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Simões JCM, Garcia DM, Mello-Filho FVD, Felício CMD, Trawitzki LVV. Relationship between bite force, occlusal contact area, and three-dimensional facial soft tissue in dentofacial deformities. Codas 2024; 36:e20230203. [PMID: 38695438 PMCID: PMC11065403 DOI: 10.1590/2317-1782/20242023203en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/10/2023] [Indexed: 05/04/2024] Open
Abstract
PURPOSE This study aimed to investigate three-dimensional facial soft tissue dimensions, maximum bite force (MBF), and occlusal contact area in patients with DFD. In addition, we analyzed the relationship between MBF and the three-dimensional facial measurements. METHODS Thirty-two patients with skeletal Class III DFD and 20 patients with Class II DFD underwent a soft tissue evaluation using surface laser scanning, as well as MBF and occlusal contact area assessments. The DFD groups were compared with each other and with 25 healthy subjects. RESULTS Significant morphological differences were found in the transversal, vertical, and anteroposterior dimensions between Class II DFD and Class III DFD. Both DFD groups presented an increased linear distance of chin height, which was strongly related with decreased MBF magnitude. The DFD groups exhibited lower MBF and occlusal contact area, with no significant differences between Class II and Class III DFD. CONCLUSION The presence of DFD affected 3D measurements of facial soft tissue, causing variations beyond normal limits, lower MBF, and occlusal contact area in both Class II and Class III DFD patients. The vertical dimension might have influenced the lower MBF magnitude in the studied skeletal deformities.
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Affiliation(s)
- Joana Carolina Martins Simões
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
- Núcleo de Apoio à Pesquisa em Morfofisiologia Craniofacial – NAP-CF, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
| | - Denny Marcos Garcia
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
- Núcleo de Apoio à Pesquisa em Morfofisiologia Craniofacial – NAP-CF, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
| | - Francisco Veríssimo De Mello-Filho
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
- Núcleo de Apoio à Pesquisa em Morfofisiologia Craniofacial – NAP-CF, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
| | - Claudia Maria De Felício
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
- Núcleo de Apoio à Pesquisa em Morfofisiologia Craniofacial – NAP-CF, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
| | - Luciana Vitaliano Voi Trawitzki
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
- Núcleo de Apoio à Pesquisa em Morfofisiologia Craniofacial – NAP-CF, Faculdade de Medicina de Ribeirão Preto – FMRP, Universidade de São Paulo – USP - Ribeirão Preto (SP), Brasil.
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Madhan S, Nascimento GG, Ingerslev J, Cornelis M, Pinholt EM, Cattaneo PM, Svensson P. Health-related quality of life, jaw function and sleep-disordered breathing among patients with dentofacial deformity. J Oral Rehabil 2024; 51:684-694. [PMID: 38239176 DOI: 10.1111/joor.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/15/2023] [Accepted: 10/30/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND OBJECTIVES Patients with dentofacial deformity (DFD) requiring orthognathic treatment have poor aesthetics, jaw function and psychological well-being, which potentially affect the quality of life. This study aimed to investigate the health-related general, oral and orthognathic quality of life, jaw function and sleep-disordered breathing at different stages of orthognathic surgical treatment. METHODS A total of 120 consecutive patients with DFD were recruited and grouped as pre-orthodontic treatment (group 1), pre-surgery (group 2), 4 months post-surgery (group 3), 24 months post-surgery (group 4) and in addition 30 controls without DFD (group 0). Outcomes were assessed using general health Short Form Survey (SF-36), Oral Health Impact (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), STOP-Bang and Jaw Function Limitation Scale (JFLS) questionnaires. In addition, presence or absence of pain was recorded. Data were tested with analysis of variance, Kruskal-Wallis test, Tukey post hoc test and structural equation modelling (SEM). RESULTS Results revealed SF-36 (p = .814) and STOP-Bang (p = .143) total scores did not differ between control and treatment groups. In contrast, OHIP-14, OQLQ and JFLS total scores differed between groups (p = .001). Higher scores were observed in groups 1 (p = .001), 2 (p = .001) and 3 (p = .041) compared to group 0, indicating poor oral health in patients with DFD. Importantly, in group 4, oral health-related quality of life was better, and OHIP-14 (p = .936) and JFLS (p = .572) scores did not differ from controls. OQLQ scores of group 4 were significantly lower than group 1 (p = .001) but higher than group 0 (p = .013). SEM results revealed a significant negative associations of pain with JFLS and OQLQ; OHIP-14 with OQLQ; OHIP-14 with SF-36; and finally STOP-Bang with SF-36. Positive associations were observed between JFLS and OHIP-14; OHIP-14 and OQLQ. CONCLUSION Oral health-related quality of life and jaw function appears to be improved 24 months after orthognathic surgery. Pain and limitation in jaw function had a negative association with health-related quality of life.
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Affiliation(s)
- Sivaranjani Madhan
- Sections for Orthodontics and Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- Visiting Researcher, Department of Oral Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- National Dental Research Institute Singapore, Duke-NUS Medical School, Singapore, Singapore
| | - Janne Ingerslev
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Marie Cornelis
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Else Marie Pinholt
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Paolo M Cattaneo
- Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, Esbjerg, Denmark
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- Faculty of Odontology, Malmø University, Sweden
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Vassis S, Sabljic S, Noeldeke B, Sefidroodi M, Küseler A, Klit Pedersen T, Stoustrup P. Effects of orthopedic treatment (distraction splint) on dentofacial deformities in patients with juvenile idiopathic arthritis. Eur J Orthod 2024; 46:cjae005. [PMID: 38376495 DOI: 10.1093/ejo/cjae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joint (TMJ), which can alter mandibular growth and development and result in dentofacial deformities. OBJECTIVE To assess the outcomes of orthopedic treatment with distraction splint (DS) in patients with JIA-related dentofacial deformity. METHODS The retrospective study involved 30 patients with JIA and unilateral TMJ involvement, another study group of 20 patients with JIA and bilateral TMJ involvement, and a control group of 18 non-JIA orthodontic patients with Class II and III malocclusions. The inclusion criteria were DS treatment and cone-beam computed tomography (CBCT) scans before (T0) and 2 years after treatment (T1). Dentofacial morphology and deformity were evaluated based on a validated three-dimensional CBCT-based morphometric analysis. Intergroup differences in outcome measures were compared at T0 and T1, and intragroup changes between T0 and T1 were assessed using the Kruskal-Wallis test. RESULTS Initial evaluations at T0 revealed significant differences between the unilateral and bilateral JIA groups and the control group for three out of eight dentofacial deformity variables: inter-side difference in total posterior mandibular height, mandibular axial angle, and posterior/anterior face height (ratio). At follow-up (T1), significant inter-group differences were only observed in total posterior mandibular height indicating that intergroup differences were less pronounced after splint treatment. Assessing inter-group changes between T0 and T1 showed that all parameters remained constant except posterior/anterior face height ratio, which significantly decreased between T0 and T1. CONCLUSIONS The findings demonstrate the potential of DS treatment for patients with JIA and unilateral or bilateral TMJ involvement to generally support normal dentofacial growth or at least limit further deterioration of dentofacial deformities.
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Affiliation(s)
- Stratos Vassis
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Sanja Sabljic
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Beatrice Noeldeke
- Department of Economics, Leibniz University Hannover, Am Königsworther Platz 1, 30167 Hannover, Germany
| | | | - Annelise Küseler
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Thomas Klit Pedersen
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
| | - Peter Stoustrup
- Section of Orthodontics, Aarhus University, Vennelyst Blvd 9, 8000 Aarhus, Denmark
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da Silva AV, da Rosa BM, Matje PRB, Rizzatto SMD, de Oliveira RB, Haas OL, de Menezes LM. Effects of SARPE and MISMARPE on correction of transverse maxillary deficiency: A preliminary comparative evaluation. Orthod Craniofac Res 2024; 27:332-338. [PMID: 37728033 DOI: 10.1111/ocr.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/24/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
AIM The present study was designed to compare, on cone-beam computed tomography imaging, the skeletal and dental effects of the SARPE (Surgically assisted rapid palatal expansion) and MISMARPE (Minimally Invasive Surgical and Miniscrew-Assisted Rapid Palatal Expansion) techniques. MATERIALS AND METHODS The sample of adult patients with transverse maxillary deficiency (TMD) was divided into two groups, and scans were obtained preoperatively (T0) and immediately after completion of expansion (T1). The posterior and anterior linear transverse distances of the maxilla and the angulation of the maxillary first molars were evaluated. The data were entered into a generalized estimating equations model to verify the postoperative effects of the different techniques. RESULTS None of the techniques caused any appreciable change in the angulation of the molars. The skeletal changes were similar, with significantly greater gains in the nasal fossa and intermaxillary distance when using the MISMARPE. CONCLUSION The technique can be an effective and lower morbidity alternative to SARPE.
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Affiliation(s)
- Andreza Vieira da Silva
- Postgraduate Program in Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bibiana Mello da Rosa
- Postgraduate Program in Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Department of Oral and Maxillofacial Surgery, São Lucas Hospital of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Private Practice at Belle & Haas OrthoFacial Surgery, Porto Alegre, RS, Brazil
| | - Paulo R B Matje
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Susana Maria Deon Rizzatto
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rogério Belle de Oliveira
- Department of Oral and Maxillofacial Surgery, São Lucas Hospital of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Private Practice at Belle & Haas OrthoFacial Surgery, Porto Alegre, RS, Brazil
| | - Orion L Haas
- Department of Oral and Maxillofacial Surgery, São Lucas Hospital of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Private Practice at Belle & Haas OrthoFacial Surgery, Porto Alegre, RS, Brazil
| | - Luciane Macedo de Menezes
- Department of Orthodontics, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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de Miranda BM, Gonçalez Miguel PT, Gonçalves FM, Costa DL, Bronholo TDPM, Guariza-Filho O, Stechman-Neto J, Santos RS, Zeigelboim BS, de Araujo CM. Impact of dentofacial deformity on the chance of being hired for a job. Front Psychol 2023; 14:1037167. [PMID: 38106396 PMCID: PMC10722433 DOI: 10.3389/fpsyg.2023.1037167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/17/2023] [Indexed: 12/19/2023] Open
Abstract
Objective This study aimed to determine the impact of dentofacial deformity on an individual's chances of being hired for a hypothetical job involving customer service. Materials and methods Face photographs (frontal and lateral) of 15 patients with moderate to severe dentofacial deformity, taken before and after orthodontic-surgical correction, were selected and randomized between two different questionnaires. In addition, five patients without dentofacial deformity were used as controls in both questionnaires. These questionnaires were taken by adults responsible for hiring personnel to work in commerce and business activities, graduates or postgraduates in business administration, with experience in recruiting and hiring personnel. The evaluation took place using a Likert scale with values ranging from 0 to 10 (in which 0 corresponded to complete disagreement and 10 to complete agreement), considering the following variables in a first impression judgment: honesty, intelligence, productivity at work, and hiring chance. Data were tabulated and statistical analysis was performed using a linear regression model for the explanatory variables that showed statistical significance in the analysis of variance (ANOVA). Effect size through Cohen's d has been corrected for all comparisons performed. Results All re-examined domains demonstrated statistical differences even when included in a multivariate model (p < 0.05), with lower mean values for those requiring pre-treatment (presenting deformity), although the effect size was small for all comparisons. Conclusion Dentofacial deformity influenced the hiring chance, although not appearing to be a preponderant factor for hiring, acting as a tiebreaker among the candidates adopted.
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Affiliation(s)
| | | | - Flavio Magno Gonçalves
- Postgraduate Program in Human Communication Health, Tuiuti University of Paraná, Curitiba, Brazil
| | | | | | - Odilon Guariza-Filho
- Department of Orthodontics, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - José Stechman-Neto
- School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
- Postgraduate Program in Human Communication Health, Tuiuti University of Paraná, Curitiba, Brazil
| | - Rosane Sampaio Santos
- Postgraduate Program in Human Communication Health, Tuiuti University of Paraná, Curitiba, Brazil
| | - Bianca Simone Zeigelboim
- Postgraduate Program in Human Communication Health, Tuiuti University of Paraná, Curitiba, Brazil
| | - Cristiano Miranda de Araujo
- School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
- Postgraduate Program in Human Communication Health, Tuiuti University of Paraná, Curitiba, Brazil
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Benato L, Miotto AV, Molinari RL, Olsson B, Carlos LDO, Thieme RD, Schiefecker MEM, Rebellato NLB, Scariot R, Klüppel LE. Body mass index and weight loss in patients submitted to orthognathic surgery: a prospective study. Dental Press J Orthod 2023; 28:e2323107. [PMID: 37970912 PMCID: PMC10637617 DOI: 10.1590/2177-6709.28.5.e2323107.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/04/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To compare the body mass index (BMI) and the weight loss (WL) in patients with dentofacial deformities who underwent monomaxillary versus bimaxillary orthognathic surgery. MATERIALS AND METHODS This prospective longitudinal study included 69 patients with dentofacial deformities who underwent surgical orthodontic treatment. Patients were divided into two groups according to the type of orthognathic surgery: monomaxillary or bimaxillary. A preoperative nutritional assessment based on BMI was performed; the percentage of involuntary WL between the preoperative and postoperative periods was also calculated. Data were collected at preoperative and 10, 40, and 90 days postoperative (PO). Statistical analysis was performed using SPSS 17.0 (IBM Corp., Armonk, NY, USA), and data are reported with 95% confidence interval. RESULTS According to BMI, patients who underwent monomaxillary surgery presented: underweight = 2.6%, normal weight = 51.3%, overweight = 35.9%, and obese = 10.3%. The subjects who underwent bimaxillary surgery presented: normal weight = 43.3%, overweight = 36.7%, and obese = 20%. BMI was similar between the groups at all time points (preoperative, p= 0.237; 10 days PO, p= 0.325; 40 days PO, p= 0.430; and 90 days PO, p= 0.609). All patients lost weight postoperatively, and WL was similar among the PO measurements (p= 0.163). CONCLUSIONS Although both monomaxillary and bimaxillary orthognathic surgeries resulted in WL and lower BMI, there was no statistically significant difference in these metrics between the two types of surgery.
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Affiliation(s)
- Leonardo Benato
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Alice Vanzela Miotto
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Romulo Lazzari Molinari
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Bernardo Olsson
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | | | - Rubia Daniela Thieme
- Federal University of Paraná, Public Policy, Department of Nutrition (Curitiba/PR, Brazil)
| | | | - Nelson Luis Barbosa Rebellato
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Rafaela Scariot
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
| | - Leandro Eduardo Klüppel
- Federal University of Paraná, School of Dentistry, Department of Oral and Maxillofacial Surgery (Curitiba/PR, Brazil)
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Tolksdorf K, Schultze-Mosgau S, Jacobs C, Tietz S, Hennig CL. Orthognathic Surgery with Interdisciplinary Digital Planning in Patients with Geroderma Osteodysplasticum: A Case Report. J Pers Med 2023; 13:1578. [PMID: 38003893 PMCID: PMC10672396 DOI: 10.3390/jpm13111578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Patients with geroderma osteodysplasticum (GO) often times have dentofacial deformities and benefit from orthognathic surgery. Because of generalized osteopenia, operations must be prepared even more meticulously than usual, and the higher risk of unfortunate fractures (bad splits) should be explained to the patients in detail. This case report is intended to portray a digital, interdisciplinary and patient-individualized planning of orthognathic surgery. It points out the individual steps that must be considered and how they can be advantageously used in patients with underlying diseases or syndromes such as GO. Through a careful digital representation of the surgical options, production of the digitally modeled splints, 3D printing and good manual surgical implementation, the quality of life of patients with GO can be increased through orthognathic surgery. Both the functions in the oral, maxillofacial region and the patient's appearance in the case presented here benefited from the interdisciplinary, individualized and digital treatment approach.
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Affiliation(s)
- Konrad Tolksdorf
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Stefan Schultze-Mosgau
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Center of Dental Medicine, Jena University Hospital, An der Alten Post 4, 07743 Jena, Germany
| | - Stephanie Tietz
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Christoph-Ludwig Hennig
- Department of Orthodontics, Center of Dental Medicine, Jena University Hospital, An der Alten Post 4, 07743 Jena, Germany
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Wang X, Wei H, Li B. From "Empirical Surgery" to "Precision Surgery": establishment and clinical application of precision orthognathic surgery system. Hua Xi Kou Qiang Yi Xue Za Zhi 2023; 41:491-501. [PMID: 37805673 PMCID: PMC10580229 DOI: 10.7518/hxkq.2023.2023152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/08/2023] [Indexed: 10/09/2023]
Abstract
Orthognathic surgery, which involve osteotomy and repositioning of the maxillomandibular complex, has recently emerged as a crucial method of correcting dentofacial deformities. The optimal placement of the maxillomandibular complex holds utmost significance during orthognathic surgery because it directly affects the surgical outcome. To accurately achieve the ideal position of the maxillomandibular complex, with the rapid advancements in digital surgery and 3D-printing technology, orthognathic surgery has entered an era of "Precision Surgery" from the pervious "Empirical Surgery." This article provides comprehensive insights into our extensive research and exploration of the treatment modality known as "precision orthognathic surgery" over the years. We also present the technical system and application in"Ortho+X" treatment modality to offer valuable references and assistance to our colleagues in the field.
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Affiliation(s)
- Xudong Wang
- Dept. of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Hongpu Wei
- Dept. of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Biao Li
- Dept. of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
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Krarup H, Pedersen TK, Frid P, Nørholt SE. Long-Term Follow-Up of Orthognathic Surgery in 19 Patients with Juvenile Idiopathic Arthritis. J Oral Maxillofac Res 2023; 14:e4. [PMID: 38222878 PMCID: PMC10783879 DOI: 10.5037/jomr.2023.14404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/30/2023] [Indexed: 01/16/2024]
Abstract
Objectives Dentofacial deformity following juvenile idiopathic arthritis with temporomandibular joint involvement is associated with functional, aesthetic, and psychosocial impairment. Surgical treatment may involve combinations of orthognathic surgery. The aims of this retrospective study were to assess orofacial symptoms, functional and aesthetic status, and stability after orthognathic surgery. Material and Methods Nineteen patients with juvenile idiopathic arthritis of the temporomandibular joint (TMJ) and dentofacial deformities were included. All patients were treated with combinations of bilateral sagittal split osteotomy, Le Fort I and/or genioplasty, between September 10, 2007 and October 17, 2017. Analysis of patient symptoms and clinical registrations, and frontal/lateral cephalograms was performed pre- and postoperative and long-term (mean: 3.8 and 2.6 years, respectively). Results Patients experienced no changes in orofacial symptoms or TMJ function, and stable normalisation of horizontal and vertical incisal relations at long-term (horizontal overbite; vertical overbite: P < 0.05). Mandibular lengthening was achieved postoperatively (from mean 79.7 to 87.2 mm; P = 0.004) and was stable. Sella-nasion to A point (SNA) and sella-nasion to B point (SNB) angles increased postoperatively (SNA, mean 79.9° to 82.8°; P = 0.022 and SNB, mean 73.9° to 77.8°; P = 0.003), however, largely reverted to preoperative status at long-term. Conclusions Orthognathic surgery normalized incisal relations while providing stable mandibular lengthening without long-term deterioration of temporomandibular joint function or orofacial symptoms. No long-term effect on jaw advancements was observed.
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Affiliation(s)
- Henrik Krarup
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
| | - Thomas Klit Pedersen
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
- Section for Orthodontics, Department of Dentistry and Oral Health, Aarhus University, AarhusDenmark.
| | - Paula Frid
- Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, TromsøNorway.
- Public Dental Service Competence Centre of North Norway, TromsøNorway.
- Department of Clinical Dentistry, UiT the Arctic University of Norway, Tromsø
Norway.
| | - Sven Erik Nørholt
- Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, AarhusDenmark.
- Section for Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, AarhusDenmark.
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Luo E. Treatment of dentofacial deformities secondary to condylar hyperplasia. Hua Xi Kou Qiang Yi Xue Za Zhi 2023; 41:369-376. [PMID: 37474468 PMCID: PMC10372531 DOI: 10.7518/hxkq.2023.2023059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/27/2023] [Indexed: 07/22/2023]
Abstract
Dentofacial deformities secondary to condylar hyperplasiais a kind of disease presenting facial asymmetry, malocclusion, temporomandibular joint dysfunction, and other symptoms caused by non-neoplastic hyperplasia of the condyle. The etiology is still unknown, and currently, pre- and post-operative orthodontics accompanied by orthognathic surgery, temporomandibular joint surgery and jawbone contouring surgery are the main treatment methods. A personalized treatment plan was developed, considering the active degree of condyle hyperplasia, the severity of the jaw deformity, and the patient's will, to correct deformity, obtain ideal occlusal relationship, and regain good temporomandibular joint function. Combined with the author's clinical experience, the etiology, clinical and imageological features, treatment aims, and surgical methods of condylar hyperplasia and secondary dentofacial deformities were discussed in this paper.
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Affiliation(s)
- En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Chengdu 610041, China
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Amarista FJ, Perez DE. Concomitant Temporomandibular Joint Replacement and Orthognathic Surgery. Diagnostics (Basel) 2023; 13:2486. [PMID: 37568850 PMCID: PMC10416914 DOI: 10.3390/diagnostics13152486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The treatment of patients with severe temporomandibular joint (TMJ) disorders and associated skeletal discrepancies presents a complex challenge for oral and maxillofacial surgeons. It is widely recognized that TMDs can impact the stability and outcomes of surgical treatments for dentofacial deformities. Consequently, addressing TMDs prior to or in conjunction with orthodontic or surgical interventions may be necessary to achieve optimal and long-lasting results. Alloplastic temporomandibular joint replacement (TMJR) and orthognathic surgery have emerged as the standard approach due to their predictability, long-term stability and excellent outcomes when addressing end-stage TMJ disease in conjunction with DFDs as it provides a comprehensive solution to address both functional and aesthetic aspects of these patients' conditions. Understanding the appropriate utilization of TMJR in conjunction with orthognathic surgery can lead to improved treatment planning and successful outcomes for patients with complex TMJ disorders and associated dentofacial deformities. This review aims to discuss the indications, preoperative evaluation, staging, sequencing, and surgical considerations involved in utilizing alloplastic TMJ replacement in the presence of dentofacial deformities.
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Affiliation(s)
- Felix Jose Amarista
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, 8210 Floyd Curl Drive, Mail Code 8124, San Antonio, TX 78229, USA;
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12
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Jeong SH, Woo MW, Shin DS, Yeom HG, Lim HJ, Kim BC, Yun JP. Three-Dimensional Postoperative Results Prediction for Orthognathic Surgery through Deep Learning-Based Alignment Network. J Pers Med 2022; 12:998. [PMID: 35743782 PMCID: PMC9225553 DOI: 10.3390/jpm12060998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/13/2022] Open
Abstract
To date, for the diagnosis of dentofacial dysmorphosis, we have relied almost entirely on reference points, planes, and angles. This is time consuming, and it is also greatly influenced by the skill level of the practitioner. To solve this problem, we wanted to know if deep neural networks could predict postoperative results of orthognathic surgery without relying on reference points, planes, and angles. We use three-dimensional point cloud data of the skull of 269 patients. The proposed method has two main stages for prediction. In step 1, the skull is divided into six parts through the segmentation network. In step 2, three-dimensional transformation parameters are predicted through the alignment network. The ground truth values of transformation parameters are calculated through the iterative closest points (ICP), which align the preoperative part of skull to the corresponding postoperative part of skull. We compare pointnet, pointnet++ and pointconv for the feature extractor of the alignment network. Moreover, we design a new loss function, which considers the distance error of transformed points for a better accuracy. The accuracy, mean intersection over union (mIoU), and dice coefficient (DC) of the first segmentation network, which divides the upper and lower part of skull, are 0.9998, 0.9994, and 0.9998, respectively. For the second segmentation network, which divides the lower part of skull into 5 parts, they were 0.9949, 0.9900, 0.9949, respectively. The mean absolute error of transverse, anterior-posterior, and vertical distance of part 2 (maxilla) are 0.765 mm, 1.455 mm, and 1.392 mm, respectively. For part 3 (mandible), they were 1.069 mm, 1.831 mm, and 1.375 mm, respectively, and for part 4 (chin), they were 1.913 mm, 2.340 mm, and 1.257 mm, respectively. From this study, postoperative results can now be easily predicted by simply entering the point cloud data of computed tomography.
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Affiliation(s)
- Seung Hyun Jeong
- Advanced Mechatronics R&D Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan 38408, Korea; (S.H.J.); (M.W.W.)
| | - Min Woo Woo
- Advanced Mechatronics R&D Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan 38408, Korea; (S.H.J.); (M.W.W.)
- School of Computer Science and Engineering, Kyungpook National University, Daegu 41566, Korea
| | - Dong Sun Shin
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, College of Dentistry, Wonkwang University, Daejeon 35233, Korea; (D.S.S.); (H.J.L.)
| | - Han Gyeol Yeom
- Department of Oral and Maxillofacial Radiology, Daejeon Dental Hospital, College of Dentistry, Wonkwang University, Daejeon 35233, Korea;
| | - Hun Jun Lim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, College of Dentistry, Wonkwang University, Daejeon 35233, Korea; (D.S.S.); (H.J.L.)
| | - Bong Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, College of Dentistry, Wonkwang University, Daejeon 35233, Korea; (D.S.S.); (H.J.L.)
| | - Jong Pil Yun
- Advanced Mechatronics R&D Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan 38408, Korea; (S.H.J.); (M.W.W.)
- KITECH School, University of Science and Technology, Daejeon 34113, Korea
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13
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Raffaini M, Arcuri F. Orthognathic surgery for juvenile idiopathic arthritis of the temporomandibular joint: a critical reappraisal based on surgical experience. Int J Oral Maxillofac Surg 2021:S0901-5027(21)00392-1. [PMID: 34815166 DOI: 10.1016/j.ijom.2021.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 11/21/2022]
Abstract
Juvenile idiopathic arthritis (JIA) involving the temporomandibular joint (TMJ) can result in significant dentofacial deformities that may require orthognathic surgical correction. The aim of this study was to assess the functional and aesthetic results relative to stability after bimaxillary surgery with counterclockwise rotation of the occlusal plane in patients with JIA. A retrospective chart review was conducted of all patients affected by JIA who underwent orthognathic surgery between January 2000 and December 2019 at the Face Surgery Centre (Parma, Italy). Patient records were evaluated for surgical indications, complications, and outcomes. The final study sample included 13 patients (12 female, one male). The mean age of the patients was 18.6 years (range 17-26 years) at the time of surgery; 12 patients had bilateral TMJ disease. At the 1-year follow-up, all patients except one had a stable occlusion with a natural, well-balanced morphology of the face and adequate dynamic excursion of the mandible. The 1-year postoperative cone beam computed tomography (CBCT) scan revealed complete ossification at all osteotomy sites. Bilateral sagittal split osteotomy with mandibular advancement is an effective procedure with a low rate of complications for patients with JIA with stable disease confirmed by preoperative CBCT or magnetic resonance imaging.
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14
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Kerbrat A, Schouman T, Decressain D, Rouch P, Attali V. Interaction between posture and maxillomandibular deformity: a systematic review. Int J Oral Maxillofac Surg 2021; 51:104-112. [PMID: 34120792 DOI: 10.1016/j.ijom.2021.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/05/2021] [Accepted: 05/07/2021] [Indexed: 11/24/2022]
Abstract
Maxillomandibular deformity (MMD) and body posture appear to be correlated. However, no systematic literature review of the available evidence to support this correlation has been performed to date. The aim of this study was to conduct a systematic literature review on posture and MMD. This systematic literature review was registered in the PROSPERO database. Systematic searches of the MEDLINE, Scopus, Cochrane Library, and Web of Science databases were performed. In total, 13 clinical studies were included. Nine found a significant association between MMD and body posture or body balance: two studies showed a correlation between increased cervical lordosis and skeletal class III MMD, two studies showed an interaction between mandibular deviation and scoliosis, four studies demonstrated a significant association between lumbar column and pelvis anatomy and MMD, and one study found a correlation between displacement of the centre of mass and MMD. However, the level of evidence is low; the methods used to evaluate body posture and MMD were inconsistent. Orthognathic surgery could modify body posture. Although there seems to be an interaction between body posture and facial deformity, the number of studies is too small and the level of evidence too low to strongly support this association.
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Affiliation(s)
- A Kerbrat
- Service de Chirurgie Maxillo-Faciale, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France; Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France.
| | - T Schouman
- Service de Chirurgie Maxillo-Faciale, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France; Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - D Decressain
- Service de Chirurgie Maxillo-Faciale, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - P Rouch
- Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - V Attali
- Arts et Métiers Sciences et Technologies, Institut de Biomécanique Humaine Georges Charpak, Paris, France; Groupe Hospitalier Universitaire APHP - Sorbonne Université, site Pitié-Salpêtrière, Service des Pathologies du Sommeil (Département R3S), Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
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15
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Zhu SS, Li YF. Comprehensive correction of maxillofacial bone deformity-consideration and combined application of orthognathic surgery and facial contouring surgery. Hua Xi Kou Qiang Yi Xue Za Zhi 2021; 39:255-259. [PMID: 34041872 DOI: 10.7518/hxkq.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The maxillofacial skeleton is the basis of the contour of the face. Orthognathic surgery and facial contouring surgery change jaw tissue and affect facial appearance in different manners. Orthognathic surgery is the main method to correct dental and maxillofacial deformities. It changes the shape of the jaw and improves the occlusal relationship by changing the three-dimensional position of the jaw. Facial contouring surgery mainly adopts the method of "bone reduction", which changes the "amount"of the jawbone by cutting a part of the bone tissue to improve the facial appearance, generally without changing oral function. The combined use of orthognathic surgery and facial contouring surgery is becoming increasingly common in clinical practice. This also requires oral and maxillofacial surgeons to have a holistic consideration of the comprehensive correction of maxillofacial bone deformity, and to perform comprehensive analysis of jaw deformities and jaw plastic surgery to achieve the most ideal results. The author's team has been engaged in the clinical work of orthognathic surgery and facial contouring surgery and accumulated rich clinical experience in the comprehensive correction of maxillofacial bone deformity. In this article, the indications, treatment goals, treatment modes, treatment methods, and key points in the surgical operations of comprehensive maxillofacial bone surgery were summarized.
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Affiliation(s)
- Song-Song Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yun-Feng Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Szyszka-Sommerfeld L, Machoy ME, Wilczyński S, Lipski M, Woźniak K. Superior Orbicularis Oris Muscle Activity in Children Surgically Treated for Bilateral Complete Cleft Lip and Palate. J Clin Med 2021; 10:jcm10081720. [PMID: 33923491 PMCID: PMC8074006 DOI: 10.3390/jcm10081720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of this cross-sectional study was to evaluate the electromyographic activity of the superior orbicularis oris muscle both in children surgically treated for bilateral complete cleft lip and palate (BCCLP) as well as in subjects without BCCLP. The study comprised 77 children aged 6.6 to 12.5 years. All the patients with clefts had previously undergone lip and palate surgery. The upper lip electromyographic (EMG) assessments were made with a DAB-Bluetooth device (Zebris Medical GmbH, Germany) at rest, while swallowing saliva, protruding lips and compressing lips. EMG measurements were also made when the subjects produced phonemes /p/, /b/, and /m/ with the vowel /a/. The Mann-Whitney U test was applied to statistically analyze the EMG values. Significantly higher median upper lip EMG activity under working conditions such as swallowing saliva, lip compression, and production of the phoneme /p/ with the vowel /a/ was observed in patients with BCCLP compared to those without a cleft. The results of the study showed that the upper lip muscle activity increases in children with BCCLP when swallowing saliva, compressing lips and during some speech movement tasks. This may be important in the aspect of the effect of surgical lip repair on the craniofacial growth.
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Affiliation(s)
- Liliana Szyszka-Sommerfeld
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (M.E.M.); (K.W.)
- Correspondence: ; Tel.: +48-91-466-17-02
| | - Monika Elżbieta Machoy
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (M.E.M.); (K.W.)
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Medical University of Silesia, Katowice, 3 Kasztanowa Street, 41200 Sosnowiec, Poland;
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland;
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70111 Szczecin, Poland; (M.E.M.); (K.W.)
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Abstract
Accurate segmentation of the jaw (i.e., mandible and maxilla) and the teeth in cone beam computed tomography (CBCT) scans is essential for orthodontic diagnosis and treatment planning. Although various (semi)automated methods have been proposed to segment the jaw or the teeth, there is still a lack of fully automated segmentation methods that can simultaneously segment both anatomic structures in CBCT scans (i.e., multiclass segmentation). In this study, we aimed to train and validate a mixed-scale dense (MS-D) convolutional neural network for multiclass segmentation of the jaw, the teeth, and the background in CBCT scans. Thirty CBCT scans were obtained from patients who had undergone orthodontic treatment. Gold standard segmentation labels were manually created by 4 dentists. As a benchmark, we also evaluated MS-D networks that segmented the jaw or the teeth (i.e., binary segmentation). All segmented CBCT scans were converted to virtual 3-dimensional (3D) models. The segmentation performance of all trained MS-D networks was assessed by the Dice similarity coefficient and surface deviation. The CBCT scans segmented by the MS-D network demonstrated a large overlap with the gold standard segmentations (Dice similarity coefficient: 0.934 ± 0.019, jaw; 0.945 ± 0.021, teeth). The MS-D network–based 3D models of the jaw and the teeth showed minor surface deviations when compared with the corresponding gold standard 3D models (0.390 ± 0.093 mm, jaw; 0.204 ± 0.061 mm, teeth). The MS-D network took approximately 25 s to segment 1 CBCT scan, whereas manual segmentation took about 5 h. This study showed that multiclass segmentation of jaw and teeth was accurate and its performance was comparable to binary segmentation. The MS-D network trained for multiclass segmentation would therefore make patient-specific orthodontic treatment more feasible by strongly reducing the time required to segment multiple anatomic structures in CBCT scans.
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Affiliation(s)
- H Wang
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J Minnema
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - K J Batenburg
- Centrum Wiskunde and Informatica, Amsterdam, the Netherlands
| | - T Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - F J Hu
- Institute of Information Technology, Zhejiang Shuren University, Hangzhou, China
| | - G Wu
- Department of Oral and Maxillofacial Surgery/Pathology, 3D Innovation Lab, Amsterdam Movement Sciences, Amsterdam UMC, Academic Centre for Dentistry Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Issa SA, Abdulnabi HA. The value of surgical articulator MT in orthognathic model surgery: Technical note and case report. Clin Case Rep 2021; 9:1163-1166. [PMID: 33768802 PMCID: PMC7981726 DOI: 10.1002/ccr3.3707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/12/2020] [Indexed: 11/29/2022] Open
Abstract
The utilize of surgical articulator MT may lead to a major reduction in time and effort that usually consuming in conventional model surgery and promoted for precise planning and surgery. It can be useful in the management of several cases of dentofacial deformities when virtual surgical planning is either unaffordable or unavailable.
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Ahl M, Marcusson A, Ulander M, Magnusson A, Cardemil C, Larsson P. Translation and validation of the English-language instrument Orthognathic Quality of Life Questionair into Swedish. Acta Odontol Scand 2021; 79:19-24. [PMID: 32432962 DOI: 10.1080/00016357.2020.1768284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION In orthognathic surgery, understanding the patient's motives for treatment is a key factor for postoperative patient satisfaction and treatment success. In countries/systems where orthognathic surgery is funded by public means, patients are referred mainly due to functional problems, although studies of quality of life related changes after treatment indicate that psychosocial and aesthetic reasons might be equal or more important for the patient. There is no available validated condition specific instruments in the Swedish language for quality of life evaluation of patients with dentofacial deformities. Aims/objectives: Cross cultural translation and adaptation of the English-language instrument 'Orthognathic Quality of Life Questionnaire' (OQLQ) into Swedish. Methods: OQLQ was translated into Swedish. A total of 121 patients in four groups were recruited and the Swedish version of the OQLQ (OQLQ-S) was tested by psychometric methods. Reliability was assessed by internal consistency and test-retest reliability. Validity was evaluated by face, convergent and discriminant validity. Results/findings and conclusions: OQLQ-S is reliable and showed good construct validity and internal consistency and can be used in a Swedish speaking population as a complement to clinical variables to evaluate patients with dentofacial deformity.
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Affiliation(s)
- Magnus Ahl
- Department of Oral and Maxillofacial Surgery, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- Maxillofacial Unit, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Agneta Marcusson
- Maxillofacial Unit, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Martin Ulander
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
- Division of Neurosciences and Inflammation, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - Anders Magnusson
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden
- Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Carina Cardemil
- Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Pernilla Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
- Centre of Oral Rehabilitation, Folktandvården Östergötland, Norrköping, Sweden
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Luo E, He Z. [Treatment of dentofacial deformities secondary to condylar resorption]. Hua Xi Kou Qiang Yi Xue Za Zhi 2020; 38:1-5. [PMID: 32037758 PMCID: PMC7184297 DOI: 10.7518/hxkq.2020.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/02/2019] [Indexed: 02/05/2023]
Abstract
Treating dentofacial deformities secondary to condylar resorption is a remarkable clinical challenge. Combined orthodontic treatment and orthognathic surgery is currently the main treatment scheme and is often integrated with temporomandibular joint surgery or conservative treatment according to the severity of condylar resorption. This paper discussed the etiology, clinical features, imaging features, treatment options, and prophylaxis of condylar resorption.
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Affiliation(s)
- En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ze He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Borys J, Maciejczyk M, Krȩtowski AJ, Antonowicz B, Ratajczak-Wrona W, Jabłońska E, Załęski P, Waszkiel D, Ładny JR, Żukowski P, Zalewska A. The Redox Balance in Erythrocytes, Plasma, and Periosteum of Patients with Titanium Fixation of the Jaw. Front Physiol 2017. [PMID: 28638348 PMCID: PMC5461302 DOI: 10.3389/fphys.2017.00386] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Titanium miniplates and screws are commonly used for fixation of jaw fractured or osteotomies. Despite the opinion of their biocompatibility, in clinical practice symptoms of chronic inflammation around the fixation develop in some patients, even many years after the application of miniplates and screws. The cause of these complications is still an unanswered question. Taking into account that oxidative stress is one of the toxic action of titanium, we have evaluated the antioxidant barrier as well as oxidative stress in the erythrocytes, plasma and periosteum covering the titanium fixation of the jaw. The study group was composed of 32 patients aged 20–30 with inserted miniplates and screws. The antioxidant defense: catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase-1 (SOD1), uric acid (UA), total antioxidant capacity (TAC), as well as oxidative damage products: advanced oxidation protein products (AOPP), advanced glycation end products (AGE), dityrosine, kynurenine, N-formylkynurenine, tryptophan, malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), total oxidant status (TOS), and oxidative status index (OSI) were evaluated. SOD1 activity (↓37%), and tryptophan levels (↓34%) showed a significant decrease while AOPP (↑25%), TOS (↑80%) and OSI (↑101%) were significantly elevated in maxillary periosteum of patients who underwent bimaxillary osteotomies as compared to the control group. SOD-1 (↓55%), TAC (↓58.6%), AGE (↓60%) and N-formylkynurenine (↓34%) was statistically reduced while AOPP (↑38%), MDA (↑29%), 4-HNE (↑114%), TOS (↑99%), and OSI (↑381%) were significantly higher in the mandibular periosteum covering miniplates/screw compared with the control tissues. There were no correlations between antioxidants and oxidative stress markers in the periosteum of all patients and the blood. As exposure to the Ti6Al4V titanium alloy leads to disturbances of redox balance in the periosteum surrounding titanium implants of the maxilla and the mandible so antioxidant supplementation should be recommended to the patients undergoing treatment of dentofacial deformities with the use of titanium implants. The results we obtained may also indicate a need to improve the quality of titanium jaw fixations through increase of TiO2 passivation layer thickness or to develop new, the most highly biodegradable materials for their production.
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Affiliation(s)
- Jan Borys
- Department of Maxillofacial and Plastic Surgery, Medical University of BialystokBialystok, Poland
| | - Mateusz Maciejczyk
- Department of Physiology, Medical University of BialystokBialystok, Poland
| | - Adam J Krȩtowski
- Clinical Research Centre, Medical University of BialystokBialystok, Poland
| | - Bozena Antonowicz
- Department of Oral Surgery, Medical University of BialystokBialystok, Poland
| | | | - Ewa Jabłońska
- Department of Immunology, Medical University BialystokBialystok, Poland
| | - Piotr Załęski
- Department of Maxillofacial and Plastic Surgery, Medical University of BialystokBialystok, Poland
| | - Danuta Waszkiel
- Department of Conservative Dentistry, Medical University BialystokBialystok, Poland
| | - Jerzy R Ładny
- Department of Emergency Medicine and Disaster, Medical University BialystokBialystok, Poland
| | - Piotr Żukowski
- Department of Restorative Dentistry, Croydon University HospitalCroydon, United Kingdom
| | - Anna Zalewska
- Department of Conservative Dentistry, Medical University BialystokBialystok, Poland
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22
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Singh A, Dhawan P, Gaurav V, Rastogi P, Singh S. Assessment of oral health-related quality of life in 9-15 year old children with visual impairment in Uttarakhand, India. Dent Res J (Isfahan) 2017; 14:43-49. [PMID: 28348617 PMCID: PMC5356388 DOI: 10.4103/1735-3327.201132] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To assess the prevalence of dental diseases among 9-15-year-old visually impaired children and find out its impact on their daily activities using the Child-Oral Impact on Daily Performance (C-OIDP) questionnaire in districts of Uttarakhand, India. MATERIALS AND METHODS A total of 423 visually impaired institutionalized children between the age group of 9-15 years were included in the study. Stratified random sampling technique was used to obtain the study population. Dental caries was recorded using dmft for primary dentition and DMFT for permanent dentition, traumatic dental injuries were assessed using traumatic dental injury index, and dentofacial anomalies were recorded using Angle's classification of malocclusion. The Hindi braille version of C-OIDP questionnaire was used to gather information regarding oral health-related quality of life (OHRQoL). RESULTS There was a high dental caries prevalence of 57.7% in visually impaired children. The prevalence of traumatic dental injuries was 50.6%. Crowding (61.5%) was the most commonly seen dentofacial anomaly and the most commonly perceived oral health problem was toothache. There was less favorable OHRQoL in males as compared to females. CONCLUSION There was a high prevalence of dental diseases in this group and higher C-OIDP scores suggestive of unfavorable OHRQoL.
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Affiliation(s)
- Aditi Singh
- Department of Paedodontics and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Preeti Dhawan
- Department of Paedodontics and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Vivek Gaurav
- Department of Paedodontics and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Pradeep Rastogi
- Department of Paedodontics and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Shilpi Singh
- Department of Public Health Dentistry, IDST, Modinagar, Uttar Pradesh, India
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Adolphs N, Ernst N, Keeve E, Hoffmeister B. Contemporary Correction of Dentofacial Anomalies: A Clinical Assessment. Dent J (Basel) 2016; 4:dj4020011. [PMID: 29563453 PMCID: PMC5851261 DOI: 10.3390/dj4020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/18/2016] [Accepted: 04/22/2016] [Indexed: 11/16/2022] Open
Abstract
Contemporary computer-assisted technologies can support the surgical team in the treatment of patients affected by dentofacial deformities. Based on own experiences of 350 patients that received orthognathic surgery by the same team from 2007 to 2015, this clinical review is intended to give an overview of the results and risks related to the surgical correction of dentofacial anomalies. Different clinical and technological innovations that can contribute to improve the planning and transfer of corrective dentofacial surgery are discussed as well. However, despite the presence of modern technologies, a patient-specific approach and solid craftsmanship remain the key factors in this elective surgery.
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Affiliation(s)
- Nicolai Adolphs
- Department of Craniomaxillofacial Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 2, Berlin 13353, Germany.
| | - Nicole Ernst
- Department of Craniomaxillofacial Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 2, Berlin 13353, Germany.
| | - Erwin Keeve
- Department of Craniomaxillofacial Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 2, Berlin 13353, Germany.
| | - Bodo Hoffmeister
- Department of Craniomaxillofacial Surgery, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 2, Berlin 13353, Germany.
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24
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Bortoluzzi MC, de Camargo Smolarek P, Claudino M, Campagnoli EB, Manfro R. Impact of Dentofacial Deformity on Quality of Life: Age and Gender Differences Evaluated Through OQLQ, OHIP and SF36. J Oral Maxillofac Res 2015; 6:e3. [PMID: 26539285 PMCID: PMC4628491 DOI: 10.5037/jomr.2015.6303] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 08/19/2015] [Indexed: 11/25/2022]
Abstract
Objectives The aim of this study was to verify the impact of dentofacial deformity on quality of life and explore gender and age differences. Material and Methods The impact of dentofacial deformity (DD) on quality of life was evaluated through questionnaires; Short Form Health Survey (SF36), Oral Health Impact Profile Questionnaire (OHIP), Orthognathic Quality of Life Questionnaire (OQLQ) and a single question answered by a Visual Analogue Scale. Results Significant differences between male and female patients were observed in domains of OQLQ (oral function, P = 0.006; awareness of facial deformity, P = 0.018; and facial aesthetics, P < 0.001) and OHIP (physical pain, P = 0.006; psychological discomfort, P = 0.007; psychological disability, P = 0.006; and handicap, P = 0.01). Conclusions The impact of dentofacial deformity was more pronounced in female Brazilian population. Age of patients with dentofacial deformity produced impacts over quality of life in different ways and according to the applied questionnaire and the interaction between age and gender may also produce different impacts in patients with dentofacial deformity. The domains of Orthognathic Quality of Life Questionnaire, Oral Health Impact Profile Questionnaire and Short Form Health Survey showed unaccepted distances in the pattern of answer rising doubts of their ability to assess quality of life as a generic and broad concept. There is a necessity to create a single quality of life instrument capable to measure impacts with sensitivity and specificity and from a generic concept to condition-specific health problem.
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Affiliation(s)
- Marcelo Carlos Bortoluzzi
- School of Dentistry, Dentistry Department, Ponta Grossa State University, Ponta Grossa, Paraná Brazil
| | | | - Marcela Claudino
- School of Dentistry, Dentistry Department, Ponta Grossa State University, Ponta Grossa, Paraná Brazil
| | - Eduardo B Campagnoli
- School of Dentistry, Dentistry Department, Ponta Grossa State University, Ponta Grossa, Paraná Brazil
| | - Rafael Manfro
- School of Dentistry, Dentistry Department, Ponta Grossa State University, Ponta Grossa, Paraná Brazil
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Eley KA, Watt-Smith SR, Golding SJ. "Black Bone" MRI: a potential non-ionizing method for three-dimensional cephalometric analysis--a preliminary feasibility study. Dentomaxillofac Radiol 2013; 42:20130236. [PMID: 24052254 DOI: 10.1259/dmfr.20130236] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES CT offers a three-dimensional solution to the inaccuracies associated with lateral cephalogram-based cephalometric analysis. However, it is associated with significant concerns regarding ionizing radiation exposure. MRI offers a non-ionizing alternative, but this has been less well investigated. We present a novel gradient echo MRI sequence ("Black Bone") and highlight the potential of this sequence in cephalometric analysis. METHODS After regional ethics approval, "Black Bone" imaging was obtained in eight patients in whom lateral cephalograms were available. "Black Bone", T1 and T2 weighted spin echo imaging were obtained in the mid-sagittal plane, and measurements were compared with those obtained on the lateral cephalogram using both the Advantage Windows Workstation (GE Medical Systems, Buckinghamshire, UK) and the Dolphin(®) cephalometric software (v. 11.5.04.23, Premium; Dolphin Imaging, Chatsworth, CA) by one assessor. Further assessment was made by scoring the ease of landmark identification on a ten-point scale. RESULTS "Black Bone" imaging surpassed T1 and T2 weighted imaging in terms of cephalometric landmark identification. A number of mid-sagittal cephalometric landmarks could not be clearly identified on T2 weighted imaging, making analysis impossible. Measurements on "Black Bone" demonstrated the smallest discrepancy when compared with those obtained on the lateral cephalogram. The discrepancy seen between measurements completed on mid-sagittal MRI and the lateral cephalogram was compounded by inherent inaccuracies of the lateral cephalogram. The overall mean discrepancy between distance measurements on "Black Bone" imaging and those on the lateral cephalogram was 1-2 mm. CONCLUSIONS Overall, "Black Bone" MRI offered an improved method of cephalometric landmark identification over routine MRI sequences, and provides a potential non-ionizing alternative to CT for three-dimensional cephalometrics.
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Affiliation(s)
- K A Eley
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
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