1
|
Lee J, Kim D, Xu X, Kuang T, Gateno J, Yan P. Predicting optimal patient-specific postoperative facial landmarks for patients with craniomaxillofacial deformities. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00149-8. [PMID: 38782663 DOI: 10.1016/j.ijom.2024.05.004] [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: 12/13/2023] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
Orthognathic surgery primarily corrects skeletal anomalies and malocclusion to enhance facial aesthetics, aiming for an improved facial appearance. However, this traditional skeletal-driven approach may result in undesirable residual asymmetry. To address this issue, a soft tissue-driven planning methodology has been proposed. This technique estimates bone movements based on the envisioned optimal facial appearance, thereby enhancing surgical accuracy and effectiveness. This study investigates the initial implementation phase of the soft tissue-driven approach, simulating the patient's ideal appearance by realigning distorted facial landmarks to an ideal state. The algorithm employs symmetrization and weighted optimization strategies, aligning projected optimal landmarks with standard cephalometric values for both facial symmetry and form, which are essential in orthognathic surgery for facial aesthetics. It also incorporates regularization to preserve the patient's facial characteristics. Validation through retrospective analysis of preoperative patients and normal subjects demonstrates this method's efficacy in achieving facial symmetry, particularly in the lower face, and promoting a natural, harmonious contour. Adhering to soft tissue-driven principles, this novel approach shows promise in surpassing traditional methods, potentially leading to enhanced facial outcomes and patient satisfaction in orthognathic surgery.
Collapse
Affiliation(s)
- J Lee
- Department of Biomedical Engineering and Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - D Kim
- Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA.
| | - X Xu
- Department of Biomedical Engineering and Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - T Kuang
- Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA
| | - J Gateno
- Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA; Department of Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, USA
| | - P Yan
- Department of Biomedical Engineering and Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| |
Collapse
|
2
|
Zhu Y, Wen A, Xiao N, Gao Z, Zheng S, Fu X, Zhao Y, Wang Y. Automatic extraction of facial median sagittal plane for patients with asymmetry based on the EDMA alignment algorithm. Head Face Med 2024; 20:34. [PMID: 38762519 PMCID: PMC11102234 DOI: 10.1186/s13005-024-00430-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/29/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND We aimed to establish a novel method for automatically constructing three-dimensional (3D) median sagittal plane (MSP) for mandibular deviation patients, which can increase the efficiency of aesthetic evaluating treatment progress. We developed a Euclidean weighted Procrustes analysis (EWPA) algorithm for extracting 3D facial MSP based on the Euclidean distance matrix analysis, automatically assigning weight to facial anatomical landmarks. METHODS Forty patients with mandibular deviation were recruited, and the Procrustes analysis (PA) algorithm based on the original mirror alignment and EWPA algorithm developed in this study were used to construct the MSP of each facial model of the patient as experimental groups 1 and 2, respectively. The expert-defined regional iterative closest point algorithm was used to construct the MSP as the reference group. The angle errors of the two experimental groups were compared to those of the reference group to evaluate their clinical suitability. RESULTS The angle errors of the MSP constructed by the two EWPA and PA algorithms for the 40 patients were 1.39 ± 0.85°, 1.39 ± 0.78°, and 1.91 ± 0.80°, respectively. The two EWPA algorithms performed best in patients with moderate facial asymmetry, and in patients with severe facial asymmetry, the angle error was below 2°, which was a significant improvement over the PA algorithm. CONCLUSIONS The clinical application of the EWPA algorithm based on 3D facial morphological analysis for constructing a 3D facial MSP for patients with mandibular deviated facial asymmetry deformity showed a significant improvement over the conventional PA algorithm and achieved the effect of a dental clinical expert-level diagnostic strategy.
Collapse
Affiliation(s)
- Yujia Zhu
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, Chengdu, China
- National Clinical Research Center for Oral Diseases, Chengdu, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Device, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Aonan Wen
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, Chengdu, China
- National Clinical Research Center for Oral Diseases, Chengdu, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Device, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Ning Xiao
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, Chengdu, China
- National Clinical Research Center for Oral Diseases, Chengdu, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Device, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Zixiang Gao
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology, Chengdu, China
- National Clinical Research Center for Oral Diseases, Chengdu, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Device, Beijing, China
- Beijing Key Laboratory of Digital Stomatology, Beijing, China
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Shengwen Zheng
- School of Computer Science, Beijing University of Posts and Telecommunications (National Pilot Software Engineering School), Beijing, China
- Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing, China
| | - Xiangling Fu
- School of Computer Science, Beijing University of Posts and Telecommunications (National Pilot Software Engineering School), Beijing, China.
- Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing, China.
| | - Yijiao Zhao
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Center of Stomatology, Chengdu, China.
- National Clinical Research Center for Oral Diseases, Chengdu, China.
- National Engineering Research Center of Oral Biomaterials and Digital Medical Device, Beijing, China.
- Beijing Key Laboratory of Digital Stomatology, Beijing, China.
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China.
| | - Yong Wang
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
- National Center of Stomatology, Chengdu, China.
- National Clinical Research Center for Oral Diseases, Chengdu, China.
- National Engineering Research Center of Oral Biomaterials and Digital Medical Device, Beijing, China.
- Beijing Key Laboratory of Digital Stomatology, Beijing, China.
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China.
| |
Collapse
|
3
|
Ajmera DH, Singh P, Leung YY, Khambay BS, Gu M. Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry: a systematic review : Establishment of the mid-sagittal reference plane: a systematic review. Clin Oral Investig 2024; 28:242. [PMID: 38575839 PMCID: PMC10995046 DOI: 10.1007/s00784-024-05620-7] [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: 05/09/2022] [Accepted: 03/13/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To systematically review the literature for mid-sagittal plane establishment approaches to identify the most effective method for constructing the mid-sagittal plane for the evaluation of facial asymmetry. MATERIALS AND METHODS Six electronic databases (PubMed, Medline (via Ovid), EMBASE (via Ovid), Cochrane Library, Web of Science, and Scopus) and grey literature were searched for the studies that computed the mid-sagittal reference plane three-dimensionally, using a combination of MeSH terms and keywords. The methodological quality and the level of evidence for the included studies were analyzed using QUADAS-2 and GRADE, respectively. RESULTS The preliminary search yielded 6746 records, of which 42 articles that met the predefined inclusion criteria were included in the final analysis. All the included articles reported the construction of the mid-sagittal reference plane (MSP) using varied methods. The risk of bias and concerns regarding the applicability of the included studies were judged to be 'low'. The level of evidence was determined to be 'low' for the effectiveness of the technique and 'moderate' for the ease of clinical applicability. CONCLUSION Despite methodological heterogeneity, this review substantiates the comparable efficacy of cephalometric and morphometric MSP construction methods. A fully automated morphometric MSP holds promise as a viable option for routine clinical use. Nevertheless, future prospective studies with an emphasis on the impact, accuracy, and clinical applicability of MSP construction techniques in cases of facial asymmetry are required. CLINICAL RELEVANCE The present review will assist clinicians in selecting the most suitable method for MSP construction, leading to improved treatment planning and ultimately more favorable treatment outcomes.
Collapse
Affiliation(s)
- Deepal Haresh Ajmera
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Pradeep Singh
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yiu Yan Leung
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Balvinder S Khambay
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
- Orthodontics Department, School of Dentistry, University of Birmingham, Birmingham, UK.
- Discipline of Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
| | - Min Gu
- Discipline of Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
4
|
Xu X, Deng HH, Kuang T, Kim D, Yan P, Gateno J. Machine Learning Effectively Diagnoses Mandibular Deformity Using Three-Dimensional Landmarks. J Oral Maxillofac Surg 2024; 82:181-190. [PMID: 37995761 PMCID: PMC10841638 DOI: 10.1016/j.joms.2023.11.002] [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: 06/13/2023] [Revised: 09/22/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Jaw deformity diagnosis requires objective tests. Current methods, like cephalometry, have limitations. However, recent studies have shown that machine learning can diagnose jaw deformities in two dimensions. Therefore, we hypothesized that a multilayer perceptron (MLP) could accurately diagnose jaw deformities in three dimensions (3D). PURPOSE Examine the hypothesis by focusing on anomalous mandibular position. We aimed to: (1) create a machine learning model to diagnose mandibular retrognathism and prognathism; and (2) compare its performance with traditional cephalometric methods. STUDY DESIGN, SETTING, SAMPLE An in-silico experiment on deidentified retrospective data. The study was conducted at the Houston Methodist Research Institute and Rensselaer Polytechnic Institute. Included were patient records with jaw deformities and preoperative 3D facial models. Patients with significant jaw asymmetry were excluded. PREDICTOR VARIABLES The tests used to diagnose mandibular anteroposterior position are: (1) SNB angle; (2) facial angle; (3) mandibular unit length (MdUL); and (4) MLP model. MAIN OUTCOME VARIABLE The resultant diagnoses: normal, prognathic, or retrognathic. COVARIATES None. ANALYSES A senior surgeon labeled the patients' mandibles as prognathic, normal, or retrognathic, creating a gold standard. Scientists at Rensselaer Polytechnic Institute developed an MLP model to diagnose mandibular prognathism and retrognathism using the 3D coordinates of 50 landmarks. The performance of the MLP model was compared with three traditional cephalometric measurements: (1) SNB, (2) facial angle, and (3) MdUL. The primary metric used to assess the performance was diagnostic accuracy. McNemar's exact test tested the difference between traditional cephalometric measurement and MLP. Cohen's Kappa measured inter-rater agreement between each method and the gold standard. RESULTS The sample included 101 patients. The diagnostic accuracy of SNB, facial angle, MdUL, and MLP were 74.3, 74.3, 75.3, and 85.2%, respectively. McNemar's test shows that our MLP performs significantly better than the SNB (P = .027), facial angle (P = .019), and MdUL (P = .031). The agreement between the traditional cephalometric measurements and the surgeon's diagnosis was fair. In contrast, the agreement between the MLP and the surgeon was moderate. CONCLUSION AND RELEVANCE The performance of the MLP is significantly better than that of the traditional cephalometric measurements.
Collapse
Affiliation(s)
- Xuanang Xu
- Postdoctoral Research Fellow, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY
| | - Hannah H Deng
- Instructor, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute and Academic Institute, Houston, TX
| | - Tianshu Kuang
- Research Assistant, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX
| | - Daeseung Kim
- Instructor, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute and Academic Institute, Houston, TX.
| | - Pingkun Yan
- P.K. Lashmet Career Development Chair Associate Professor, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY
| | - Jaime Gateno
- Chairman and Professor, Department of Oral and Maxillofacial Surgery, Houston Methodist, Houston, TX; Professor of Department of Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, NY
| |
Collapse
|
5
|
Lee J, Kim D, Xu X, Kuang T, Gateno J, Yan P. Predicting Optimal Patient-Specific Postoperative Facial Landmarks for Patients with Craniomaxillofacial Deformities. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.13.23299919. [PMID: 38187692 PMCID: PMC10767768 DOI: 10.1101/2023.12.13.23299919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Orthognathic surgery traditionally focuses on correcting skeletal abnormalities and malocclusion, with the expectation that an optimal facial appearance will naturally follow. However, this skeletal-driven approach can lead to undesirable facial aesthetics and residual asymmetry. To address these issues, a soft-tissue-driven planning method has been proposed. This innovative method bases bone movement estimates on the targeted ideal facial appearance, thus increasing the surgical plan's accuracy and effectiveness. This study explores the initial phase of implementing a soft-tissue-driven approach, simulating the patient's optimal facial look by repositioning deformed facial landmarks to an ideal state. The algorithm incorporates symmetrization and weighted optimization strategies, aligning projected optimal landmarks with standard cephalometric values for both facial symmetry and form, which are integral to facial aesthetics in orthognathic surgery. It also includes regularization to preserve the patient's original facial characteristics. Validated using retrospective analysis of data from both preoperative patients and normal subjects, this approach effectively achieves not only facial symmetry, particularly in the lower face, but also a more natural and normalized facial form. This novel approach, aligning with soft-tissue-driven planning principles, shows promise in surpassing traditional methods, potentially leading to enhanced facial outcomes and patient satisfaction in orthognathic surgery.
Collapse
Affiliation(s)
- Jungwook Lee
- Department of Biomedical Engineering and Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Daeseung Kim
- Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, 77030, USA
| | - Xuanang Xu
- Department of Biomedical Engineering and Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| | - Tianshu Kuang
- Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, 77030, USA
| | - Jaime Gateno
- Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, 77030, USA
- Department of Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, NY, 10021, USA
| | - Pingkun Yan
- Department of Biomedical Engineering and Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY 12180, USA
| |
Collapse
|
6
|
Pei J, Liao X, Ge L, Liu J, Jiang X. Anterior cerebral falx plane in MR images to estimate the craniofacial midline. Sci Rep 2023; 13:16489. [PMID: 37779134 PMCID: PMC10543626 DOI: 10.1038/s41598-023-42807-6] [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: 04/07/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023] Open
Abstract
Multiple methods have been proposed for evaluating the symmetry of facial contour by utilizing the median sagittal plane of the skull as a reference and measuring the maxillofacial region. To replace the manual mark point analysis method, we used the anterior cerebral falx plane in MRI images as an indicator of the craniofacial midline. The MRI examination data of 30 individuals were analyzed with a MeVisLab workstation. Two independent examiners performed 15 anthropometric measurements (4 angular, 11 linear) and compared the MRI-based anterior cerebral falx plane with the manual mark point analysis of the craniofacial midline estimation. All measurements were repeated after 3 weeks. Statistical analyses included the repeatability and reproducibility of the 2 methods based on intra-observer and inter-observer correlation coefficients (ICCs), respectively. Precision was estimated by intergroup comparison of the coefficient of variation. The anterior falx plane derived from the MRI data resulted in an intra-observer ICC of 0.869 ± 0.065 (range 0.733-0.936) and inter-observer ICC of 0.876 ± 0.0417 (0.798-0.932) for all measurements, showing significant correlations with the ICC values obtained by the mark point method (p < 0.05). The coefficient of variation showed that the precisions of the 2 methods were statistically comparable. We conclude that, for MRI-based craniofacial midline estimation, measurements made using the anterior cerebral falx plane are as precise, repeatable, and reproducible as those using the manual mark point analysis method. It has a high potential for application in radiation-free 3-dimensional craniofacial analysis.
Collapse
Affiliation(s)
- Jun Pei
- Affiliated Hospital of Chifeng University, Yuanlin Road 98, Chi Feng, 150400, Neimenggu, China
| | - Xu Liao
- Affiliated Hospital of Chifeng University, Yuanlin Road 98, Chi Feng, 150400, Neimenggu, China
| | - Lingling Ge
- Affiliated Hospital of Chifeng University, Yuanlin Road 98, Chi Feng, 150400, Neimenggu, China
| | - Jianwei Liu
- Affiliated Hospital of Chifeng University, Yuanlin Road 98, Chi Feng, 150400, Neimenggu, China
| | - Xiling Jiang
- Affiliated Hospital of Chifeng University, Yuanlin Road 98, Chi Feng, 150400, Neimenggu, China.
| |
Collapse
|
7
|
Ajmera DH, Zhang C, Ng JHH, Hsung RTC, Lam WYH, Wang W, Leung YY, Khambay BS, Gu M. Three-dimensional assessment of facial asymmetry in class III subjects, part 2: evaluating asymmetry index and asymmetry scores. Clin Oral Investig 2023; 27:5813-5826. [PMID: 37615775 PMCID: PMC10560190 DOI: 10.1007/s00784-023-05193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/28/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES To evaluate the outcomes of corrective surgical treatment for craniofacial asymmetry using four different methods with the aim of developing the best technique for craniofacial asymmetry assessment. MATERIALS AND METHODS CBCT images of twenty-one class III subjects with surgically corrected craniofacial asymmetry and twenty-one matched controls were analyzed. Twenty-seven hard tissue landmarks were used to quantify asymmetry using the following methodologies: the asymmetry index (AI), asymmetry scores based on the clinically derived midline (CM), Procrustes analysis (PA), and modified Procrustes analysis (MPA). RESULTS Modified Procrustes analysis successfully identified pre-operative asymmetry and revealed severe asymmetry at the mandibular regions compared to controls, which was comparable to the asymmetry index and clinically derived midline methods, while Procrustes analysis masked the asymmetric characteristics. Likewise, when comparing the post-surgical outcomes, modified Procrustes analysis not only efficiently determined the changes evidencing decrease in facial asymmetry but also revealed significant residual asymmetry in the mandible, which was congruent with the asymmetry index and clinically derived midline methods but contradictory to the results shown by Procrustes analysis. CONCLUSIONS In terms of quantifying cranio-facial asymmetry, modified Procrustes analysis has evidenced to produce promising results that were comparable to the asymmetry index and the clinically derived midline, making it a more viable option for craniofacial asymmetry assessment. CLINICAL RELEVANCE Modified Procrustes analysis is proficient in evaluating cranio-facial asymmetry with more valid clinical representation and has potential applications in assessing asymmetry in a wide spectrum of patients, including syndromic patients.
Collapse
Affiliation(s)
- Deepal Haresh Ajmera
- Discipline of Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Congyi Zhang
- Department of Computer Science, The University of Hong Kong, Hong Kong SAR, China
| | - Janson Hoi Hei Ng
- Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Richard Tai-Chiu Hsung
- Department of Computer Science, Hong Kong Chu Hai College, Hong Kong SAR, China
- Division of Oral and Maxillofacial Surgery, Faculty, of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Walter Yu Hang Lam
- Discipline of Prosthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Wenping Wang
- Department of Computer Science, The University of Hong Kong, Hong Kong SAR, China
- Texas A&M University, College Station, TX, USA
| | - Yiu Yan Leung
- Division of Oral and Maxillofacial Surgery, Faculty, of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Balvinder S Khambay
- Discipline of Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
- Institute of Clinical Sciences, College of Medical and Dental Sciences, The School of Dentistry, University of Birmingham, Birmingham, UK
| | - Min Gu
- Discipline of Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
8
|
Zhu Y, Fu X, Zhang L, Zheng S, Wen A, Xiao N, Wang Y, Zhao Y. A mathematical algorithm of the facial symmetry plane: Application to mandibular deformity 3D facial data. J Anat 2022; 240:556-566. [PMID: 34841516 PMCID: PMC8819050 DOI: 10.1111/joa.13564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/24/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022] Open
Abstract
The three-dimensional (3D) symmetry reference plane (SRP) is the premise and basis of 3D facial symmetry analysis. Currently, most methods for extracting the SRP are based on anatomical landmarks measured manually using a digital 3D facial model. However, as different clinicians have varying definitions of landmarks, establishing common methods suitable for different types of facial asymmetry remains challenging. The present study aimed to investigate and evaluate a novel mathematical algorithm based on power function weighted Procrustes analysis (PWPA) to determine 3D facial SRPs for patients with mandibular deviation. From 30 patients with mandibular deviation, 3D facial SRPs were determined using both our PWPA algorithms (two functions) and the traditional PA algorithm (experimental groups). A reference plane, defined by experts, was considered the 'truth plane'. The 'position error' index of mirrored landmarks was created to quantitatively evaluate the difference among the PWPA SRPs and the truth plane, including overall differences and regional differences of the face (upper, middle and lower). The 'angle error' values between the SRPs and the truth plane in the experimental groups were also evaluated in this study. Statistics and measurement analyses were used to comprehensively evaluate the clinical suitability of the PWPA algorithms to construct the SRP. The average angle error values between the PWPA SRPs of the two functions and the truth plane were 1.21 ± 0.65° and 1.18 ± 0.62°, which were smaller than those between the PA SRP and the truth plane. The position error values of mirrored landmarks constructed using the PWPA algorithms for the whole face and for each facial partition were lower than those constructed using the PA algorithm. In conclusion, for patients with mandibular deviation, this novel mathematical algorithm provided a more suitable SRP for their 3D facial model, which achieved a result approaching the true effect of experts.
Collapse
Affiliation(s)
- Yujia Zhu
- Center of Digital Dentistry/Department of ProsthodonticsPeking University School and Hospital of StomatologyBeijingPR China
- National Center of StomatologyBeijingPR China
- National Clinical Research Center for Oral DiseasesBeijingPR China
- National Engineering Laboratory for Digital and Material Technology of StomatologyBeijingPR China
- Beijing Key Laboratory of Digital StomatologyBeijingPR China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of HealthBeijingPR China
| | - Xiangling Fu
- School of Computer ScienceBeijing University of Posts and Telecommunications (National Pilot Software Engineering School)BeijingPR China
- Key Laboratory of Trustworthy Distributed Computing and ServiceMinistry of EducationBeijing University of Posts and TelecommunicationsBeijingPR China
| | - Lei Zhang
- Center of Digital Dentistry/Department of ProsthodonticsPeking University School and Hospital of StomatologyBeijingPR China
- National Center of StomatologyBeijingPR China
- National Clinical Research Center for Oral DiseasesBeijingPR China
- National Engineering Laboratory for Digital and Material Technology of StomatologyBeijingPR China
- Beijing Key Laboratory of Digital StomatologyBeijingPR China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of HealthBeijingPR China
| | - Shengwen Zheng
- School of Computer ScienceBeijing University of Posts and Telecommunications (National Pilot Software Engineering School)BeijingPR China
- Key Laboratory of Trustworthy Distributed Computing and ServiceMinistry of EducationBeijing University of Posts and TelecommunicationsBeijingPR China
| | - Aonan Wen
- Center of Digital Dentistry/Department of ProsthodonticsPeking University School and Hospital of StomatologyBeijingPR China
- National Center of StomatologyBeijingPR China
- National Clinical Research Center for Oral DiseasesBeijingPR China
- National Engineering Laboratory for Digital and Material Technology of StomatologyBeijingPR China
- Beijing Key Laboratory of Digital StomatologyBeijingPR China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of HealthBeijingPR China
| | - Ning Xiao
- Center of Digital Dentistry/Department of ProsthodonticsPeking University School and Hospital of StomatologyBeijingPR China
- National Center of StomatologyBeijingPR China
- National Clinical Research Center for Oral DiseasesBeijingPR China
- National Engineering Laboratory for Digital and Material Technology of StomatologyBeijingPR China
- Beijing Key Laboratory of Digital StomatologyBeijingPR China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of HealthBeijingPR China
| | - Yong Wang
- Center of Digital Dentistry/Department of ProsthodonticsPeking University School and Hospital of StomatologyBeijingPR China
- National Center of StomatologyBeijingPR China
- National Clinical Research Center for Oral DiseasesBeijingPR China
- National Engineering Laboratory for Digital and Material Technology of StomatologyBeijingPR China
- Beijing Key Laboratory of Digital StomatologyBeijingPR China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of HealthBeijingPR China
| | - Yijiao Zhao
- Center of Digital Dentistry/Department of ProsthodonticsPeking University School and Hospital of StomatologyBeijingPR China
- National Center of StomatologyBeijingPR China
- National Clinical Research Center for Oral DiseasesBeijingPR China
- National Engineering Laboratory for Digital and Material Technology of StomatologyBeijingPR China
- Beijing Key Laboratory of Digital StomatologyBeijingPR China
- Research Center of Engineering and Technology for Computerized Dentistry Ministry of HealthBeijingPR China
| |
Collapse
|
9
|
邱 淑, 朱 玉, 王 时, 王 飞, 叶 红, 赵 一, 刘 云, 王 勇, 周 永. [Preliminary clinical application verification of complete digital workflow of design lips symmetry reference plane based on posed smile]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:193-199. [PMID: 35165490 PMCID: PMC8860648 DOI: 10.19723/j.issn.1671-167x.2022.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To automatically construct lips symmetry reference plane (SRP) based on posed smile, and to evaluate its advantages over conventional digital aesthetic design. METHODS Eighteen subjects' three-dimensional facial and dentition data were gathered in this study. The lips SRP of experimental groups were used with the standard weighted Procrustes analysis (WPA) algorithm and iterative closest point (ICP), respectively. A reference plane defined by experts based on regional ICP algorithm, served as the truth plane. The angle error values between the lips SRP of WPA algorithm in the experimental groups and the truth plane were evaluated in this study, and the lips SRP of ICP algorithm of the experimental groups was calculated in the same way. The lips SRP based on posed smile as a reference for aesthetic design and evaluate preliminary clinical application. RESULTS The average angle error between the lips SRP of WPA algorithm and the truth plane was 1.78°±1.24°, which was smaller than that between the lips SRP of ICP and the truth plane 7.41°±4.31°. There were significant differences in the angle errors among the groups (P < 0.05). In the aesthetic design of anterior teeth, automatically constructing the lips SRP of WPA algorithm based on posed smile and the original symmetry plane by re-ference compared with the prosthetic design, the subjects' scores on the lips SRP of WPA algorithm based on posed smile (8.48±0.57) were higher than those on the original symmetry plane (5.20±1.31). CONCLUSION Automatically constructing the lips SRP of WPA algorithm based on posed smile was more accurate than ICP algorithm, which was consistent with the truth plane. Moreover, it can provide an important reference for oral aesthetic diagnosis and aesthetic analysis of the restoration effect. In the aesthetic design of anterior teeth, automatically constructing the lips SRP of WPA algorithm based on posed smile can improve the patients' satisfaction in esthetic rehabilitation.
Collapse
Affiliation(s)
- 淑婷 邱
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 玉佳 朱
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 时敏 王
- 北京大学口腔医学院·口腔医院 义齿加工中心,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Center of Dental Laboratory, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 飞龙 王
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 红强 叶
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 一姣 赵
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 云松 刘
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 勇 王
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 永胜 周
- 北京大学口腔医学院·口腔医院国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| |
Collapse
|
10
|
Apostolakis D, Michelinakis G, Kamposiora P, Papavasiliou G. The current state of Computer Assisted Orthognathic Surgery: A narrative review. J Dent 2022; 119:104052. [DOI: 10.1016/j.jdent.2022.104052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/12/2022] [Accepted: 01/22/2022] [Indexed: 12/23/2022] Open
|
11
|
Midsagittal Plane First: Building a Strong Facial Reference Frame for Computer-Aided Surgical Simulation. J Oral Maxillofac Surg 2021; 80:641-650. [PMID: 34942153 DOI: 10.1016/j.joms.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE A facial reference frame is a 3-dimensional Cartesian coordinate system that includes 3 perpendicular planes: midsagittal, axial, and coronal. The order in which one defines the planes matters. The purposes of this study are to determine the following: 1) what sequence (axial-midsagittal-coronal vs midsagittal-axial-coronal) produced more appropriate reference frames and 2) whether orbital or auricular dystopia influenced the outcomes. METHODS This study is an ambispective cross-sectional study. Fifty-four subjects with facial asymmetry were included. The facial reference frames of each subject (outcome variable) were constructed using 2 methods (independent variable): axial plane first and midsagittal plane first. Two board-certified orthodontists together blindly evaluated the results using a 3-point categorical scale based on their careful inspection and expert intuition. The covariant for stratification was the existence of orbital or auricular dystopia. Finally, Wilcoxon signed rank tests were performed. RESULTS The facial reference frames defined by the midsagittal plane first method was statistically significantly different from ones defined by the axial plane first method (P = .001). Using the midsagittal plane first method, the reference frames were more appropriately defined in 22 (40.7%) subjects, equivalent in 26 (48.1%) and less appropriately defined in 6 (11.1%). After stratified by orbital or auricular dystopia, the results also showed that the reference frame computed using midsagittal plane first method was statistically significantly more appropriate in both subject groups regardless of the existence of orbital or auricular dystopia (27 with orbital or auricular dystopia and 27 without, both P < .05). CONCLUSIONS The midsagittal plane first sequence improves the facial reference frames compared with the traditional axial plane first approach. However, regardless of the sequence used, clinicians need to judge the correctness of the reference frame before diagnosis or surgical planning.
Collapse
|
12
|
Rathod PK, Yadav R, Bhutia O, Roychoudhury A, Bhatt K, Kaur K. Is Zygomatic Osteotomy a Viable Option to Achieve Symmetry and Stability in Post-traumatic Residual Deformity of the Zygomaticomaxillary Complex? J Oral Maxillofac Surg 2021; 79:1328.e1-1328.e13. [PMID: 33610490 DOI: 10.1016/j.joms.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE In residual deformity cases, it is difficult to reposition the zygomaticomaxillary-complex (ZMC) intraoperatively, due to resorbed fracture edges, and lack of zygoma analysis to 3-dimensionally quantify the deformity. Instability after zygomatic osteotomy and miniplate fixation (ZOMF) due to the gap between osteotomized segments, scar tissue, muscle pull, and other factors is also unknown. The study aims to evaluate symmetry and stability after ZOMF. MATERIALS AND METHODS In this prospective study, a ZMC analysis was designed and patients with unilateral post-traumatic residual deformity (>10 weeks) of ZMC were treated with ZOMF. Measurements were evaluated on affected and unaffected sides at preoperatively, immediately, and 6 months postoperatively using MIMICS software. The primary outcome variable was the symmetry and stability of ZMC. Secondary parameters were changes in orbital volume, diplopia, ocular motility, mouth opening, and patient satisfaction. P < .05 was considered statistically significant. The continuous variables were compared by paired t-test. The change within the continuous variable with time was assessed by repeated measure ANOVA, followed by multiple comparisons using the Bonferroni test. The changes within the categorical variable were assessed by the McNemar test. RESULTS Ten patients were enrolled (mean age = 29.2 ± 9.97 years; male:female = 9:1; right:left = 4:6). The mean duration from trauma to surgery was 34.84 ± 31.35 weeks. There was an improvement in the symmetry in anteroposteriorly (P = .005), mediolaterally (P = .001), and at the arch (P = .011) postoperatively. All parameters remained stable at 6 months postoperatively (difference not significant, P > .05); with the median satisfaction score of 4 of 5. Significant improvement in mouth opening (P = .014) and orbital volume (P = .001) was noted. CONCLUSIONS Virtual measurements as per the proposed protocol helped in communication and quantifying ZMC. Four-point fixation with miniplates provided enough stability over the 6-month follow-up period.
Collapse
Affiliation(s)
- Prem Kumar Rathod
- Junior Resident, Division of Oral and Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Yadav
- Associate Professor, Division of Oral and Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi, India.
| | - Ongkila Bhutia
- Professor, Division of Oral and Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Ajoy Roychoudhury
- Professor and Head, Division of Oral and Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Krushna Bhatt
- Assistant Professor, Division of Oral and Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi, India
| | - Kamalpreet Kaur
- Senior Resident, Division of Oral and Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
13
|
朱 玉, 赵 一, 郑 盛, 温 奥, 傅 湘, 王 勇. [A method for constructing three-dimensional face symmetry reference plane based on weighted shape analysis algorithm]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 53:220-226. [PMID: 33550361 PMCID: PMC7867962 DOI: 10.19723/j.issn.1671-167x.2021.01.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To establish a novel method based on three-dimensional (3D) shape analysis and weighted Procrustes analysis (WPA) algorithm to construct a 3D facial symmetry reference plane (SRP), automatically assigning weight to facial anatomical landmarks. The WPA algorithm suitability for commonly observed clinical cases of mandibular deviation were analysed and evaluated. METHODS Thirty patients with mandibular deviation were recruited for this study. The 3D facial SRPs were extracted independently based on original-mirror alignment method. Thirty-two anatomical landmarks were selected from the overall region by three times to obtain the mean coordinate. The SRP of experimental groups 1 and 2 were using the standard Procrustes analysis (PA) algorithm and WPA algorithm, respectively. A reference plane defined by experts based on regional iterative closest point (ICP) algorithm, served as the ground truth. Three experts manually selecting facial regions with good symmetry for original model, and common region was included in the study. The angle error values between the SRP of WPA algorithm in the experimental group 1 and the truth plane were evaluated in this study, and the SRP of PA algorithm of experimental group 2 was calculated in the same way. Statistics and measurement analysis were used to comprehensively evaluate the clinical suitability of the WPA algorithm to calculate the SRP. A paired t-test analysis (two-tailed) was conducted to compare the angles. RESULTS The average angle error between the SRP of WPA algorithm and the ground truth was 1.53°±0.84°, which was smaller than that between the SRP of PA and the ground truth (2.06°±0.86°). There were significant differences in the angle errors among the groups (P < 0.05). For the patients with severe mandibular deviation that the distance between pogonion and facial midline greater than 12 mm, the average angle error of the WPA algorithm was 0.86° smaller than that of the PA algorithm. CONCLUSION The WPA algorithm, based on weighted shape analysis, can provide a more adaptable SRP than the standard PA algorithm when applied to mandibular deviation patients and preliminarily simulate the diagnosis strategies of clinical experts.
Collapse
Affiliation(s)
- 玉佳 朱
- 北京大学口腔医学院·口腔医院, 口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院口腔修复教研室, 北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 一姣 赵
- 北京大学口腔医学院·口腔医院, 口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院口腔修复教研室, 北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 盛文 郑
- 北京邮电大学计算机学院(国家示范性软件学院), 北京 100876School of Computer Science, Beijing University of Posts and Telecommunications (National Pilot Software Engineering School), Beijing 100876, China
- 北京邮电大学可信分布式计算与服务教育部重点实验室, 北京 100876Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing 100876, China
| | - 奥楠 温
- 北京大学口腔医学院·口腔医院, 口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院口腔修复教研室, 北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 湘玲 傅
- 北京邮电大学计算机学院(国家示范性软件学院), 北京 100876School of Computer Science, Beijing University of Posts and Telecommunications (National Pilot Software Engineering School), Beijing 100876, China
- 北京邮电大学可信分布式计算与服务教育部重点实验室, 北京 100876Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing 100876, China
| | - 勇 王
- 北京大学口腔医学院·口腔医院, 口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学口腔医学院·口腔医院口腔修复教研室, 北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| |
Collapse
|
14
|
Zhu Y, Zheng S, Yang G, Fu X, Xiao N, Wen A, Wang Y, Zhao Y. A novel method for 3D face symmetry reference plane based on weighted Procrustes analysis algorithm. BMC Oral Health 2020; 20:319. [PMID: 33176780 PMCID: PMC7659067 DOI: 10.1186/s12903-020-01311-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to establish a novel method, using the weighted Procrustes analysis (WPA) algorithm, which assigns weight to facial anatomical landmarks, to construct a three-dimensional facial symmetry reference plane (SRP) for mandibular deviation patients. METHODS Three-dimensional facial SRPs were independently extracted from 15 mandibular deviation patients using both our WPA algorithm and the standard PA algorithm. A reference plane was defined to serve as the ground truth. To determine whether the WPA SRP or the PA SRP was closer to the ground truth, we measured the position error of mirrored landmarks, the facial asymmetry index (FAI) error, and the angle error for the global face and each facial third partition. RESULTS The average angle error between the WPA SRP and the ground truth was 1.66 ± 0.81°, which was smaller than that between the PA SRP and the ground truth. The position error of the mirrored landmarks constructed using the WPA algorithm in the global face (3.64 ± 1.53 mm) and each facial partition was lower than that constructed using the PA algorithm. The average FAI error of the WPA SRP was - 7.77 ± 17.02 mm, which was smaller than that of the PA SRP. CONCLUSIONS This novel automatic algorithm, based on weighted anatomic landmarks, can provide a more adaptable SRP than the standard PA algorithm when applied to severe mandibular deviation patients and can better simulate the diagnosis strategies of clinical experts.
Collapse
Affiliation(s)
- Yujia Zhu
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,NHC Key Laboratory of Digital Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,Beijing Key Laboratory of Digital Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,National Clinical Research Center for Oral Diseases, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China
| | - Shengwen Zheng
- School of Software Engineering, Beijing University of Posts and Telecommunications, No.10 Xitucheng Road, Haidian District, Beijing, 100876, China.,Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, No.10 Xitucheng Road, Haidian District, Beijing, 100876, China
| | - Guosheng Yang
- School of Software Engineering, Beijing University of Posts and Telecommunications, No.10 Xitucheng Road, Haidian District, Beijing, 100876, China.,Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, No.10 Xitucheng Road, Haidian District, Beijing, 100876, China
| | - Xiangling Fu
- School of Software Engineering, Beijing University of Posts and Telecommunications, No.10 Xitucheng Road, Haidian District, Beijing, 100876, China.,Key Laboratory of Trustworthy Distributed Computing and Service, Ministry of Education, Beijing University of Posts and Telecommunications, No.10 Xitucheng Road, Haidian District, Beijing, 100876, China
| | - Ning Xiao
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,NHC Key Laboratory of Digital Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,Beijing Key Laboratory of Digital Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,National Clinical Research Center for Oral Diseases, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China
| | - Aonan Wen
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,NHC Key Laboratory of Digital Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,Beijing Key Laboratory of Digital Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.,National Clinical Research Center for Oral Diseases, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China
| | - Yong Wang
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,NHC Key Laboratory of Digital Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,Beijing Key Laboratory of Digital Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,National Clinical Research Center for Oral Diseases, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.
| | - Yijiao Zhao
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,NHC Key Laboratory of Digital Technology of Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,Beijing Key Laboratory of Digital Stomatology, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China. .,National Clinical Research Center for Oral Diseases, No.22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, China.
| |
Collapse
|
15
|
Quantitative evaluation of symmetry after navigation-guided surgical recontouring of zygomatic fibrous dysplasia: a comparative study. Int J Oral Maxillofac Surg 2020; 49:1640-1647. [PMID: 32595065 DOI: 10.1016/j.ijom.2020.06.001] [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: 01/27/2019] [Revised: 03/28/2020] [Accepted: 06/02/2020] [Indexed: 11/21/2022]
Abstract
Zygomatic fibrous dysplasia is a slowly progressive disorder of bone, which commonly causes facial asymmetry. Precise surgical recontouring can effectively improve facial aesthetics. The aim of this study was to quantitatively evaluate the effectiveness of surgical navigation guidance in correcting zygomatic asymmetry. The study included 26 patients with unilateral zygomatic fibrous dysplasia who underwent bony recontouring. They were divided into two groups according to the use of intraoperative surgical navigation (navigation group and conventional group; n=13 in each group). Clinical outcomes were evaluated using three-dimensional computed tomography. Six pairs of landmarks were identified, and the coordinates were used to calculate asymmetry indices. The curvature of protruding regions in the surgical area was measured to determine facial skeletal symmetry in three dimensions. The results were compared between the groups. All patients recovered uneventfully and their facial symmetry and aesthetics improved. For three of the six pairs of landmarks, symmetry was better in the navigation group than in the conventional group (all P≤ 0.02). The postoperative curvature ratios were better (more symmetrical) in the navigation group (P= 0.01). Surgical navigation enhances postoperative facial symmetry. However, the clinical significance of this enhancement when compared to conventional non-navigation surgery needs further investigation.
Collapse
|
16
|
Bao T, Yu D, Luo Q, Wang H, Liu J, Zhu H. Quantitative assessment of symmetry recovery in navigation-assisted surgical reduction of zygomaticomaxillary complex fractures. J Craniomaxillofac Surg 2019; 47:311-319. [DOI: 10.1016/j.jcms.2018.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/29/2018] [Accepted: 12/06/2018] [Indexed: 11/17/2022] Open
|
17
|
Espinosa S, Rabanal C, Toro-Ibacache V. Morphometric Characterization of Asymmetric Mandibles Due to Condylar Hyperactivity. J Oral Maxillofac Surg 2019; 77:1056-1067. [PMID: 30689968 DOI: 10.1016/j.joms.2018.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Mandibular asymmetry related to condylar hyperactivity (CH) presents a complex set of morphologic features that pose challenges for its correction. Using state-of-the-art morphometric techniques, this report provides a detailed and hierarchical description of the features present in CH-related asymmetric mandibles and offers new knowledge for the surgical treatment of CH. MATERIALS AND METHODS Sixty patients were included in the sample. Thirty had CH-related asymmetric mandibles and the other 30 had clinically symmetric mandibles. Twenty-eight 3-dimensional landmarks were placed on computed tomographically based reconstructions of each participant's mandible and analyzed using geometric morphometric analysis for the quantitative and qualitative comparison of their morphologic features. RESULTS All 60 participants exhibited asymmetry. However, those with CH exhibited a broad range of shapes and even shared several morphologic features with the controls. Mainly the ramus and then the body were the main contributors of the differences between groups. CONCLUSIONS There is considerable overlap of anatomic features characterizing symmetric and asymmetric mandibles; based on shape alone, the 2 groups can be easily misclassified. The ramus and body of the affected side in CH-related asymmetric mandibles were the main contributors to asymmetry of the structure. The chin, a usual diagnostic structure, did not greatly contribute to the structural asymmetry of the mandible.
Collapse
Affiliation(s)
- Sebastian Espinosa
- Attending Surgeon, Department of Oral and Maxillofacial Surgery, Hospital Sótero del Río, Santiago, Chile.
| | - Carolina Rabanal
- Attending Radiologist, Department of Oral and Maxillofacial Radiology, Hospital Sótero del Río, Santiago, Chile
| | - Viviana Toro-Ibacache
- Researcher, Centro de Análisis Cuantitativo en Antropología Dental, Facultad de Odontología, Universidad de Chile, Santiago, Chile; Researcher, Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| |
Collapse
|
18
|
Sutton PH, Gateno J, English JD, Paranilam J, Teichgraeber JF, Xia JJ. Both the Observer's Expertise and the Subject's Facial Symmetry Can Affect Anatomical Position of the Head. J Oral Maxillofac Surg 2018; 77:406.e1-406.e9. [PMID: 30395819 DOI: 10.1016/j.joms.2018.09.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/10/2018] [Accepted: 09/25/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE It is easier to judge facial deformity when the patient's head is in anatomic position. The purposes of this study were to determine 1) whether a group of expert observers would agree more than a group of nonexperts on what is the correct anatomic position of the head, 2) whether there would be more variation in the alignment of an asymmetrical face compared with a symmetrical one, and 3) whether the alignments of experts would be more repeatable than those of nonexperts. MATERIALS AND METHODS Thirty-one orthodontists (experts) and 31 dental students (nonexperts) were recruited for this mixed-model study. They were shown randomly oriented 3-dimensional head photographs of an adult with a symmetrical face and an adolescent with an asymmetrical face. In viewing software, the observers oriented the images into anatomic position. They repeated the orientations 4 weeks later. Data were analyzed using a generalized linear model and Bland-Altman plots. The primary predictor variables were experience and symmetry status. The outcome variable was the anatomic position of the head. The other variables of interest included time and orientation direction. RESULTS There was a statistically significant difference between measurements completed by experts and nonexperts (F1,60 = 14.83; P < .01). The interaction between expertise and symmetrical status showed a statistically significant difference between symmetrical and asymmetrical faces in the expert and nonexpert groups (F1,60 = 9.93; P = .003). The interaction between expertise and time showed a statistically significant difference in measurement over time in the expert and nonexpert groups (F1,60 = 4.66; P = .03). CONCLUSIONS The study shows that experts can set a head into anatomic position better than nonexperts. In addition, facial asymmetry has a profound effect on the ability of an observer to align a head in the correct anatomic position. Moreover, observer-guided alignment is not reproducible.
Collapse
Affiliation(s)
- Peter H Sutton
- Former Resident, Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX; Current, Private Practice, Beaumont, TX
| | - Jaime Gateno
- Chairman and Professor, Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital, Houston, TX; Professor of Clinical Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, NY
| | - Jeryl D English
- Professor, and Fred and Dianne Garrett Endowed Chair, Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX
| | - Jaya Paranilam
- Assistant Professor of Biostatistics, Institute for Academic Medicine, Houston Methodist Research Institute, Houston, TX
| | - John F Teichgraeber
- Professor and Chief, Division of Pediatric Plastic Surgery, Department of Pediatric Surgery, Medical School, The University of Texas Health Science Center at Houston, Houston, TX
| | - James J Xia
- Director, Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX; Professor of Oral and Maxillofacial Surgery, Institute for Academic Medicine, Houston Methodist Hospital, Houston, TX; and Professor of Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, NY.
| |
Collapse
|
19
|
Gateño J, Jones TL, Shen SGF, Chen KC, Jajoo A, Kuang T, English JD, Nicol M, Teichgraeber JF, Xia JJ. Fluctuating asymmetry of the normal facial skeleton. Int J Oral Maxillofac Surg 2017; 47:534-540. [PMID: 29103833 DOI: 10.1016/j.ijom.2017.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/06/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to produce reliable estimations of fluctuating facial asymmetry in a normal population. Fifty-four computed tomography (CT) facial models of average-looking and symmetrical Chinese subjects with a class I occlusion were used in this study. Eleven midline landmarks and 12 pairs of bilateral landmarks were digitized. The repeatability of the landmark digitization was first evaluated. A Procrustes analysis was then used to measure the fluctuating asymmetry of each CT model, after all of the models had been scaled to the average face size of the study sample. A principal component analysis was finally used to establish the direction of the fluctuating asymmetries. The results showed that there was excellent absolute agreement among the three repeated measurements. The mean fluctuating asymmetry of the average-size face varied at each anthropometric landmark site, ranging from 1.0mm to 2.8mm. At the 95% upper limit, the asymmetries ranged from 2.2mm to 5.7mm. Most of the asymmetry of the midline structures was mediolateral, while the asymmetry of the bilateral landmarks was more equally distributed. These values are for the average face. People with larger faces will have higher values, while subjects with smaller faces will have lower values.
Collapse
Affiliation(s)
- J Gateño
- Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital, Houston, Texas, USA; Oral and Maxillofacial Surgery, Weill Medical College, Cornell University, New York, USA
| | - T L Jones
- Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA; Private Practice, Plano, Texas, USA
| | - S G F Shen
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University College of Medicine, Shanghai, China
| | - K-C Chen
- Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, Texas, USA; Oral and Maxillofacial Surgery, National Cheng-Kung University Medical College and Hospital, Tainan, Taiwan
| | - A Jajoo
- Department of Mathematics, University of Houston, Houston, Texas, USA
| | - T Kuang
- Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, Texas, USA
| | - J D English
- Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - M Nicol
- Department of Mathematics, University of Houston, Houston, Texas, USA
| | - J F Teichgraeber
- Division of Pediatric Plastic Surgery, Department of Pediatric Surgery, The University of Texas Houston Health Science Center, Houston, Texas, USA
| | - J J Xia
- Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital, Houston, Texas, USA; Oral and Maxillofacial Surgery, Weill Medical College, Cornell University, New York, USA; Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University College of Medicine, Shanghai, China; Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, Texas, USA.
| |
Collapse
|
20
|
Jansen J, Dubois L, Schreurs R, Gooris PJJ, Maal TJJ, Beenen LF, Becking AG. Should Virtual Mirroring Be Used in the Preoperative Planning of an Orbital Reconstruction? J Oral Maxillofac Surg 2017; 76:380-387. [PMID: 29100830 DOI: 10.1016/j.joms.2017.09.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 09/18/2017] [Accepted: 09/20/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Mirroring has been used as a diagnostic tool in orbital wall fractures for many years, but limited research is available proving the assumed symmetry of orbits. The purpose of this study was to evaluate volume and contour differences between orbital cavities in healthy humans. MATERIALS AND METHODS In this cross-sectional study, the left and right orbital cavities of a consecutive sample of patients' computed tomograms were measured. Inclusion criteria were patients with no sign of orbital or sinus pathology or fracture. Outcome variables were differences in volume and contour. Descriptive statistics and Student paired t test were used for data analysis of orbital volume and distance maps were used for analysis of orbital contour. RESULTS The sample was composed of 100 patients with a mean age of 57; 50% were men. The total mean orbital volume was 27.53 ± 3.11 mL. Mean difference between cavities was 0.44 ± 0.31 mL or 1.59% (standard deviation [SD], 1.10%). The orbital contour showed high similarity, with an absolute mean left-versus-right difference of 0.82 mm (SD, 0.23 mm). CONCLUSION The authors hypothesize that the measured differences between right and left orbital volumes and contours are clinically minor. In consequence, the use of mirroring tools as part of preoperative planning in orbital reconstruction is legitimate with the aim of simulating the pre-traumatized anatomy.
Collapse
Affiliation(s)
- Jesper Jansen
- PhD Student, Department of Oral and Maxillofacial Surgery, Orbital Unit and 3D Lab, Academic Medical Centre of Amsterdam, Academic Centre for Dentistry Amsterdam, University of Amsterdam, Amsterdam, The Netherlands.
| | - Leander Dubois
- Staff Member, Department of Oral and Maxillofacial Surgery, Orbital Unit and 3D Lab, Academic Medical Centre of Amsterdam, Academic Centre for Dentistry Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Ruud Schreurs
- PhD Student, Department of Oral and Maxillofacial Surgery, Orbital Unit and 3D Lab, Academic Medical Centre of Amsterdam, Academic Centre for Dentistry Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter J J Gooris
- Staff Member and Co-Supervisor, Department of Oral and Maxillofacial Surgery, Orbital Unit and 3D Lab, Academic Medical Centre of Amsterdam, Academic Centre for Dentistry Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Thomas J J Maal
- Staff Member and Co-Supervisor, Department of Oral and Maxillofacial Surgery, Orbital Unit and 3D Lab, Academic Medical Centre of Amsterdam, Academic Centre for Dentistry Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Ludo F Beenen
- Staff Member, Department of Radiology, Academic Medical Centre of Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Alfred G Becking
- Professor and Supervisor, Department of Oral and Maxillofacial Surgery, Orbital Unit and 3D Lab, Academic Medical Centre of Amsterdam, Academic Centre for Dentistry Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
21
|
Dreiseidler T, Lentzen MP, Zirk M, Safi AF, Zoeller JE, Kreppel M. Systematic three-dimensional analysis of wafer-based maxillary repositioning procedures in orthognathic surgery. J Craniomaxillofac Surg 2017; 45:1828-1834. [PMID: 28927954 DOI: 10.1016/j.jcms.2017.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 07/20/2017] [Accepted: 08/22/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE Little is known about the three-dimensional (3D) transfer accuracy in maxillary repositioning procedures based on conventionally manufactured dental-mounted wafers. The purpose of the present study was a systematic 3D analysis for wafer-based maxillary positioning in orthognathic surgery. MATERIALS AND METHODS A total of 92 patients underwent Le Fort I in addition to mandibular bilateral sagittal split osteotomies (BSSO). Alignment of the pre- and postsurgical CBCT data sets allowed measuring maxillary position changes in axial, sagittal and transversal directions. RESULTS The highest achieved absolute transfer inaccuracies were 1.37 mm, ±0.84 in the sagittal direction, followed by 1.15 mm, ±0.69 in the axial, as well as 1.05 mm, ±0.79 in the transversal direction. The largest relative deviations could be found for repositions in the transversal plane (109.4%, ±4.5), followed by the axial (66.2%, ±51.5) and sagittal plane (49.3%, ±2.2). Significant transfer accuracy differences of repositioning procedures in the sagittal direction, mainly advancement procedures, could be detected if performed with (1.75 mm, ±0.90) or without (1.18 mm, ±0.78) additional rotational correction component. No significant differences were found between unidirectional and multidirectional maxillary correction procedures. CONCLUSION The present study for the first time delivers systematic 3D accuracy data of wafer-based maxillary positioning procedures, attesting to its feasibility but also further encouraging the search for improvement strategies.
Collapse
Affiliation(s)
- Timo Dreiseidler
- University of Cologne, Dept. of Craniomaxillofacial and Plastic Surgery (Head: Professor Dr. Dr. Joachim E. Zoeller), Kerpener Straße 62, D-50924 Cologne, Germany.
| | - Max-Philipp Lentzen
- University of Cologne, Dept. of Craniomaxillofacial and Plastic Surgery (Head: Professor Dr. Dr. Joachim E. Zoeller), Kerpener Straße 62, D-50924 Cologne, Germany
| | - Matthias Zirk
- University of Cologne, Dept. of Craniomaxillofacial and Plastic Surgery (Head: Professor Dr. Dr. Joachim E. Zoeller), Kerpener Straße 62, D-50924 Cologne, Germany
| | - Ali-Farid Safi
- University of Cologne, Dept. of Craniomaxillofacial and Plastic Surgery (Head: Professor Dr. Dr. Joachim E. Zoeller), Kerpener Straße 62, D-50924 Cologne, Germany
| | - Joachim E Zoeller
- University of Cologne, Dept. of Craniomaxillofacial and Plastic Surgery (Head: Professor Dr. Dr. Joachim E. Zoeller), Kerpener Straße 62, D-50924 Cologne, Germany
| | - Matthias Kreppel
- University of Cologne, Dept. of Craniomaxillofacial and Plastic Surgery (Head: Professor Dr. Dr. Joachim E. Zoeller), Kerpener Straße 62, D-50924 Cologne, Germany
| |
Collapse
|
22
|
Hughes GN, Gateño J, English JD, Teichgraeber JF, Xia JJ. There is variability in our perception of the standard head orientation. Int J Oral Maxillofac Surg 2017; 46:1512-1516. [PMID: 28521964 DOI: 10.1016/j.ijom.2017.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/16/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
Abstract
The purposes of this study were to determine: (1) whether an observer's perception of the correct anatomical alignment of the head changes with time, and (2) whether different observers agree on the correct anatomical alignment. To determine whether the perception of the correct anatomical alignment changes with time (intra-observer comparison), a group of 30 observers were asked to orient, into anatomical alignment, the three-dimensional (3D) head photograph of a normal man, on two separate occasions. To determine whether different observers agree on the correct anatomical alignment (inter-observer comparison), the observed orientations were compared. The results of intra-observer comparisons showed substantial variability between the first and second anatomical alignments. Bland-Altman coefficients of repeatability for pitch, yaw, and roll, were 6.9°, 4.4°, and 2.4°, respectively. The results of inter-observer comparisons showed that the agreement for roll was good (sample variance 0.4, standard deviation (SD) 0.7°), the agreement for yaw was moderate (sample variance 2.0, SD 1.4°), and the agreement for pitch was poor (sample variance 15.5, SD 3.9°). In conclusion, the perception of correct anatomical alignment changes considerably with time. Different observers disagree on the correct anatomical alignment. Agreement among multiple observers was bad for pitch, moderate for yaw, and good for roll.
Collapse
Affiliation(s)
- G N Hughes
- Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA; Private Practice, Long Beach, CA, USA
| | - J Gateño
- Department of Oral and Maxillofacial Surgery, Houston Methodist Hospital, Houston, TX, USA; Clinical Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, USA
| | - J D English
- Department of Orthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J F Teichgraeber
- Division of Pediatric Plastic Surgery, Department of Pediatric Surgery, The University of Texas Houston Health Science Center, Houston, TX, USA
| | - J J Xia
- Clinical Surgery (Oral and Maxillofacial Surgery), Weill Medical College, Cornell University, New York, USA; Surgical Planning Laboratory, Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, USA; Oral and Maxillofacial Surgery, Institute for Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.
| |
Collapse
|
23
|
Design, development and clinical validation of computer-aided surgical simulation system for streamlined orthognathic surgical planning. Int J Comput Assist Radiol Surg 2017; 12:2129-2143. [PMID: 28432489 DOI: 10.1007/s11548-017-1585-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/04/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE There are many proven problems associated with traditional surgical planning methods for orthognathic surgery. To address these problems, we developed a computer-aided surgical simulation (CASS) system, the AnatomicAligner, to plan orthognathic surgery following our streamlined clinical protocol. METHODS The system includes six modules: image segmentation and three-dimensional (3D) reconstruction, registration and reorientation of models to neutral head posture, 3D cephalometric analysis, virtual osteotomy, surgical simulation, and surgical splint generation. The accuracy of the system was validated in a stepwise fashion: first to evaluate the accuracy of AnatomicAligner using 30 sets of patient data, then to evaluate the fitting of splints generated by AnatomicAligner using 10 sets of patient data. The industrial gold standard system, Mimics, was used as the reference. RESULT When comparing the results of segmentation, virtual osteotomy and transformation achieved with AnatomicAligner to the ones achieved with Mimics, the absolute deviation between the two systems was clinically insignificant. The average surface deviation between the two models after 3D model reconstruction in AnatomicAligner and Mimics was 0.3 mm with a standard deviation (SD) of 0.03 mm. All the average surface deviations between the two models after virtual osteotomy and transformations were smaller than 0.01 mm with a SD of 0.01 mm. In addition, the fitting of splints generated by AnatomicAligner was at least as good as the ones generated by Mimics. CONCLUSION We successfully developed a CASS system, the AnatomicAligner, for planning orthognathic surgery following the streamlined planning protocol. The system has been proven accurate. AnatomicAligner will soon be available freely to the boarder clinical and research communities.
Collapse
|