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Kitamura T, Uegomori-Yokura A, Oku Y, Maeo K, Kohira W, Suzuki Y, Yamakawa Y, Ueda K, Sato H, Ishimaru H, Kanomi R, Yamasaki Y, Iwasaki T. Effects of adenoid hypertrophy on nasopharyngeal airway ventilation: A computational fluid dynamics study. Int J Pediatr Otorhinolaryngol 2024; 180:111961. [PMID: 38705134 DOI: 10.1016/j.ijporl.2024.111961] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES Adenoid hypertrophy causes impaired nasopharyngeal airways (NA) ventilation. However, it is difficult to evaluate the ventilatory conditions of NA. Therefore, this study aimed to analyze the nasopharyngeal airway resistance (NARES) based on computational fluid dynamics simulations and the nasopharyngeal airway depth (NAD) and adenoid hypertrophy grade measured on cephalometric cone-beam computed tomography images and determine the relationship between NAD and grade and NARES to ultimately assess using cephalometric measurements whether NA has airway obstruction defects. METHODS Cephalogram images were generated from cone-beam computed tomography data of 102 children (41 boys; mean age: 9.14 ± 1.43 years) who received orthodontic examinations at an orthodontic clinic from September 2012 to March 2023, and NAD and adenoid grade and NARES values were measured based on computational fluid dynamics analyses using a 3D NA model. Nonlinear regression analyses were used to evaluate the relationship between NARES and NAD and correlation coefficients to evaluate the relationship between grade and NARES. RESULTS NARES was inversely proportional to the cube of NAD (R2 = 0.786, P < 0.001), indicating a significant relationship between these variables. The resistance NARES increased substantially when the distance NAD was less than 5 mm. However, adenoid Grade 4 (75 % hypertrophy) was widely distributed. CONCLUSIONS These study findings demonstrate that the ventilatory conditions of NA can be determined based on a simple evaluation of cephalogram images. An NAD of less than 5 mm on cephalometric images results in NA obstruction with substantially increased airflow resistance.
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Affiliation(s)
- Takamasa Kitamura
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | - Yoichiro Oku
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kei Maeo
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Wakana Kohira
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yukari Suzuki
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshihito Yamakawa
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kimiko Ueda
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hideo Sato
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | | | - Youichi Yamasaki
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tomonori Iwasaki
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
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Shetty SSS, Kamath A, Shetty P, Quadras DD, Siddartha R, Rao A. SIDS plane: A simple and innovative alternative to Frankfurt horizontal plane. J Orthod Sci 2023; 12:27. [PMID: 37351410 PMCID: PMC10282532 DOI: 10.4103/jos.jos_84_22] [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: 09/15/2022] [Revised: 11/20/2022] [Accepted: 12/14/2022] [Indexed: 06/24/2023] Open
Abstract
AIMS AND OBJECTIVES To derive a new horizontal plane which can be a suitable alternative to Frankfurt horizontal plane (FH plane). MATERIALS AND METHODS 200 pre-treatment lateral roentogenic cephalograms from patient records in the department of orthodontics and dentofacial orthopaedics were traced. The landmarks were identified and marked and the measurements were carried out. Patients with all skeletal relationships were included in the study. The angle formed between the lines connecting anatomic porion, orbitale and machine porion was measured and tabulated. Dimorphism between the genders if any was also evaluated. RESULTS The mean angulation between the planes from the anatomic porion to orbitale to machine porion (PoA-Or-PoM) in our sample is 3.14 ± 2.17°. PoA to Or to PoM angulation for males is 2.57° and for females is 3.4°. CONCLUSIONS SIDS plane also called as derived FH plane given here is a reliable and easily reproducible alternative to the FH plane.
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Affiliation(s)
| | - Apoorva Kamath
- Department of Orthodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Praveena Shetty
- Department of Orthodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Dilip Daniel Quadras
- Department of Orthodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
| | - R Siddartha
- Department of Orthodontics, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
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Goyal D, Kumar P, Jain S. Digital evaluation and correlation of facial growth patterns assessed on lateral CEPH and orthopantomogram through ONECEPH mobile application. J Orthod Sci 2023; 12:29. [PMID: 37351393 PMCID: PMC10282550 DOI: 10.4103/jos.jos_71_22] [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: 08/05/2022] [Revised: 10/12/2022] [Accepted: 10/27/2022] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the correlation of gonial angle and three linear measurements on OPG and lateral cephalograms and their effects on the different facial patterns using the OneCeph android app. METHOD About 90 pre-treatment digital lateral cephalograms and OPGs of 90 patients were selected and divided into 3 categories, based on their growth patterns. The OPGs and lateral cephalograms were uploaded on the OneCeph android app. After calibrating using One linear measurement i.e. length of extracted premolar for OPG and ruler in radiograph for lateral cephalogram, Gonial angle (Ar- Go-Me), ANS-Me (LAFH), U1-NF, L1-MP were measured. The data were collected, tabulated, and subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%. RESULTS Values for parameters were highest in the vertical growth pattern followed by average and horizontal in both cephalogram and OPG. Upon comparison of lateral cephalogram and OPG, no significant difference was observed in gonial angle and a significant difference in LAFH and L1-MP in all three growth patterns with OPG scores greater than cephalometric tracing. The interclass coefficient test indicated almost perfect agreement for the gonial angle between the two methods. A substantial agreement was seen for U1-NF on lateral cephalogram and OPG in the vertical group. Also, a fair agreement in the vertical and horizontal group was observed in Lower anterior mandibular height. CONCLUSION Vertical parameters such as gonial angle and maxillary anterior dental height can be accurately determined on an OPG by the OneCeph application.
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Affiliation(s)
- Diksha Goyal
- Department of Orthodontics and Dentofacial Orthopaedics, ITS-CDSR, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Piush Kumar
- Department of Orthodontics and Dentofacial Orthopaedics, ITS-CDSR, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Shubhangi Jain
- Department of Orthodontics and Dentofacial Orthopaedics, ITS-CDSR, Muradnagar, Ghaziabad, Uttar Pradesh, India
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Jaiswal P, Gandhi A, Gupta AR, Malik N, Singh SK, Ramesh K. Reliability of Photogrammetric Landmarks to the Conventional Cephalogram for Analyzing Soft-Tissue Landmarks in Orthodontics. J Pharm Bioallied Sci 2021; 13:S171-S175. [PMID: 34447068 PMCID: PMC8375858 DOI: 10.4103/jpbs.jpbs_634_20] [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: 10/02/2020] [Revised: 10/03/2020] [Accepted: 10/04/2020] [Indexed: 11/04/2022] Open
Abstract
Background Graber introduced facial photographs as an internal diagnostic aid. Facial photographs could serve as an important alternative assessment tool in the absence of equipment for cephalometric analysis. Objectives The present study was aimed at assessing whether analyzing the photographs could have precision for assessing the landmarks appropriate for facial analysis. In addition, the relationship between frontal cephalogram and measurements on photographs was assessed. Materials and Methods Twenty individuals including both males and females within the age range of 18 years to 28 years were enrolled in the study. Frontal facial photographs, as well as frontal cephalograms, were obtained for all the included study participants. Various soft-tissue vertical and horizontal landmarks were marked on both radiographs and photographs. The data were collected and subjected to statistical analysis. Results The results showed a statistically insignificant difference between all the vertical and horizontal parameters on photographs and cephalograms. The reliability of the digital photographs was comparable to that of the cephalograms with nonsignificant differences in the recorded mean values using the one-way ANOVA test where the statistical significance level was kept at P ≤ 0.05. Conclusion The present study concluded that photography is a cost-effective and reliable method for soft-tissue landmark identification, and allows recording the images of sufficient quantity for analysis. Low-cost and easily captured photographic images can replace costly radiographic procedures without causing any discomfort to the patients.
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Affiliation(s)
- Pragya Jaiswal
- Depatment of Dentistry, Bharat Ratna Late Shri Atal Bihari Vajpayee Memorial Government Medical College, Rajnandgaon, Chhattisgarh, India
| | - Aniruddha Gandhi
- Depatment of Dentistry, Bharat Ratna Late Shri Atal Bihari Vajpayee Memorial Government Medical College, Rajnandgaon, Chhattisgarh, India
| | - Abhinav Raj Gupta
- Consultant Orthodontist, GS Memorial Plastic Surgery Hospital and Trauma Center, Patna, Bihar, India
| | - Nidhi Malik
- Department of Orthodontics, Mithila Minority Dental College, Darbhanga, Bihar, India
| | - Sanjay Kumar Singh
- Department of Orthodontics and Orthopedics, Patna Medical College and Hospital, Patna, Bihar, India
| | - Kumar Ramesh
- Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India
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Shin W, Yeom HG, Lee GH, Yun JP, Jeong SH, Lee JH, Kim HK, Kim BC. Deep learning based prediction of necessity for orthognathic surgery of skeletal malocclusion using cephalogram in Korean individuals. BMC Oral Health 2021; 21:130. [PMID: 33736627 PMCID: PMC7977585 DOI: 10.1186/s12903-021-01513-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 12/24/2020] [Accepted: 03/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Posteroanterior and lateral cephalogram have been widely used for evaluating the necessity of orthognathic surgery. The purpose of this study was to develop a deep learning network to automatically predict the need for orthodontic surgery using cephalogram. METHODS The cephalograms of 840 patients (Class ll: 244, Class lll: 447, Facial asymmetry: 149) complaining about dentofacial dysmorphosis and/or a malocclusion were included. Patients who did not require orthognathic surgery were classified as Group I (622 patients-Class ll: 221, Class lll: 312, Facial asymmetry: 89). Group II (218 patients-Class ll: 23, Class lll: 135, Facial asymmetry: 60) was set for cases requiring surgery. A dataset was extracted using random sampling and was composed of training, validation, and test sets. The ratio of the sets was 4:1:5. PyTorch was used as the framework for the experiment. RESULTS Subsequently, 394 out of a total of 413 test data were properly classified. The accuracy, sensitivity, and specificity were 0.954, 0.844, and 0.993, respectively. CONCLUSION It was found that a convolutional neural network can determine the need for orthognathic surgery with relative accuracy when using cephalogram.
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Affiliation(s)
- WooSang Shin
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, Korea.,School of Electronics Engineering College of IT Engineering, Kyungpook National University, Daegu, Korea
| | - Han-Gyeol Yeom
- Department of Oral and Maxillofacial Radiology, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Ga Hyung Lee
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Jong Pil Yun
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, Korea
| | - Seung Hyun Jeong
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, Korea
| | - Jong Hyun Lee
- Safety System Research Group, Korea Institute of Industrial Technology (KITECH), Gyeongsan, Korea.,School of Electronics Engineering College of IT Engineering, Kyungpook National University, Daegu, Korea
| | - Hwi Kang Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea
| | - Bong Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, Wonkwang University College of Dentistry, Daejeon, Korea.
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Svystun O, Schropp L, Wenzel A, Spin-Neto R. Sella Turcica Area and Location of Point Sella in Cephalograms Acquired with Simulated Patient Head Movements. J Contemp Dent Pract 2021; 22:207-214. [PMID: 34210916] [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] [Indexed: 06/13/2023]
Abstract
AIM AND OBJECTIVE This study assesses changes in the sella turcica area (STA) and location of the cephalometric point sella (S) on lateral cephalograms acquired by charge-coupled device (CCD)-based cephalostats with and without simulated patient head movements. MATERIALS AND METHODS A real skull was placed on a robot, able to simulate four head movements (anteroposterior translation/lifting/nodding/lateral rotation) at three distances (0.75/1.5/3 mm) and two patterns (returning to 0.5 mm away from the start position/staying at maximum movement excursion). Two ProMax-2D cephalostats (Dimax-3, D-3 or Dimax-4, D-4), and an Orthophos-SL cephalostat (ORT) acquired cephalograms during the predetermined movements ("cases," 48 images/unit) and without movement ("controls," 24 images/unit). Three observers manually traced the contour of sella turcica and marked point sella using a computer mouse. STA was calculated in pixels2 by dedicated software based on the tracing. S was defined by its x and y coordinates recorded by the same software in pixels. Ten percent of the images were assessed twice. The difference between cases and controls (case minus control) for the STA and S (namely Diff-STA and Diff-S) was calculated and assessed through descriptive statistics. RESULTS Inter- and intraobserver agreement ranged from moderate to good for STA and S. Diff-STA ranged from -42.5 to 12.9% (D-3), -15.3 to 9.6% (D-4), and -25.3 to 39.9% (ORT). Diff-S was represented up to 50% (D-3), 134% (D-4), and 103% (ORT) of the mean sella turcica diameter in control images. CONCLUSION Simulated head movements caused significant distortion in lateral cephalograms acquired by CCD-based cephalostats, as seen from STA and S alterations, depending on the cephalostat. CLINICAL SIGNIFICANCE Patient-related errors, including patient motion artifacts, are influential factors for the reliability of cephalometric tracing.
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Affiliation(s)
- Olesya Svystun
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Lars Schropp
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark, e-mail:
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Vakili FG, Nouri-Vaskeh M, Eghbali E, Fakhim SA. Nasopharyngeal structure development in patients with cleft palate who underwent repair surgery. J Stomatol Oral Maxillofac Surg 2021; 123:22-26. [PMID: 33515789 DOI: 10.1016/j.jormas.2021.01.008] [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] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/15/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to compare the developmental characteristics of bony nasopharyngeal (NP) in children with cleft palate (CP) and non-cleft subjects. METHODS This study was conducted on 64 non-syndromic CP patients who underwent repair surgery and 23 non-cleft subjects as controls. Lateral cephalograms were performed on participants at rest in the natural head position. The X-coordinate and the Y-coordinate of three points on cephalograms were determined as Hormion (Ho), posterior maxillary point (PMP) and anterior point of the atlas (At) representing the anterior-posterior (AP) and vertical dimension of the NP. The linear dimension of the NP (i.e. Ho-At, Ho-PMP, At-PMP) and its area was also calculated. RESULTS The bony structures of NP in the clef-affected subjects in isolated CP subgroup, had a significantly greater downward development in the maxillary region (PMP) (both with p = 0.001), more linear growth in cranial-maxillary (Ho-PMP) dimension (p = 0.017 and 0.004, respectively), and larger area (p = 0.017 and <0.001, respectively), when compared to normal subjects. There was no significant difference between either the unilateral cleft lip and palate (CLP) or bilateral CLP group with the control group regarding AP, vertical, and linear growth of the NP and its area (P > 0.05). CONCLUSIONS Patients with repaired CP had downward deviated posterior maxilla, more linear growth in cranial-maxillary dimension and larger area compared to normal subjects. Among CP subtypes, a balanced growth was observed among repaired UCLP and BCLP patients, suggesting that with appropriate repaired surgery, normal development of the NP region could be expected in these subtypes.
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Affiliation(s)
- Farid Ghazi Vakili
- Department of Otorhinolaryngology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Nouri-Vaskeh
- Tropical and Communicable Diseases Research Centre, Iranshahr University of Medical Sciences, Iranshahr, Iran; Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Elham Eghbali
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran
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Seon S, Lee HW, Jeong BJ, Lee BS, Kwon YD, Ohe JY. Study of soft tissue changes in the upper lip and nose after backward movement of the maxilla in orthognathic surgery. J Korean Assoc Oral Maxillofac Surg 2020; 46:385-392. [PMID: 33377463 PMCID: PMC7783182 DOI: 10.5125/jkaoms.2020.46.6.385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/03/2020] [Revised: 09/14/2020] [Accepted: 09/24/2020] [Indexed: 11/28/2022] Open
Abstract
Objectives This study evaluates soft tissue changes of the upper lip and nose after maxillary setback with orthognathic surgery such as Le Fort I or anterior segmental osteotomy. Materials and Methods All 50 patients with bimaxillary protrusion and skeletal Class II malocclusion underwent Le Fort I or anterior segmental osteotomy with backward movement. Soft and hard tissue changes were analyzed using cephalograms collected preoperatively and 6 months postoperatively. Results Cluster analysis on the ratios shows that 2 lines intersected at 4 mm point. Based on this point, we divided the subjects into 2 groups Group A (less than 4 mm, 27 subjects) and Group B (more than 4 mm, 23 subjects). Also, each group was divided according to changes of upper incisor angle (≥4°=A1, B1 or <4°=A2, B2). The correlation between A and B groups for Aʼ/ANS and Ls/Is (P<0.001) was significant; Aʼ/A (P=0.002), PRN/A (P=0.043), PRN/ANS (P=0.032), and St/Is (P=0.010). Variation of nasolabial angle between the two groups was not significant. There was no significant correlation of vertical movement and angle variation. Conclusion The ratio of soft tissue to hard tissue movement depends on the amount of posterior movement in the maxilla, showing approximately two times higher rates in most of the midface when posterior movement was greater than 4 mm. The soft tissue changes caused by posterior movement of the maxilla were little affected by angular changes of upper incisors. Interestingly, nasolabial angle showed a different tendency between A and B groups and was more affected by incisal angular changes when horizontal posterior movement was less than 4 mm.
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Affiliation(s)
- Suyun Seon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Hyun-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Bong-Jin Jeong
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Baek-Soo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Joo-Young Ohe
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Korea
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Abstract
An estimation of the appropriate tubing depth for fixation is helpful to prevent inadvertent endobronchial intubation and prolapse of cuff from the vocal cord. A feasible estimation formula should be established. We measured the anatomical length of the upper-airway tract through the oral and nasal pathways on cephalometric radiographs and tried to establish the estimation formula from the height of the patient. The oral upper-airway tract was measured from the tip of the incisor to the vocal cord. The nasal upper-airway tract was measured from the tip of the nostril to the vocal cord. The tracts were smoothly traced by using software. The length of the oral upper-airway tract was 13.2 ± 0.8 cm, and the nasal upper-airway tract was 16.1 ± 0.9 cm. We found no gender difference ( p > .05). The correlations between the patients' height and the length of the oral and nasal upper-airway tracts were 0.692 and 0.760, respectively. We found that the formulas (height/10) - 3 (in cm) for oral upper-airway and (height/10) + 1 (in cm) for nasal upper-airway tract are the simple fit estimation formulas. The average error and standard deviation of the estimated values from the measured values were 0.50 ± 0.66 cm for the oral tract and 0.39 ± 0.63 cm for the nasal tract. Thus, considering the length of the intubation marker of each product (DM), we would like to propose the length of tube fixation as (height/10) + 1 + DM for nasal intubation and (height/10) - 3 + DM for oral intubation. In conclusion, the estimation formulas of (height/10) - 3 + DM and (height/10) + 1 + DM for oral and nasal intubation, respectively, are within almost 1 cm error in most cases.
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Affiliation(s)
- Keiko Yao
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Kinuko Goto
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Reina Shimazu
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Satoshi Tachikawa
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
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Savoldi F, Xinyue G, McGrath CP, Yang Y, Chow SC, Tsoi JKH, Gu M. Reliability of lateral cephalometric radiographs in the assessment of the upper airway in children: A retrospective study. Angle Orthod 2019; 90:47-55. [PMID: 31403838 DOI: 10.2319/022119-131.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To test the reliability of Lateral cephalometric radiographs (LCRs) for use in the assessment of the upper airway, hyoid bone, soft palate, and tongue. MATERIALS AND METHODS The records of 57 healthy Chinese children from a nonhospital population (mean age = 12.6 years, SD = 0.5, 28 males and 29 females) who received two consecutive LCRs in the natural head posture were retrospectively analyzed. Fifteen linear, angular, and area measurements were used to describe the airway, hyoid bone, soft palate, and tongue. The reliability between the two LCRs was assessed with the intraclass correlation coefficient (ICC) and F-test. Errors were estimated with the Dahlberg and Bland-Altman method, and intra- and inter-assessor agreements were determined. RESULTS Measurements of upper airway and hyoid bone had excellent method reliability, intra-assessor reliability, and inter-assessor reliability (ICC > 0.8). However, the method reliability and the inter-assessor reliability for soft palate and tongue was less favorable (ICC from 0.60 to 0.96). Soft palate area and thickness were the most critical parameters. Intra-assessor reliability was greater than both method reliability and inter-assessor reliability (which were similar). CONCLUSIONS The measurement of upper airway morphology, defined as the intramural space, and of the hyoid bone position were highly reliable on LCRs of children. However, the limited reliability in the assessment of tongue and soft palate area may compromise the diagnostic application of LCRs to these structures.
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Duan H, Xia L, He W, Lin Y, Lu Z, Lan Q. Accuracy of lateral cephalogram for diagnosis of adenoid hypertrophy and posterior upper airway obstruction: A meta-analysis. Int J Pediatr Otorhinolaryngol 2019; 119:1-9. [PMID: 30658139 DOI: 10.1016/j.ijporl.2019.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Accurate diagnosis of adenoid hypertrophy and posterior upper airway obstruction using a lateral cephalogram is challenging. No universal guidelines for assessing adenoidal enlargement and upper airway obstruction have been established. We performed a meta-analysis to assess the diagnostic accuracy of a lateral cephalogram for adenoid hypertrophy. METHODS After searching a wide range of electronic databases and screening titles and abstracts, we evaluated full papers describing potentially eligible studies according to predefined inclusion criteria. Quality assessment was conducted by adapting the Quality Assessment of Diagnostic Accuracy Studies-2 checklist, and a 2 × 2 contingency table was constructed based on these results. Two authors independently judged the studies and extracted the data. The diagnostic accuracy of a lateral cephalogram for adenoid hypertrophy and posterior upper airway obstruction was calculated using a bivariate meta-analysis model. The Q-test and I2 index were used to test the heterogeneity. RESULTS Nine studies were included in the meta-analysis. The pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio were 0.86 [95% confidence interval (CI): 0.76-0.92], 0.59 (95% CI: 0.42-0.73), 9.00 (95% CI: 5-17), 2.1 (95% CI: 1.5-3.0), and 0.24 (95% CI: 0.15-0.37), respectively. The area under the summary receiver operator characteristic curve was 0.83 (95% CI: 0.80-0.86). Meta-regression analysis revealed that the sample size and study design significantly contributed to the heterogeneity of sensitivity. CONCLUSIONS Our findings suggest that the lateral cephalogram exhibits very good diagnostic accuracy (area under the curve: 0.86) for the diagnosis of adenoid hypertrophy and posterior upper airway obstruction. Nevertheless, the rate of false-positive diagnoses should be further considered.
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Affiliation(s)
- Hanzhong Duan
- Department of Neurosurgery, The Second Affiliated Hospital of Soochow University, 1055#Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China; Department of Otolaryngology, Zhejiang Xiaoshan Hospital, 728#Yucaibei Road, Hangzhou, Zhejiang Province, 311201, PR China.
| | - Li Xia
- Department of Otolaryngology, Zhejiang Xiaoshan Hospital, 728#Yucaibei Road, Hangzhou, Zhejiang Province, 311201, PR China.
| | - Wangfang He
- Department of Otolaryngology, Zhejiang Xiaoshan Hospital, 728#Yucaibei Road, Hangzhou, Zhejiang Province, 311201, PR China.
| | - Yongdong Lin
- Department of Otolaryngology, Zhejiang Xiaoshan Hospital, 728#Yucaibei Road, Hangzhou, Zhejiang Province, 311201, PR China.
| | - Zhihui Lu
- Department of Otolaryngology, Zhejiang Xiaoshan Hospital, 728#Yucaibei Road, Hangzhou, Zhejiang Province, 311201, PR China.
| | - Qing Lan
- Department of Neurosurgery, The Second Affiliated Hospital of Soochow University, 1055#Sanxiang Road, Suzhou, Jiangsu Province, 215004, PR China.
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12
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Hsu WE, Wu TY. Comparison of upper airway measurement by lateral cephalogram in upright position and CBCT in supine position. J Dent Sci 2019; 14:185-191. [PMID: 31205607 PMCID: PMC6558349 DOI: 10.1016/j.jds.2019.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 12/10/2018] [Revised: 01/08/2019] [Indexed: 11/27/2022] Open
Abstract
Background/Purpose Obstructive sleep apnea syndrome (OSAS) is a common form of sleep disorder. Lateral cephalograms and cone-beam computed tomography (CBCT) have been used for evaluation. However, it is lack of position comparison for these two assessments. Therefore, this study was aimed to evaluate the difference of upper airway measurements taken from lateral cephalograms in upright position and CBCT in supine position. Material and methods This retrospective study enrolled patients with lateral cephalograms and CBCT images due to diagnostic necessity. The anterior-posterior distance of most constricted area in pharynx (PASmin) and the distance from mandibular plane to hyoid bone (MP-H) were identified and measured from 21 normal subjects without obstructive sleep apnea (9 males and 12 females, mean age 21.2 years). A paired data were measured from lateral cephalograms taken in upright position and lateral cephalometric images derived from CBCT taken in supine position. Both images were taken within two months. All data were analyzed statistically. Results No significant difference was identified in intra-examiner reliability (P > 0.05). PASmin measured from lateral cephalograms in upright position was larger than that taken from CBCT derived cephalometric images, but without statistical significant difference (P = 0.073). Significant difference of MP-H length was identified between two different image taking methods (P = 0.000), and the measurement was significantly larger in cephalograms taken from upright position. No correlations were found among the variables (Body Mass Index (BMI), age, gender) in this study. The only two variables correlated were PASmin and MP-H, and they were negatively correlated (r = −0.535). Conclusion The anterior-posterior distance of most constricted area in pharynx (PASmin) and distance of mandibular plane to hyoid bone (MP-H) can be influenced due to change of body position.
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Affiliation(s)
- Wun Eng Hsu
- Division of Orthodontic and Pediatric Dentistry, Taipei Veterans General Hospital, Taiwan.,School of Dentistry, National Yang-Ming University, Taiwan
| | - Tzu Ying Wu
- Division of Orthodontic and Pediatric Dentistry, Taipei Veterans General Hospital, Taiwan.,School of Dentistry, National Yang-Ming University, Taiwan
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13
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Almurtadha RH, Alhammadi MS, Fayed MMS, Abou-El-Ezz A, Halboub E. Changes in Soft Tissue Profile After Orthodontic Treatment With and Without Extraction: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2018; 18:193-202. [PMID: 30077373 DOI: 10.1016/j.jebdp.2017.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 07/29/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to evaluate the soft tissue changes in adult orthodontic patients who received extraction treatment in comparison to their counterparts who received nonextraction orthodontic treatment. METHODS Electronic databases (CENTRAL-Cochrane Register of Controlled Trials, PubMed, Embase, EBESCOhost, LILACS, and Google Scholar) were searched up to March 2015. Handsearching was performed too. The selection process included controlled trials (prospective or retrospective and randomized or nonrandomized) on adult patients receiving orthodontic extraction treatment compared within the same study to a group treated without extraction. The outcomes of interest were the changes in linear and angular cephalometric measurements specific for soft tissue profile. Studies which fulfilled the selection criteria were retrieved. They were assessed for methodological quality based on a validated checklist. Studies of moderate to high quality were included. RESULTS Of the nine full texts which fulfilled the selection criteria, 5 were eligible for the quantitative analysis; they scored a moderate quality. Meta-analysis showed a significant increase regarding the nasolabial angle, upper lip thickness, labrale superioris to E-Line, and labrale inferioris to E-line in the extraction group, suggesting the flattening of the profile following extraction treatment. CONCLUSION A significant retraction of the lips and an increase in the nasolabial angle are associated with extraction protocols, but the degree to which these changes are considered detrimental/beneficial to the profile could be affected by different factors. Since these finding are based on studies of moderate quality, future research with well-conducted methodologies are highly recommended.
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Affiliation(s)
- Rian H Almurtadha
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Maged S Alhammadi
- Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
| | - Mona M S Fayed
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Amr Abou-El-Ezz
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Suvarna S, Singh RK, Pachar RB, Kundra S, Arya S, Mehta LK. Evaluation of Predictability of Suitable Implant Lengths as related to Accurate Treatment Planning using Recent Roentgenographic Measures: A Key to Success. J Contemp Dent Pract 2018; 19:535-540. [PMID: 29807963] [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] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND AIM Selection of suitable length of dental implants is very subjective and largely depends on clinical evidences and operator's expertise. The present study was aimed to assess the role of cone beam computed tomography (CBCT) and cephalograms as far as the selection of right implant length is concerned. MATERIALS AND METHODS The study includes 220 patients for whom radiographic and follow-up records were obtained. There were 105 males and 115 females in the age range of 22 to 58 years. A total of 98 implant sites in different edentulous areas were studied. Length of implant was predicted at treatment planning and compared with finally placed implant at surgical stages. It also includes the in-depth exploration of (1) number of implants placed per patient, (2) implant per edentulous areas, (3) implant location, and (4) implant region. For prediction of implant lengths, CBCT results were obtained and compared with cephalometric findings. Accuracies of implant lengths as planned by CBCT and cephalometric images were also studied at treatment planning and surgical stages. Statistical analysis and results: Upon statistical comparisons, we found that larger implant lengths chosen at treatment planning stage did not change in 65.5% of patients. In addition, the smaller length implants were just about the same as that with larger dimensions. The CBCT results were satisfactory (up to 98.5%). Cephalometry was performed well in this prediction, especially in posterior mandible (87.9%). However, its performance in anterior maxillary region was not satisfactory (69.6%). Intergroup comparisons of CBCT and cephalometric results at different regions were significant (p < 0.001). CONCLUSION Our study results show insignificant changes in the length of implants that was exactly planned using CBCT scans. Therefore, accurate prediction of implant lengths can be done using CBCT scans as they have superior and advanced tools that facilitate presurgical decision-making. Lateral cephalometric evaluation has been shown as an imperative radiographic tool for determining implant lengths as it confirmed the significance bone resorption on the selection of implant length at different sites. CLINICAL SIGNIFICANCE The CBCT and lateral cephalogram offer excellent anatomical details that can be judiciously applied for treatment planning and other clinical decision-making, including selection of correct implant length. Our study advocates thorough cephalometric evaluations of mandible wherein implants are to be placed for implant-supported overdentures.
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Affiliation(s)
- Suraj Suvarna
- Department of Prosthodontics, ITS Dental College, Greater Noida, Uttar Pradesh, India, Phone: +919312403324, e-mail:
| | - Ravishek K Singh
- Department of Prosthodontics, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh, India
| | - Renu B Pachar
- Department of Prosthodontics, Maharaja Ganga Singh Dental College & Research Centre, Sri Ganganagar, Rajasthan, India
| | - Sachin Kundra
- Department of Prosthodontics, Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, Uttar Pradesh, India
| | - Sankalp Arya
- Department of Prosthodontics, ITS Dental College, Greater Noida, Uttar Pradesh, India
| | - Lata K Mehta
- Department of Pedodontics and Preventive Dentistry, PDM Dental College & Research Institute, Bahadurgarh, Haryana, India
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Sugiki Y, Kobayashi Y, Uozu M, Endo T. Association between skeletal morphology and agenesis of all four third molars in Japanese orthodontic patients. Odontology 2018; 106:282-288. [PMID: 29330705 PMCID: PMC5995980 DOI: 10.1007/s10266-017-0336-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/15/2017] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to clarify differences in skeletal morphologies between male and female orthodontic patients with and without agenesis of all four third molars. A total of 64 patients (32 males and 32 females) with agenesis of all four third molars without agenesis of other teeth were selected as the third molars agenesis group (group 1). In addition, 64 patients (32 males and 32 females) with all these teeth were selected as controls (group 2). Lateral cephalograms taken between the ages of 14 and 30 years were used to compare skeletal morphology between groups 1 and 2 and between sexes. Maxillary length (P < 0.001), lower facial height (P < 0.05), gonial angle (P < 0.001) and mandibular plane angle (P < 0.001) were significantly smaller in group 1 than in group 2. Irrespective of the presence or absence of all four third molars, males had significantly smaller lower facial height (P < 0.01) and mandibular plane angle (P < 0.001) and significantly greater total mandibular length (P < 0.001), mandibular body length (P < 0.001) and mandibular ramus height (P < 0.001) than females. Japanese orthodontic patients with agenesis of all four third molars had significantly small maxillary length, lower facial height, gonial angle and mandibular plane angle.
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Affiliation(s)
- Yoshiko Sugiki
- Orthodontic Dentistry, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan.
| | - Yoshiki Kobayashi
- Orthodontic Dentistry, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan
| | - Miwa Uozu
- Orthodontics and Dentofacial Orthopedics, Field of Oral and Maxillofacial Growth and Development, Course of Clinical Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan
| | - Toshiya Endo
- Orthodontics and Dentofacial Orthopedics, Field of Oral and Maxillofacial Growth and Development, Course of Clinical Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan
- Department of Orthodontics, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan
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Aneja V, Raval R, Aneja P, Rai KK, Agarwal S, Chuadhary S. Evaluation of Mandibular Condylar Changes in Patients Following Orthognathic Surgery: A Retrospective Study. Niger J Surg 2017; 23:37-41. [PMID: 28584510 PMCID: PMC5441214 DOI: 10.4103/1117-6806.199961] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following orthognathic surgery, as well as to assess what factors may have contributed to the problems. METHODOLOGY A diagnosis of progressive condylar resorption (PCR) was made by comparison of preoperative and postoperative radiographs (cephalometric radiograms), as well as clinical evaluations. The radiographs were taken for each patient preoperatively and postoperatively, which include immediately after osteotomy, at 6 months and 24 months. Additional radiographs were taken when required. Then, preoperative and postoperative tracings were compared at 24 months postoperatively. RESULTS AND CONCLUSION It can be concluded from this study that females of relative low age (<18 years) appeared to be a high-risk factor for the occurrence of condylar alteration including PCR. A steep mandibular plane angle, the low facial height ratio (post/ant), and magnitude of surgery were also significantly related to the occurrence of condylar alteration, but the multivariance regression showed that these parameters had only limited value.
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Affiliation(s)
- Vikas Aneja
- Department of Oral and Maxillofacial Surgery, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar, Rajasthan, India
| | - Rushik Raval
- Department of Oral and Maxillofacial Surgery, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar, Rajasthan, India
| | - Parul Aneja
- Department of Periodontology and Implantology, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar, Rajasthan, India
| | - K K Rai
- Department of Oral and Maxillofacial Surgery, Bapuji Dental College, Davangere, Karnataka, India
| | - Sumit Agarwal
- Department of Oral and Maxillofacial Surgery, Rama Dental College, Kanpur, Uttar Pradesh, India
| | - Satyapal Chuadhary
- Department of Oral and Maxillofacial Surgery, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar, Rajasthan, India
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Inamassu-Lemes SM, Fuziy A, Costa ALF, Carvalho PEG, Nahás-Scocate ACR. Dentoskeletal and Soft Tissue Effects in the Treatment of Class II Malocclusion with Klammt's Elastic Open Activator. J Contemp Dent Pract 2016; 17:63-9. [PMID: 27084865 DOI: 10.5005/jp-journals-10024-1804] [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: 11/23/2022]
Abstract
AIM The purpose of this study was to evaluate the dentoskeletal and soft tissue effects resulting from treatment with Klammt's elastic open activator (EOA) functional orthopedic appliance in patients with Class II malocclusion characterized by mandibular deficiency. MATERIALS AND METHODS Teleradiographs were evaluated in the lateral aspect of the initial (T1) and final (T2) orthopedic phases for 16 patients with Class II, Division 1 malocclusion. The age range was from 9 to 11.2 years, with a mean age of 9.9 years. The cephalometric points were demarcated, and cephalometric measurements were obtained by the same investigator to avoid interobserver variability. RESULTS The EOA promoted increased lower anterior facial height (LAFH), increased effective mandibular length, clockwise rotation of the mandible, retrusion and verticalization of the upper incisors, proclination and protrusion of the lower incisors, extrusion of the upper molars, mesial movement of the lower molars and anterior projection of the lower lip. CONCLUSION Skeletal changes characterized by an increase in mandibular length and dentoalveolar changes with an emphasis on the verticalization and retrusion of the upper incisors, proclination of the lower incisors and mesial positioning of the lower molars were key to improving the occlusal relationship and esthetic facial factors. CLINICAL SIGNIFICANCE The EOA is well indicated in patients with Class II malocclusion due to mandibular deficiency with increased overbite, proclined upper incisors and verticalized lower incisors.
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Affiliation(s)
| | - Acácio Fuziy
- Professor, Department of Orthodontics, University of São Paulo City São Paulo, Brazil 03071000, Phone: +551121781310, e-mail:
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Bronoosh P, Khojastepour L. Analysis of Pharyngeal Airway Using Lateral Cephalogram vs CBCT Images: A Cross-sectional Retrospective Study. Open Dent J 2015; 9:263-6. [PMID: 26464593 PMCID: PMC4598371 DOI: 10.2174/1874210601509010263] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 12/09/2014] [Accepted: 05/25/2015] [Indexed: 11/22/2022] Open
Abstract
Background : As the basic biological relationship of form and function, changes in the normal pattern of nasopharyngeal space can profoundly affect the development of the craniofacial growth. The lateral cephalogram, part of the patient’s normal records for orthodontic treatment, may show some of these changes either at the initial examination or later during treatment. The validity of the information the lateral cephalogram may present, have been questioned previously. The aim of this study was to assess correlation between the area and the volume measurements of pharyngeal airway size in a lateral cephalogram and a 3-dimensional (3D) cone-beam computed tomography (CBCT) scan in adolescent subjects. Materials and Methods : CBCT scan and a lateral cephalogram of 35 subjects which were taken within 1 week were included in this study. Airway area of the region of interest from the lateral cephalogram and airway volume over the same of region of interest from the CBCT scan were assessed for all patients. The correlation between the area and the volume measurements were evaluated statistically by Pearson’s correlation coefficient test. Mann Whitney U Test was used for comparing the area and the volume measurements in different sex. Results : Strong correlation was found between lateral cephalogram and CBCT measurements of pharyngeal airway. (r=0.831). Conclusion : Pharyngeal airway area on a lateral cephalogram is correlated strongly with volumetric data on CBCT images. Henceforth the use of CBCT images for volume measurements in orthodontic patients can aid in the better evaluation of airways and acted as a diagnostic instrument in this area.
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Affiliation(s)
- Pegah Bronoosh
- Department of Oral and Maxillofacial Radiology, Dental School, Shiraz University of Medical Science, Shiraz, Iran
| | - Leila Khojastepour
- Department of Oral and Maxillofacial Radiology, Dental School, Shiraz University of Medical Science, Shiraz, Iran
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Abstract
Introduction: Gonial angle is an important parameter of the craniofacial complex giving an indication about the vertical parameters and symmetry of the facial skeleton. Both orthopantomogram (OPG) and lateral cephalograms can be used for the measurement of gonial angle. Because of the superimpositions seen on lateral cephalograms, reliable measurement of the gonial angle becomes difficult. The aim of the present study is to check the possible application and reliability of OPG for gonial angle determination by clarifying whether there is any significant difference between the determination of gonial angle from OPG and cephalogram. Materials and Methods: Gonial angle measurements were made on lateral cephalograms and orthopantomograms of 98 patients - 44 males (mean age 25.9 years) and 54 females (mean age 21.3 years), and compared using Statistical Package for Social Sciences. Results: One-way analysis of variance demonstrated no significant differences between the values of gonial angles determined by lateral cephalogram and panoramic radiography. Pearson correlation showed a high correlation between cephalometric and OPG gonial angle value. Conclusion: Panoramic radiography can be used to determine the gonial angle as accurately as a lateral cephalogram. For determination of the gonial angle, an OPG may be a better choice than a lateral cephalogram as there are no interferences due to superimposed images of anatomical structures as in a lateral cephalogram. Thus, the present study substantiates the possibility of enhancing the clinical versatility of the panoramic radiograph, which is an indispensable tool for dental diagnosis.
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Affiliation(s)
- Mandeep Kaur Bhullar
- Department of Orthodontics and Dentofacial Orthopedics, Luxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India
| | - Amandeep Singh Uppal
- Department of Conservative Dentistry and Endodontics, HSJ Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Gulsheen Kaur Kochhar
- Department of Pedodontics and Preventive Dentistry, Swami Devi Dayal Hospital and Dental College, Barwala, Panchkula, Haryana, India
| | - Sanjay Chachra
- Department of Pedodontics and Preventive Dentistry, Swami Devi Dayal Hospital and Dental College, Barwala, Panchkula, Haryana, India
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Abstract
Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools, specially imaging methods, have become mandatory. From the simple intra-oral periapical X-rays, advanced imaging techniques like computed tomography, cone beam computed tomography, magnetic resonance imaging and ultrasound have also found place in modern dentistry. Changing from analogue to digital radiography has not only made the process simpler and faster but also made image storage, manipulation (brightness/contrast, image cropping, etc.) and retrieval easier. The three-dimensional imaging has made the complex cranio-facial structures more accessible for examination and early and accurate diagnosis of deep seated lesions. This paper is to review current advances in imaging technology and their uses in different disciplines of dentistry.
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Abstract
AIM Growth and development of the human face provides a fascinating interplay of form and function. Among the various facial bones, the mandible plays a very important role during various growth-modification therapies. These treatment modalities will yield a better result in less time if properly correlated with skeletal maturity. It is very essential to know where the site of growth occurs and also the time when it occurs or ceases to occur. This study was conducted to assess the mandibular dimensions at various stages of skeletal maturation. MATERIALS AND METHODS The subjects included 6 to 18-year-old children who were grouped according to their middle phalanx of the third finger stages of skeletal maturity. Lateral cephalographs were taken and, from their cephalometric tracings, linear and angular measurements of the mandible were made. The values obtained were subjected to statistical analysis. RESULTS Results showed that the mandibular height, length and symphysis thickness increased with skeletal maturity. An increase in angles SNB (Sella, Nasion, Supramentale) and L1-MP (Long axis lower incisors- Mandibular plane) and a decrease in the gonial angle and ANB (Subspinale, Nasion, Supramentale) angle were observed. CONCLUSION The study showed a significant correlation between mandibular growth and skeletal maturity.
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Affiliation(s)
- Priya Subramaniam
- Department of Pedodontics, The Oxford Dental College, Hospital and Research Centre, Bangalore, India
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Hindocha AD, Vartak VN, Bhandari AJ, Dudani M. A cephalometric study to determine the plane of occlusion in completely edentulous patients: part I. J Indian Prosthodont Soc 2010; 10:203-7. [PMID: 22131664 PMCID: PMC3056949 DOI: 10.1007/s13191-011-0049-x] [Citation(s) in RCA: 10] [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: 07/16/2010] [Accepted: 02/03/2011] [Indexed: 11/24/2022] Open
Abstract
To determine the relationship between the plane of occlusion and the Camper's line (ala-tragus line). Lateral cephalograms of 105 dentulous subjects were obtained after outlining the tragus and the base of the ala of the nose with radiopaque markers. Tracings of the cephalograms were done and the relationship between the plane of occlusion and the Camper's line (ala-tragus line) was noted. The most common tragal reference as a posterior landmark for determination of plane of occlusion was found to be below inferior (in 30.48% of subjects), and inferior (in 24.76% of subjects). The least common tragal reference was found to be above superior (in 3.82% of subjects) followed by superior of tragus and the point between superior and middle of the tragus (in 6.66% of subjects). The tragal reference in this study population was more towards the inferior of the tragus, with most of the times being below the inferior border. Therefore, the orientation of the plane of occlusion using the superior of tragus as a posterior landmark (according to the widely accepted definition of Camper's line) may be considered to be questionable. Further, the use of the tragus as a posterior landmark for the orientation of the plane of occlusion may be questioned on the basis of the findings of this study.
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Affiliation(s)
- Amit D. Hindocha
- Department of Prosthodontics, Sinhgad Dental College and Hospital, Vadgaon (Bk), Pune, Maharashtra 411041 India
- 404, Tulip, Blossom n’ Springs, S no. 134/2/1-9, Baner-Pashan Link road, Pashan, Pune, Maharashtra 411021 India
| | - Vikas N. Vartak
- Department of Prosthodontics, Sinhgad Dental College and Hospital, Vadgaon (Bk), Pune, Maharashtra 411041 India
| | | | - Mohit Dudani
- Department of Prosthodontics, Sinhgad Dental College and Hospital, Vadgaon (Bk), Pune, Maharashtra 411041 India
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