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Wiechens B, Backhaus SJ, Oestreicher D, Beutner D, Schliephake H, Meyer-Marcotty P, Brockmeyer P. Assessment of oropharyngeal respiratory volume and sleep apnoea scores using peripheral arterial tonometry may improve diagnosis and treatment planning of combined dysgnathia therapy approaches. J Oral Rehabil 2024; 51:733-742. [PMID: 38100245 DOI: 10.1111/joor.13641] [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: 07/28/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Increased daytime sleepiness is a frequently reported symptom in patients with pronounced dysgnathia. OBJECTIVES This study investigated possible correlations using home peripheral arterial tonometry (PAT) and oropharyngeal airway volume determination in patients with dysgnathia and daytime sleepiness. METHODS Twenty patients (13 male, median age 27.6 ± 6.8 years) with abnormal sleep history and 10 skeletal neutral configured controls (6 male, median age 29.5 ± 4.2 years) with normal sleep history were examined. Patients and controls were evaluated for apnoea-hypopnoea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index (ODI), snoring volume (dB), total sleep time (TST) and REM-percentage (REM). Airway volumetry was measured via CBCT. Individual user experience for PAT was assessed using the User Experience Questionnaire (UEQ). RESULTS Patients had significantly higher respiratory scores than controls. AHI increased 4.6-fold (p = .006), RDI 2.5-fold (p = .008) and ODI 6.4-fold (p < .001). Oropharyngeal volumes showed a 30% decrease (p = .003). dB, TST and REM showed no significant differences. AHI (r = -.51; p = .005), ODI (r = -.60; p < .001) and RDI (r = -.45; p = .016) correlated negatively with pharyngeal volume. Wits appraisal correlated negatively with oropharyngeal volume (r = -.47; p = .010) and positively with AHI (r = .41; p = .03) and ODI (r = .49; p = .007). dB and TST (r = -.49; p = .008) and REM and RDI (r = -.43; p = .02) correlated negatively. UEQ-KPI (2.17 ± 0.24) confirmed excellent usability of PAT. CONCLUSION Patients with mandibular retrognathia and abnormal sleep history showed significantly higher respiratory indices and smaller oropharyngeal volumes than neutrally configured controls. The dygnathia severity directly influenced the risk of obstructive sleep apnoea.
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Affiliation(s)
- Bernhard Wiechens
- Department of Orthodontics, University Medical Center Goettingen, Goettingen, Germany
| | - Sören J Backhaus
- Department of Cardiology and Pneumology University Medical Center Goettingen, Goettingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Goettingen, Goettingen, Germany
| | - David Oestreicher
- Department of Otorhinolaryngology, University Medical Center Goettingen, Goettingen, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, University Medical Center Goettingen, Goettingen, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
| | | | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
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Ahn HJ, Byun SH, Baek SH, Park SY, Yi SM, Park IY, On SW, Kim JC, Yang BE. A Comparative Analysis of Artificial Intelligence and Manual Methods for Three-Dimensional Anatomical Landmark Identification in Dentofacial Treatment Planning. Bioengineering (Basel) 2024; 11:318. [PMID: 38671740 PMCID: PMC11048285 DOI: 10.3390/bioengineering11040318] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
With the growing demand for orthognathic surgery and other facial treatments, the accurate identification of anatomical landmarks has become crucial. Recent advancements have shifted towards using three-dimensional radiologic analysis instead of traditional two-dimensional methods, as it allows for more precise treatment planning, primarily relying on direct identification by clinicians. However, manual tracing can be time-consuming, mainly when dealing with a large number of patients. This study compared the accuracy and reliability of identifying anatomical landmarks using artificial intelligence (AI) and manual identification. Thirty patients over 19 years old who underwent pre-orthodontic and orthognathic surgery treatment and had pre-orthodontic three-dimensional radiologic scans were selected. Thirteen anatomical indicators were identified using both AI and manual methods. The landmarks were identified by AI and four experienced clinicians, and multiple ANOVA was performed to analyze the results. The study results revealed minimal significant differences between AI and manual tracing, with a maximum deviation of less than 2.83 mm. This indicates that utilizing AI to identify anatomical landmarks can be a reliable method in planning orthognathic surgery. Our findings suggest that using AI for anatomical landmark identification can enhance treatment accuracy and reliability, ultimately benefiting clinicians and patients.
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Affiliation(s)
- Hee-Ju Ahn
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sae-Hoon Baek
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sang-Yoon Park
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sang-Min Yi
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - In-Young Park
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
- Department of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sung-Woon On
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University Dongtan Sacred Heart Hospital, Hawseong 18450, Republic of Korea
| | - Jong-Cheol Kim
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Mir Dental Hospital, Daegu 41940, Republic of Korea
| | - Byoung-Eun Yang
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
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Borzabadi-Farahani A. Systematic Review and Meta-Analysis of the Index of Orthognathic Functional Treatment Need for Detecting Subjects with Great Need for Orthognathic Surgery. Cleft Palate Craniofac J 2023:10556656231216833. [PMID: 38037271 DOI: 10.1177/10556656231216833] [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: 12/02/2023] Open
Abstract
Index of Orthognathic Functional Treatment Need (IOFTN) Identifies patients with greatest need for orthoganthic surgery. This systematic review looks into the available evidence on prevalence of patients with great treatment need (IOFTN 4&5) who had orthognathic surgery in previous studies. Literature search of the major electronic databases was carried out for articles published between 2014 and September 2023, looking for "Index of Orthognathic Functional Treatment Need","Orthognathic Surgery","IOFTN", "Epidemiology" and "Dentofacial Deformity". The prevalence of patients identified with IOFTN grades of 4&5 was calculated. A random-effect model was employed and the Forest and Galbraith plots were produced. The pooled prevalence estimate for subjects with IOFTN scores of 4&5 was calculated. The heterogeneity among studies was assessed with the I2 statistics. In total, 14 retrospective studies conducted between 2015 and 2019 in 7 countries (UK, New Zealand, Iran, Pakistan, Turkey, Malaysia, Japan) were included, reporting on 1339 orthognathic patients. The sample sizes ranged from 30 to 200. Only 7 studies reported on the subcategories of the IOFTN for grades 1, 2&3. The prevalence of orthognathic patients with IOFTN scores of 4 & 5 ranged from 79% to 100%. The heterogeneity I2 statistics was 16%. The pooled prevalence estimate for subjects with IOFTN scores of 4&5 was 92% (95% CI, 0.91-0.94%). According to this meta-analysis, IOFTN successfully identified 92% of patients who underwent orthognathic surgery with a great need for treatment (Grade 4 & 5). To enhance the identification of patients with well-compensated malocclusions, previous orthodontic treatment, or extreme occlusal deviations (e.g., proclination or retroclination of incisors), it would be advantageous to employ additional means alongside IOFTN for assessing orthognathic need in this group.
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Affiliation(s)
- Ali Borzabadi-Farahani
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
- Crouch End Orthodontics, London, UK
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Miotto AV, Bonotto DV, Silva JSC, De Souza JF, Sebastiani AM, Scariot R. Temporomandibular Disorders at the Preoperative Time of Orthognathic Surgery. Diagnostics (Basel) 2023; 13:2922. [PMID: 37761289 PMCID: PMC10528885 DOI: 10.3390/diagnostics13182922] [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: 07/27/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Individuals seeking orthodontic treatment combined with orthognathic surgery (OS) have a high prevalence of temporomandibular disorders (TMDs), but the relationship between TMD diagnoses and dentofacial deformities (DFDs) is still controversial. Therefore, this cross-sectional study with a comparison group aimed to analyze the association between dentofacial deformities and TMDs. METHODOLOGY Eighty patients undergoing OS were consecutively selected from the stomatology department of the Federal University of Paraná between July 2021 and July 2022. Forty patients who would undergo OS composed the group of participants with DFD, and forty who received other types of attention and did not present changes in the dental bone bases formed the group without DFDs (DFDs and no DFDs groups). The groups were matched for sex, age, and self-reported ethnicity. The diagnostic criteria for TMDs (DC/TMDs) were used to diagnose TMD based on the Axis I criteria. The psychosocial aspects, oral behaviors in wakefulness, and sleep bruxism were evaluated through the Axis II criteria. The data were analyzed with a 5% significance level. RESULTS The presence of DFDs was significantly associated with arthralgia (p = 0.01). The other types of TMDs were not associated with DFDs. Comorbidities, habits, and psychosocial variables were not associated with DFDs at a level of 0.05. (p > 0.05). In analyzing the participants with arthralgia, the ones with this condition presented higher frequencies of sleep bruxism (p = 0.046). CONCLUSIONS Participants with DFDs presented a significantly higher frequency of arthralgia when compared to no DFDs ones. Sleep bruxism was associated with the occurrence of joint TMDs in these participants.
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Affiliation(s)
| | | | | | | | - Aline Monise Sebastiani
- Department of Stomatology, School of Dentistry, Federal University of Paraná, 623 Prefeito Lothário Meissner Avenue, Curitiba 80210-170, PR, Brazil; (A.V.M.); (J.S.C.S.); (J.F.D.S.); (R.S.)
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Ravelo V, Olate G, de Moraes M, Guevara HG, Parra M, Olate S. TMJ Position in Symmetric Dentofacial Deformity. J Clin Med 2022; 11. [PMID: 35806915 DOI: 10.3390/jcm11133631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/10/2022] Open
Abstract
The aim of this research was to analyze the facial class, presence of malocclusion, and the mandibular plane and to relate this to the mandibular condyle position. A cross-sectional study in subjects under analysis for orthognathic surgery was done. The mandibular plane, the gonial angle, and the molar class were included to compare the coronal and sagittal position of the condyle and the joint space observed in the CBCT. The measurements were obtained by the same observer at an interval of two weeks. In addition, the Spearman test was performed to determine the correlation using a p value < 0.05 to observe any significant differences. Eighty-nine male and female subjects (18 to 58 years old, 24.6 ± 10.5) were included. In the coronal section, subjects with CIII had a greater mediolateral distance (MLD, p = 0.0001) and greater vertical distance (SID, p = 0.0001) than subjects with CII. In terms of the skeletal class and the mandibular plane, it was observed that subjects in the CII group had a greater mandibular angle (open angle) (p = 0.04) than the CII group and was related to the anterior position of the condyle. The most anterior condylar position was observed in the CII group (p = 0.03), whereas a posterior condylar position was significant in CIII subjects (p = 0.03). We can conclude that the sagittal position of the TMJ was related to the mandibular plane and the skeletal class showing a higher mandibular angle and most anterior position of the condyle in CII subjects and a lower mandibular angle and most posterior position of the condyle in CIII subjects. The implications for surgical treatment have to be considered.
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Zhu S, Wang X, Yang X, Wang X, Tian L, Liu S, Zheng G, Tang Z, Wu G, Li Z, Bai X, Huang X, Huang L, Xi W, Zhu Y. Experts' consensus on precaution and treatment for complications of sagittal split ramus osteotomy. Hua Xi Kou Qiang Yi Xue Za Zhi 2022; 40:247-254. [PMID: 38597003 PMCID: PMC9207788 DOI: 10.7518/hxkq.2022.03.001] [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] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/14/2022] [Indexed: 04/11/2024]
Abstract
Sagittal split ramus osteotomy (SSRO) is a versatile orthognathic procedure for correcting mandibular deformities. Various complications can possibly occur when performing SSRO, and it can even cause serious adverse consequences because of the complexity of anatomy and operative procedures. The types of complications and their accompanying clinical manifestations are closely related to the choice of diagnosis and treatment strategies and clinical outcomes. To discuss the causes, prevention, and treatment measures of various common complications of SSRO, domestic orthognathic surgery experts prepared this consensus to increase the awareness of SSRO complications, thereby ensuring safe surgical procedure and good results.
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Affiliation(s)
- Songsong Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xudong Wang
- Dept. of Oral and Craniomaxillofacial Surgery, Shanghai Ninth Peoples 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
| | - Xuewen Yang
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Xiaoxia Wang
- Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Lei Tian
- Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, School of Stomatology, The Air Force Medical University, Xi'an 710032, China
| | - Shuguang Liu
- Dept. of Oral and Maxillofacial Surgery, Stomatology Hospital, Southern Medicine University, Guangzhou 510280, China
| | - Guangsen Zheng
- Dept. of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Zhenglong Tang
- Dept. of Oral and Maxillofacial Surgery, Stomatological Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Guomin Wu
- Dept. of Oral and Maxillofacial Surgery, Stomatology Hospital, Jilin University, Changchun 130021, China
| | - Zhiyong Li
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine; Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310006, China
| | - Xiaofeng Bai
- Dept. of Oral and Maxillofacial Surgery, China Medical University School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Xuanping Huang
- Guangxi Medical University College of Stomatology, Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Clinical Research Center for Craniofacial Deformity, Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Nanning 530021, China
| | - Li Huang
- Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Laboratory of Facial Rehabilitation and Reconstruction, Fujian Medical University, Fuzhou 350005, China
| | - Weihong Xi
- Dept. of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine Jiangxi Province, Nanchang 330006, China
| | - Yaomin Zhu
- Dept. of Oral and Maxillofacial Surgery, Shenzhen University General Hospital, Shenzhen 518000, China
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Duarte V, Zaror C, Villanueva J, Andreo M, Dallaserra M, Salazar J, Pont À, Ferrer M. Oral Health-Related Quality of Life Changes in Patients with Dentofacial Deformities Class II and III after Orthognathic Surgery: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19:1940. [PMID: 35206128 DOI: 10.3390/ijerph19041940] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/01/2022] [Accepted: 02/05/2022] [Indexed: 01/27/2023]
Abstract
Our aim was to assess the impact of combined orthodontic–surgical treatment on patients’ oral health-related quality of life (OHRQoL) according to type of dentofacial deformities, by synthesizing the available evidence. Methods: Search was conducted in the PubMed, Embase/MEDLINE, Scopus, and Cochrane databases. The eligibility criteria were studies that measured OHRQoL before–after orthognathic surgery, with results disaggregated by Class II and III. Two researchers independently performed the selection process, data extraction, and methodological quality assessment. Meta-analysis of the standard mean differences (SMD) was performed using random effect models. Results: The search identified 1047 references. Thirteen studies met the inclusion criteria, and four were included in the meta-analysis. The SMD of OHRQL global score showed large improvement 4–7 months after surgery in Class II and III patients (2.09, 95% CI 0.68 to 3.49 and 1.96, 95% CI 1.22 to 2.70, respectively). The sensitivity analyses, excluding studies with weak methodological quality, showed that Class III patients’ improvement in functional limitation was significantly higher than in Class II patients (SMD 0.57, 95% CI 0.12–1.02). Conclusions: There is not enough evidence to support differences between Class II and III patients in the OHRQoL impact after orthognathic surgery, but findings suggest lower improvement of some domains in Class II patients.
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Rojas Reyna BR, Ramírez Prado MI, Orozco Orozco NI, Rodríguez Pérez LR, Simg Alor AA, Quirarte Echavarría VM. [Diagnostic and treatment alternatives for the correction of facial asymmetries: a literature review]. Rev Cient Odontol (Lima) 2022; 10:e098. [PMID: 38389908 PMCID: PMC10880717 DOI: 10.21142/2523-2754-1001-2022-098] [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: 08/10/2021] [Accepted: 02/22/2022] [Indexed: 02/24/2024] Open
Abstract
Facial symmetry refers to a complete coincidence of each facial component on the sagittal plane, while asymmetry refers to the bilateral difference between these components. The presence of perfect bilateral symmetry is almost never present in human, so it is more common for individuals to predominate facial asymmetry. However, this condition can result from functional and esthetic problems. This research seeks to determine the alternatives, diagnosis and ideal treatment plan for the correction of each type of facial asymmetry through orthognathic surgery. For this purpose, a review of articles published between 2015 to date was carried out. Selecting those that were focused on describing or evaluating facial and dentofacial symmetry and asymmetry, type of diagnosis or treatment plan, including clinical cases. The Google search engine, SciELO and databases of medical interest, such as PubMed, PMC and Medigraphic were used. According to the research and treatments carried out during the last few years in the dental clinic, it has been proven that orthognathic treatment accompanied by previous planning is the best option for the management of skeletal facial asymmetries.
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Affiliation(s)
- Braulio Rafael Rojas Reyna
- Facultad de Odontologia de la Universidad Veracruzana Campus Minatitlan. Veracruz, Mexico. , , , , , Universidad Veracruzana Facultad de Odontologia Universidad Veracruzana Campus Minatitlan Veracruz Mexico
| | - María Isabel Ramírez Prado
- Facultad de Odontologia de la Universidad Veracruzana Campus Minatitlan. Veracruz, Mexico. , , , , , Universidad Veracruzana Facultad de Odontologia Universidad Veracruzana Campus Minatitlan Veracruz Mexico
| | - Norma Idalia Orozco Orozco
- Facultad de Odontologia de la Universidad Veracruzana Campus Minatitlan. Veracruz, Mexico. , , , , , Universidad Veracruzana Facultad de Odontologia Universidad Veracruzana Campus Minatitlan Veracruz Mexico
| | - Luis Renán Rodríguez Pérez
- Facultad de Odontologia de la Universidad Veracruzana Campus Minatitlan. Veracruz, Mexico. , , , , , Universidad Veracruzana Facultad de Odontologia Universidad Veracruzana Campus Minatitlan Veracruz Mexico
| | - Ana Alicia Simg Alor
- Facultad de Odontologia de la Universidad Veracruzana Campus Minatitlan. Veracruz, Mexico. , , , , , Universidad Veracruzana Facultad de Odontologia Universidad Veracruzana Campus Minatitlan Veracruz Mexico
| | - Víctor Manuel Quirarte Echavarría
- Facultad de Odontologia de la Universidad Veracruzana Campus Minatitlan. Veracruz, Mexico. , , , , , Universidad Veracruzana Facultad de Odontologia Universidad Veracruzana Campus Minatitlan Veracruz Mexico
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Tefera AT, Bekele BG, Derese K, Andualem G. Prevalence of Occlusal Features and Their Relation to Sociodemographic Variables in Northwest Ethiopia: A Cross-Sectional Study. Clin Cosmet Investig Dent 2021; 13:459-468. [PMID: 34785955 PMCID: PMC8590399 DOI: 10.2147/ccide.s332552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/28/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Malocclusion affects the chewing, dental aesthetics, jaw development, and overall attractiveness of individuals. The negative impact of malocclusion is high, particularly in adolescents who can be the target of teasing, intimidation, and name-calling. Even if, malocclusion is a common problem in developing countries, there was a paucity of data in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of malocclusion in northwest Ethiopia. METHODS This cross-sectional study was done at the University of Gondar comprehensive hospital from December 1, 2019, to October 30, 2020. Four hundred seventy-six study participants were selected using a systematic random sampling method. Data collection was done using a structured interviewer-administered questionnaire. Qualified dental professionals examined malocclusion traits according to the WHO oral health survey tool and evaluated for the presence of malocclusion in terms of angles classification, open bite, crossbite, spacing, and crowding. Data entry was done using Epi-Info 7, and analyzed by SPSS 26. Descriptive statistics and logistic regression was done to analyze the data. RESULTS A total of 476 subjects were included in the study with a mean age of 29.83 (SD±14.013). The prevalence of malocclusion was 55.9% (95% CI: 51.39-60.28). The common occlusal traits were class-I malocclusion with minor discrepancy (34.9%), anterior crowding (22.9%), and anterior open bite (21.6%). The prevalence of anterior crossbite, posterior crossbite, class-II, and class-III malocclusion was 5.9%, 3.8%, 10.9%, and 8.0%, respectively. Males (AOR=1.6, 95% CI: 1.11, 2.30), urban residents (AOR=1.64, 95% CI: 1.06, 2.56), monthly income of ≤2500 Ethiopian Birr (AOR=1.27, 95% CI: 1.02, 1.59) and mouth breathers (AOR=2.50, 95% CI: 1.72, 2.63) were significantly associated with malocclusion. CONCLUSION Significant amount of the study participants had malocclusion. Males, urban residents, low monthly income, and mouth breathing habits were independent factors for a malocclusion. Therefore, early attention to the development of the dentition and occlusion, and necessary functional correction during childhood are important to reduce its prevalence and lifelong adverse effect. Moreover, publicly financed orthodontic treatment should be scheduled, and supplied to individuals in desperate need of orthodontic care.
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Affiliation(s)
| | | | - Kirubel Derese
- Department of Dentistry, University of Gondar, Gondar, Ethiopia
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10
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Gaszyńska E. [Surgery first as an alternative approach in patients treated for dentofacial deformities]. Pol Merkur Lekarski 2021; 49:84-87. [PMID: 33713101] [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] [Indexed: 06/12/2023]
Abstract
Recently surgery first became more popular alternative for treatment of dentofacial deformities. In this approach treatment starts from orthognathic surgery. Immediately after othognathic surgery facial aesthetics and oral function are improved. Thus main complaints of the orthognathic patients are resolved early during treatment period. Indications for surgery first approach are wider than years ago and include: skeletal Class II and III malocclusion, skeletal open bite, bimaxillary protrusion, even cases with severe facial asymmetry are reported. The key point for gaining stable results and total treatment time shortening is an appropriate surgical occlusion. For higher precision of treatment 3D virtual planning is recommended. Total treatment time depends on: number of contact points in surgical occlusion, number of extracted teeth and postsurgical midline deviation. Surgery first is a good alternative approach in some patients treated for dentofacial deformities. Stability in this approach is similar to conventional method of treatment and both methods result in quality of life improvement. As there is lack of presurgical orthodontics in surgery first approach patients avoid transient deterioration in facial aesthetics and oral function that results in higher satisfaction and shorter total treatment time.
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Affiliation(s)
- Ewelina Gaszyńska
- Department of Nutrition and Epidemiology, Medical University of Łódź, Poland
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11
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Pastuszak P, Dunin-Wilczyńska I, Lasota A. Frequency of Additional Congenital Dental Anomalies in Children with Cleft Lip, Alveolar and Palate. J Clin Med 2020; 9:E3813. [PMID: 33255766 PMCID: PMC7760661 DOI: 10.3390/jcm9123813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/16/2020] [Revised: 11/15/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to assess the risk of incidence of additional congenital dental anomalies in children with nonsyndromic cleft lip, alveolar and/without palate (CL/P). Hypodontia, hyperdontia and canines impaction was recognized. From patients with CL/P treated at the Clinic of Congenital Facial Deformities in Chair and Department of Jaw Orthopedics Medical University of Lublin, 56 subjects were randomly selected. On the panoramic radiographs taken at the age of 8-12 years, the angle of upper unerupted canines was measured using Westerlund's recommendations. The supernumerary teeth and hypodontia were checked. The procedures: maxillary expansion, secondary alveolar bone graft (SABG) and extraction of primary canines were noted. The frequency of canines impaction was 5.36%. Hypodontia was found in 37.5% of patients; hyperdontia was present in 23.21% of patients. No influence of procedures (expansion of the maxilla, SABG, deciduous canines extraction) on permanent maxillary canine eruption was proved. Patients with CL/P are exposed to the unfavorable position of unerupted maxillary canines most frequently in the cleft area of complete cleft. Maxillary lateral incisor on the cleft side is most frequently affected with congenital anomaly. Hypodontia and hyperdontia do not influence maxillary canine impaction. Good clinical result was achieved with an applied approach, which should be widely introduced.
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Affiliation(s)
| | | | - Agnieszka Lasota
- Chair and Department of Jaw Orthopedics, Medical University of Lublin, 20-093 Lublin, Poland; (P.P.); (I.D.-W.)
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12
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Leung YY, Wang R, Wong NSM, Li DTS, Au SW, Choi WS, Su YX. Surgical morbidities of sagittal split ramus osteotomy versus intraoral vertical ramus osteotomy for the correction of mandibular prognathism: a randomized clinical trial. Int J Oral Maxillofac Surg 2020; 50:933-939. [PMID: 33168369 DOI: 10.1016/j.ijom.2020.06.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/22/2020] [Revised: 04/14/2020] [Accepted: 06/23/2020] [Indexed: 11/30/2022]
Abstract
The sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) are two common orthognathic procedures for the treatment of mandibular prognathism. This randomized clinical trial compared the surgical morbidities between SSRO and IVRO for patients with mandibular prognathism over the first 2 years postoperative. Ninety-eight patients (40 male, 58 female) with a mean age of 24.4±3.5 years underwent bilateral SSRO (98 sides) or IVRO (98 sides) as part or all of their orthognathic surgery. IVRO presented less short-term and long-term surgical morbidity in general. The SSRO group had a greater incidence of inferior alveolar nerve deficit at all follow-up time points (P< 0.01). There was more TMJ pain at 6 weeks (P= 0.047) and 3 months (P= 0.001) postoperative in the SSRO group. The SSRO group also presented more minor complications, which were related to titanium plate exposure and infection. There were no major complications for either technique in this study. Despite the need for intermaxillary fixation, IVRO appears to be associated with less surgical morbidity than SSRO when performed as a mandibular setback procedure to treat mandibular prognathism.
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Affiliation(s)
- Y Y Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
| | - R Wang
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - N S M Wong
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - D T S Li
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - S W Au
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - W S Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Y-X Su
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
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13
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Muñoz-Pereira ME, Haas-Junior OL, Da Silva Meirelles L, Machado-Fernández A, Guijarro-Martínez R, Hernández-Alfaro F, de Oliveira RB, Pagnoncelli RM. Stability and surgical complications of tooth-borne and bone-borne appliances in surgical assisted rapid maxillary expansion: a systematic review. Br J Oral Maxillofac Surg 2020; 59:e29-e47. [PMID: 33431313 DOI: 10.1016/j.bjoms.2020.08.017] [Citation(s) in RCA: 5] [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: 04/18/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
Abstract
The objective of this systematic review was to evaluate the stability and complications of tooth-borne (TB), bone-borne (BB) and hybrid (TB-BB) appliances in surgically assisted rapid maxillary expansion (SARME). Database searches were conducted (PubMed, Embase, Cochrane Library and SciELO), as well as a grey literature search (Google Scholar) and hand searches of reference lists. Forty-six articles were included after study selection (κ=0.854). After eligibility assessment, 16 articles and one article from the grey literature were processed (κ=0.866) and six articles were selected by hand searching, for a total of 23 articles included. Regarding stability, TB appliances showed width relapse rates ranging from 4 to 35% in canines, from 1 to 37% in premolars and from 0.2 to 49.5% in molars. In BB appliances, width relapse rates were 1.7-21% in canines, 1.5% in premolars and 4.6-11.5% in molars. In hybrid appliances, the width relapse rate was 14% in premolars, with a 1.8% overexpansion reported in the molar region. In TB and BB appliances, skeletal relapse rates were similar on the nasal floor (11-53% and 41.6%, respectively) and at the level of the maxilla (18% and 16%, respectively). The most common complications were bone resorption in TB appliances (18.14%) and appliance-related complications in BB appliances (17.9%). The risk of bias was high in 19 studies, medium in three studies and low in one study. The TB and BB appliances used in SARME were considered to have a high long-term stability. BB appliances appeared to have fewer relapses than TB appliances due to a more parallel distribution of forces exerted. However, relapse appears to be highly influenced by postorthodontic treatments, where arch-form coordination is achieved in the consolidation period with the purpose of overexpansion correction, alignment and final vertical adjustments. Further randomised controlled trials with long-term data and large sample sizes are needed to support evidence-based clinical decision-making and to allow meta-analytic studies of stability outcomes regarding the type of anchorage in SARME.
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Affiliation(s)
- M E Muñoz-Pereira
- Professor at Division of Oral and Maxillofacial Surgery, Department of Diagnostic and Surgical Sciences, University of Costa Rica - San Pedro de Montes de Oca, San José́; PhD Program at Department of Oral and Maxillofacial Surgery, Pontifical University of Rio Grande do Sul (PUCRS)- Porto Alegre, RS, Brazil.
| | - O L Haas-Junior
- Professor at Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS) - Porto Alegre, RS. Brazil; Institute of Maxillofacial Surgery, Teknon Medical Center - Barcelona, Spain
| | - L Da Silva Meirelles
- PhD Program at Department of Oral and Maxillofacial Surgery, Pontifical University of Rio Grande do Sul (PUCRS)- Porto Alegre, RS, Brazil
| | - A Machado-Fernández
- PhD Program at Department of Oral and Maxillofacial Surgery, Pontifical University of Rio Grande do Sul (PUCRS)- Porto Alegre, RS, Brazil
| | - R Guijarro-Martínez
- Institute of Maxillofacial Surgery, Teknon Medical Center - Barcelona, Spain; Assistant Professor, Department of Orthodontics, Cardenal Herrera-CEU, Universidad de Valencia- Valencia, Spain
| | - F Hernández-Alfaro
- Department Head at Institute of Maxillofacial Surgery, Teknon Medical Center - Barcelona, Spain; Department Head Professor at Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya - Sant Cugat del Vallès, Barcelona, Spain
| | - R B de Oliveira
- Professor at Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS) - Porto Alegre, RS. Brazil
| | - R M Pagnoncelli
- Professor at Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS) - Porto Alegre, RS. Brazil
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14
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Ooi K, Inoue N, Matsushita K, Yamaguchi HO, Mikoya T, Kawashiri S, Tei K. Comparison of Maximum Mouth Opening Following Mandibular Bilateral Sagittal Splitting Ramus osteotomies in Class III Females Using Two Different Osteosynthesis Methods. J Oral Rehabil 2020; 47:1242-1246. [PMID: 32706400 DOI: 10.1111/joor.13059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/01/2020] [Revised: 06/01/2020] [Accepted: 07/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Limitation of mouth opening is a common complaint following orthognathic surgery. OBJECTIVES This investigation reports on the progress of maximum incisal opening following orthognathic surgery and compares the impact of two different osteosynthesis methods on mouth opening in female patients with Class III dentofacial deformities. METHODS Forty cases of skeletal class III malocclusion were divided into twenty cases treated using the conventional single miniplate osteosynthesis method (P1) and twenty cases using the additional L-shaped miniplate osteosynthesis method (P2). No significant differences in pre-operative clinical status were detected between the P1 and P2 group, and all patients were managed with elastics in the post-operative period. Independent mouth opening exercises were initiated seven days after surgery, and inter-incisal distance was measured as maximum mouth opening (MMO) at 1 week, 2 weeks, and 1, 2, 3, 6 months. Statistical analysis was performed in order to analyse differences in MMO between the P1 and P2 groups (Prism 7 GraphPad software, San Diego, CA). Values of P < .05 were considered to be significant. RESULTS MMO significantly increased from 2 weeks after surgery in both groups. The MMO of P2 was significantly larger than that of P1 in all experimental periods after surgery. MMO was statistically improved in P2 at 2 months after surgery, while MMO in P1 was significantly smaller than the pre-operative MMO, even at 6 months post-operative. A minimum MMO of 40 mm was achieved by all patients. CONCLUSION L-shaped miniplate osteosynthesis was more useful for early limitation of mandibular opening improvement than conventional single miniplate osteosynthesis.
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Affiliation(s)
- Kazuhiro Ooi
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.,Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Nobuo Inoue
- Gerodontology, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuhiro Matsushita
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hiro-O Yamaguchi
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Tadashi Mikoya
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Shuichi Kawashiri
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Kanchu Tei
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
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15
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Hong SO, Poomkonsarn S, Millesi G, Liu SYC. Upper airway stimulation as an alternative to maxillomandibular advancement for obstructive sleep apnoea in a patient with dentofacial deformity: case report with literature review. Int J Oral Maxillofac Surg 2019; 49:908-913. [PMID: 31870520 DOI: 10.1016/j.ijom.2019.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/15/2018] [Revised: 05/21/2019] [Accepted: 08/16/2019] [Indexed: 12/17/2022]
Abstract
Obstructive sleep apnoea (OSA) is characterized by repeated upper airway collapse leading to oxygen desaturation resulting in cardiovascular and neurocognitive sequelae. Upper airway surgeries such as palatopharyngoplasty, tongue base surgery, and maxillomandibular advancement can improve patient tolerance of continuous positive airway pressure, quality of life, and the severity of OSA. Upper airway stimulation (UAS) of the hypoglossal nerve is a contemporary US Food and Drug Administration-approved treatment modality for OSA with a fundamentally different mechanism. We report the case of a 65-year-old male with a high body mass index, hypertension, diabetes, dentofacial deformity, and severe OSA. He presented with a respiratory distress index (RDI) of 89.1 events per hour, apnoea-hypopnoea index (AHI) of 82.7 events per hour, and minimum oxygen saturation of 75%. He chose to undergo UAS. Initially, complete concentric collapse of the velum was found during drug-induced sedation endoscopy, which was converted by palatopharyngoplasty to meet inclusion criteria for UAS. The patient achieved surgical cure with postoperative RDI and AHI of 2 events per hour with minimum oxygen saturation of 83%, and resolution of daytime somnolence. UAS is an effective surgical option to broaden the surgeon's ability to treat OSA, especially if facial skeletal surgery is contraindicated or declined by the patient with dentofacial deformity.
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Affiliation(s)
- S O Hong
- Department of Oral and Maxillofacial Surgery (Dentistry), International St. Mary's Hospital, Catholic Kwandong University, Incheon, South Korea
| | - S Poomkonsarn
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA; Center of Excellence in Otolaryngology Head and Neck Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - G Millesi
- Department of Craniomaxillofacial and Oral Surgery, University Hospital, Medical University of Vienna, Vienna, Austria
| | - S Y C Liu
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA.
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16
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Aoki J, Shinozuka K, Yamagata K, Nakamura R, Sato T, Ohtani S, Ogisawa S, Yanagawa K, Tonogi M. Cephalometric analysis of the pharyngeal airway space after maxillary advancement surgery. J Oral Sci 2019; 61:529-533. [PMID: 31548456 DOI: 10.2334/josnusd.18-0422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/01/2022]
Abstract
This study evaluated the effect of maxillary advancement surgery on the size of the pharyngeal airway space (PAS). Lateral cephalometric radiographs were collected for 90 patients (29 men and 61 women; average age, 27.2 ± 8.1 years) before (T1) and 1 year after (T2) maxillary advancement surgery. Horizontal and vertical changes in the maxilla and PAS were measured and classified by distance. The maxilla was advanced horizontally by 2.9 ± 1.7 mm and vertically by 2.7 ± 1.4 mm. Upward maxillary movement of ≥4 mm significantly increased PAS (mean change in PAS, 2.6 mm), and upward maxillary movement significantly decreased the posterior nasal spine to the P-point. Only patients with vertical advancement ≥4 mm and horizontal advancement of 3 mm had significant increases in all three PAS parameters. Although forward maxillary movement is believed to have a large effect on PAS, it is suggest that upward vertical movement is more effective for improving PAS. Both the extent and direction of maxillar movement should be considered. Future studies should use cone-beam computed tomography to evaluate the effect of axial direction and differences in PAS.
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Affiliation(s)
- Junya Aoki
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Keiji Shinozuka
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
| | - Kanako Yamagata
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Ryota Nakamura
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Takako Sato
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
| | - Saori Ohtani
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Shouhei Ogisawa
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Keiichi Yanagawa
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Morio Tonogi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
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Ogisawa S, Shinozuka K, Aoki J, Yanagawa K, Himejima A, Nakamura R, Yamagata K, Sato T, Suzuki M, Tanuma T, Tonogi M. Computational fluid dynamics analysis for the preoperative prediction of airway changes after maxillomandibular advancement surgery. J Oral Sci 2019; 61:398-405. [PMID: 31327806 DOI: 10.2334/josnusd.18-0130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/01/2022]
Abstract
Maxillomandibular advancement surgery is useful for treatment of sleep apnea. However, preoperative analysis and evaluation to facilitate decision-making regarding the direction and distance of maxillomandibular movement has primarily consisted of morphological analysis; physiological function is not evaluated. To improve preoperative prediction, this study used fluid simulation to investigate the characteristics and effects of airway changes associated with maxillomandibular movement. A one-dimensional model with general applicability was thus developed. Actual measurements of flow in patients were used in this fluid simulation, thus achieving an analysis closer to clinical conditions. The simulation results were qualitatively consistent with the actual measurements, which confirmed the usefulness of the simulation. In addition, the results of the one-dimensional model were within the error ranges of the actual measurements. The present results establish a foundation for using accumulating preoperative measurement data for more-precise prediction of postoperative outcomes.
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Affiliation(s)
- Shouhei Ogisawa
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Keiji Shinozuka
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
| | - Junya Aoki
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Keiichi Yanagawa
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Akio Himejima
- First Department of Oral and Maxillofacial Surgery, Osaka Dental University
| | - Ryota Nakamura
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Kanako Yamagata
- Division of Oral Structural and Functional Biology, Nihon University Graduate School of Dentistry
| | - Takako Sato
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
| | - Masaaki Suzuki
- Department of Otolaryngology, Teikyo University Chiba Medical Center
| | - Tadashi Tanuma
- Laboratory of Fluid-Structural Simulation and Design, Teikyo University Strategic Innovation and Research Center
| | - Morio Tonogi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
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Ooi K, Inoue N, Matsushita K, Yamaguchi H, Mikoya T, Minowa K, Kawashiri S, Nishikata S, Tei K. Incidence of anterior disc displacement without reduction of the temporomandibular joint in patients with dentofacial deformity. Int J Oral Maxillofac Surg 2018; 47:505-510. [PMID: 29305246 DOI: 10.1016/j.ijom.2017.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 07/01/2017] [Revised: 10/03/2017] [Accepted: 11/30/2017] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the incidence of anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) in patients with dentofacial deformity. Eighty-eight female patients (176 joints) with skeletal class III malocclusion and 33 female patients (66 joints) with skeletal class II malocclusion, with or without anterior open bite and asymmetry, were evaluated. Magnetic resonance imaging (MRI) of the TMJ was used to diagnose ADDwoR. A statistical analysis was performed to examine the relationship between ADDwoR and skeletal structure. ADDwoR was present in 37 of the 66 joints (56.1%) in class II compared to 34 of the 176 joints (19.3%) in class III (P<0.05). In class III, ADDwoR was significantly more common in joints with mandibular asymmetry (24/74; 32.4%) than in joints with open bite (9/62; 14.5%) and joints with open bite and without mandibular asymmetry (1/38; 2.6%). In class II, ADDwoR was significantly less common in joints with mandibular asymmetry and without open bite (1/8; 12.5%). ADDwoR was only observed on the deviated side in both class III and class II with mandibular asymmetry. The prevalence of ADDwoR differed according to the dentofacial morphology.
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Affiliation(s)
- K Ooi
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Department of Oral and Maxillofacial Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.
| | - N Inoue
- Gerodontology, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - K Matsushita
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - H Yamaguchi
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - T Mikoya
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - K Minowa
- Dental Radiology, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - S Kawashiri
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - S Nishikata
- Oral and Maxillofacial Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, Japan
| | - K Tei
- Oral and Maxillofacial Surgery, Department of Oral Patho-biological Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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Xia JJ, Gateno J, Teichgraeber JF, Yuan P, Chen KC, Li J, Zhang X, Tang Z, Alfi DM. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 1: planning sequence. Int J Oral Maxillofac Surg 2015; 44:1431-40. [PMID: 26573562 DOI: 10.1016/j.ijom.2015.06.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 05/29/2015] [Accepted: 06/08/2015] [Indexed: 11/21/2022]
Abstract
The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also on an accurate surgical plan. The adoption of computer-aided surgical simulation (CASS) has created a paradigm shift in surgical planning. However, planning an orthognathic operation using CASS differs fundamentally from planning using traditional methods. With this in mind, the Surgical Planning Laboratory of Houston Methodist Research Institute has developed a CASS protocol designed specifically for orthognathic surgery. The purpose of this article is to present an algorithm using virtual tools for planning a double-jaw orthognathic operation. This paper will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice.
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Xia JJ, Gateno J, Teichgraeber JF, Yuan P, Li J, Chen KC, Jajoo A, Nicol M, Alfi DM. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 2: three-dimensional cephalometry. Int J Oral Maxillofac Surg 2016; 44:1441-50. [PMID: 26573563 DOI: 10.1016/j.ijom.2015.06.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [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: 04/06/2015] [Revised: 05/27/2015] [Accepted: 06/08/2015] [Indexed: 11/25/2022]
Abstract
Three-dimensional (3D) cephalometry is not as simple as just adding a 'third' dimension to a traditional two-dimensional cephalometric analysis. There are more complex issues in 3D analysis. These include how reference frames are created, how size, position, orientation and shape are measured, and how symmetry is assessed. The main purpose of this article is to present the geometric principles of 3D cephalometry. In addition, the Gateno-Xia cephalometric analysis is presented; this is the first 3D cephalometric analysis to observe these principles.
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Affiliation(s)
- J J Xia
- Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA; Oral and Maxillofacial Surgery, Institute for Academic Medicine, Houston Methodist Hospital, Houston, TX, USA; Oral and Maxillofacial Surgery, Weill Medical College, Cornell University, NY, USA.
| | - J Gateno
- Oral and Maxillofacial Surgery, Institute for Academic Medicine, Houston Methodist Hospital, Houston, TX, USA; Oral and Maxillofacial Surgery, Weill Medical College, Cornell University, NY, USA; Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - J F Teichgraeber
- Division of Pediatric Plastic Surgery, Department of Pediatric Surgery, The University of Texas Health Science Center at Houston, TX, USA
| | - P Yuan
- Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA
| | - J Li
- Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA
| | - K-C Chen
- Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA; Department of Oral and Maxillofacial Surgery, National Cheng-Kung University Medical College and Hospital, Tainan, Taiwan
| | - A Jajoo
- Department of Mathematics, University of Houston, TX, USA
| | - M Nicol
- Department of Mathematics, University of Houston, TX, USA
| | - D M Alfi
- Oral and Maxillofacial Surgery, Institute for Academic Medicine, Houston Methodist Hospital, Houston, TX, USA; Oral and Maxillofacial Surgery, Weill Medical College, Cornell University, NY, USA; Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital, Houston, TX, USA
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Ryan FS, Moles DR, Shute JT, Clarke A, Cunningham SJ. Social anxiety in orthognathic patients. Int J Oral Maxillofac Surg 2015; 45:19-25. [PMID: 26304605 DOI: 10.1016/j.ijom.2015.05.021] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/15/2015] [Accepted: 05/29/2015] [Indexed: 11/26/2022]
Abstract
There is evidence that patients seeking orthognathic treatment may be motivated by social anxiety disorder (SAD). The aim of this study was to investigate SAD in orthognathic patients using the Brief Fear of Negative Evaluation Scale (BFNES) and to compare these findings with those of the general population. This was a cross-sectional, questionnaire study conducted in two parts. Firstly, a national survey was conducted to yield data for the BFNES from a large, random sample of the UK general population. Secondly, orthognathic patients completed the BFNES. The BFNES scores are reported in two formats: the original 12-item scale (O-BFNES) and a shorter eight-item version (S-BFNES). With regards to the national survey, 1196 individuals participated. The mean O-BFNES score was 29.72 (standard deviation (SD) 9.39) and S-BFNES score was 15.59 (SD 7.67). With regards to the orthognathic sample, 61 patients participated. The mean O-BFNES score was 39.56 (SD 10.35) and the mean S-BFNES score was 24.21 (SD 8.41). Orthognathic patients had significantly higher scores than the general UK population (P<0.001), and multiple linear regression revealed that age, gender, and patient status were all independent predictors of BFNES scores. From the results of this study, orthognathic patients experience significantly higher levels of social anxiety than the general population.
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Affiliation(s)
- F S Ryan
- Orthodontic Department, Eastman Dental Hospital, UCLH, London, UK.
| | - D R Moles
- Peninsula Dental School, Plymouth, Devon, UK
| | - J T Shute
- Orthodontic Department, Eastman Dental Hospital, UCLH, London, UK
| | | | - S J Cunningham
- Orthodontic Department, Eastman Dental Hospital, UCLH, London, UK
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Dantas JFC, Neto JNN, de Carvalho SHG, Martins IMCLD, de Souza RF, Sarmento VA. Satisfaction of skeletal class III patients treated with different types of orthognathic surgery. Int J Oral Maxillofac Surg 2014; 44:195-202. [PMID: 25444480 DOI: 10.1016/j.ijom.2014.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 11/13/2013] [Revised: 07/07/2014] [Accepted: 09/22/2014] [Indexed: 11/18/2022]
Abstract
The aim of this study was to compare the satisfaction of skeletal class III patients following treatment with three different methods of orthognathic surgery. Eighty-two patients were divided into three groups according to the surgical procedure performed to correct their class III dentofacial deformity, and answered a questionnaire designed to determine the patient's opinion of the aesthetic and functional treatment outcomes. Differences in the patterns of responses to questions in the questionnaire related to satisfaction between the three clinical groups were evaluated by χ(2) and Fisher's exact tests (α=5%). Eighty patients (97.6%) reported being satisfied with the treatment received. There was no significant difference in response patterns among clinical groups when assessing the improvement in facial appearance, chewing, speech, and socialization. Maxillary advancement led to higher levels of improvement in breathing (P<0.0003). Class III patients treated by orthognathic surgery had high levels of satisfaction with the aesthetic and functional outcomes of their treatment.
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Affiliation(s)
- J F C Dantas
- Department of Oral and Maxillofacial Surgery, Portuguese Hospital, Salvador, Bahia, Brazil.
| | - J N N Neto
- Department of Propaedeutics, Dental School at Araruna, State University of Paraíba, Araruna, Paraíba, Brazil
| | - S H G de Carvalho
- Department of Propaedeutics, Dental School at Araruna, State University of Paraíba, Araruna, Paraíba, Brazil
| | - I M C L deB Martins
- Health Science Centre, Federal University of Paraiba, João Pessoa, Paraíba, Brazil
| | - R F de Souza
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - V A Sarmento
- Department of Propaedeutics and Integrated Clinic, Dental School of the Federal University of Bahia, Salvador, Bahia, Brazil
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Abstract
ORTHOGNATHIC SURGERY IS A UNIQUE ENDEAVOR IN FACIAL SURGERY a patient's appearance and occlusal function can be improved significantly, impacting the patient's sense of self and well-being. Successful outcomes in modern orthognathic surgery rely on close collaboration between the surgeon and the orthodontist across all stages of treatment, from preoperative planning to finalization of occlusion. Virtual computer planning promotes a more accurate analysis of dentofacial deformity and preoperative planning. It is also an invaluable aid in providing comprehensive patient education. In this article, the author describes the general surgical principles that underlie orthognathic surgery, highlighting the sequence of treatment, preoperative analysis of dentofacial deformity, surgical execution of the treatment plan, and possible complications.
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Affiliation(s)
- David Y Khechoyan
- Division of Plastic Surgery, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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