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Krneta Đokić B, Zhurov A, Richmond S, Verdenik I, Ovsenik M. 3D soft‐tissue evaluation of a Class III treatment with rapid maxillary expander and face mask in pre‐pubertal phase—A retrospective cohort study. Orthod Craniofac Res 2020; 23:323-331. [DOI: 10.1111/ocr.12373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Bojana Krneta Đokić
- Department of Orthodontics and Dentofacial Orthopedics Faculty of Medicine University of Ljubljana Ljubljana Slovenia
| | - Alexei Zhurov
- Department of Applied Clinical Research and Public Health School of Dentistry Cardiff UK
| | - Stephen Richmond
- Department of Applied Clinical Research and Public Health School of Dentistry Cardiff UK
| | - Ivan Verdenik
- Department of Obstetrics and Gynecology University Medical Centre Ljubljana Ljubljana Slovenia
| | - Maja Ovsenik
- Department of Orthodontics and Dentofacial Orthopedics Faculty of Medicine University of Ljubljana Ljubljana Slovenia
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Thiesen G, Freitas MPM, Gribel BF, Kim KB. Comparison of maxillomandibular asymmetries in adult patients presenting different sagittal jaw relationships. Dental Press J Orthod 2019; 24:54-62. [PMID: 31508707 PMCID: PMC6733234 DOI: 10.1590/2177-6709.24.4.054-062.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 10/22/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study aims at using cone beam computed tomography (CBCT) to analyze the maxillomandibular characteristics present in adults with mandibular asymmetries and different sagittal jaw relationships. METHODS 360 patients were selected and divided into three groups (Class I, Class II, and Class III), with 120 individuals per group. The groups were then subdivided according to the intensity of lateral deviation of the gnathion point, into: 1) relative symmetry, 2) moderate asymmetry, and 3) severe asymmetry. Three planes of reference were established in the CBCT images and several measurements were taken to compare the bilateral skeletal differences between the intensities of asymmetry for the different sagittal jaw relationships. RESULTS When the groups were compared by the intensity of asymmetry, significant differences among patients with relative symmetry and moderate to severe asymmetry were found. This was especially noticed for severe asymmetry, suggesting that the deviation of the chin did not constitute the only morphological alteration for these patients, especially because a series of measurements showed significant bilateral differences. When comparing sagittal jaw relationships, the only significant finding was the vertical positioning of the gonion between Class II and III patients with severe asymmetry. CONCLUSIONS When comparing the three sagittal jaw relationships with the same intensity of asymmetry, most maxillofacial aspects were quite similar. The only difference was found for patients with severe asymmetry, as the individuals with Class II showed greater bilateral difference in the vertical positioning of the gonion, when compared to patients with Class III.
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Affiliation(s)
- Guilherme Thiesen
- Universidade do Sul de Santa Catarina, Departamento de Ortodontia (Florianópolis/SC, Brazil)
| | | | | | - Ki Beom Kim
- Saint Louis University, Department of Orthodontics (Saint Louis/MO, USA)
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Duran GS, Di̇ndaroğlu F, Kutlu P. Hard- and soft-tissue symmetry comparison in patients with Class III malocclusion. Am J Orthod Dentofacial Orthop 2019; 155:509-522. [PMID: 30935606 DOI: 10.1016/j.ajodo.2018.05.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Our aim was to describe hard- and soft-tissue asymmetry in people who have a skeletal Class III malocclusion, and to compare with those without asymmetry. We also performed a regional analysis of a possible correlation between facial soft- and hard-tissue asymmetries. METHODS This retrospective study was performed with the use of the computed tomographic scans of 60 subjects. The skeletal Class III subjects were categorized into 2 subgroups: soft-tissue menton deviation ≤4 mm (n = 20) versus >4 mm (n = 20). The Class III groups were compared with a Class I symmetry group (n = 20). Hard and soft tissues were segmented into different morphologic areas and deviation calculated. Pearson correlation coefficients were obtained, and 1-way analysis of variance was conducted for statistical analysis. RESULTS The highest deviation in the hard tissues of the Class III asymmetry group was in the corpus region (5.55 ± 3.05 mm), with the second highest in the angulus region (4.70 ± 2.43 mm). The highest average deviation in the soft tissues was seen in the lower cheek (7.04 ± 3.46 mm). In the different study groups, the amounts of asymmetry measured in anatomic structures on the mandible were found to be highly correlated between neighboring structures. CONCLUSIONS Clinically and statistically significant differences were found in the anatomic regions located in the middle and lower thirds of the face. There was a medium or high correlation between condyle, coronoid process, ramus, and angulus regions. A low level of correlation was observed between middle face and mandibular asymmetries in hard-tissue upper cheek and lower cheek regions were correlated with different mandibular regions.
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Affiliation(s)
- Gökhan Serhat Duran
- Department of Orthodontics, Gülhane Faculty of Dentistry, Sağlık Bilimleri University, Etlik, Ankara, Turkey.
| | - Furkan Di̇ndaroğlu
- Department of Orthodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
| | - Pınar Kutlu
- Department of Orthodontics, Gülhane Faculty of Dentistry, Sağlık Bilimleri University, Etlik, Ankara, Turkey
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Hong C, Choi K, Kachroo Y, Kwon T, Nguyen A, McComb R, Moon W. Evaluation of the 3dMDface system as a tool for soft tissue analysis. Orthod Craniofac Res 2018. [PMID: 28643910 DOI: 10.1111/ocr.12178] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the accuracy of three-dimensional stereophotogrammetry by comparing values obtained from direct anthropometry and the 3dMDface system. To achieve a more comprehensive evaluation of the reliability of 3dMD, both linear and surface measurements were examined. SETTING AND SAMPLE POPULATION UCLA Section of Orthodontics. Mannequin head as model for anthropometric measurements. MATERIAL AND METHODS Image acquisition and analysis were carried out on a mannequin head using 16 anthropometric landmarks and 21 measured parameters for linear and surface distances. 3D images using 3dMDface system were made at 0, 1 and 24 hours; 1, 2, 3 and 4 weeks. Error magnitude statistics used include mean absolute difference, standard deviation of error, relative error magnitude and root mean square error. Intra-observer agreement for all measurements was attained. RESULTS Overall mean errors were lower than 1.00 mm for both linear and surface parameter measurements, except in 5 of the 21 measurements. The three longest parameter distances showed increased variation compared to shorter distances. No systematic errors were observed for all performed paired t tests (P<.05). Agreement values between two observers ranged from 0.91 to 0.99. CONCLUSIONS Measurements on a mannequin confirmed the accuracy of all landmarks and parameters analysed in this study using the 3dMDface system. Results indicated that 3dMDface system is an accurate tool for linear and surface measurements, with potentially broad-reaching applications in orthodontics, surgical treatment planning and treatment evaluation.
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Affiliation(s)
- C Hong
- UCLA Department of Orthodontics, Los Angeles, CA, USA
| | - K Choi
- UCLA School of Dentistry, Los Angeles, CA, USA
| | - Y Kachroo
- UCLA Department of Orthodontics, Los Angeles, CA, USA
| | - T Kwon
- UCLA School of Dentistry, Los Angeles, CA, USA
| | - A Nguyen
- UCLA School of Dentistry, Los Angeles, CA, USA
| | - R McComb
- UCLA Department of Orthodontics, Los Angeles, CA, USA
| | - W Moon
- UCLA Department of Orthodontics, Los Angeles, CA, USA
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Al-Rudainy D, Ju X, Stanton S, Mehendale FV, Ayoub A. Assessment of regional asymmetry of the face before and after surgical correction of unilateral cleft lip. J Craniomaxillofac Surg 2018; 46:974-978. [PMID: 29752048 DOI: 10.1016/j.jcms.2018.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 03/19/2018] [Accepted: 03/27/2018] [Indexed: 11/15/2022] Open
Abstract
This study was carried out on 26 unilateral cleft lip and palate (UCLP) cases with mean age 3.6 ± 0.7 months.3D facial images were captured for each infant 2-3 days before the repair of cleft lip and at 4 months following surgery at a mean age of 8.2 ± 1.8 months, using a stereophotogrammetry imaging system. An iterative closest point (ICP) algorithm was used to superimpose the 3D facial model to its mirror image using VRMesh software. After the superimposition, the face model was divided into seven anatomical regions. Asymmetry of the entire face and of the anatomical regions was calculated by measuring the absolute distances between the 3D facial surface model and its mirror image. Colour maps were used to illustrate the patterns and magnitude of the facial asymmetry before and after surgery. There were significant decreases in the asymmetry scores for the nose, upper lip and the cheeks as a result of the surgical repair of cleft lips. Surgery did not change the magnitude of the asymmetry scores for the lower lip and chin. Residual nasolabial asymmetries were detected. The main outcome of the findings of this innovative study is to inform the required surgical refinement of primary repair of cleft lip in order to minimise facial asymmetry. We have presented a sensitive tool that could be used for comparative analysis of lip repair at various cleft centres and to guide secondary corrective surgery when required.
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Affiliation(s)
- Dhelal Al-Rudainy
- Orthodontic Department, College of dentistry, University of Baghdad, Iraq; Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Xiangyang Ju
- Medical Devices Unit, Department of Clinical Physics and Bioengineering, National Health Service of Greater Glasgow and Clyde, United Kingdom
| | - Steve Stanton
- Royal Hospital for Sick Children, Edinburgh, United Kingdom
| | | | - Ashraf Ayoub
- Oral and Maxillofacial Surgery, College of Medical, Veterinary and Life Sciences, School of Medicine, Dental School, University of Glasgow, Glasgow, United Kingdom.
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Johal A, Chaggar A, Zou LF. A three-dimensional soft tissue analysis of Class III malocclusion: a case-controlled cross-sectional study. J Orthod 2017; 45:16-22. [PMID: 28678642 DOI: 10.1080/14653125.2017.1331893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study used the optical surface laser scanning technique to compare the facial features of patients aged 8-18 years presenting with Class I and Class III incisor relationship in a case-control design. MATERIALS AND METHODS Subjects with a Class III incisor relationship, aged 8-18 years, were age and gender matched with Class I control and underwent a 3-dimensional (3-D) optical surface scan of the facial soft tissues. RESULTS Landmark analysis revealed Class III subjects displayed greater mean dimensions compared to the control group most notably between the ages of 8-10 and 17-18 years in both males and females, in respect of antero-posterior (P = 0.01) and vertical (P = 0.006) facial dimensions. Surface-based analysis, revealed the greatest difference in the lower facial region, followed by the mid-face, whilst the upper face remained fairly consistent. CONCLUSION Significant detectable differences were found in the surface facial features of developing Class III subjects.
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Affiliation(s)
- Ama Johal
- a Institute of Dentistry, Bart's and The London School of Medicine and Dentistry , Queen Mary University of London , UK
| | - Amrit Chaggar
- a Institute of Dentistry, Bart's and The London School of Medicine and Dentistry , Queen Mary University of London , UK
| | - Li Fong Zou
- a Institute of Dentistry, Bart's and The London School of Medicine and Dentistry , Queen Mary University of London , UK
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Thiesen G, Gribel BF, Freitas MPM, Oliver DR, Kim KB. Craniofacial features affecting mandibular asymmetries in skeletal Class II patients. J Orofac Orthop 2017; 78:437-445. [PMID: 28667433 DOI: 10.1007/s00056-017-0100-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/14/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the characteristics affecting different intensities of mandibular asymmetry in skeletal Class II adults using three-dimensional images. This study is clinically relevant since it allows professionals to evaluate the morphological components related to these deformities and more carefully obtain correct diagnosis and treatment plan for such patients. METHODS Cone-beam computed tomography data of 120 Class II patients (40 with relative symmetry, 40 with moderate asymmetry, and 40 with severe asymmetry) were imported to SimPlant Ortho Pro® 2.0 software (Dental Materialise, Leuven, Belgium). Three reference planes were established and linear measurements were performed from specific landmarks to these planes, comparing the deviated side and the contralateral side in each group, as well as the differences between groups. The correlation between midline mandibular asymmetry and other variables was also evaluated. Statistical analyses considered a significance level of 5%. RESULTS Comparing the values obtained on the deviated side and on the contralateral side, there were significant differences for patients with moderate asymmetry and severe asymmetry. However, differences were seen more often in severe mandibular asymmetries. In those patients, there was a significant correlation of the gnathion deviation with lower dental midline deviation, difference in the lateral gonion positions, difference in the mandibular rami heights, and difference in the jugale vertical displacements. CONCLUSIONS For skeletal Class II patients with mandibular asymmetry, some craniofacial features are related to chin deviation and require proper evaluation, including the bilateral differences in the ramus height, mandibular body length, transverse and vertical positioning of the gonion and jugale points.
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Affiliation(s)
- Guilherme Thiesen
- Department of Orthodontics, University of Southern Santa Catarina, Av. Madre Benvenuta, 1285 Santa Monica, 88035-001, Florianopolis, SC, Brazil.
- Department of Orthodontics, Saint Louis University, St. Louis, MO, USA.
| | | | - M P M Freitas
- Department of Orthodontics, Luteran University of Brazil, Canoas, Brazil
| | - D R Oliver
- Department of Orthodontics, Saint Louis University, St. Louis, MO, USA
| | - K B Kim
- Department of Orthodontics, Saint Louis University, St. Louis, MO, USA
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Krneta B, Zhurov A, Richmond S, Ovsenik M. Diagnosis of Class III malocclusion in 7- to 8-year-old children--a 3D evaluation. Eur J Orthod 2014; 37:379-85. [PMID: 25336564 DOI: 10.1093/ejo/cju059] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to characterize facial and jaw morphology of children with Class III malocclusion in early mixed dentition. METHODS This study was conducted on 7- to 8-year-old Caucasian children, 48 children with Class III malocclusion and 91 children with normal occlusion. Surface images of faces and study casts were obtained using laser scanning. Two average facial templates were constructed for the males and females in the control group. The facial images were superimposed on the corresponding average templates. Facial parameters, palatal volumes, and gingival surface areas were measured and group differences were quantified. The analysis of variance was used for statistical evaluation of the measured parameters. RESULTS The results revealed shorter lower face height (P < 0.001), concave facial profile (P < 0.001), retruded maxilla (P < 0.001), protruded mandible (P < 0.001), retrusive mid-face restricted area (P < 0.001), reduced gingival surface area of the maxilla (P = 0.013), and reduced maxilla/mandible gingival surface area ratio (P < 0.001) in the Class III group compared to the control group. There were no differences between the groups in upper face height, restricted areas of the upper and lower face, palatal volume, and gingival surface area of the mandible (P > 0.05). LIMITATIONS Regardless of the fact that the prevalence of Class III malocclusion is rather small, the sample size could be larger. CONCLUSIONS Class III subjects show clinically relevant facial and jaws characteristics in pre-pubertal growth period. A comprehensive diagnosis should include transverse dimension analysis.
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Affiliation(s)
- Bojana Krneta
- *Department of Dental and Jaw Orthopaedics, Medical Faculty, University of Ljubljana, Slovenia
| | - Alexei Zhurov
- **Dental Health and Biological Sciences, Dental school, Cardiff University, Cardiff, UK
| | - Stephen Richmond
- **Dental Health and Biological Sciences, Dental school, Cardiff University, Cardiff, UK
| | - Maja Ovsenik
- *Department of Dental and Jaw Orthopaedics, Medical Faculty, University of Ljubljana, Slovenia,
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