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Li L, Chen Y, Wang J, Luo N, Wu Y, Dai H, Zhou J. Long-term morphometric changes in the anterior alveolar bone in adolescents and adults after space closure: A retrospective study. Orthod Craniofac Res 2023; 26:618-631. [PMID: 36975738 DOI: 10.1111/ocr.12657] [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: 10/07/2022] [Revised: 02/20/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES To analyse the morphometric changes in the anterior alveolar bone of both the maxilla and mandible after space closure and retention for 18-36 mo in adults and adolescents. MATERIALS AND METHODS Forty-two subjects with 4 first premolars extracted followed by retracting anterior teeth were included and divided into two age groups: adult group (4 males, 17 females, mean age: 23.67 ± 5.29 y, treatment duration: 27.95 mo, retention duration: 26.96 mo, ANB: 4.8 ± 2.1, U1-L1: 117.2 ± 9.2, U1-PP: 120.2 ± 7.2, L1-MP: 99.2 ± 5.3) and adolescent group (6 males, 15 females, mean age: 11.52 ± 1.21 y, treatment duration: 26.18 mo, retention duration: 25.79 mo, ANB: 5.2 ± 2.1, U1-L1: 116.0 ± 8.6, U1-PP: 119.8 ± 4.9, L1-MP: 99.7 ± 4.9). Alveolar bone height and thickness of anterior teeth in both groups were measured using cone beam computed tomography (CBCT) imaging performed at the pretreatment (T1), posttreatment (T2) and retention phases (T3). One-way repeated-measure ANOVAs were performed to evaluate the alveolar bone changes. Voxel-based superimpositions were performed to measure the amount of tooth movement. RESULTS After orthodontic treatment, the lingual bone height and thickness of both arches and the labial bone height of the mandible decreased significantly in both age groups (P < .05). Most of the labial bone height and thickness of the maxilla in both groups remained unchanged (P > .05). After retention, the lingual bone height and thickness increased significantly in both age groups (P < .05). The amounts of increased height ranged from 1.08 to 1.64 mm in adults and from 0.78 to 1.21 mm in adolescents, and the amounts of increased thickness ranged from 0.23 mm to 0.62 mm in adults and from 0.16 mm to 0.36 mm in adolescents. Obvious movements of the anterior teeth during retention were not found (P > .05). CONCLUSIONS Although lingual alveolar bone loss occurred in adolescents and adults during orthodontic treatment, continuous remodelling occurred in the later retention phase, which provides a reference for clinical treatment planning of bimaxillary dentoalveolar protrusion.
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Affiliation(s)
- Lingfeng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yanxi Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jingxi Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Nan Luo
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yan Wu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Hongwei Dai
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jingping Zhou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Chu G, Zhang R, He Y, Ng CH, Gu M, Leung YY, He H, Yang Y. Deep Learning Models for Automatic Upper Airway Segmentation and Minimum Cross-Sectional Area Localisation in Two-Dimensional Images. Bioengineering (Basel) 2023; 10:915. [PMID: 37627800 PMCID: PMC10451171 DOI: 10.3390/bioengineering10080915] [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: 06/05/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE To develop and validate convolutional neural network algorithms for automatic upper airway segmentation and minimum cross-sectional area (CSAmin) localisation in two-dimensional (2D) radiographic airway images. MATERIALS AND METHODS Two hundred and one 2D airway images acquired using cone-beam computed tomography (CBCT) scanning were randomly assigned to a test group (n = 161) to train artificial intelligence (AI) models and a validation group (n = 40) to evaluate the accuracy of AI processing. Four AI models, UNet18, UNet36, DeepLab50 and DeepLab101, were trained to automatically segment the upper airway 2D images in the test group. Precision, recall, Intersection over Union, the dice similarity coefficient and size difference were used to evaluate the performance of the AI-driven segmentation models. The CSAmin height in each image was manually determined using three-dimensional CBCT data. The nonlinear mathematical morphology technique was used to calculate the CSAmin level. Height errors were assessed to evaluate the CSAmin localisation accuracy in the validation group. The time consumed for airway segmentation and CSAmin localisation was compared between manual and AI processing methods. RESULTS The precision of all four segmentation models exceeded 90.0%. No significant differences were found in the accuracy of any AI models. The consistency of CSAmin localisation in specific segments between manual and AI processing was 0.944. AI processing was much more efficient than manual processing in terms of airway segmentation and CSAmin localisation. CONCLUSIONS We successfully developed and validated a fully automatic AI-driven system for upper airway segmentation and CSAmin localisation using 2D radiographic airway images.
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Affiliation(s)
- Guang Chu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; (G.C.)
| | - Rongzhao Zhang
- Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Yingqing He
- Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Chun Hown Ng
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; (G.C.)
| | - Min Gu
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; (G.C.)
| | - Yiu Yan Leung
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Hong He
- Department of Orthodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan 430072, China
| | - Yanqi Yang
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; (G.C.)
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Detailed Correlation between Central Incisor Movement and Alveolar Bone Resorption in Adults with Orthodontic Premolar Extraction Treatment: A Retrospective Cohort CBCT Study. J Clin Med 2022; 11:jcm11226872. [PMID: 36431349 PMCID: PMC9692330 DOI: 10.3390/jcm11226872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background: This study aims to explore the detailed correlation between the movement of maxillary and mandibular central incisors and alveolar bone resorption in adults who had orthodontic premolar extraction treatment. Methods: A total of 63 adult patients (mean age, 24.41 years) who received orthodontic treatment with the extraction of four first premolars were included in this study. CBCT images were obtained before and after treatment. Three-dimensional evaluations of the movement of 252 central incisors (126 maxillary and 126 mandibular incisors) and alveolar bone changes were conducted. Four points were used to describe the incisor movement: C (cusp point), R (root apex point), M (mid-point of root neck), and L (labial cementoenamel junction point). The thickness of labial and palatal alveolar bone was assessed at the crestal, mid-root, and apical levels of incisors. The results were analyzed with Spearman’s correlation and multilinear regression. Results: Matching the measurements of central incisor movement and alveolar bone resorption, significant correlations could be observed. For maxillary central incisors, the labial alveolar bone resorption at the crestal level was correlated with the movement of Point L (r = 0.290, p < 0.05), and the labial alveolar bone resorption at the apical level was correlated with Point M (r = 0.387, p < 0.05). For mandibular central incisors, the labial alveolar bone resorption at the apical level was correlated with the movement of Point M (r = 0.493, p < 0.05) and R (r = 0.498, p < 0.01); the palatal alveolar bone resorption at the mid-root level with Point M (r = -0.170, p < 0.01); and the palatal alveolar bone resorption at the apical level with Point R (r = 0.177, p < 0.01). Conclusions: This study investigated the concrete correlations between central incisor movement and alveolar bone resorption in adults after orthodontic treatment with premolar extraction. It is potentially helpful for orthodontists to have a relatively accurate prediction of alveolar bone resorption based on the specific movements of central incisors and to reduce the risk of alveolar bone resorption by better adjusting the three-dimensional movement types of incisors.
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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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A comparison of the precision of 3D images of facial tissues from the forensic point of view. FORENSIC IMAGING 2022. [DOI: 10.1016/j.fri.2021.200471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Effects of fixed functional appliances with temporary anchorage devices on Class II malocclusion: A systematic review and meta‑analysis. J World Fed Orthod 2021; 10:59-69. [PMID: 33785320 DOI: 10.1016/j.ejwf.2021.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of fixed functional appliances (FFAs) in conjunction with temporary anchorage devices (TADs) has been proposed to enhance skeletal changes and reduce proclination of the lower incisors. OBJECTIVES To systematically investigate the skeletal and dentoalveolar effects of FFAs with TADs on Class II malocclusion in adolescents. METHODS Electronic searches of databases and manual searches of references were performed up to August 30, 2020. Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) focusing on adolescent patients treated with FFAs combining TADs were included. The modified Cochrane risk-of-bias tool (R.O.B 2.0) and ROBINS-I (Risk of Bias in Non-randomized Studies-of Interventions) Tool were used to assess the risk of bias in RCTs and CCTs, respectively. Meta-analyses of SNA, SNB, ANB, Co-Gn, SN-MP, the lower and upper incisor inclination changes were performed. Subgroup analyses and sensitivity analyses were conducted based on TAD types, FFA types, record types and types of study designs. RESULTS Ten studies were included with a sample size of 281. Meta-analyses revealed significant differences in the changes in SNB (mean difference [MD] 0.67; 95% confidence interval [CI] 0.04-1.29), ANB (MD -1.22, 95% CI -2.04 to -0.39), Co-Gn (MD 1.57; 95% CI 0.22-2.92), inclination of the lower incisors (MD -5.64, 95% CI -7.78 to -3.50)] and inclination of the upper incisors (MD -1.91; 95% CI -3.69 to -0.13). TAD types and FFA types seem to affect the treatment outcome. CONCLUSIONS Compared with FFAs alone, FFAs with TADs exhibit superior skeletal effects and reduce the inclination of the lower incisors in the short term; however, the evidence showed moderate to high risk of bias. Registration number CRD42020177611.
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Lin Y, Ma X, Huang Y, Mu L, Yang L, Zhao M, Xie F, Zhang C, Xu J, Lu J, Teng L. [Three-dimensional measurement analysis of midface morphology in Treacher Collins syndromes]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:86-94. [PMID: 33448205 DOI: 10.7507/1002-1892.202009004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To three-dimensionally calculate the craniofacial parameters of midface of patients with Treacher Collins syndrome (TCS) in China, in order to understand the changes in the spatial position relationship between the various anatomical structures of the midface. Methods CT imaging data of TCS patients and age- and gender-matched normal populations between January 2013 and July 2020 was retrospectively analyzed. A total of 33 cases met the selection criteria for inclusion in the study, including 14 cases in the TCS group and 19 cases in the control group. ProPlan CMF 3.0 software was used to perform three-dimensional digital reconstruction of the craniofacial bone, measure the anatomical parameters of the midface, and analyze its morphological structure; at the same time perform three-dimensional digital reconstruction of the upper airway for morphological analysis (measure upper airway volume). Results CT images analysis revealed that all 14 patients with TCS presented the typical features with downward slanting of the palpebral fissures and different degrees of zygomatico-orbital complex dysplasia. Cephalometric and morphological analysis of the midface revealed that, multiple transverse diameters of the midface of TCS patients were significantly decreased when compared with the control group ( P<0.05), such as the width of the maxillary base, the length of the maxillary complex, and some distances related to the nasal morphology; but the distance between bilateral orbitales increased in TCS group ( P<0.05). Several anteroposterior distances in TCS group were decreased significantly when compared to control group and the distance between the skull base point and the posterior nasal spine was the most shortened ( P<0.05). But there was no significant difference of the distance between nasion and anterior nasal spine, which represented anterior midface height, between groups ( P>0.05). The skull base angle and SNB angle (the angle between the sella point-nose root point-inferior alveolar seat point) of the TCS group both decreased when compared with the control group ( P<0.05), but there was no significant difference in SNA angle (the angle between the sella point-nose root point-upper alveolar seat point) between the two groups ( P>0.05). The total volume of the upper airway was (24 621.07±8 476.63) mm 3 in the TCS group, which was significantly lower than that of the control group [(32 864.21±13 148.74) mm 3] ( t=2.185, P=0.037). Conclusion The transverse distances, anteroposterior distances, and multiple craniofacial angles measurement of TCS patients were significantly decreased when compared to the control group, presented with different degrees of zygomatico-orbital complex dysplasia, nasal and maxillary dysplasia, but there was no obvious restriction in face height development. Reduced internal diameters of the upper airway maybe responsible for the decreased upper airway volume of patients with TCS.
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Affiliation(s)
- Yanxian Lin
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Xiaoyang Ma
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Yuanliang Huang
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Lin Mu
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Liya Yang
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Minghao Zhao
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Fang Xie
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Chao Zhang
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Jiajie Xu
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Jianjian Lu
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
| | - Li Teng
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100144, P.R.China
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Pan F, Yang Z, Wang J, Cai R, Liu J, Zhang C, Liao W. Influence of orthodontic treatment with premolar extraction on the spatial position of maxillary third molars in adult patients: a retrospective cohort cone-bean computed tomography study. BMC Oral Health 2020; 20:321. [PMID: 33176777 PMCID: PMC7661228 DOI: 10.1186/s12903-020-01314-0] [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: 05/22/2020] [Accepted: 11/04/2020] [Indexed: 02/05/2023] Open
Abstract
Background Based on low-dose radiation Cone-bean computed tomography (CBCT) images, This study aims to establish a space coordinate system, which offers more precise and comparable evaluation on changes of maxillary third molars influenced by orthodontic treatment with premolar extraction in adults. The system suggests promising application prospect in future studies related to CBCT superimposition and evaluation for its feasibility and efficiency. Methods Forty-nine maxillary third molars from 27 patients (mean age, 20.78 years) were included. CBCT images were obtained before and after orthodontic treatment with premolars extracted (mean treatment duration, 31.47 months). The changes in the position, angulation, and rotation of the third molars were evaluated with a space coordinate system using four landmarks: anterior nasal spine (ANS), posterior nasal spine (PNS), left and right orbitales. Results After orthodontic treatment, the third molars moved forward (adjusted mean, 1.44 mm) (p < 0.001) and downward (adjusted mean, 2.87 mm) (p < 0.001) accompanied by outward rotation of the crowns (adjusted mean, 5.38°) (p = 0.001), while changes in angulation were insignificant. Conclusions This was the first study to systematically investigate the spatial position change of maxillary third molars in adult patients who received orthodontic treatment with premolar extraction. During the process, maxillary third molars moved downward and forward accompanied by outward rotation of the crowns. Orthodontists should take tooth movement potential into consideration when making extraction plans.
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Affiliation(s)
- Fangwei Pan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhentao Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ruilie Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jialing Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chenghao Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wen Liao
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Deep Convolutional Neural Networks Based Analysis of Cephalometric Radiographs for Differential Diagnosis of Orthognathic Surgery Indications. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10062124] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to evaluate the deep convolutional neural networks (DCNNs) based on analysis of cephalometric radiographs for the differential diagnosis of the indications of orthognathic surgery. Among the DCNNs, Modified-Alexnet, MobileNet, and Resnet50 were used, and the accuracy of the models was evaluated by performing 4-fold cross validation. Additionally, gradient-weighted class activation mapping (Grad-CAM) was used to perform visualized interpretation to determine which region affected the DCNNs’ class classification. The prediction accuracy of the models was 96.4% for Modified-Alexnet, 95.4% for MobileNet, and 95.6% for Resnet50. According to the Grad-CAM analysis, the most influential regions for the DCNNs’ class classification were the maxillary and mandibular teeth, mandible, and mandibular symphysis. This study suggests that DCNNs-based analysis of cephalometric radiograph images can be successfully applied for differential diagnosis of the indications of orthognathic surgery.
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Cone-Beam Computed Tomography in Orthodontics. Dent J (Basel) 2019; 7:dj7030089. [PMID: 31480667 PMCID: PMC6784482 DOI: 10.3390/dj7030089] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/05/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.
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Huang J, Hu J, Luo R, Xie S, Wang Z, Ye Y. Linear measurements of sinus floor elevation based on voxel-based superimposition of cone beam computed tomography images. Clin Implant Dent Relat Res 2019; 21:1048-1053. [PMID: 31392828 DOI: 10.1111/cid.12830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/14/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Postsurgical evaluation of sinus floor elevation regularly involves linear measurements of the elevated volumes in the cone beam computed tomography (CBCT) images. The accuracy of measurements could be compromised due to ill-defined sinus floor outline if implants are placed simultaneously. PURPOSE The aim was to examine a CBCT superimposition method to improve the measurement accuracy. MATERIALS AND METHODS Twenty patients who received transalveolar sinus floor elevation with immediate implantation were enrolled. CBCTs before and after surgery were transformed into digital imaging and communications in medicine format and imported into the Dolphin Imaging software. Voxel-based superimposition was automated to merge the files. In the superimposed image, parameters including alveolar bone height, protruded implant length, and total elevated height were measured. The superimposition and measurements were performed independently by two examiners and in two timepoints with 1-week time interval. We used intraclass correlation coefficient (ICC) to analyze the interexaminer and intraexaminer agreements. RESULTS Of measured parameters, the mean of difference between two timepoints ranged from 0.18 to 0.26 mm by examiner 1, and from 0.16 to 0.20 mm by examiner 2. ICCs were equal or greater than 0.98, indicating perfect intraexaminer agreement. For interexaminer reliability, the largest mean of difference was 0.27 mm in measuring alveolar bone height between two examiners. ICCs were greater than 0.98, showing perfect interexaminer agreement. CONCLUSIONS The voxel-based superimposition of pre- and post-surgical CBCT images with Dolphin Imaging is an effective and reliable way for linear measurements so as to assess the surgical outcome. There is minimal effect on reproducibility of measured data by different timepoints or performers.
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Affiliation(s)
- Jie Huang
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Jiahui Hu
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Rongchun Luo
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Sisi Xie
- Department of Cellular and Genetic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Zuolin Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Ying Ye
- Department of Oral Implantology, School and Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
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