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Wu J, Jia W, Su X, Zhang K, Huang Y, Lei Y. Three-dimensional analysis of mandibular morphology asymmetry and temporomandibular joint position in patients with unilateral Brodie bite. Orthod Craniofac Res 2024; 27:474-484. [PMID: 38217321 DOI: 10.1111/ocr.12755] [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] [Accepted: 01/01/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVE Previous studies have shown unilateral posterior crossbite is associated with mandibular asymmetry in morphology and position. However, it remains unclear whether unilateral Brodie bite plays a similar role in mandibular development. Therefore, this study aims to investigate the morphological and positional symmetry of mandibles in patients with unilateral Brodie bite by three-dimensional anaylsis. METHODS Fourteen patients with unilateral Brodie bite (mean age 18.43 ± 4.24 years) and fourteen sex- and age-matched patients with normal occlusion (mean age 18.07 ± 5.48 years) underwent cone-beam computed tomography (CBCT) scans. 3D surface mesh models of their mandibles were established using Mimics Research 19.0. The surface matching percentage was compared between the original and mirrored mandible by Geomagic Control X software. Furthermore, the dimension and position of the temporomandibular joint (TMJ) were determined for both groups using InVivoDental 5.0. RESULTS For surface-to-surface deviation analysis, the percentage of mismatch in patients with unilateral Brodie bite was significantly higher than the control group at ±0.50 mm, ±0.75 mm, and ±1.00 mm tolerance (P < .001). In patients with unilateral Brodie syndrome, the condyles on the scissors-bite side showed a significantly more anterior position (P = .03), greater medial inclination (P < .01), and larger posterior TMJ space (P = .01) than the non-scissors-bite side. CONCLUSION Patients with unilateral Brodie bite exhibit a more asymmetrical mandibular morphology, with a greater anterior condylar position and posterior joint space on the scissors-bite side, indicating that early diagnosis and treatment may be necessary for patients with unilateral Brodie bite.
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Affiliation(s)
- J Wu
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - W Jia
- Department of Stomatology, The Second People's Hospital of Hunan province, Changsha, Hunan, China
| | - X Su
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - K Zhang
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Y Huang
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Y Lei
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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España-Pamplona P, Zamora-Martinez N, Tarazona-Álvarez B, Pangrazio-Kulbersh V, Paredes-Gallardo V. Three-dimensional quantification of mandibular asymmetries in Caucasian adult patients with different sagittal and vertical skeletal patterns. A cone beam study using 3D segmentation and mirroring procedures. Head Face Med 2023; 19:54. [PMID: 38098053 PMCID: PMC10720065 DOI: 10.1186/s13005-023-00400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION An accurate identification of mandibular asymmetries is required by modern orthodontics and orthognathic surgery to improve diagnosis and treatment planning of such deformities. Although craniofacial deformities are very frequent pathologies, some types of asymmetries can be very difficult to assess without the proper diagnostic tools. The purpose of this study was to implement the usage of three-dimensional (3D) segmentation procedures to identify asymmetries at the mandibular level in adult patients with different vertical and sagittal patterns where the asymmetries could go unnoticed at the observational level. METHODS The study sample comprised 60 adult patients (33 women and 27 men, aged between 18 and 60 years). Subjects were divided into 3 sagittal and vertical skeletal groups. CBCT images were segmented, mirrored and voxel-based registered with reference landmarks using ITK-SNAP® and 3DSlicer® software's. 3D surface models were constructed to evaluate the degree of asymmetry at different anatomical levels. RESULTS There was a degree of asymmetry, with the left hemimandible tending to contain the right one (0.123 ± 0.270 mm (CI95% 0.036-0.222; p < 0.001). Although the subjects under study did not present significant differences between mandibular asymmetries and their sagittal or vertical skeletal pattern (p = 0.809 and p = 0.453, respectively), a statistically significant difference has been found depending on the anatomical region (p < 0.001; CI95%=1.020-1.021), being higher in the condyle, followed by the ramus and the corpus. CONCLUSIONS Although mandibular asymmetries cannot be correlated with vertical and sagittal skeletal patterns in symmetric patients, knowledge about 3D segmentation procedures and color maps can provide valuable information to identify mandibular asymmetries.
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Affiliation(s)
- Pilar España-Pamplona
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain.
| | - Natalia Zamora-Martinez
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
| | - Beatriz Tarazona-Álvarez
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
| | | | - Vanessa Paredes-Gallardo
- Faculty of Medicine and Dentistry, School of Dentistry, University of Valencia, C/ Gasco Oliag, 1, Valencia, 46010, Spain
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Leonardi R, Ronsivalle V, Isola G, Cicciù M, Lagravère M, Flores-Mir C, Lo Giudice A. External root resorption and rapid maxillary expansion in the short-term: a CBCT comparative study between tooth-borne and bone-borne appliances, using 3D imaging digital technology. BMC Oral Health 2023; 23:558. [PMID: 37573295 PMCID: PMC10422725 DOI: 10.1186/s12903-023-03280-9] [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: 03/10/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND The aim of the study was to analyze and compare external root resorption (ERR) in patients treated with tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). METHODS The sample included 40 subjects who received tooth-borne RME (TB group, average age: 13.1 ± 1.08 years) or bone-borne RME (BB group, average age: 14.5 ± 1.11 years) and Cone-beam computed tomography (CBCT) scans before treatment (T0) and after 3-month of retention (T1). A specific 3D Imaging technology was used to generate 3D models of posterior dentition (M1 = maxillary first molars, P2 = second premolars, P1 = first premolar) and calculate volumetric data (mean and percentage values) and shape changes, the latter obtained from deviation analysis between the radicular models at different time points. Evaluation of radicular length changes was performed for each tooth. Data were statistically analysed to perform intra-timing and inter-groups comparisons. RESULTS A significant reduction of radicular volume and length was found in posterior dentition in both groups (p < 0.05), and the M1 (volume) and its palatal root (length) were mostly involved in this response. No differences were found between M1, P1 and P2 (p > 0.05) when volumetric changes were calculated as percentage of the total volume. Deviation analysis revealed that the radicular areas mostly affected by shape change were the apex and bucco-medial side. The amount of ERR was significantly greater in TB group compared to BB group. CONCLUSIONS BB-RME treatment could reduce the amount of ERR at the post-expansion stage.
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Affiliation(s)
- Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, Section of Periodontology, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Catania, Italy
| | - Manuel Lagravère
- Orthodontic Graduate Program, University of Alberta, Edmonton, AB, Canada
| | - Carlos Flores-Mir
- Orthodontic Graduate Program, University of Alberta, Edmonton, AB, Canada
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy.
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Three-Dimensional Distance Mapping Method to Evaluate Mandibular Symmetry and Morphology of Adults with Unilateral Premolar Scissors Bite. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12125814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Objective: This study aimed to evaluate the association between unilateral premolar scissors bite and mandibular symmetry of adults via the 3D distance mapping method. (2) Methods: A total of 53 cone-beam computed tomography (CBCT) images of adults with unilateral premolar scissors bite were set as study samples. A total of 53 age- and sex-matched samples without scissors bite were in the control group. Three-dimensional mandibular models and seven mandibular functional units, including condylar process (Co), coronoid process (Cr), mandibular ramus (Ra), mandibular angle (Ma), alveolar process (Ap), mandibular body (Mb), and chin process (Ch) were constructed and mirrored. After superimposition of the original and the mirrored models, 3D distance maps and deviation analysis were performed to evaluate the mandibular symmetry and morphology. (3) Results: In the study group, the matching percentages of the entire mandible (50.79 ± 10.38%), Ap (67.00 ± 12.68%), Mb (66.62 ± 9.44%), Ra (62.52 ± 11.00%), Ch (80.75 ± 9.86%), and Co (62.78 ± 13.56) were lower than that of the entire mandible (58.60 ± 5.52) (p < 0.01), Ap (73.83 ± 8.88%) (p < 0.01), Mb (72.37 ± 8.69%) (p < 0.01), Ra (68.60 ± 7.56%) (p < 0.01), Ch (85.23 ± 6.80%) (p < 0.01), and Co (67.58 ± 10.32%) (p < 0.05) in the control group. However, Cr and Ma showed no significant difference (p > 0.05). (4) Conclusions: The 3D distance mapping method provided a qualitative and quantitative mandibular symmetry and morphology assessment. Mandibular asymmetry was found in adults with unilateral premolar scissors bites. Mandibular functional units, including the alveolar process, mandibular body, mandibular ramus, chin process, and condylar process, showed significant differences, while no significant difference was observed in the coronoid process and mandibular angle.
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Lo Giudice A, Ronsivalle V, Spampinato C, Leonardi R. Fully automatic segmentation of the mandible based on convolutional neural networks (CNNs). Orthod Craniofac Res 2021; 24 Suppl 2:100-107. [PMID: 34553817 DOI: 10.1111/ocr.12536] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/15/2021] [Accepted: 06/10/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To evaluate the accuracy of automatic deep learning-based method for fully automatic segmentation of the mandible from CBCTs. SETTING AND SAMPLE POPULATION CBCT-derived mandible fully automatic segmentation. METHODS Forty CBCT scans from healthy patients (20 females and 20 males, mean age 23.37 ± 3.34) were collected, and a manual mandible segmentation was carried out by using Mimics software. Twenty CBCT scans were randomly selected and used for training the artificial intelligence model file. The remaining 20 CBCT segmentation masks were used to test the accuracy of the CNN automatic method by comparing the segmentation volumes of the 3D models obtained with automatic and manual segmentations. The accuracy of the CNN-based method was also assessed by using the DICE Score coefficient (DSC) and by the surface-to-surface matching technique. The intraclass correlation coefficient (ICC) and Dahlberg's formula were used respectively to test the intra-observer reliability and method error. Independent Student's t test was used for between-groups volumetric comparison. RESULTS Measurements were highly correlated with an ICC value of 0.937, while the method error was 0.24 mm3 . A difference of 0.71 (±0.49) cm3 was found between the methodologies, but it was not statistically significant (P > .05). The matching percentage detected was 90.35% (±1.88) (tolerance 0.5 mm) and 96.32% ± 1.97% (tolerance 1.0 mm). The differences, measured as DSC in percentage, between the assessments done with both methods were, respectively, 2.8% and 3.1%. CONCLUSION The tested deep learning CNN-based technology is accurate and performs as well as an experienced image reader but at much higher speed, which is of significant clinical relevance.
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Affiliation(s)
- Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, University of Catania, Catania, Italy
| | - Concetto Spampinato
- Department of Computer and Telecommunications Engineering, University of Catania, Catania, Italy
| | - Rosalia Leonardi
- Department of Orthodontics, School of Dentistry, University of Catania, Catania, Italy
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Three-dimensional zygomatic changes after rapid maxillary expansion in growing patients. J Orofac Orthop 2021; 84:147-156. [PMID: 34542641 DOI: 10.1007/s00056-021-00348-5] [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: 03/30/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the effects of rapid maxillary expansion (RME) treatment on the zygomatic bone complex (ZBC). METHODS In this single-center retrospective study, pre- and posttreatment cone-beam computed tomography (CBCT) images of 38 patients treated with RME were analyzed to investigate changes in the coordinates of the ZBC landmarks. At the start of treatment (T0), the patients' mean age was 11.1 ± 3.8 years (range 8.3-14.9 years). Cohen's d test was used to evaluate statistical differences. RESULTS There were statistically significant differences between T0 and T1 (P < 0.01) in the measurement values for the maxillary transverse width (ΔT: 3.18 ± 2.58, d: 1.23), frontozygomatic sutures (ΔT: 1.09 ± 0.56, d: 0.43), lowest point of the zygomaticomaxillary sutures (ΔT: 3.16 ± 1.78, d: 0.78), frontomaxillary angular parameter (right side ΔT: 2.81 ± 1.63, d: 1.73; left side ΔT: 2.52 ± 1.20, d: 2.10), frontozygomatic angular parameter (right side ΔT: 2.81 ± 1.63 d: 1.07; left side ΔT: 2.21 ± 2.79, d: 0.61), anterior intermaxillary distance (ΔT: 2.11 ± 1.42, d: 0.99), interzygomaticotemporal distance (ΔT: 2.00 ± 2.42, d: 0.99), and zygomatic angular parameter (right side ΔT: 2.06 ± 1.29, d: 1.6; left side ΔT: 2.02 ± 1.86, d: 1.09). CONCLUSIONS After RME in growing patients, the zygomatic bone showed pyramidal expansion in the coronal plane and parallel palatal expansion in the axial plane. In addition, significant lateral relocation of the zygomatic bone occurred. The zygomatic bone tended to rotate outward in conjunction with the maxilla, with a typical center of rotation close to the superior side of the frontozygomatic suture. These results shed light on the patterns of skeletal expansion in the zygomatic bone associated with RME in growing patients.
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Leonardi R, Lo Giudice A, Farronato M, Ronsivalle V, Allegrini S, Musumeci G, Spampinato C. Fully automatic segmentation of sinonasal cavity and pharyngeal airway based on convolutional neural networks. Am J Orthod Dentofacial Orthop 2021; 159:824-835.e1. [PMID: 34059213 DOI: 10.1016/j.ajodo.2020.05.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION This study aimed to test the accuracy of a new automatic deep learning-based approach on the basis of convolutional neural networks (CNN) for fully automatic segmentation of the sinonasal cavity and the pharyngeal airway from cone-beam computed tomography (CBCT) scans. METHODS Forty CBCT scans from healthy patients (20 women and 20 men; mean age, 23.37 ± 3.34 years) were collected, and manual segmentation of the sinonasal cavity and pharyngeal subregions were carried out by using Mimics software (version 20.0; Materialise, Leuven, Belgium). Twenty CBCT scans from the total sample were randomly selected and used for training the artificial intelligence model file. The remaining 20 CBCT segmentation masks were used to test the accuracy of the CNN fully automatic method by comparing the segmentation volumes of the 3-dimensional models obtained with automatic and manual segmentations. The accuracy of the CNN-based method was also assessed by using the Dice score coefficient and by the surface-to-surface matching technique. The intraclass correlation coefficient and Dahlberg's formula were used to test the intraobserver reliability and method error, respectively. Independent Student t test was used for between-groups volumetric comparison. RESULTS Measurements were highly correlated with an intraclass correlation coefficient value of 0.921, whereas the method error was 0.31 mm3. A mean difference of 1.93 ± 0.73 cm3 was found between the methodologies, but it was not statistically significant (P >0.05). The mean matching percentage detected was 85.35 ± 2.59 (tolerance 0.5 mm) and 93.44 ± 2.54 (tolerance 1.0 mm). The differences, measured as the Dice score coefficient in percentage, between the assessments done with both methods were 3.3% and 5.8%, respectively. CONCLUSIONS The new deep learning-based method for automated segmentation of the sinonasal cavity and the pharyngeal airway in CBCT scans is accurate and performs equally well as an experienced image reader.
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Affiliation(s)
- Rosalia Leonardi
- Department of Orthodontics, School of Dentistry, University of Catania, Catania, Italy.
| | - Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, University of Catania, Catania, Italy
| | - Marco Farronato
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, University of Catania, Catania, Italy
| | | | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania, Italy
| | - Concetto Spampinato
- Department of Computer and Telecommunications Engineering, University of Catania, Catania, Italy
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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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Ouni I, Ammar S, Charfeddine A, Chouchen F, Mansour L. Evaluation of condylar changes in relation to various malocclusions: A systematic review. SAUDI JOURNAL OF ORAL SCIENCES 2021. [DOI: 10.4103/sjoralsci.sjoralsci_25_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Lo Giudice A, Ronsivalle V, Zappalà G, Leonardi R, Campagna P, Isola G, Palazzo G. The Evolution of the Cephalometric Superimposition Techniques from the Beginning to the Digital Era: A Brief Descriptive Review. Int J Dent 2021; 2021:6677133. [PMID: 33981342 PMCID: PMC8088383 DOI: 10.1155/2021/6677133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/13/2021] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
Superimposition of craniofacial structures from radiographic examination has been always used for assessing changes in the maxilla-mandibular complexes, especially for the evaluation of potential changes occurring during growth as well as after orthodontic treatment and/or maxillofacial surgery. However, the availability of cone beam computed tomography (CBCT) and the recent advancement in 3D imaging have allowed the development of specific techniques for the registration and superimposition of virtual three-dimensional anatomical structures, improving the diagnosis and treatment plan strategies. In the present paper, it will be discussed the evolution of superimposition techniques from the beginning (2D) to the newest 3D approach, describing the most used methods and their main advantages and disadvantages, focusing primarily on accuracy and reproducibility of each technique.
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Affiliation(s)
- A. Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - V. Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - G. Zappalà
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - R. Leonardi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - P. Campagna
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - G. Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - G. Palazzo
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
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Palazzo G, Ronsivalle V, Oteri G, Lo Giudice A, Toro C, Campagna P, Patini R, Bocchieri S, Bianchi A, Isola G. Comparison between Additive and Subtractive CAD-CAM Technique to Produce Orthognathic Surgical Splints: A Personalized Approach. J Pers Med 2020; 10:jpm10040273. [PMID: 33322616 PMCID: PMC7768501 DOI: 10.3390/jpm10040273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/30/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
The present study aimed to evaluate the accuracy of digitally designed surgical splints generated with milling technology (material subtractive procedure) and with 3D printing technology (material additive procedure) through a customized approach in the planning of surgical orthognathic splints. Cone beam computed tomography (CBCT) examinations and scanned dental models of 10 subjects who had required surgical treatment of skeletal malocclusion were included. Simulation of the orthognathic surgery was performed according to dento-skeletal and aesthetic characteristics of the subjects and the visual treatment objective (VTO), using Dolphin3D software (Dolphin Imaging, version 11.0, Chatsworth, CA, USA). Afterward, the Appliance Designer software (3Shape A/S, Copenhagen, Denmark) was used to digitally design the surgical splints that were generated twice using laser stereolithography technology (DWS 0.29D, DWS, Vicenza, Italy) and milling technology (Sirona inLab MC X5). Finally, each physical splint was digitalized using a desktop scanner (D500 3D, 3Shape A/S, Copenhagen, Denmark) in order to perform deviation analysis using the original project as a reference. The relative percentage of matching (trueness) was calculated (Geomagic Control X software (3D Systems, version 2018.1.1, 3D Systems, Rock Hill, SC, USA). An Independent Student's t-test was used to statistically analyze the data. The milled splints showed a lower value of root to mean square (RMS) relative to the original project (0.20 mm ± 0.018) compared to the prototyped splints (0.31 ± 0.021) (p < 0.001). According to the present findings, surgical splints generated with milling technology present higher trueness compared with 3D printing technology.
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Affiliation(s)
- Giuseppe Palazzo
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, School of Dentistry, University of Messina, Via Consolare Valeria 1, 98123 Messina, Italy;
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
| | - Corrado Toro
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
| | - Paola Campagna
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
| | - Romeo Patini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Institute of Dentistry and Maxillofacial Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence: (R.P.); (G.I.); Tel.: +39-06-3015-4286 (R.P.); +39-09-5743-5359 (G.I.)
| | - Salvatore Bocchieri
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
| | - Alberto Bianchi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124 Catania, Italy; (G.P.); (V.R.); (A.L.G.); (C.T.); (P.C.); (S.B.); (A.B.)
- Correspondence: (R.P.); (G.I.); Tel.: +39-06-3015-4286 (R.P.); +39-09-5743-5359 (G.I.)
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A New Approach to Set the Absolute Midsagittal Plane of the Mandible Using a Similarity Index in Skeletal Class III Patients with Facial Asymmetry. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study sought to test the feasibility of a newly developed plane called computed modified absolute mandibular midsagittal plane (cmAMP) based on the similarity index (SI) for evaluating the stereoscopical symmetry of the mandible by comparison with other proposed midsagittal planes. This study involved 29 adult patients (15 men, 14 women; average age, 23.1 ± 6.9 years) with skeletal Class III facial asymmetry who underwent bimaxillary orthognathic surgery. Using cone-beam computed tomography images taken before and 1 year after surgery, cmAMP with the highest SI value between the two anterior segments of the hemi-mandible was set by a computer algorithm. Results show that the SI using cmAMP had the highest value (0.83 ± 0.04) before surgery compared to the other midsagittal planes, and was not significantly different from the SI (0.80 ± 0.05) using a facial midsagittal plane (MSP) after surgery. The distance (1.15 ± 0.74 mm) and angle (2.02 ± 0.82°) between MSP and cmAMP after surgery were significantly smaller than those between MSP and other midsagittal planes. In conclusion, the cmAMP plane best matches the two anterior segments of hemi-mandible symmetrically and is the closest to MSP after orthognathic surgery in skeletal Class III patients with facial asymmetry.
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Lo Giudice A, Quinzi V, Ronsivalle V, Farronato M, Nicotra C, Indelicato F, Isola G. Evaluation of Imaging Software Accuracy for 3-Dimensional Analysis of the Mandibular Condyle. A Comparative Study Using a Surface-to-Surface Matching Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134789. [PMID: 32635238 PMCID: PMC7370104 DOI: 10.3390/ijerph17134789] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to assess the accuracy of 3D rendering of the mandibular condylar region obtained from different semi-automatic segmentation methodology. A total of 10 Cone beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the condyles by using three free-source software (Invesalius, version 3.0.0, Centro de Tecnologia da Informação Renato Archer, Campinas, SP, Brazil; ITK-Snap, version2.2.0; Slicer 3D, version 4.10.2) and one commercially available software Dolphin 3D (Dolphin Imaging, version 11.0, Chatsworth, CA, USA). The same models were also manually segmented (Mimics, version 17.01, Materialise, Leuven, Belgium) and set as ground truth. The accuracy of semi-automatic segmentation was evaluated by (1) comparing the volume of each semi-automatic 3D rendered condylar model with that obtained with manual segmentation, (2) deviation analysis of each 3D rendered mandibular models with those obtained from manual segmentation. No significant differences were found in the volumetric dimensions of the condylar models among the tested software (p > 0.05). However, the color-coded map showed underestimation of the condylar models obtained with ITK-Snap and Slicer 3D, and overestimation with Dolphin 3D and Invesalius. Excellent reliability was found for both intra-observer and inter-observer readings. Despite the excellent reliability, the present findings suggest that data of condylar morphology obtained with semi-automatic segmentation should be taken with caution when an accurate definition of condylar boundaries is required.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Vincenzo Quinzi
- Post Graduate School of Orthodontics, Department of Life, Health and Environmental Sciences, University of L’Aquila, V.le San Salvatore, 67100 L’Aquila, Italy;
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Marco Farronato
- Department of Medicine, Surgery and Dentistry, Section of Orthodontics, University of Milan, 20122 Milan, Italy;
| | - Carmelo Nicotra
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Francesco Indelicato
- Department of General Surgery and Surgical-Medical Specialties, Section of Oral Surgery and Periodontology, School of Dentistry, University of Catania, 95123 Catania, Italy;
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Section of Oral Surgery and Periodontology, School of Dentistry, University of Catania, 95123 Catania, Italy;
- Correspondence: ; Tel.: +39-095-3782453
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Lo Giudice A, Ronsivalle V, Grippaudo C, Lucchese A, Muraglie S, Lagravère MO, Isola G. One Step before 3D Printing-Evaluation of Imaging Software Accuracy for 3-Dimensional Analysis of the Mandible: A Comparative Study Using a Surface-to-Surface Matching Technique. MATERIALS 2020; 13:ma13122798. [PMID: 32575875 PMCID: PMC7345160 DOI: 10.3390/ma13122798] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/10/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023]
Abstract
The accuracy of 3D reconstructions of the craniomaxillofacial region using cone beam computed tomography (CBCT) is important for the morphological evaluation of specific anatomical structures. Moreover, an accurate segmentation process is fundamental for the physical reconstruction of the anatomy (3D printing) when a preliminary simulation of the therapy is required. In this regard, the objective of this study is to evaluate the accuracy of four different types of software for the semiautomatic segmentation of the mandibular jaw compared to manual segmentation, used as a gold standard. Twenty cone beam computed tomography (CBCT) with a manual approach (Mimics) and a semi-automatic approach (Invesalius, ITK-Snap, Dolphin 3D, Slicer 3D) were selected for the segmentation of the mandible in the present study. The accuracy of semi-automatic segmentation was evaluated: (1) by comparing the mandibular volumes obtained with semi-automatic 3D rendering and manual segmentation and (2) by deviation analysis between the two mandibular models. An analysis of variance (ANOVA) was used to evaluate differences in mandibular volumetric recordings and for a deviation analysis among the different software types used. Linear regression was also performed between manual and semi-automatic methods. No significant differences were found in the total volumes among the obtained 3D mandibular models (Mimics = 40.85 cm3, ITK-Snap = 40.81 cm3, Invesalius = 40.04 cm3, Dolphin 3D = 42.03 cm3, Slicer 3D = 40.58 cm3). High correlations were found between the semi-automatic segmentation and manual segmentation approach, with R coefficients ranging from 0,960 to 0,992. According to the deviation analysis, the mandibular models obtained with ITK-Snap showed the highest matching percentage (Tolerance A = 88.44%, Tolerance B = 97.30%), while those obtained with Dolphin 3D showed the lowest matching percentage (Tolerance A = 60.01%, Tolerance B = 87.76%) (p < 0.05). Colour-coded maps showed that the area of greatest mismatch between semi-automatic and manual segmentation was the condylar region and the region proximate to the dental roots. Despite the fact that the semi-automatic segmentation of the mandible showed, in general, high reliability and high correlation with the manual segmentation, caution should be taken when evaluating the morphological and dimensional characteristics of the condyles either on CBCT-derived digital models or physical models (3D printing).
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
| | - Cristina Grippaudo
- Department of Orthodontics, University of Sacred Heart of Rome, 00168 Rome, Italy;
| | - Alessandra Lucchese
- Department of Orthodontics, Vita-Salute San Raffaele University, 10,090 Milan, Italy;
| | - Simone Muraglie
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
| | - Manuel O. Lagravère
- Orthodontic Graduate Program, ECHA 5-524, Faculty of Medicine and Dentistry, University of Alberta, 11405-87 Ave, Edmonton, AB T6G1Z1, Canada;
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario “Vittorio Emanuele—G. Rodolico”, Via S. Sofia 78, 95123 Catania, Italy; (A.L.G.); (V.R.); (S.M.)
- Correspondence: ; Tel.: +39-0953-782-453
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