Accepted: 01/26/2010] [Indexed: 10/19/2022]
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Jović N. [Distraction osteogenesis in the treatment of facial and mandibular deformities]. VOJNOSANIT PREGL 2006; 63:297-304. [PMID: 16605197 DOI: 10.2298/vsp0603297j] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
<Zakljucak> Prikazani protokoli lecenja i kriterijumi uspesnosti svakako ce zahtevati dalje izmene i dopune, ali se mogu koristiti u buducim klinickim studijama u cilju obezbedjivanja objektivnih podataka. Buduci pravci razvoja kraniofacijalne OD ukljucuju: uticaj faktora rasta na OD, uticaj OD na kraniofacijalni skelet u procesu rasta, usavrsavanje tehnike osteotomije putem endoskopije, razvoj minijaturnih multidirekcionih distrakcionih uredjaja koji omogucavaju interceptivnu OD i modifikaciju i usavrsavanje protokola lecenja putem kraniofacijalne OD.
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Affiliation(s)
- Nebojsa Jović
- Vojnomedicinska akademija, Klinika za maksilofacijalnu, oralnu hirurgiju i implantologiju, Beograd
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Cheung LK, Chua HDP. A meta-analysis of cleft maxillary osteotomy and distraction osteogenesis. Int J Oral Maxillofac Surg 2006; 35:14-24. [PMID: 16154316 DOI: 10.1016/j.ijom.2005.06.008] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2005] [Revised: 05/06/2005] [Accepted: 06/13/2005] [Indexed: 11/25/2022]
Abstract
This meta-analysis aims to provide evidence-based data to assist surgeons to make an informed choice between distraction osteogenesis or conventional osteotomy for cleft lip and palate patients. A PUBMED search of the National Library of Medicine from 1966 to December 2003 was conducted. Keywords used in the search were 'cleft', 'distraction', 'maxilla', 'maxillary', 'advancement', 'osteotomy', and 'orthognathic surgery'. This study concluded that distraction osteogenesis tends to be preferred to conventional osteotomy for younger CLP patients with more severe deformities. In such cases it was feasible to use distraction to correct moderate to large movement of the maxilla by either complete or incomplete Le Fort I osteotomy, and a concurrent mandibular osteotomy was less frequently required. Intra-operative and post-operative complications were uncommon with either technique, and some of the traditional ischemic complications related to conventional osteotomy were replaced by infection of the oral mucosa due to the prolonged retention of the distractors. There is still no conclusive data on any differences in surgical relapse, velopharyngeal function and speech between the two techniques. Both distraction osteogenesis and conventional osteotomy can deliver a marked improvement in facial aesthetics.
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Affiliation(s)
- L K Cheung
- Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, Prince Philip Dental Hospital, 34 Hospital Road, The University of Hong Kong, Hong Kong SAR, China.
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