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Han MD, Graca S, Miloro M. What is the angular accuracy of regional voxel-based registration for segmental Le Fort I and genioplasty osteotomies? Int J Oral Maxillofac Surg 2024; 53:571-577. [PMID: 38184402 DOI: 10.1016/j.ijom.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/06/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
Among the accuracy analysis techniques for orthognathic surgery, regional voxel-based registration (R-VBR) has robust data, but remains unvalidated for smaller jaw segments. The purpose of this study was to validate the angular accuracy of R-VBR for segmental Le Fort I (SLFI) and genioplasty osteotomies. Postoperative cone beam computed tomography (CBCT) of consecutive patients with three-piece SLFI or genioplasties was rotated to a known pitch/roll/yaw (P/R/Y). Using R-VBR, a copy of the raw CBCT was superimposed onto the rotated CBCT at four mutual regions of interest (ROI): anterior, right posterior, and left posterior maxilla, and chin. The P/R/Y of each was subtracted from those of the rotated CBCT to calculate the angular error. The predictor and outcome variables were ROI and absolute angular error, respectively. The accuracy threshold was 0.5°. Ten SLFI and 34 genioplasties were analyzed based on the sample size calculation. The one-sample t-test and Wilcoxon signed rank test were applied in the analysis. The mean absolute error was 0.20-0.54° for the maxillary segments (all P ≤ 0.01) and 0.83-2.51° for the genioplasty segments (all P < 0.001). R-VBR has variable angular accuracy for SLFI osteotomies and may be insufficient for genioplasty. The findings may allow the design and interpretation of studies on SLFI and genioplasty with greater rigor, thereby contributing to minimizing the discrepancy between planned and achieved outcomes.
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Affiliation(s)
- M D Han
- Department of Oral and Maxillofacial Surgery, University of Illinois Chicago College of Dentistry, Chicago, IL, USA.
| | - S Graca
- Department of Oral and Maxillofacial Surgery, University of Illinois Chicago College of Dentistry, Chicago, IL, USA
| | - M Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois Chicago College of Dentistry, Chicago, IL, USA
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Zhang J, Han Y, Zhong H. Accuracy assessment between computer-guided surgery planning and actual tooth position during tooth autotransplantation. Dent Traumatol 2024. [PMID: 38794910 DOI: 10.1111/edt.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND/AIM This study aims to evaluate the precision and efficacy of utilizing computer-aided design (CAD) in combination with three-dimensional printing technology for tooth transplantation. MATERIAL AND METHODS This study analysed 50 transplanted teeth from 48 patients who underwent tooth transplantation surgery with the aid of CAD and positional guides. A consistent coordinate system was established using preoperative and postoperative cone-beam computed tomography images. Linear displacements and angular deviations were calculated by identifying key regions in both virtual designs and actual transplanted teeth. Additionally, an analysis was conducted to explore potential factors influencing these deviations. RESULTS The mean cervical deviation, apical deviation, and angular deviation among the 50 transplanted teeth were 1.16 ± 0.57 mm, 1.80 ± 0.94 mm, and 6.82 ± 3.14°, respectively. Cervical deviation was significantly smaller than apical deviation. No significant difference in deviation was observed among different recipient socket locations, holding true for both single-root, and multi-root teeth. However, a significant difference was noted in apical deviation between single-root and multi-root teeth. Our analysis identified a correlation between apical deviation and root length, leading to the development of a prediction model: Apical deviation = 0.1390 × (root length) + 0.2791. CONCLUSIONS The postoperative position of the donor teeth shows discrepancies compared to preoperative simulation when utilizing CAD and 3D printed templates during autotransplantation procedures. Continual refinement of preoperative design is a crucial endeavour.
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Affiliation(s)
- Jiaming Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yue Han
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haoyan Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Ronsivalle V, Leonardi R, Lagravere M, Flores-Mir C, Grippaudo C, Alessandri Bonetti G, Lo Giudice A. Medium-term effects of rapid maxillary expansion on nasal cavity and pharyngeal airway volumes considering age as a factor: A retrospective study. J Dent 2024; 144:104934. [PMID: 38461886 DOI: 10.1016/j.jdent.2024.104934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVES The medium-term effects of rapid maxillary expansion (RME) on nasal cavity (NC) and upper airway (UA) dimensions based on chronological age are still unclear. This retrospective study evaluated the medium-term changes occurring in the NC and pharyngeal airways (PA) after RME in two distinct age-based cohorts of patients. METHODS This retrospective study included 48 subjects who underwent RME grouped in two cohorts: a 6-9-year-old group (EEG group: early expansion group - 25 subjects) and an 11-14-year-old group (LEG group: late expansion group - 23 subjects). NC and PA volumes were analyzed from CBCT imaging segmentation before RME (T0) and twelve months after RME (T1). The amount of maxillary expansion (PW) and minimal cross-sectional area (CSmin) were also considered. RESULTS All PAs' volumetric sub-regions, CSmin and PW showed a significant volumetric increment (p < 0.05). Inter-group comparisons showed significant differences (p < 0.05) for nasopharynx and CSmin parameters (p < 0.05), while no significant changes were recorded for the other UA's sub-regions and PW (p > 0.05). According to a deviation analysis, part of the UA increase (more marked for the nasopharynx area) may have occurred due to reduced adenotonsillar tissues, which were larger in the EEG group. CONCLUSIONS Twelve months after treatment, clinicians should not expect changes in the UAs dimensions to be solely related to treatment effects of RME; instead, normal craniofacial growth changes and spontaneous regression of the adenotonsillar tissue could represent the most significant factors influencing UAs changes. CLINICAL SIGNIFICANCE From the clinical perspective, the results of the present study encourage caution when considering the therapeutic effects of RME on airways dimensions.
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Affiliation(s)
- Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Oral Surgery, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy.
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
| | - Manuel Lagravere
- Orthodontic Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Orthodontic Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Cristina Grippaudo
- Orthodontic Graduate Program, University of Roma Cattolica - Sacro Cuore
| | | | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Via Santa Sofia 78, 95123, Catania, Italy
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Barone S, Cevidanes L, Miranda F, Gurgel ML, Anchling L, Hutin N, Bianchi J, Goncalves JR, Giudice A. Enhancing skeletal stability and Class III correction through active orthodontist engagement in virtual surgical planning: A voxel-based 3-dimensional analysis. Am J Orthod Dentofacial Orthop 2024; 165:321-331. [PMID: 38010236 PMCID: PMC10923113 DOI: 10.1016/j.ajodo.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Skeletal stability after bimaxillary surgical correction of Class III malocclusion was investigated through a qualitative and quantitative analysis of the maxilla and the distal and proximal mandibular segments using a 3-dimensional voxel-based superimposition among virtual surgical predictions performed by the orthodontist in close communication with the maxillofacial surgeon and 12-18 months postoperative outcomes. METHODS A comprehensive secondary data analysis was conducted on deidentified preoperative (1 month before surgery [T1]) and 12-18 months postoperative (midterm [T2]) cone-beam computed tomography scans, along with virtual surgical planning (VSP) data obtained by Dolphin Imaging software. The sample for the study consisted of 17 patients (mean age, 24.8 ± 3.5 years). Using 3D Slicer software, automated tools based on deep-learning approaches were used for cone-beam computed tomography orientation, registration, bone segmentation, and landmark identification. Colormaps were generated for qualitative analysis, whereas linear and angular differences between the planned (T1-VSP) and observed (T1-T2) outcomes were calculated for quantitative assessments. Statistical analysis was conducted with a significance level of α = 0.05. RESULTS The midterm surgical outcomes revealed a slight but significantly less maxillary advancement compared with the planned position (mean difference, 1.84 ± 1.50 mm; P = 0.004). The repositioning of the mandibular distal segment was stable, with insignificant differences in linear (T1-VSP, 1.01 ± 3.66 mm; T1-T2, 0.32 ± 4.17 mm) and angular (T1-VSP, 1.53° ± 1.60°; T1-T2, 1.54° ± 1.50°) displacements (P >0.05). The proximal segments exhibited lateral displacement within 1.5° for both the mandibular right and left ramus at T1-VSP and T1-T2 (P >0.05). CONCLUSIONS The analysis of fully digital planned and surgically repositioned maxilla and mandible revealed excellent precision. In the midterm surgical outcomes of maxillary advancement, a minor deviation from the planned anterior movement was observed.
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Affiliation(s)
- Selene Barone
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy.
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Felicia Miranda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marcela Lima Gurgel
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Luc Anchling
- Chemistry and Chemical Engineering School - Digital Sciences School Lyon, Lyon, France
| | - Nathan Hutin
- Chemistry and Chemical Engineering School - Digital Sciences School Lyon, Lyon, France
| | - Jonas Bianchi
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
| | - Joao Roberto Goncalves
- Department of Pediatric Dentistry, School of Dentist, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Amerigo Giudice
- Department of Health Sciences, School of Dentistry, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Mehta S, Vishwanath M, Patel A, Vich ML, Allareddy V, Yadav S. Long-term evaluation of soft-tissue changes after miniscrew-assisted and conventional rapid palatal expansion using voxel-based superimposition of cone-beam computed tomography scans. Am J Orthod Dentofacial Orthop 2024; 165:332-343. [PMID: 38032552 DOI: 10.1016/j.ajodo.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION This study aimed to evaluate the soft-tissue changes in the long-term after miniscrew-assisted rapid palatal expansion (MARPE) and conventional rapid palatal expansion (RPE) appliances compared with a matched control group using voxel-based superimposition of cone-beam computed tomography (CBCT) scans. METHODS A total of 180 CBCTs for 60 patients at 3-time points were evaluated: pretreatment (T1), postexpansion (T2), and posttreatment (T3) for 3 groups: (1) MARPE, (2) RPE, and (3) controls (time-period T1 to T3: MARPE, 2 years 8 months; RPE, 2 years 9 months; control, 2 years 7 months). The voxel-based superimposition technique was used to superimpose the CBCT scans, after which the soft-tissue surfaces were extracted from the superimposed T1-CBCT, T2-CBCT, and T3-CBCT scans. Nine landmarks were identified on the CBCT scans: nasion, A-point, pogonion, right and left alar base, right and left zygoma, and right and left gonion. The coordinates of the 9 parameters were obtained in the x-axis, y-axis, and z-axis for the CBCT scans and subjected to statistical analyses. The changes in the soft-tissue surfaces were also evaluated by color-coded maps for short-term (T2) and long-term (T3) changes. The mean changes from T1 to T2 and T1 to T3 were tested against no change within the groups by paired t test, and the mean changes among the 3 groups were compared with analysis of variance F test with Tukey's Honest significant difference used for adjusting P values for multiple testing. RESULTS In the short term, both MARPE and RPE led to a significant downward movement of pogonion, left gonion, and lateral movement of the right and left alar base compared with controls at T2 (P <0.05). In addition, MARPE led to a significant downward movement of right gonion than controls at T2 (P <0.05). Moreover, RPE led to a significant downward and forward movement of A-point and downward movement of the right and left alar base than controls at T2 (P <0.05). However, in the long-term, there were no significant differences in the soft-tissue changes among the MARPE, RPE, and control groups. CONCLUSIONS MARPE and RPE do not lead to significant soft-tissue changes in the long term when compared with controls.
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Affiliation(s)
- Shivam Mehta
- Department of Orthodontics, Texas A&M University College of Dentistry, Dallas, Tex.
| | - Meenakshi Vishwanath
- Department of Growth and Development, University of Nebraska Medical Center, College of Dentistry, Lincoln, Nebr
| | | | | | | | - Sumit Yadav
- Department of Growth and Development, University of Nebraska Medical Center, College of Dentistry, Lincoln, Nebr
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Mordente CM, Oliveira DD, Palomo JM, Cardoso PA, Assis MAL, Zenóbio EG, Souki BQ, Soares RV. The effect of micro-osteoperforations on the rate of maxillary incisors' retraction in orthodontic space closure: a randomized controlled clinical trial. Prog Orthod 2024; 25:6. [PMID: 38342823 PMCID: PMC10859353 DOI: 10.1186/s40510-023-00505-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/29/2023] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND This single-centered randomized controlled clinical trial aimed to evaluate the effectiveness of micro-osteoperforations (MOPs) in accelerating the orthodontic retraction of maxillary incisors. METHODS Forty-two patients aged 16-40 were recruited and randomly assigned into two groups, one which underwent MOPs (MOPG) in the buccal and palatal region of all maxillary incisors immediately before the start of retraction and one which did not (CG). Eligibility criteria included the orthodontic need for maxillary first premolars extraction and space closure in two phases. The primary outcome of the study consisted of measuring the rate of space closure and, consequently, the rate of incisors' retraction using digital model superimposition 14 days later and monthly thereafter for the next 4 months. The secondary outcomes included measuring anchorage loss, central incisors' inclination, and root length shortening, analyzed using cone beam computed tomography scans acquired before retraction and 4 months after retraction. Randomization was performed using QuickCalcs software. While clinical blinding was not possible, the image's examinator was blinded. RESULTS Twenty-one patients were randomly assigned to each group. However, due to various reasons, a total of 37 patients (17 male and 20 female) were analyzed (mean age: 24.3 ± 8.1 years in the MOPG; 22.2 ± 4.2 years in the CG) during the trial. No statistically significant difference was found between the MOPG and the CG regarding the incisors' retraction measured at different time points at the incisal border (14 days, 0.4 mm vs. 0.5 mm; 1 month, 0.79 mm vs. 0.77 mm; 2 months, 1.47 mm vs. 1.41 mm; 3 months, 2.09 mm vs. 1.88 mm; 4 months, 2.62 mm vs. 2.29 mm) and at the cervical level (14 days, 0.28 mm vs. 0.30 mm; 1 month, 0.41 mm vs. 0.32 mm; 2 months, 0.89 mm vs. 0.61 mm; 3 months, 1.36 mm vs. 1.10 mm; 4 months, 1.73 mm vs. 1.39 mm). Similarly, no statistically significant differences were detected in the space closure, anchorage loss, central incisors' inclination, and radicular length between groups. No adverse effect was observed during the trial. CONCLUSIONS MOPs did not accelerate the retraction of the maxillary incisors, nor were they associated with greater incisor inclination or root resorption. Trial registration ClinicalTrials.gov NCT03089996. Registered 24 March 2017- https://clinicaltrials.gov/ct2/show/NCT03089996 .
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Affiliation(s)
- Carolina Morsani Mordente
- Graduate Program in Dentistry, School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Dauro Douglas Oliveira
- Graduate Program in Dentistry, Department of Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Polyana Araújo Cardoso
- Graduate Program in Dentistry, Department of Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marina Araújo Leite Assis
- Graduate Program in Dentistry, School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Elton Gonçalves Zenóbio
- Graduate Program in Dentistry, School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Bernardo Quiroga Souki
- Graduate Program in Dentistry, Department of Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rodrigo Villamarim Soares
- Graduate Program in Dentistry, School of Dentistry, Pontifical Catholic University of Minas Gerais, Avenida Dom José Gaspar, 500, Prédio 46, Sala 101, Belo Horizonte, MG, 30535-901, Brazil.
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Hu Y, Zheng M, Chen J, Guo C, Chen J. Accuracy and reliability of mandibular digital model superimposition based on the morphological characteristics of vessels in extraction adult patients. BMC Oral Health 2024; 24:125. [PMID: 38267962 PMCID: PMC10809553 DOI: 10.1186/s12903-023-03836-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/27/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND This study aimed to validate the availability of superimposing full-color mandibular digital models (DMs) by the morphological characteristics of vessels in extraction adult patients. METHODS Twenty-eight adult patients were included, and their DMs were superimposed with pre- and posttreatment cone beam computed tomography (CBCT) and the morphological characteristics of lingual vessels. The measurements of each tooth were compared under the same coordinate system. RESULTS The ICC results displayed exceptional agreement in intra- and interrater assessments, with scores exceeding 0.891 in the crown for intrarater agreement and scores surpassing 0.888 in the crown for interrater agreement. Furthermore, no statistically significant differences were found in the 2 superimposition methods (P > 0.05). CONCLUSION The morphological characteristics of vessels under the mucogingival junction in the lingual side of mandible of are stable enough for the superimposition of mandibular DMs in the adult patients undergo orthodontic treatment with premolars extraction.
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Affiliation(s)
- Yaozheng Hu
- Department of Orthodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
| | - Mengyu Zheng
- Department of Orthodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
| | - Jin Chen
- Department of Orthodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
| | - Chenlin Guo
- Department of Orthodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China
| | - Jianming Chen
- Department of Orthodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Medical University, Guangzhou, China.
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, China.
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Ito A, Mayama A, Oyanagi T, Ogura H, Seiryu M, Fukunaga T, Kitaura H, Mizoguchi I. Three-dimensional morphologic analysis of the maxillary alveolar bone after anterior tooth retraction with temporary anchorage devices. Angle Orthod 2023; 93:667-674. [PMID: 37922391 PMCID: PMC10633794 DOI: 10.2319/120122-827.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/01/2023] [Indexed: 11/05/2023] Open
Abstract
OBJECTIVES To investigate three-dimensional (3D) morphologic changes in the alveolar bone around the maxillary central incisors of patients who underwent premolar extraction and subsequent anterior tooth retraction using temporary anchorage devices (TADs). MATERIALS AND METHODS The subjects consisted of 16 patients with bimaxillary protrusion. The maxillary anterior teeth were retracted using sliding or loop mechanics and TADs for anchorage reinforcement. Cephalograms and computed tomography scans taken pretreatment and posttreatment were registered with respect to the palatal structures. The movement of the maxillary central incisors and morphologic changes in the anterior alveolar bone were evaluated quantitatively. RESULTS Displacement in the palatal direction was observed in the alveolar bone around the incisors and the interdental septum. The displacement and bone remodeling/tooth movement ratio were larger on the labial side than the palatal side, and decreased progressively from the crest to apex level. The bone thickness was significantly increased on the labial side and decreased on the palatal side. CONCLUSIONS Regional differences exist in morphologic changes of the alveolar bone during anterior tooth retraction using TADs. Attention should be paid to the crest region of the palatal alveolar bone because of its small original thickness and low remodeling activity.
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Affiliation(s)
- Arata Ito
- Corresponding author: Dr Arata Ito, Division of Orthodontics and Dentofacial Orthopedics, Department of Community Social Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, Japan (e-mail: )
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Hong YY, Zhou MQ, Cai CY, Han J, Ning N, Kang T, Chen XP. Efficacy of upper-incisor torque control with clear aligners: a retrospective study using cone-beam computed tomography. Clin Oral Investig 2023; 27:3863-3873. [PMID: 37036513 DOI: 10.1007/s00784-023-05006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/28/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES The objectives of this retrospective clinical study were to evaluate the efficacy of clear aligners on upper-incisor torque control, with the expectation of providing guidance for clinics. MATERIALS AND METHODS Pretreatment (T0) and posttreatment (T1) cone-beam computed tomography (CBCT) scans of 47 patients with a nonextraction treatment using clear aligners were obtained and 120 upper-incisors with torque ≥5° were selected. Voxel-based superimpositions were performed using Dolphin imaging software and achieved movements were then measured. Difference between achieved and predicted movement (DAPM) and the efficiency for upper-incisor torque were used to evaluate the torque control efficacy. RESULTS The achieved torque movement with clear aligners was lower than predicted significantly, as the mean efficiency was 46.81±33.95%. Additionally, the achieved incisor movement of the crown and root differed significantly from the predicted movement, especially root movement. CONCLUSIONS Clear aligners struggle to control upper-incisor torque, particularly root movement. In that case, overcorrection is necessary to prevent torque loss. CLINICAL RELEVANCE Clear aligners remain a limitation on torque control and overcorrection should be considered.
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Affiliation(s)
- Ya-Ya Hong
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Meng-Qi Zhou
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China
| | - Chao-Ying Cai
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China
- Department of Dentistry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Han
- Department of Pediatric Dentistry, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Nan Ning
- MeiQi Technology, Zhejiang, China
| | - Ting Kang
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China.
| | - Xue-Peng Chen
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China.
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Tang H, Cui X, Li H, Zheng F, Chen Y, Jiang J. Effects of vertical control on anatomic and aerodynamic characteristics of the oropharyngeal airway during premolar extraction treatment of Class II hyperdivergent nonsevere crowding malocclusion. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00256-1. [PMID: 37245126 DOI: 10.1016/j.ajodo.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION This study aimed to analyze the effects of premolar extraction treatment with vertical control on changes in the anatomy and aerodynamics of the oropharynx in Class II hyperdivergent malocclusion with nonsevere crowding. METHODS Thirty-nine patients with Class II hyperdivergent malocclusion were enrolled consecutively. All the participants underwent 4 premolar extractions. The high-pull J-hook and mini-implants were used to provide vertical control. Cone-beam computed tomography was performed before and after treatment. The participants were divided into a decreased lower vertical facial height group (n = 23) and an increased lower vertical facial height group (n = 16) on the basis of superimposition. The aerodynamic characteristics, including airway resistance (inspiration, Rin; expiration, Rex) and maximum velocity (inspiration, Vmaxin; expiration, Vmaxex) at inspiration and expiration, were calculated using computational fluid dynamics. Anatomic characteristics, including volume and cross-sectional area (CSAmin), were measured using the Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). RESULTS After treatment, the median volume and CSAmin increased by 2357 mm3 and 43 mm2, respectively, and median Rin and Vmaxex decreased by 0.15 Pa/L/min and 0.24 m×s-1, respectively, in decreased lower vertical facial height group. In contrast, the median CSAmin decreased by 9.5 mm2 in the increased lower vertical facial height group. All the changes were statistically significant (all P <0.05). Significant differences in volume, CSAmin, Rin, and Vmaxex were observed between the 2 groups. CONCLUSIONS Vertical control might improve the anatomic and aerodynamic characteristics of the oropharyngeal airway during premolar extraction treatment of Class II hyperdivergent malocclusion with nonsevere crowding.
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Affiliation(s)
- Hongyi Tang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xinyu Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huazhi Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Fu Zheng
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Youchao Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jiuhui Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
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11
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Trevisiol L, Bersani M, Martinez Garza A, Alvarado E, Arnett GW, D'Agostino A. Accuracy of virtual surgical planning in bimaxillary orthognathic surgery with mandible first sequence: A retrospective study. J Craniomaxillofac Surg 2023:S1010-5182(23)00093-8. [PMID: 37355372 DOI: 10.1016/j.jcms.2023.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/27/2023] [Accepted: 05/23/2023] [Indexed: 06/26/2023] Open
Abstract
The aim of this study was to verify treatment accuracy using virtual surgical planning (VSP) with a mandible-first sequence and strict surgical protocol to determine what surgical and methodological factors might influence outcomes. VSP transfer accuracy was evaluated retrospectively through a modified method involving voxel-based superimposition in patients who had undergone bimaxillary surgery with a mandible-first sequence to correct dentoskeletal deformities. Data analysis showed that the movements planned and those executed were substantially equivalent (p < 0.01), with the exception of mandibular and maxillary sagittal movements that were 0.72 ± 0.90 mm and 1.41 ± 1.04 mm smaller, respectively, than planned. This study showed that a mandible-first sequence is accurate for transferring virtual surgical planning intraoperatively. There are several factors involved in the proper transfer of virtual planning beyond the software, such as surgical technique and sequencing. Inaccurate sagittal movements and maxillary repositioning seem to depend mainly on surgical factors.
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Affiliation(s)
- Lorenzo Trevisiol
- Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Massimo Bersani
- Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy.
| | | | | | | | - Antonio D'Agostino
- Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
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12
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Wang S, Liu D, Guo R, Huang Y, Liu X, Wang X, Li W. Maxillary cortical bone remodeling characteristics in extraction patients: A cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00072-0. [PMID: 37024336 DOI: 10.1016/j.ajodo.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 04/08/2023]
Abstract
INTRODUCTION This study aimed to evaluate labial and palatal cortical bone remodeling (BR) characteristics and related aspects of maxillary incisors after retraction, as these aspects are still controversial among orthodontists. METHODS Cortical BR and incisor movement of 44 patients (aged 26.18 ± 4.71 years) who underwent maxillary first premolar extraction and incisor retraction were analyzed using superimposed cone-beam computed tomography images. Labial BR/tooth movement (BT) ratios at the crestal, midroot (S2), and apical (S3) levels were compared using the Friedman test and pairwise comparisons. Multivariate linear regressions were used to explore the relationships between the labial BT ratio and several factors, including age, ANB angle, mandibular plane angle, and incisor movement patterns. According to the type of palatal cortical BR observed, the patients were divided into 3 groups: type I (no BR without root penetration of the original palatal border [RPB]), type II (BR with RPB), and type III (no BR with RPB). Student's t test was used to compare the type II and III groups. RESULTS The mean labial BT ratios at all levels were <1.00 (0.68-0.89). This value at the S3 level was significantly smaller than that at the crestal and S2 levels (P <0.01). Multivariate linear regression indicated that the tooth movement pattern negatively correlates with the BT ratio at S2 and S3 levels (P <0.01). Type I was noted in 40.9% of the patients, and similar proportions exhibited type II (29.5%, 25.0%) or type III remodeling (29.5%, 34.1%). The retraction distance of the incisors in type III patients was significantly larger than in type II patients (P <0.05). CONCLUSIONS The amount of cortical BR secondary to maxillary incisor retraction is less than the tooth movement. Bodily retraction may lead to lower labial BT ratios at the S3 and S2 levels. Roots penetrating the original border of the cortical plate are necessary for palatal cortical BR initiation.
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Affiliation(s)
- Shuo Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Dawei Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Runzhi Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Yiping Huang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Xiaomo Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Xuedong Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Weiran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
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13
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Han MD, Kwon TG, Miloro M, Chakrabarty S. What Is the Linear Accuracy of Regional Voxel-Based Registration for Orthognathic Surgery Landmarks? J Oral Maxillofac Surg 2023; 81:546-556. [PMID: 36828126 DOI: 10.1016/j.joms.2023.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 01/07/2023] [Accepted: 01/27/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE While regional voxel-based registration (R-VBR) has been shown to have excellent reproducibility and angular accuracy, there are limited data on the linear accuracy of R-VBR for common orthognathic surgery landmarks, or on whether angular accuracy correlates with linear accuracy. The purpose of this study was to estimate the linear accuracy of R-VBR for several skeletal landmarks commonly used in orthognathic surgical planning, and to measure the correlation between angular and linear discrepancies. MATERIALS AND METHODS This is a retrospective cross-sectional study of consecutive patients treated at a single center with nonsegmental LeFort I and bilateral sagittal split osteotomy surgery from January 2019 to November 2020. Cone beam computed tomography at the preoperative (T0) and immediate postoperative (T1) stages were analyzed to measure the postoperative positional changes of 11 orthognathic landmarks in 4 regions of interest (ROI) using R-VBR performed twice by two examiners. Pairwise correlation analysis and canonical correlation analysis were performed for the angular discrepancies (primary predictor variable) and the linear discrepancies (primary outcome variable) to measure the correlation between the two. RESULTS In cone beam computed tomography analysis of 28 eligible subjects (16 males, 12 females; mean age 18.9 years, range 15 to 25), the mean absolute (MA) angular discrepancies ranged from 0.15° to 0.55°, while the corresponding MA linear discrepancies ranged from 0.05 to 0.41 mm. There was a strong correlation between angular and linear discrepancies that was statistically significant (P = .001 to .04, Spearman's rank correlation coefficient 0.38 to 0.87). CONCLUSIONS For nonsegmental LeFort I osteotomies and bilateral sagittal split osteotomy, R-VBR has excellent linear accuracy within a single voxel size (0.3 mm) for commonly used orthognathic landmarks in the maxillary and distal mandibular ROI. The MA linear discrepancy for the proximal mandibular segment ROI was greater than a single voxel size, with a maximum of 0.41 mm.
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Affiliation(s)
- Michael D Han
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Illinois Chicago, Chicago, IL.
| | - Tae-Geon Kwon
- Professor, Department of Oral and Maxillofacial Surgery, Kyungpook National University, Daegu, South Korea
| | - Michael Miloro
- Professor and Head, Department of Oral and Maxillofacial Surgery, University of Illinois Chicago, Chicago, IL
| | - Sayan Chakrabarty
- Statistical Consultant, Department of Statistics, University of Illinois Urbana-Champaign, Champaign, IL
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Sheeran S, Hartsfield J, Omami G, Bazina M. Comparison of two 3-dimensional user-friendly voxel-based maxillary and 2-dimensional superimposition methods. Am J Orthod Dentofacial Orthop 2023; 163:117-125. [PMID: 36549828 DOI: 10.1016/j.ajodo.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cephalometric superimpositions have many uses in orthodontics, including growth evaluation and outcome assessment. However, 2-dimensional (2D) cephalograms can be distorted and yield incomplete 2D data. Cone-beam computed tomography (CBCT) imaging provides a 3-dimensional (3D), undistorted, and more complete patient analysis. CBCT imaging provides many unique advantages to the orthodontic practice and can influence how treatment outcomes are assessed. This study aimed to investigate the validity of 3D maxillary voxel-based superimpositions compared with the 2D method recommended by the American Board of Orthodontists. METHODS This retrospective study included pretreatment and posttreatment CBCT images of 30 adolescent patients. The images were superimposed using the 3D voxel-based tools in Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). Two different 3D anatomic registration areas (3DA-3DB) were tested for the validity and reproducibility of the 3D maxillary superimpositions as compared with the 2D method. Linear and angular measurements were used to evaluate the dental changes of the maxillary right central incisor and first molar. Data distribution was normal by the Shapiro-Wilk W test. A mixed model analysis of variance test was done to compare the 3 superimposition types within each subject, followed by pairwise Tukey-Kramer comparisons when indicated. RESULTS After applying the Benjamini-Hochberg procedure to control the false discovery rate at 0.05 with multiple testing, the U1 vertical difference was statistically significant (P <0.0001) for the superimposition method, though the mean differences were clinically nonsignificant (0.52 mm, 0.76 mm). The U1 angular and U6 vertical differences were not statistically significant for the superimposition method (P = 0.3636 and P = 0.1863, respectively). CONCLUSIONS The 3D voxel-based maxillary superimpositions showed similar results to conventional 2D superimpositions recommended by the American Board of Orthodontists.
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Affiliation(s)
- Shelby Sheeran
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Ky
| | - James Hartsfield
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Galal Omami
- Division of Oral Medicine, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Mohamed Bazina
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Ky.
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15
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Park YS, Choi JH, Kim Y, Choi SH, Lee JH, Kim KH, Chung CJ. Deep Learning-Based Prediction of the 3D Postorthodontic Facial Changes. J Dent Res 2022; 101:1372-1379. [PMID: 35774018 DOI: 10.1177/00220345221106676] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
With the increase of the adult orthodontic population, there is a need for an accurate and evidence-based prediction of the posttreatment face in 3 dimensions (3D). The objectives of this study are 1) to develop a 3D postorthodontic face prediction method based on a deep learning network using the patient-specific factors and orthodontic treatment conditions and 2) to validate the accuracy and clinical usability of the proposed method. Paired sets (n = 268) of pretreatment (T1) and posttreatment (T2) cone-beam computed tomography (CBCT) of adult patients were trained with a conditional generative adversarial network to generate 3D posttreatment facial data based on the patient's gender, age, and the changes of upper (ΔU1) and lower incisor position (ΔL1) as input. The accuracy was calculated with prediction error and mean absolute distances between real T2 (T2) and predicted T2 (PT2) near 6 perioral landmark regions, as well as percentage of prediction error less than 2 mm using test sets (n = 44). For qualitative evaluation, an online survey was conducted with experienced orthodontists as panels (n = 56). Overall, PT2 indicated similar 3D changes to the T2 face, with the most apparent changes simulated in the perioral regions. The mean prediction error was 1.2 ± 1.01 mm with 80.8% accuracy. More than 50% of the experienced orthodontists were unable to distinguish between real and predicted images. In this study, we proposed a valid 3D postorthodontic face prediction method by applying a deep learning algorithm trained with CBCT data sets.
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Affiliation(s)
- Y S Park
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - J H Choi
- Smile Future Orthodontics, Seoul, Korea.,Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Y Kim
- Imagoworks Inc., Seoul, Korea
| | - S H Choi
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - J H Lee
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.,Department of Orthodontics, Gangnam Severance Hospital Yonsei University, Seoul, Korea
| | - K H Kim
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.,Department of Orthodontics, Gangnam Severance Hospital Yonsei University, Seoul, Korea
| | - C J Chung
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.,Department of Orthodontics, Gangnam Severance Hospital Yonsei University, Seoul, Korea
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16
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Kanavakis G, Ghamri M, Gkantidis N. Novel Anterior Cranial Base Area for Voxel-Based Superimposition of Craniofacial CBCTs. J Clin Med 2022; 11:jcm11123536. [PMID: 35743607 PMCID: PMC9225157 DOI: 10.3390/jcm11123536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023] Open
Abstract
A standard method to assess changes in craniofacial morphology over time is through the superimposition of serial patient images. This study evaluated the reliability of a novel anterior cranial base reference area, principally including stable midline structures (EMACB) after an early age, and compared it to the total anterior cranial base (TACB) and an area including only midline structures (MACB). Fifteen pairs of pre-existing serial CBCT images acquired from growing patients were superimposed with all techniques by applying a best-fit registration algorithm of corresponding voxel intensities (Dolphin 3D software). The research outcomes were the reproducibility of each technique and the agreement between them in skeletal change detection, as well as their validity. The TACB and EMACB methods were valid, since the superimposed midline ACB structures consistently showed adequate overlap. They also presented perfect overall reproducibility (median error < 0.01 mm) and agreement (median difference < 0.01 mm). MACB showed reduced validity, higher errors, and a moderate agreement to the TACB. Thus, the EMACB method performed efficiently and mainly included the stable midline ACB structures during growth. Based on the technical, anatomical, and biological principles applied when superimposing serial 3D data to assess craniofacial changes, we recommend the EMACB method as the method of choice to fulfil this purpose.
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Affiliation(s)
- Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, UZB-University Center for Dental Medicine, University of Basel, 4058 Basel, Switzerland;
- Department of Orthodontics, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Mohammed Ghamri
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, 3010 Bern, Switzerland;
- Directorate of Health Affairs-Jeddah, Ministry of Health, Riyadh 11176, Saudi Arabia
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, 3010 Bern, Switzerland;
- Correspondence: ; Tel.: +41-031-632-098
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17
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Li H, Sun C, Chen Y, Sun Z, Gao X. Quantitative changes of upper airway in class III patients undergoing bimaxillary surgery after one-year follow-up: a retrospective study. Head Face Med 2022; 18:14. [PMID: 35440012 PMCID: PMC9016938 DOI: 10.1186/s13005-022-00317-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background Bimaxillary surgery is often performed for class III malocclusion, and its complex influence on the upper airway has been well considered. The aim of this research was to provide a scaled formula between upper airway volume changes and bone movements in Class III patients after orthognathic surgery. Materials and methods Using a retrospective study design, the investigators enrolled a total of 30 class III malocclusion patients who were undergoing bimaxillary surgery as the study subjects. The subjects included 15 males and 15 females, and their average age was 23.3 ± 3.4 years. CBCT (cone beam tomography) was performed both before and one year after the surgery for each patient. The changes in the soft palate, tongue and upper airway were measured by using CBCT data that was collected before and after surgery. 3D superimposition of CBCT was performed to calculate three-dimensional jaw movements. A multiple regression analysis was used to calculate the quantitative relationship between airway volume changes and jaw movements. Results The nasopharynx airway volume was observed to be increased by 1064.0 ± 1336.2 mm3, whereas the retropalatal and retroglossal airway volumes were observed to be decreased by 1399.0 ± 2881.6 mm3 and 1433.8 ± 3043.4 mm3, respectively, after the surgery. One millimetre forward and downward movements of the PNS resulted in increases of 626.90 mm3 and 392.18 mm3 in nasopharynx airway volume, respectively. Moreover, one millimetre retrogression of the B point caused decreases of 314.6 mm3 and 656.6 mm3 in the retropalatal and retroglossal airway volume, respectively. The changes in the soft palate contributed to the decrease in the retropalatal airway volume, whereas the tongue compensated for the decrease in the retroglossal airway volume. Conclusion The movements of the PNS and B points could be used to predict upper airway volumetric changes in Class III patients after maxillary advancement and mandibular setback.
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Affiliation(s)
- Haizhen Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Chongke Sun
- Department of Radiology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, People's Republic of China
| | - Yanlong Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Zhipeng Sun
- Department of Radiology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, People's Republic of China
| | - Xuemei Gao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
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Andriola FDO, Haas Junior OL, Guijarro-Martínez R, Hernández-Alfaro F, de Oliveira RB, Pagnoncelli RM, Swennen GRJ. Computed tomography imaging superimposition protocols to assess outcomes in orthognathic surgery: a systematic review with comprehensive recommendations. Dentomaxillofac Radiol 2022; 51:20210340. [PMID: 34520241 PMCID: PMC8925870 DOI: 10.1259/dmfr.20210340] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES A systematic review was performed to analyze the current evidence on three-dimensional (3D) computed tomography (CT) superimposition protocols used to assess dentomaxillofacial changes after orthognathic and orthofacial surgery. Accuracy, reproducibility, and efficiency were evaluated. METHODS The search was divided into Main Search (PubMed, EMBASE, Cochrane Library, LILACS, and SciELO), Grey Literature search (Google Scholar and Open Grey), and Manual search. Thirteen studies were included. Of these, 10 reported data on accuracy, 10 on reproducibility and five on efficiency. Seven proposed or evaluated methods of voxel-based superimposition, three focused on the surface-based technique, one compared surface- and voxel-based superimposition protocols, one used the maximum mutual information algorithm, and one described a landmark-based superimposition method. Cone-beam computed tomography (CBCT) was the most common imaging technique, being used in 10 studies. RESULTS The accuracy of most methods was high, showing mean differences smaller than voxels' dimensions, ranging between 0.05 and 1.76 mm for translational accuracy, and 0.10-1.09° for rotational accuracy. The overall reproducibility was considered good as demonstrated by the small mean error (range: 0.01-0.26 mm) and high correlation coefficients (range: 0.53-1.00). Timing to complete virtual superimposition techniques ranged between a few seconds up to 40 min. CONCLUSIONS Voxel-based superimposition protocols presented the highest accuracy and reproducibility. Moreover, superimposition protocols that used automated processes and involved only one software were the most efficient.
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Affiliation(s)
| | | | | | | | - Rogério Belle de Oliveira
- Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rogério Miranda Pagnoncelli
- Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Xu W, Tan H, Meng X, Huang Y, Cao L, Zheng L. Improved lip esthetics in patients with skeletal Class III malocclusion and facial asymmetry after isolated mandibular orthognathic surgery. Am J Orthod Dentofacial Orthop 2022; 161:e407-e415. [PMID: 34996662 DOI: 10.1016/j.ajodo.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Asymmetry of the lips severely affects facial esthetics and is often one of the chief complaints of orthognathic patients, especially those with Class III malocclusion. The objectives of this study were to investigate the changes in lip symmetry in patients with mandibular prognathism and deviation and the relationships between jaw hard tissue and lip soft-tissue changes. METHODS Three-dimensional facial scan and cone-beam computed tomography scan data of 30 orthodontic-orthognathic patients treated with bilateral sagittal split ramus osteotomy were combined to conduct the research. Paired-sample t test and Pearson correlation coefficient were applied to compare the differences in the same variable before and after the orthognathic surgery and the potential correlations between the changes in hard and soft variables. To explore the important hard tissue variables influencing the lip soft-tissue changes, linear regression analysis was performed. RESULTS Although there was significant upper lip asymmetry presurgery, the upper lip asymmetry was corrected postsurgery. Surgical correction of the mandibular deviation was also accompanied by lengthening of the bilateral philtrum crests. Improvement in lip asymmetry and lengthening of the philtrum crests were primarily related to the transverse correction of the mandible rather than sagittal changes. The corresponding prediction formulas were established. CONCLUSIONS The isolated mandibular bilateral sagittal split ramus osteotomy surgery can substantially improve the upper and lower lip asymmetry in patients with mandibular prognathism and deviation, but one should be wary of the unesthetic effects associated with lengthening of the philtrum crests.
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Affiliation(s)
- Wenjie Xu
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hao Tan
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xuehuan Meng
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yumei Huang
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Li Cao
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Leilei Zheng
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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20
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Ghamri M, Kanavakis G, Gkantidis N. Reliability of Different Anterior Cranial Base Reference Areas for Voxel-Based Superimposition. J Clin Med 2021; 10:jcm10225429. [PMID: 34830711 PMCID: PMC8622398 DOI: 10.3390/jcm10225429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 01/22/2023] Open
Abstract
The study aimed to evaluate the reliability and reproducibility and compare the outcomes of two 3D voxel-based superimposition techniques for craniofacial CBCT images, using anterior cranial base areas of different extent as references. Fifteen preexisting pairs of serial CBCTs (initial age: 11.7 ± 0.6 years; interval: 1.7 ± 0.4 years) were superimposed on total anterior cranial base (TACB) or middle anterior cranial base (MACB) structures through the Dolphin 3D software. The overlap of the reference structures was assessed visually to indicate reliability. All superimpositions were repeated by the same investigator. Outcomes were compared to assess the agreement between the two methods. Reliability was perfect for the TACB and moderate for the MACB method (p = 0.044). Both areas showed good overall reproducibility, though in individual cases there were notable differences for MACB superimpositions, ranging from −1.84 to 1.64 mm (TACB range: −0.48 to 0.31 mm). The overall agreement in the detected T0/T1 changes was also good, though it was significantly reduced for individual measurements (median < 0.01 mm, IQR: 0.46 mm, range: −2.81 to 0.73 mm). In conclusion, the voxel-based superimposition on TACB was more reliable and showed higher reproducibility than the superimposition on MACB. Thus, the extended anterior cranial base area is recommended for the assessment of craniofacial changes.
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Affiliation(s)
- Mohammed Ghamri
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, 3010 Bern, Switzerland;
- Directorate of Health Affairs-Jeddah, Ministry of Health, Riyadh 11176, Saudi Arabia
| | - Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, UZB-University Center for Dental Medicine, University of Basel, 4058 Basel, Switzerland;
- Department of Orthodontics, Tufts University School of Dental Medicine, Boston, MA 02111, USA
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, 3010 Bern, Switzerland;
- Correspondence: ; Tel.: +41-031-632-0985
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Leonardi R, Ronsivalle V, Lagravere MO, Barbato E, Isola G, Lo Giudice A. Three-dimensional assessment of the spheno-occipital synchondrosis and clivus after tooth-borne and bone-borne rapid maxillary expansion. Angle Orthod 2021; 91:822-829. [PMID: 34129666 PMCID: PMC8549551 DOI: 10.2319/013021-86.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/01/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To assess changes in spheno-occipital synchondrosis after rapid maxillary expansion (RME) performed with conventional tooth-borne (TB) and bone-borne (BB) appliances. MATERIALS AND METHODS This study included 40 subjects with transverse maxillary deficiency who received TB RME or BB RME. Cone-beam computed tomography images (CBCT) were taken before treatment (T0), and after a 6-month retention period (T1). Three-dimensional surface models of the spheno-occipital synchondrosis and basilar part of the occipital bone were generated. The CBCTs taken at T0 and T1 were registered at the anterior cranial fossa via voxel-based superimposition. Quantitative evaluation of Basion displacement was performed with linear measurements and Euclidean distances. The volume of the synchndrosis was also calculated for each time point as well as the Nasion-Sella-Basion angle (N-S-Ba°). All data were statistically analyzed to perform inter-timing and intergroup comparisons. RESULTS In both groups, there was a small increment of the volume of the synchondrosis and of N-S-Ba° (P < .05). Basion showed a posterosuperior pattern of displacement. However, no significant differences (P > .05) were found between the two groups. CONCLUSIONS Although TB and BB RME seemed to have some effects on the spheno-occipital synchondrosis, differences were very small and clinically negligible.
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What Do We Know Beyond Reliability in Voxel-Based Registration? Validation of the Accuracy of Regional Voxel-Based Registration (R-VBR) Techniques for Orthognathic Surgery Analysis. J Oral Maxillofac Surg 2021; 80:296-302. [PMID: 34758348 DOI: 10.1016/j.joms.2021.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Despite having excellent reproducibility, the accuracy of regional voxel-based registration (R-VBR) techniques used for postoperative orthognathic surgical analysis has not been validated. The purpose of this study was to validate the accuracy of R-VBR. METHODS Preoperative (T0) and postoperative (T1) cone beam computed tomography (CBCT) of consecutive patients treated at a single center with nonsegmental LeFort I and bilateral sagittal split osteotomy were included. T1 CBCTs were oriented to match that of the standardized T0, and thus were assigned a known rotational transformation matrix in pitch/roll/yaw (P/R/Y), to create T1'. A copy of T1 (cT1) was made and was superimposed to T1' using R-VBR for 4 regions of interest (ROI): maxilla, distal mandible, right proximal mandible, and left proximal mandible, to create cT1'. The transformation matrix for each of the ROI was compared to those of T1' using paired t test and Bland-Altman analysis. RESULTS Twenty-eight eligible subjects' CBCTs were analyzed. Mean difference between T1' and cT1' ranged from -0.08 to 0.14° (maximum 0.73°), with no statistically significant differences (P = 0.216 to 1). Mean absolute difference ranged from 0.13 to 0.31° (maximum 0.73°). Bland-Altman analysis showed good agreement between T1' and cT1', indicating excellent accuracy. CONCLUSIONS R-VBR using the maxilla, distal mandible, and the bilateral proximal mandibular segments as ROI has excellent accuracy in terms of rotational measurements.
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23
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Valid 3D surface superimposition references to assess facial changes during growth. Sci Rep 2021; 11:16456. [PMID: 34385558 PMCID: PMC8361153 DOI: 10.1038/s41598-021-95942-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 08/03/2021] [Indexed: 11/08/2022] Open
Abstract
Currently, the primary techniques applied for the assessment of facial changes over time utilize 2D images. However, this approach has important limitations related to the dimensional reduction and the accuracy of the used data. 3D facial photography has been recently introduced as a risk-free alternative that overcomes these limitations. However, the proper reference areas that should be used to superimpose serial 3D facial images of growing individuals are not yet known. Here, we tested various 3D facial photo superimposition reference areas and compared their outcomes to those of a standard anterior cranial base superimposition technique. We found that a small rectangular area on the forehead plus an area including the middle part of the nose and the lower wall of the orbital foramen provided comparable results to the standard technique and showed adequate reproducibility. Other reference areas that have been used so far in the literature were less reliable. Within the limitations of the study, a valid superimposition reference area for serial 3D facial images of growing individuals is suggested. The method has potential to greatly expand the possibilities of this highly informative, risk free, and easily obtained 3D tool for the assessment of facial changes in growing individuals.
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Yamashita AL, Iwaki Filho L, Ferraz FWDS, Ramos AL, Previdelli ITDS, Pereira OCN, Tolentino EDS, Chicarelli M, Iwaki LCV. Accuracy of three-dimensional soft tissue profile prediction in orthognathic surgery. Oral Maxillofac Surg 2021; 26:271-279. [PMID: 34302576 DOI: 10.1007/s10006-021-00988-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the accuracy of three-dimensional (3D) soft tissue prediction in bimaxillary orthognathic surgery. METHODS Cone-beam computed tomographs of 88 patients with class II (n = 46) and class III (n = 42) malocclusions, who underwent bimaxillary orthognathic surgery, were included in this retrospective study. 3D soft tissue prediction and postoperative outcome were compared by using ten landmarks of facial soft tissues. Patients' sex and age were also assessed. Results were analyzed using a mixed model methodology (p < 0.05). RESULTS The success criterion adopted was a mean discrepancy of < 2 mm. Most mandibular landmarks indicated a tendency for underprediction with a downward direction in class II patients, with some values > 2 mm. In class III, there was overprediction with a downward direction for the mandibular landmarks, with values < 2 mm. More accurate results were found in female and older patients. CONCLUSIONS 3D surgical planning showed clinically acceptable results for predicting soft tissues in patients undergoing bimaxillary orthognathic surgery, with more accurate results for class III patients. Although some differences were found when age and sex were interacted, a consistent association between these variables could not be stated. These results support the clinician, as accuracy can provide a strong guide to the surgeon when planning surgical orthodontic treatment.
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Affiliation(s)
- Amanda Lury Yamashita
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil.
| | - Liogi Iwaki Filho
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | - Flávio Wellington da Silva Ferraz
- Department of Oral and Maxillofacial Surgery, Clinics Hospital of Medicine School and University Hospital of University of São Paulo, São Paulo, São Paulo, Brazil
| | - Adilson Luiz Ramos
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | | | | | - Elen de Souza Tolentino
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | - Mariliani Chicarelli
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
| | - Lilian Cristina Vessoni Iwaki
- Department of Dentistry, State University of Maringá, Avenida Mandacaru n° 1550, bloco S-08, Maringá, Paraná, CEP: 87080-000, Brazil
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Leonardi R, Giudice AL, Isola G, Spampinato C. Deep learning and computer vision: Two promising pillars, powering the future in orthodontics. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Nguyen H, Shin JW, Giap HV, Kim KB, Chae HS, Kim YH, Choi HW. Midfacial soft tissue changes after maxillary expansion using micro-implant-supported maxillary skeletal expanders in young adults: A retrospective study. Korean J Orthod 2021; 51:145-156. [PMID: 33984222 PMCID: PMC8133895 DOI: 10.4041/kjod.2021.51.3.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/13/2020] [Accepted: 11/16/2020] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of this retrospective study was to assess the midfacial soft tissue changes following maxillary expansion using micro-implant-supported maxillary skeletal expanders (MSEs) in young adults by cone-beam computerized tomography (CBCT) and to evaluate the correlations between hard and soft tissue changes after MSE usage. Methods Twenty patients (mean age, 22.4 years; range, 17.6–27.1) with maxillary transverse deficiency treated with MSEs were selected. Mean expansion amount was 6.5 mm. CBCT images taken before and after expansion were superimposed to measure the changes in soft and hard tissue landmarks. Statistical analyses were performed using paired t-test and Pearson’s correlation analysis on the basis of the normality of data. Results Average lateral movement of the cheek points was 1.35 mm (right) and 1.08 mm (left), and that of the alar curvature points was 1.03 mm (right) and 1.02 mm (left). Average forward displacement of the cheek points was 0.59 mm (right) and 0.44 mm (left), and that of the alar curvature points was 0.61 mm (right) and 0.77 mm (left) (p < 0.05). Anterior nasal spine (ANS), posterior nasal spine (PNS), and alveolar bone width showed significant increments (p < 0.05). Changes in the cheek and alar curvature points on both sides significantly correlated with hard tissue changes (p < 0.05). Conclusions Maxillary expansion using MSEs resulted in significant lateral and forward movements of the soft tissues of cheek and alar curvature points on both sides in young adults and correlated with the maxillary suture opening at the ANS and PNS.
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Affiliation(s)
- Hieu Nguyen
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Jeong Won Shin
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Hai-Van Giap
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Ki Beom Kim
- Department of Orthodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, MO, USA
| | - Hwa Sung Chae
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Young Ho Kim
- Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Hae Won Choi
- Department of Orthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Han G, Li J, Wang S, Wang L, Zhou Y, Liu Y. A comparison of voxel- and surface-based cone-beam computed tomography mandibular superimposition in adult orthodontic patients. J Int Med Res 2021; 49:300060520982708. [PMID: 33459090 PMCID: PMC7816535 DOI: 10.1177/0300060520982708] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy, reliability, and efficiency of voxel- and surface-based registrations for cone-beam computed tomography (CBCT) mandibular superimposition in adult orthodontic patients. METHODS Pre- and post-orthodontic treatment CBCT scans of 27 adult patients were obtained. Voxel- and surface-based CBCT mandibular superimpositions were performed using the mandibular basal bone as a reference. The accuracy of the two methods was evaluated using the absolute mean distance measured. The time that was required to perform the measurements using these methods was also compared. Statistical differences were determined using paired t-tests, and inter-observer reliability was assessed by intraclass correlation coefficients (ICCs). RESULTS The absolute mean distance on seven mandible surface areas between voxel- and surface-based registrations was similar but not significantly different. ICC values of the surface-based registration were 0.918 to 0.990, which were slightly lower than those of voxel-based registration that ranged from 0.984 to 0.996. The time required for voxel-based registration and surface-based registration was 44.6 ± 2.5 s and 252.3 ± 7.1 s, respectively. CONCLUSIONS Both methods are accurate and reliable and not significantly different from each other. However, voxel-based registration is more efficient than surface-based registration for CBCT mandibular superimposition.
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Affiliation(s)
- Gaofeng Han
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jing Li
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Shuo Wang
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Linchuan Wang
- Department of General Dentistry, University of Rochester Eastman Institute for Oral Health Rochester, Rochester, NY, USA
| | - Yanheng Zhou
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Al-Taai N, Levring Jäghagen E, Persson M, Ransjö M, Westerlund A. A Superimposition-Based Cephalometric Method to Quantitate Craniofacial Changes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105260. [PMID: 34069290 PMCID: PMC8156959 DOI: 10.3390/ijerph18105260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/02/2022]
Abstract
To assess the craniofacial changes related to growth and/or to orthodontic and orthognathic treatments, it is necessary to superimpose serial radiographs on stable structures. However, conventional superimposition provides only a graphical illustration of these changes. To increase the precision of growth and treatment evaluations, it is desirable to quantitate these craniofacial changes. The aims of this study were to (1) evaluate a superimposition-based cephalometric method to process numerical data for craniofacial growth changes and (2) identify a valid, reliable, and feasible method for superimposition. Forty pairs of cephalograms were analyzed at T1 and T2 (mean age 9.9 and 15.0 years, respectively). The superimposition-based cephalometric method involved relating the sagittal and vertical measurements on the T2 radiographs to the nasion and sella landmarks on the T1 radiographs. Validity and reliability were evaluated for three superimposition methods: the sella-nasion (SN); the tuberculum sella-wing (TW); and Björk’s structural. Superimposition-based cephalometrics can be used to quantify craniofacial changes digitally. The numerical data from the superimposition-based cephalometrics reflected a graphical illustration of superimposition and differed significantly from the data acquired through conventional cephalometrics. Superimposition using the TW method is recommended as it is valid, reliable, and feasible.
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Affiliation(s)
- Nameer Al-Taai
- Orthodontics, Department of Odontology, Umeå University, SE-901 85 Umeå, Sweden; (M.P.); (M.R.)
- Correspondence: ; Tel.: +46-70-416-5676
| | - Eva Levring Jäghagen
- Oral and Maxillofacial Radiology, Department of Odontology, Umeå University, SE-901 85 Umeå, Sweden;
| | - Maurits Persson
- Orthodontics, Department of Odontology, Umeå University, SE-901 85 Umeå, Sweden; (M.P.); (M.R.)
| | - Maria Ransjö
- Orthodontics, Department of Odontology, Umeå University, SE-901 85 Umeå, Sweden; (M.P.); (M.R.)
- Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden;
| | - Anna Westerlund
- Department of Orthodontics, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden;
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Lo Giudice A, Leonardi R, Ronsivalle V, Allegrini S, Lagravère M, Marzo G, Isola G. Evaluation of pulp cavity/chamber changes after tooth-borne and bone-borne rapid maxillary expansions: a CBCT study using surface-based superimposition and deviation analysis. Clin Oral Investig 2021; 25:2237-2247. [PMID: 32860529 DOI: 10.1007/s00784-020-03539-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare volume and shape changes of pulp chamber of maxillary posterior teeth between tooth-borne and bone-borne maxillary expansions in adolescents. MATERIALS AND METHODS This study included 36 adolescents with bilateral maxillary crossbite who received tooth-borne rapid maxillary expansion (TB group, average age 14.4 years) or bone-borne rapid maxillary expansion (BB group, average age 14.7 years). Cone beam computed tomography (CBCT) was taken before treatment (T1) and after a 6-month retention period (T2). Volumetric and shape changes of pulp chamber of maxillary first molars and premolars were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT-derived models of pulp chamber. Student's t tests were used to (1) compare T1 and T2 volumes of pulp chambers in TB and BB groups and (2) assess differences between the two groups in the post-treatment volumetric changes and in the percentage of matching of 3D pulp models. RESULTS All investigated teeth showed a reduction of pulp volume, being this difference significant in both TB (p < 0.0001) and BB (p < 0.0001) groups. The volumetric reduction was greater in the TB group; also, subjects in the TB group showed a lower percentage of matching between T1 and T2 pulp models (p < 0.0001). The area most affected by shape change was that of pulp horns. CONCLUSIONS TB expander could induce a higher volumetric reduction of pulp chamber of posterior teeth compared with BB expander, in the short term. CLINICAL RELEVANCE The present findings add new information concerning the effects of RME protocols on pulp tissue.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Rosalia Leonardi
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | | | - Manuel Lagravère
- Orthodontic Graduate Program, Edmonton Clinic Health Academy, University of Alberta, 5th Floor, 11405 - 87 Avenue NW, Edmonton, Alberta, Canada
| | - Giuseppe Marzo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, V.le San Salvatore, 67100, L'Aquila, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
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Leonardi RM, Aboulazm K, Giudice AL, Ronsivalle V, D'Antò V, Lagravère M, Isola G. Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique. Clin Oral Investig 2021; 25:1775-1785. [PMID: 32743674 DOI: 10.1007/s00784-020-03480-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment. MATERIALS AND METHODS Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a "best-fit" algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student's t tests. RESULTS A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001). CONCLUSIONS Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant. CLINICAL RELEVANCE Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings.
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Affiliation(s)
- Rosalia Maria Leonardi
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy.
| | - Khaled Aboulazm
- Department of Orthodontics, School of Dentistry, Pharos University, Alexandria, Egypt
| | - Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
| | - Vincenzo D'Antò
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, Naples, Italy
| | - Manuel Lagravère
- Department of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Gaetano Isola
- Department of Orthodontics, School of Dentistry, Policlinico Universitario "Vittorio Emanuele", University of Catania, Catania, Italy
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Kanavakis G, Häner ST, Matthey F, Gkantidis N. Voxel-based superimposition of serial craniofacial cone-beam computed tomographies for facial soft tissue assessment: Reproducibility and segmentation effects. Am J Orthod Dentofacial Orthop 2021; 159:343-351.e1. [PMID: 33641815 DOI: 10.1016/j.ajodo.2020.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The aim of this investigation was to evaluate the reproducibility of a voxel-based 3-dimensional superimposition method and the effect of segmentation error on determining soft tissue surface changes. METHODS A total of 15 pairs of serial cone-beam computed tomography images (interval: 1.69 ± 0.37 years) from growing subjects (initial age: 11.75 ± 0.59 years) were selected from an existing digital database. Each pair was superimposed on the anterior cranial base, in 3 dimensions with Dolphin 3D software (version 2.1.6079.17633; Dolphin Imaging & Management Solutions, Chatsworth, Calif). The reproducibility of superimposition outcomes and surface segmentation were tested with intra- and interoperator comparisons. RESULTS Median differences in inter- and intrarater measurements at various areas presented a range of 0.08-0.21 mm. In few instances, the differences were larger than 0.5 mm. In areas where T0-T1 changes were increased, the error did not appear to increase. However, the method error increased the farther the measurement area was from the superimposition reference structure. For individual images, the median soft tissue segmentation error ranged from 0.05 to 0.06 at various areas and in no subject exceeded 0.13 mm. CONCLUSIONS The presented voxel-based superimposition method was efficient and well reproducible. The segmentation process was a minimal source of error; however, there were a few cases in which the total error was more than 0.5 mm and could be considered clinically significant. Therefore, this method can be used clinically to assess 3-dimensional soft tissue changes during orthodontic treatment in growing patients.
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Affiliation(s)
- Georgios Kanavakis
- Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine, University of Basel, Basel, Switzerland; Department of Orthodontics, Tufts University School of Dental Medicine, Boston, Mass.
| | - Simeon T Häner
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | | | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
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Bin LR, Filho LI, Yamashita AL, de Souza Pinto GN, Mendes RA, Ramos AL, Dos Santos Previdelli IT, Iwaki LCV. How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space? Angle Orthod 2021; 90:715-722. [PMID: 33378484 DOI: 10.2319/120919-782.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) after bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT scans of 48 patients were divided into two groups: group 1: maxillary advancement and mandibular setback (n = 24); group 2: maxillomandibular advancement (n = 24). The CBCTs were acquired 1 to 2 months preoperatively and 6 to 8 months postoperatively. A kappa test was used to determine intra- and interexaminer agreement. Area, volume, and linear measurements of MSs and PASs obtained before and after surgery were compared using a mixed model (P < .05). RESULTS All variables of the MS showed significant postsurgical reductions in both groups, except the MS length, which showed a significant increase in group 2. Volume and minimum axial area of PAS showed statistically significant postsurgical increases in both groups (P < .05). CONCLUSIONS Despite the reduction in the MS and the increase in the PAS, results indicated that the airway was not negatively affected after maxillomandibular advancement and maxillary advancement with mandibular setback.
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Giap HV, Shin JW, Chae HS, Kim YH, Paeng JY, Choi HW. Pharyngeal Airway Morphology in Skeletal Class III With Mandibular Asymmetry is Improved After Bimaxillary Orthognathic Surgery. J Oral Maxillofac Surg 2021; 79:1107-1121. [PMID: 33549539 DOI: 10.1016/j.joms.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The relationship between pharyngeal airway morphology and jawbone movements in skeletal Class III patients with mandibular asymmetry after orthognathic surgery remains unclear. This study was to measure the changes in pharyngeal airway morphology in skeletal Class III patients with mandibular asymmetry after bimaxillary surgery and evaluate associations between changes in pharyngeal airway morphology and skeletal movements. METHODS In this retrospective cohort study, skeletal Class III patients who underwent bimaxillary surgery were enrolled. The predictor variable was facial symmetry status divided into 2 groups, asymmetric (Group A) and symmetric (Group B). The primary outcome variables were changes in airway parameters, including cross-sectional linear distances, cross-sectional area (CSA), minimum CSA (Min-CSA), and volume; and airway asymmetry index between the preoperative and 6-month postoperative imaging studies. Correlation analysis was performed between upper airway and skeletal changes. RESULTS Twenty-five patients were included in this study, with 15 patients in Group A (mean age: 23.00 years; BMI: 22.83) and 10 patients in Group B (mean age: 22.30 years; BMI: 22.48). Group A showed a higher asymmetry index than Group B at T0; however, no significant differences compared to Group B at T1. The airway volume was significantly decreased in the oropharynx in Group A at T1, whereas it showed no significant differences in Group B (P < .05). Lateral movement of B point and Menton showed positive correlations with changes in Min-CSA in the oropharynx and negative correlations with changes in airway asymmetry index (P < .05). CONCLUSIONS Pharyngeal airway exhibited an asymmetrical and constricted morphology in Group A before surgery. The airway morphology in Group A showed a tendency to adopt a symmetrical and less constricted shape after surgery. The airway space was reduced in the oropharynx in Group A after surgery. Surgical correction of mandibular asymmetry correlated with the improvement of pharyngeal airway morphology.
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Affiliation(s)
- Hai-Van Giap
- Graduate student, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Jeong Won Shin
- Clinical Professor, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Hwa Sung Chae
- Adjunctive Professor, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Young Ho Kim
- Professor, Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Jun-Young Paeng
- Clinical Professor, Department of Oral and maxillofacial surgery, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hae Won Choi
- Clinical Associate Professor, Department of Orthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Li C, Lin L, Zheng Z, Chung CH. A User-Friendly Protocol for Mandibular Segmentation of CBCT Images for Superimposition and Internal Structure Analysis. J Clin Med 2021; 10:jcm10010127. [PMID: 33401443 PMCID: PMC7796406 DOI: 10.3390/jcm10010127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Since cone-beam computed tomography (CBCT) technology has been widely adopted in orthodontics, multiple attempts have been made to devise techniques for mandibular segmentation and 3D superimposition. Unfortunately, as the software utilized in these methods are not specifically designed for orthodontics, complex procedures are often necessary to analyze each case. Thus, this study aimed to establish an orthodontist-friendly protocol for segmenting the mandible from CBCT images that maintains access to the internal anatomic structures. METHODS The "sculpting tool" in the Dolphin 3D Imaging software was used for segmentation. The segmented mandible images were saved as STL files for volume matching in the 3D Slicer to validate the repeatability of the current protocol and were exported as DICOM files for internal structure analysis and voxel-based superimposition. RESULTS The mandibles of all tested CBCT datasets were successfully segmented. The volume matching analysis showed high consistency between two independent segmentations for each mandible. The intraclass correlation coefficient (ICC) analysis on 20 additional CBCT mandibular segmentations further demonstrated the high consistency of the current protocol. Moreover, all of the anatomical structures for superimposition identified by the American Board of Orthodontics were found in the voxel-based superimposition, demonstrating the ability to conduct precise internal structure analyses with the segmented images. CONCLUSION An efficient and precise protocol to segment the mandible while retaining access to the internal structures was developed on the basis of CBCT images.
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Affiliation(s)
- Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Correspondence: (C.L.); (C.-H.C.); Tel.: +1-215-898-7130 (C.-H.C.)
| | - Leanne Lin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Zhong Zheng
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, CA 90095, USA;
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Correspondence: (C.L.); (C.-H.C.); Tel.: +1-215-898-7130 (C.-H.C.)
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Ferraz FWDS, Iwaki-Filho L, Souza-Pinto GND, Iwaki LCV, Li AT, Cardoso MDA. A comparative study of the accuracy between two computer-aided surgical simulation methods in virtual surgical planning. J Craniomaxillofac Surg 2020; 49:84-92. [PMID: 33376041 DOI: 10.1016/j.jcms.2020.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/22/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The aim of this retrospective and observational study was to compare the accuracy of two different virtual surgical planning (VSP) protocols, namely, the CASS method and the modified CASS method. MATERIALS AND METHODS The patients underwent bimaxillary orthognathic surgery, planned using either the CASS method or the modified CASS method. Linear and angular discrepancies between the VSP outcome and postoperative outcome for both groups were compared for maxilla, mandible, and chin segments. Aside from the comparison between both groups, additional criteria were used to determine the accuracy of the protocol based on a linear and angular difference between planned and actual outcomes of less than 2 mm and 4°, respectively. The intergroup comparisons were performed by one-way ANOVA, with the level of significance set at 5%. RESULTS A total of 21 patients, of both genders, were assigned into group I (n = 11), planned with the CASS method, and group II (n = 10), planned with the modified CASS method. Both the CASS and modified CASS methods presented similar accuracy with regard to linear differences for the maxilla, mandible, and chin segments, except for ΔX for the mandibular segment, where the modified CASS method showed slightly better accuracy. However, there was a statistically significant difference with regard to angular differences in the chin segment, with the CASS method shown to be the more accurate. Aside from Δpitch for the chin segment, no linear or angular differences exceeded 2 mm or 4°. CONCLUSION Although statistically significant differences were found with regard to angular measurements in the chin segment, the accuracy of the modified CASS method for virtual planning can be considered as clinically equivalent, with a performance comparable to that of the CASS method.
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Affiliation(s)
- Flavio Wellington da Silva Ferraz
- Oral and Maxillofacial Surgery, Hospital Das Clínicas, University of São Paulo (USP), Rua Dr Eneas de Carvalho, 255, 05403-010, São Paulo, São Paulo, Brazil.
| | - Liogi Iwaki-Filho
- Oral and Maxillofacial Surgery, State University of Maringá (UEM), Avenida Mandacaru, 1550, 87080-000, Maringá, Paraná, Brazil.
| | - Gustavo Nascimento de Souza-Pinto
- Oral Radiology and Stomatology, Department of Dentistry, State University of Maringá (UEM), Avenida Mandacaru, 1550, 87080-000, Maringá, Paraná, Brazil.
| | - Lilian Cristina Vessoni Iwaki
- Oral Radiology and Stomatology, Department of Dentistry, State University of Maringá (UEM), Avenida Mandacaru, 1550, 87080-000, Maringá, Paraná, Brazil.
| | - An Tien Li
- Department of Dentistry, School of Health Sciences, University of Brasilia (UNB), Campus Universitário Darcy Ribeiro, Brasília, 70910-900, Distrito Federal, Brazil.
| | - Mauricio de Almeida Cardoso
- Department of Dentistry, São Leopoldo Mandic, Rua Dr José Rocha Junqueira, 13, 13045-755, Campinas, São Paulo, Brazil.
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Dot G, Rafflenbeul F, Salmon B. Voxel-based superimposition of Cone Beam CT scans for orthodontic and craniofacial follow-up: Overview and clinical implementation. Int Orthod 2020; 18:739-748. [PMID: 33011138 DOI: 10.1016/j.ortho.2020.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/10/2020] [Indexed: 01/14/2023]
Abstract
INTRODUCTION The increasing use of three-dimensional (3D) imaging in orthodontics has led to the development of 3D superimposition techniques. These techniques use stable anatomic structures as references in order to compare Cone Beam CT (CBCT) scans of the same subject at different time-points. Three methods have been described in the literature: landmark-based, surface-based and voxel-based 3D superimpositions. OBJECTIVE This article focuses on the voxel-based approach, which is the most described and the only one that can be fully automatized. The aim of this paper is to offer clinicians a practical tutorial on craniofacial voxel-based 3D superimposition. MATERIAL AND METHODS We provide an updated overview of the available implementation methods, describing their methodology, validations, main steps, advantages and drawbacks. The historical open-source method is the most widespread for research purposes, but takes around three hours to achieve for an experienced operator. Several commercially-available software perform superimpositions in a few minutes. RESULTS We used two of the available methods to conduct the superimposition process with three representative clinical cases in order to illustrate the different types of results that can be obtained. CONCLUSIONS Commercially-available software provide user-friendly and fully automatized superimposition methods, allowing clinicians to perform it easily and helping to reduce human error in image analysis. Still, quantitative evaluation of the results remains the main challenge of this technique.
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Affiliation(s)
- Gauthier Dot
- Université de Paris, Service d'Odontologie, AP-HP, Hopital Pitié-Salpétrière, 75013 Paris, France.
| | - Frédéric Rafflenbeul
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Département d'Orthopédie Dento-Faciale, 67000 Strasbourg, France
| | - Benjamin Salmon
- France laboratoire pathologie, imagerie et biothérapies orofaciales, EA2496, université Paris Descartes, UFR odontologie, 92120 Montrouge, France; Université Paris, Service de Médecine Buccodentaire, Hôpital Bretonneau, AP-HP, 75018 Paris, France
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Denadai R, Chou PY, Lin YY, Yao CF, Chen YA, Huang CS, Lo LJ, Chen YR. Type of maxillary segment mobilization affects three-dimensional nasal morphology. J Plast Reconstr Aesthet Surg 2020; 74:592-604. [PMID: 33041238 DOI: 10.1016/j.bjps.2020.08.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/24/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Surgical mobilization of the maxillary segment affects nasal morphology. This study assessed the impact of the type of maxillary mobilization on the three-dimensional (3D) nasal morphometry. METHODS Pre- and postsurgery cone beam computed tomography-derived facial image datasets of consecutive patients who underwent two-jaw orthognathic surgery were reviewed. Using preoperative 3D facial models as the positional reference of the skeletal framework, 12-month postoperative 3D facial models were classified into four types of maxillary mobilizations (advancement [n = 83], setback [n = 24], intrusion [n = 55], and extrusion [n = 52]) and four types of final maxillary positions (anterosuperior [n = 44], anteroinferior [n = 39], posterosuperior [n = 11], and posteroinferior [n = 13]). Six 3D soft tissue nasal morphometric parameters were measured, with excellent intra- and interexaminer reliability scores (ICC>0.897) for all the measurements. The 3D nasal change for each nasal parameter was computed as the difference between postoperative and preoperative measurement values. RESULTS The intrusion maxillary mobilization resulted in a significantly (all p<0.05) larger 3D nasal change in terms of alar width, alar base width, and nostril angle parameters, and a smaller change in terms of the nasal tip height parameter than the extrusion maxillary mobilization; however, no significant (all p>0.05) difference was observed between advancement and setback maxillary mobilizations. The anterosuperior and posterosuperior maxillary positions had a significantly (all p<0.05) larger 3D nasal change in terms of the alar base width and nostril angle than the anteroinferior and posteroinferior maxillary positions. CONCLUSION The type of maxillary mobilization affects the 3D nasal morphometry.
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Affiliation(s)
- Rafael Denadai
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Sao Paulo, Brazil
| | - Pang-Yun Chou
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
| | - Yi-Yu Lin
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Chuan-Fong Yao
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Ying-An Chen
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Chiung-Shing Huang
- Department of Craniofacial Orthodontics and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ray Chen
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
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Lo Giudice A, Rustico L, Ronsivalle V, Nicotra C, Lagravère M, Grippaudo C. Evaluation of the changes of orbital cavity volume and shape after tooth-borne and bone-borne rapid maxillary expansion (RME). Head Face Med 2020; 16:21. [PMID: 32900389 PMCID: PMC7487642 DOI: 10.1186/s13005-020-00235-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/01/2020] [Indexed: 12/26/2022] Open
Abstract
Objective To assess and compare volumetric and shape changes of the orbital cavity in patients treated with tooth-borne (TB) and bone-borne (BB) rapid maxillary expansion (RME). Study design Forty adolescents with bilateral maxillary cross-bite received tooth-borne (TB group = 20; mean age 14.27 ± 1.36 years) or bone-borne (BB group = 20; mean age of 14.62 ± 1.45 years) maxillary expander. Cone-beam computed tomography (CBCT) were taken before treatment (T1) and 6-month after the expander activation (T2). Volumetric and shape changes of orbital cavities were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT-derived models of pulp chamber. Student’s t tests were used to 1) compare T1 and T2 volumes of orbital cavities in TB and BB groups, 2) compare volumetric changes and the percentage of matching of 3D orbital models (T1-T2) between the two groups. Results Both TB and BB groups showed a slight increase of the orbital volume (0.64 cm3 and 0.77 cm3) (p < 0.0001). This increment were significant between the two groups (p < 0.05) while no differences were found in the percentage of matching of T1/T2 orbital 3D models (p > 0.05). The areas of greater changes were detected in the proximity of the frontozygomatic and frontomaxillary sutures. Conclusion TB-RME and BB-RME would not seem to considerably affect the anatomy or the volume of the orbital cavity in adolescents.
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Affiliation(s)
- Antonino Lo Giudice
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | | | - Vincenzo Ronsivalle
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | - Carmelo Nicotra
- Department of Medical-Surgical Specialties - Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "V. Emanuele,", Via Santa Sofia 78, 95123, Catania, Italy
| | - Manuel Lagravère
- Orthodontic Graduate Program, University of Alberta, Edmonton, Alberta, Canada
| | - Cristina Grippaudo
- Dental and Maxillofacial Institute, Head and Neck Department, Fondazione Policlinico Gemelli IRCCS, Catholic University of Sacred Heart, 00168, Rome, Italy
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Yao CCJ, Chang ZC, Lai HH, Hsu LF, Hwang HM, Chen YJ. Architectural changes in alveolar bone for dental decompensation before surgery in Class III patients with differing facial divergence: a CBCT study. Sci Rep 2020; 10:14379. [PMID: 32873841 PMCID: PMC7463229 DOI: 10.1038/s41598-020-71126-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/10/2020] [Indexed: 11/09/2022] Open
Abstract
This study aimed to investigate alveolar bone change around mandibular anterior teeth during orthodontic decompensation in patients with skeletal Class III malocclusion and different vertical facial patterns. The records of 29 consecutive Class III patients selected from those pending two-jaw orthognathic surgery were divided into low (≤ 28°), average (30°-37°), and high (≥ 39°) mandibular plane angle (MPA) groups. The DICOM files of CBCT scans and STL files of digital dental models, taken before (T1) and after (T2) presurgical orthodontic treatment, were imported into Dolphin imaging software to reconstruct dentoskeletal images. T1 and T2 images were superimposed and analyzed for bone thickness and height at the level of root apex on each mid-sagittal slice of six mandibular anterior teeth. Differences between T1 and T2 were analyzed by non-parametric tests and mixed-effect model analysis. The results showed that the measurements of alveolar bone height generally decreased after treatment, regardless of MPA. The facial divergence, incisor irregularity, tooth site, treatment time, and change in proclination were identified as the significant factors affecting alveolar bone thickness and height during treatment. The presurgical orthodontic treatment to decompensate mandibular anterior teeth should be very careful in all MPA groups.
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Affiliation(s)
- Chung-Chen Jane Yao
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Zwei-Chieng Chang
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hsiang-Hua Lai
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Li-Fang Hsu
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hann-Min Hwang
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Yi-Jane Chen
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan. .,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan.
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Follow-up observation of patients with obstructive sleep apnea treated by maxillomandibular advancement. Am J Orthod Dentofacial Orthop 2020; 158:527-534. [PMID: 32807630 DOI: 10.1016/j.ajodo.2019.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION This study aimed to evaluate the follow-up observation of patients with obstructive sleep apnea treated with maxillomandibular advancement (MMA) procedure with or without genial tubercle advancement (GTA). METHODS A total of 25 patients (mean age 37.1 ± 17.3 years) were included in the study. Cone-beam computed tomography scans were taken before treatment; after presurgical orthodontic treatment; immediately after MMA procedure; and follow-up visit. All Digital Imaging and Communications in Medicine files were analyzed using the Dolphin 3D Imaging software program (Dolphin Imaging and Management Solutions, Chatsworth, Calif) to determine the total airway volume (TAV), airway area (AA), and minimal cross-sectional area (MCA). Dolphin 3D voxel-based superimposition was used to determine the amount of skeletal advancement with MMA and changes after surgery. RESULTS Significant increase in TAV, AA, and MCA was found with MMA treatment (40.6%, 28.8%, and 56.4%, respectively, P <0.0001). Smaller but significant decrease in TAV, AA, and MCA was found during a follow-up visit (20.0%, 9.7%, and 26.8%, respectively, P <0.0001) giving a net increase of TAV, AA and MCA (35.8%, 27.1%, and 45.9%, respectively). No significant differences were found in any of the airway measurements with or without the GTA procedure. The average forward movements of the maxilla, mandible, and chin were 6.6 mm, 8.2 mm, and 11.4 mm, respectively. A relapse of less than 1 mm was found in each of the variables during the follow-up period. No correlation was found between the magnitudes of skeletal advancement and the change in oropharyngeal airway space (OPAS). CONCLUSIONS Significant increase in OPAS can be expected with MMA surgery with or without GTA procedure in patients diagnosed with obstructive sleep apnea. A partial loss in OPAS was found during the follow-up visit. The surgical movements were found to be stable, with less than 1 mm of relapse during the follow-up period, which was not clinically significant.
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Accuracy and reliability of voxel-based dentoalveolar registration (VDAR) in orthognathic surgical patients: a pilot study with two years' follow-up. Br J Oral Maxillofac Surg 2020; 59:413-418. [PMID: 33714624 DOI: 10.1016/j.bjoms.2020.08.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/10/2020] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to validate the applicability of using maxillary voxel-based dentoalveolar registration (VDAR) at long-term follow up in orthognathic surgical patients. A retrospective sample of 25 patients (skeletal class II or III) who underwent bimaxillary orthognathic surgery was recruited and divided into two groups. Group A included 15 patients (seven females, eight males, mean (SD) age 25.8 (14.4) years) with unrestored dentition and group B involved 10 patients (five females, five males, mean (SD) age: 26.2 (11.9) years) with dental restorative treatment. Postoperative cone-beam computed tomography (CBCT) scans were acquired at four time-points, one to six weeks (T1), six months (T2), one year (T3) and two years (T4). Voxel- based registration was applied using the cranial base and then complete dental segment with part of the alveolar bone at T1-T2, T1-T3 and T1-T4 time-intervals. The translational and rotational accuracy and reproducibility of the registered maxillary segment was evaluated at these three intervals by analysing the transformation matrix using singular value decomposition. All translational and rotational measurements showed excellent reliability in both groups without any significant difference. The combined translational and rotational difference was found to be within the clinically acceptable range of 2mm and 4°. The VDAR was found to be accurate and reliable to be utilised for a long-term skeletal follow-up in orthognathic surgical patients.
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Mai DDP, Stucki S, Gkantidis N. Assessment of methods used for 3-dimensional superimposition of craniofacial skeletal structures: a systematic review. PeerJ 2020; 8:e9263. [PMID: 32547877 PMCID: PMC7278889 DOI: 10.7717/peerj.9263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/09/2020] [Indexed: 01/08/2023] Open
Abstract
Background So far, several techniques have been recommended for the assessment of craniofacial changes through skeletal tissue superimposition, but the evidence that supports them remains unexplored. The purpose of the present study is to assess the available literature on skeletal-tissue superimpositions of serial craniofacial CT or CBCT images used to detect morphological changes. Materials and Methods Medline (via Pubmed), EMBASE, Google Scholar, Cochrane Library, Open Grey and Grey Literature Report were searched (last search: 17.11.2019) using specific terms that fulfilled the requirements of each database in the context of the study aim. Hand searches were also performed. The outcomes of interest were the accuracy, precision, or agreement between skeletal-tissue superimposition techniques to assess changes in the morphology of craniofacial structures. Studies of any design with sample size ≥3 were assessed by two authors independently. The study protocol was registered in PROSPERO (ID: CRD42019143356). Results Out of 832 studies, fifteen met the eligibility criteria. From the 15 included studies, 12 have shown high total risk of bias, one low risk of bias, and two studies have shown unclear risk of bias. Thirteen out of the 15 studies showed high applicability concerns, two unclear and no study had low applicability concerns. There was high heterogeneity among studies regarding the type of participants, sample size, growth status, machines, acquisition parameters, superimposition techniques, assessment techniques and outcomes measured. Fourteen of them were performed on Cone Beam Computed Tomography (CBCT) and one on Computed Tomography (CT) derived 3D models. Most of the studies (eleven) used voxel-based registration, one landmark-based registration and three studies compared different registration techniques, which include the surface-based registration. Concerning the area of interest, nine studies focused on the anterior cranial base and certain facial structures, four on maxillary structures and four on mandibular structures. Non-growing participants were included in six studies, growing in eight, whereas one study had both. Conclusion Most of the available studies had methodological shortcomings and high applicability concerns. At the moment, certain voxel-based and surface-based superimpositions seem to work properly and to be superior to landmark-based superimposition. However, further research in the field is required to develop and properly validate these techniques on different samples, through high quality studies with low applicability concerns.
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Affiliation(s)
- Daniel Dinh-Phuc Mai
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Sven Stucki
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
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Huang J, Ban C, Liu L, Ye Y. Dynamics and risk indicators of intrasinus elevation height following transalveolar sinus floor elevation with immediate implant placement: a longitudinal cohort study. Int J Oral Maxillofac Surg 2020; 50:109-115. [PMID: 32507405 DOI: 10.1016/j.ijom.2020.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/19/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022]
Abstract
Successful intrasinus graft consolidation is essential for the treatment outcome of transalveolar sinus floor elevation (SFE). This study was performed to examine the dynamics and risk indicators related to the elevation height after transalveolar SFE with grafting material and simultaneous implant placement. Fifty-two patients with 55 sites undergoing transalveolar SFE with immediate implant placement were enrolled retrospectively. Cone beam computed tomography (CBCT) images were collected and saved in DICOM format, at the following time-points: pre-surgery (T0), immediately post-surgery (T1), and 6 months post-surgery (T2). Voxel-based CBCT superimposition was performed to measure the sinus width, residual alveolar height, implant protrusion length, total elevation height, and apical graft height. The change in total elevation height from T1 to T2 was defined as the study outcome. Clinical and linear variables were analysed using linear regression. From T1 to T2, the total elevation height showed an average reduction of 1.0±1.1mm, while 10.9% sites showed an increased elevation height. Univariate regression analysis showed no significant correlation between tested clinical or linear variables and the study outcome. The results suggest that the change in elevation height was not influenced by the alveolar or sinus dimensions, graft materials, implant diameter, implant protrusion length, or the total elevation height at T1.
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Affiliation(s)
- J Huang
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - C Ban
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - L Liu
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Y Ye
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China.
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Jeon JH. In vitro precision evaluation of blue light scanning of abutment teeth made with impressions and dental stone casts according to different 3D superimposition methods. J Prosthodont Res 2020; 64:368-372. [PMID: 32173362 DOI: 10.1016/j.jpor.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/28/2019] [Accepted: 10/17/2019] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this in vitro study was to determine the precision evaluation of blue light scanning of abutment teeth impressions and dental stone casts according to different 3D superimposition methods. METHODS Impressions and dental stone casts of the maxillary canine, 1st premolar, and 1st molar were fixed; they were repeatedly scanned 11 times, (6 types, total n = 66). Stereolithography (STL) files were superimposed one by one, and used to obtain 10 root mean square (RMS) values with the 2 superimposition methods (best-fit-alignment, no control). Statistical analysis included the independent t test and one-way ANOVA with Tukey honest significant differences (α = 0.05). RESULTS RMS ± Standard Deviation (SD) values for the best-fit-alignment method of the abutment teeth impressions of the maxillary canine, 1st premolar, and 1st molar was 8.07 ± 0.76, 5.03 ± 0.23, and 6.59 ± 0.24, respectively, and those of the no control method were 9.36 ± 0.82, 7.10 ± 1.14, and 8.17 ± 0.36 respectively. RMS ± SD values for the best-fit-alignment method for the dental stone casts were 4.07 ± 0.27, 3.39 ± 0.07, and 3.29 ± 0.07, respectively, and those for the no control method were 6.26 ± 2.50, 4.98 ± 1.16, and 4.55± 0.74, respectively. CONCLUSIONS Using different 3D superimposition methods, blue light scanning of abutment teeth impressions and dental stone casts shows high precision. The no control method showed lower precision best-fit-alignment. However, the results may help advance the digital dental CAD/CAM research and the clinical field of Prosthodontics.
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Affiliation(s)
- Jin-Hun Jeon
- Research director, Research & Development Dept., 4RD Co., 9, Sejong-daero 1-gil, Jung-gu, Seoul, Republic of Korea.
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Effectiveness of subspinal Le Fort I osteotomy in preventing postoperative nasal deformation. J Plast Reconstr Aesthet Surg 2020; 73:1326-1330. [PMID: 32197886 DOI: 10.1016/j.bjps.2020.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/31/2019] [Accepted: 02/09/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE This study sought to determine the effectiveness of subspinal Le Fort I osteotomy (SLFIO) in preventing nasal deformation, by analyzing changes in the nasal profile on three-dimensional computed tomography (3D-CT) images. PATIENTS AND METHODS The participants were 39 Japanese patients with mandibular prognathism (6 men and 33 women) who underwent bilateral sagittal split ramus osteotomy and Le Fort I osteotomy with maxillary advancement: SLFIO was performed in 20 patients and conventional Le Fort I osteotomy (CLFIO) in 19 patients. All patients underwent modified alar base cinch suture, V-Y closure, and reduction of the piriform aperture. CT data acquired before and 1 year after the surgery were evaluated three-dimensionally with software to determine changes in the nasal profile. RESULTS Changes in alar width, alar base width, nasal length, and nasofrontal angle were significantly smaller following SLFIO than following CLFIO, although there were no significant differences in nasal projection, nasal tip angle, or nasolabial angle between two procedures. CONCLUSION SLFIO for anterior repositioning of the maxilla can prevent undesirable transverse soft tissue changes of the nose.
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Tonin RH, Iwaki Filho L, Yamashita AL, Ferraz FWDS, Tolentino EDS, Previdelli ITDS, Brum B, Iwaki LCV. Accuracy of 3D virtual surgical planning for maxillary positioning and orientation in orthognathic surgery. Orthod Craniofac Res 2020; 23:229-236. [PMID: 31925879 DOI: 10.1111/ocr.12363] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 12/15/2019] [Accepted: 12/31/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This retrospective and observational study evaluated the accuracy of a 3D virtual surgical planning (VSP) for the maxillary positioning and orientation in patients undergoing bimaxillary orthognathic surgery, comparing the planned and postoperative outcomes. SETTING AND SAMPLE POPULATION Seventy consecutive patients of both sexes, who were submitted to bimaxillary orthognathic surgery between 2015 and 2019 were included in our study. MATERIAL AND METHODS The patients were evaluated by fusing preoperative planning and postoperative outcome using cone-beam computed tomography scan evaluation. Three-dimensional VSP and postoperative outcomes were compared by using three linear and three angular measurements. The main outcome interest was the difference between the VSP movement, and the surgical movement obtained. The success criterion adopted was a mean linear difference of <2 mm and a mean angular difference of <4°. RESULTS Results were analysed using a linear mixed model with fixed and random effects, at α = .05. No significant statistical differences were found for linear and angular measurements between the planned and postsurgical outcomes (P > .05). All overlapping points presented values within the range considered clinically irrelevant (<2 mm; <1°). CONCLUSIONS Three-dimensional VSP was executed with a high degree of accuracy. When comparing the planned and postsurgical outcomes, all overlapping points presented values within the range considered clinically irrelevant.
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Affiliation(s)
| | | | | | - Flávio Wellington da Silva Ferraz
- Oral and Maxillofacial Surgery Department, Clinics Hospital of Medicine School and University Hospital of the University of São Paulo, São Paulo, Brazil
| | | | | | - Beatriz Brum
- Statistic Department, State University of Maringá, Maringá, Brazil
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Gandedkar NH, Vaid NR, Darendeliler MA, Premjani P, Ferguson DJ. The last decade in orthodontics: A scoping review of the hits, misses and the near misses! Semin Orthod 2019. [DOI: 10.1053/j.sodo.2019.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yatabe M, Prieto JC, Styner M, Zhu H, Ruellas AC, Paniagua B, Budin F, Benavides E, Shoukri B, Michoud L, Ribera N, Cevidanes L. 3D superimposition of craniofacial imaging-The utility of multicentre collaborations. Orthod Craniofac Res 2019; 22 Suppl 1:213-220. [PMID: 31074129 DOI: 10.1111/ocr.12281] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/18/2023]
Abstract
Clinical applications of 3D image registration and superimposition have contributed to better understanding growth changes and clinical outcomes. The use of 3D dental and craniofacial imaging in dentistry requires validate image analysis methods for improved diagnosis, treatment planning, navigation and assessment of treatment response. Volumetric 3D images, such as cone-beam computed tomography, can now be superimposed by voxels, surfaces or landmarks. Regardless of the image modality or the software tools, the concepts of regions or points of reference affect all quantitative of qualitative assessments. This study reviews current state of the art in 3D image analysis including 3D superimpositions relative to the cranial base and different regional superimpositions, the development of open source and commercial tools for 3D analysis, how this technology has increased clinical research collaborations from centres all around the globe, some insight on how to incorporate artificial intelligence for big data analysis and progress towards personalized orthodontics.
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Affiliation(s)
- Marilia Yatabe
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | | | - Martin Styner
- University of North Carolina, Chapel Hill, North Carolina
| | - Hongtu Zhu
- University of North Carolina, Chapel Hill, North Carolina
| | - Antonio Carlos Ruellas
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | | | | | - Erika Benavides
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Brandon Shoukri
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Loic Michoud
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Nina Ribera
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Lucia Cevidanes
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
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Häner ST, Kanavakis G, Matthey F, Gkantidis N. Voxel-based superimposition of serial craniofacial CBCTs: Reliability, reproducibility and segmentation effect on hard-tissue outcomes. Orthod Craniofac Res 2019; 23:92-101. [PMID: 31529585 DOI: 10.1111/ocr.12347] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To test the reliability and reproducibility of a fast and user-friendly voxel-based 3D superimposition method and the effect of bone segmentation on its outcomes. SETTING AND SAMPLE POPULATION This prospective methodological study assessed 15 pairs of pre-existing serial CBCT images (interval: 1.69 ± 0.37 years) obtained from growing patients (initial age: 11.75 ± 0.59 years). MATERIALS AND METHODS Volumes were superimposed on the anterior cranial base using Dolphin 3D software. Reliability was assessed visually, by inspecting the overlap of the superimposition reference structures. Reproducibility was tested with intra- and inter-operator comparisons of superimposition outcomes. RESULTS The method presented good reliability in all cases. The median differences between intra- and inter-operator comparisons at various tested areas ranged from 0.06 to 0.16 mm and from 0.15 to 0.24 mm, respectively. In few individual cases, differences exceeded 0.5 mm. There was no evidence that the error increased upon increase in the magnitude of the detected T0-T1 changes. However, the superimposition error increased when the distance between the measurement area and the superimposition reference also increased. For a single image, the median error of bone surface segmentation ranged in different areas between 0.05 and 0.12 mm, with few exceptions where it slightly exceeded 0.25 mm. CONCLUSIONS The tested voxel-based superimposition method presented good efficiency, cranial base matching and reproducibility in a growing patient sample. Segmentation error was considered minimal. The total error reached clinically relevant levels in very few cases. Thus, this technique is considered appropriate for clinical use, when 3D assessment of craniofacial changes is required.
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Affiliation(s)
- Simeon T Häner
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | | | | | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
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Eliliwi M, Bazina M, Palomo JM. kVp, mA, and voxel size effect on 3D voxel-based superimposition. Angle Orthod 2019; 90:269-277. [PMID: 31549857 DOI: 10.2319/012719-52.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the effect of changing kVp, mA, and voxel size on the accuracy of voxel-based superimposition on the anterior cranial base. MATERIALS AND METHODS Cone beam computed tomography (CBCT) scans were taken on a phantom skull using different kVp, mA, and voxel size combinations. CBCT scans were superimposed using commercially available software. Two separate open-source software programs were used to generate a three-dimensional (3D) color map objective assessment of the differences in seven different regions: Nasion, Point A, Zygomatic (right and left), Point B, and Gonial (right and left). Each region had around 200 points that were used to calculate the mean differences between the superimpositions. RESULTS Intraclass correlation showed excellent reliability (0.95). Lowering the kVp made the biggest difference, showing an average discrepancy of 0.7 ± 0.3 mm, and a high mean of 1.4 ± 0.3 in the Right Gonial region. Lowering the mA showed less of a discrepancy, with an average of 0.373 ± 0.2 mm, and the highest discrepancy, also on the Right Gonial Area, of 0.7 ± 0.1 mm. The voxel size had the least impact on the accuracy of registered volumes, with mean discrepancy values of less than 0.2 mm. CONCLUSIONS Using different CBCT settings can affect the accuracy of the voxel-based superimposition method. This is particularly the case when using low kVp values, while changes in mA or voxel sizes did not significantly interfere with the superimposition outcome.
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