1
|
Blasi A, Nucera R, Ronsivalle V, Candida E, Grippaudo C. Asymmetry index for the photogrammetric assessment of facial asymmetry. Am J Orthod Dentofacial Orthop 2022; 162:394-402. [PMID: 35562291 DOI: 10.1016/j.ajodo.2021.04.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/04/2021] [Accepted: 04/04/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Facial asymmetry is common and can be clinically related to dental malocclusion, facial bone development, muscular imbalance, and soft tissues thickness, which should be assessed during diagnosis to choose proper treatment options. This study aimed to quantify the amount of symmetry/asymmetry in previously defined symmetrical and asymmetrical subjects, analyzing full-face 3-dimensional images. METHODS Seventy-six orthodontic patients' 3-dimensional face images were obtained with the 3dMD Trio-system (Atlanta, Ga) and processed with the Geomagic Control (64-bit; 3D Systems, Rock Hill, SC) software. Patients were divided into symmetrical and asymmetrical groups through a surface-based technique. Sixteen facial landmarks were positioned, an asymmetry index was calculated for each landmark, and an evaluation diagram of facial asymmetry was created through the asymmetry index mean and standard deviation of symmetrical and asymmetrical landmarks. RESULTS The asymmetry index mean varied from 0.05 to 1.51 in the symmetrical group and from 0.05 to 2.84 in the asymmetrical group. This study suggests that landmarks located in the lower third of the face have a greater asymmetry index than other landmarks. CONCLUSIONS The landmark-based technique does not exhibit statistically significant differences among asymmetrical and symmetrical patients for some landmarks. This approach provides useful information about the localization and the extension of asymmetry, in which bilateral landmarks showed a higher amount of asymmetry than median landmarks.
Collapse
Affiliation(s)
- Anna Blasi
- Head and Neck Department, IRCCS Fondazione Policlinico "A. Gemelli," Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Nucera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Messina, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, University of Catania, Catania, Italy
| | - Ettore Candida
- Head and Neck Department, IRCCS Fondazione Policlinico "A. Gemelli," Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Cristina Grippaudo
- Head and Neck Department, IRCCS Fondazione Policlinico "A. Gemelli," Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
2
|
Pedersoli L, Dalessandri D, Tonni I, Bindi M, Isola G, Oliva B, Visconti L, Bonetti S. Facial Asymmetry Detected with 3D Methods in Orthodontics: A Systematic Review. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2111251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Historically, the development of two-dimensional (2D) imaging techniquesforerun that of three-dimensional (3D) ones. Some 2D methods are still considered valid and effective to diagnose facial asymmetry but 3D techniques may provide more precise and accurate measurements.
Objective:
The aim of this work is to analyze the accuracy and reliability of the imaging techniques available for the diagnosis of facial asymmetry in orthodontics and find the most reliable.
Methods:
A search strategy was implemented using PubMed (National Library of Medicine, NCBI).
Results:
A total of 3201 papers were identified in electronic searches. 90 articles, available in full text, were included in the qualitative synthesis consisting of 8 reviews on the diagnosis of facial asymmetry, 22 in vivo and in vitro studies on 2D methods and 60 in vivo and in vitro studies on 3D methods to quantify the asymmetry.
Conclusion:
2D techniques include X-ray techniques such as posterior-anterior cephalogram, which still represents the first level exam in the diagnosis of facial asymmetry. 3D techniques represent the second level exam in the diagnosis of facial asymmetry. The most current used techniques are CBCT, stereophotogrammetry, laser scanning, 3D optical sensors and contact digitization. The comparison between bilateral parameters (linear distances, angles, areas, volumes and contours) and the calculation of an asymmetry index represent the best choices for clinicians who use CBCT. The creation of a color-coded distance map seems to represent the most accurate, reliable and validated methods for clinicians who use stereophotogrammetry, laser scanning and 3D optical sensors.
Collapse
|
3
|
Ha SW, Kim SJ, Choi JY, Baek SH. Characterization of facial asymmetry phenotypes in adult patients with skeletal Class III malocclusion using three-dimensional computed tomography and cluster analysis. Korean J Orthod 2022; 52:85-101. [PMID: 35321948 PMCID: PMC8964472 DOI: 10.4041/kjod.2022.52.2.85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/22/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To classify facial asymmetry (FA) phenotypes in adult patients with skeletal Class III (C-III) malocclusion. Methods A total of 120 C-III patients who underwent orthognathic surgery (OGS) and whose three-dimensional computed tomography images were taken one month prior to OGS were evaluated. Thirty hard tissue landmarks were identified. After measurement of 22 variables, including cant (°, mm), shift (mm), and yaw (°) of the maxilla, maxillary dentition (Max-dent), mandibular dentition, mandible, and mandibular border (Man-border) and differences in the frontal ramus angle (FRA, °) and ramus height (RH, mm), K-means cluster analysis was conducted using three variables (cant in the Max-dent [mm] and shift [mm] and yaw [°] in the Man-border). Statistical analyses were conducted to characterize the differences in the FA variables among the clusters. Results The FA phenotypes were classified into five types 1) non-asymmetry type (35.8%); 2) maxillary-cant type (14.2%; severe cant of the Max-dent, mild shift of the Man-border); 3) mandibular-shift and yaw type (16.7%; moderate shift and yaw of the Man-border, mild RH-difference); 4) complex type (9.2%; severe cant of the Max-dent, moderate cant, severe shift, and severe yaw of the Man-border, moderate differences in FRA and RH); and 5) maxillary reverse-cant type (24.2%; reverse-cant of the Max-dent). Strategic decompensation by pre-surgical orthodontic treatment and considerations for OGS planning were proposed according to the FA phenotypes. Conclusions This FA phenotype classification may be an effective tool for differential diagnosis and surgical planning for Class III patients with FA.
Collapse
|
4
|
Jaiswal P, Gandhi A, Gupta AR, Malik N, Singh SK, Ramesh K. Reliability of Photogrammetric Landmarks to the Conventional Cephalogram for Analyzing Soft-Tissue Landmarks in Orthodontics. J Pharm Bioallied Sci 2021; 13:S171-S175. [PMID: 34447068 PMCID: PMC8375858 DOI: 10.4103/jpbs.jpbs_634_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/03/2020] [Accepted: 10/04/2020] [Indexed: 11/04/2022] Open
Abstract
Background Graber introduced facial photographs as an internal diagnostic aid. Facial photographs could serve as an important alternative assessment tool in the absence of equipment for cephalometric analysis. Objectives The present study was aimed at assessing whether analyzing the photographs could have precision for assessing the landmarks appropriate for facial analysis. In addition, the relationship between frontal cephalogram and measurements on photographs was assessed. Materials and Methods Twenty individuals including both males and females within the age range of 18 years to 28 years were enrolled in the study. Frontal facial photographs, as well as frontal cephalograms, were obtained for all the included study participants. Various soft-tissue vertical and horizontal landmarks were marked on both radiographs and photographs. The data were collected and subjected to statistical analysis. Results The results showed a statistically insignificant difference between all the vertical and horizontal parameters on photographs and cephalograms. The reliability of the digital photographs was comparable to that of the cephalograms with nonsignificant differences in the recorded mean values using the one-way ANOVA test where the statistical significance level was kept at P ≤ 0.05. Conclusion The present study concluded that photography is a cost-effective and reliable method for soft-tissue landmark identification, and allows recording the images of sufficient quantity for analysis. Low-cost and easily captured photographic images can replace costly radiographic procedures without causing any discomfort to the patients.
Collapse
Affiliation(s)
- Pragya Jaiswal
- Depatment of Dentistry, Bharat Ratna Late Shri Atal Bihari Vajpayee Memorial Government Medical College, Rajnandgaon, Chhattisgarh, India
| | - Aniruddha Gandhi
- Depatment of Dentistry, Bharat Ratna Late Shri Atal Bihari Vajpayee Memorial Government Medical College, Rajnandgaon, Chhattisgarh, India
| | - Abhinav Raj Gupta
- Consultant Orthodontist, GS Memorial Plastic Surgery Hospital and Trauma Center, Patna, Bihar, India
| | - Nidhi Malik
- Department of Orthodontics, Mithila Minority Dental College, Darbhanga, Bihar, India
| | - Sanjay Kumar Singh
- Department of Orthodontics and Orthopedics, Patna Medical College and Hospital, Patna, Bihar, India
| | - Kumar Ramesh
- Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India
| |
Collapse
|
5
|
Morgan N, Suryani I, Shujaat S, Jacobs R. Three-dimensional facial hard tissue symmetry in a healthy Caucasian population group: a systematic review. Clin Oral Investig 2021; 25:6081-6092. [PMID: 34386858 DOI: 10.1007/s00784-021-04126-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/03/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to quantify the symmetry of the facial hard tissue structures using three-dimensional radiographic imaging modalities in a normal Caucasian population group. MATERIALS AND METHODS Electronic literature search was conducted in the following databases: PubMed, Embase, Web of Science, and Cochrane Library up to February 2021. The studies assessing symmetry of facial bones using computed tomography (CT) and cone beam CT were included. RESULTS The initial search revealed 8811 studies. Full-text analysis was performed on 33 studies. Only 10 studies were found eligible based on the inclusion criteria. The qualitative analysis revealed that a significant variability existed in relation to the methodologies applied for symmetry quantification. CONCLUSION The current review suggested that the overall relative symmetry of the normal Caucasian population group varied depending on the skeletal structure being assessed; however, majority of the observations showed a symmetry within the range of 1 mm without any significant difference between left and right sides. CLINICAL RELEVANCE The quantification of facial hard tissue structure symmetry is vital for the diagnosis and treatment planning of orthodontic and/or maxillofacial surgical procedures. Prospero registration number CRD42020169908.
Collapse
Affiliation(s)
- Nermin Morgan
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.
- Department of Oral Medicine, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | - Isti Suryani
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
6
|
Three-dimensional acquisition technologies for facial soft tissues – Applications and prospects in orthognathic surgery. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:721-728. [DOI: 10.1016/j.jormas.2020.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 11/23/2022]
|
7
|
Ortún-Terrazas J, Fagan MJ, Cegoñino J, Illipronti-Filho E, Pérez Del Palomar A. Towards an early 3D-diagnosis of craniofacial asymmetry by computing the accurate midplane: A PCA-based method. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 191:105397. [PMID: 32092615 DOI: 10.1016/j.cmpb.2020.105397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/11/2020] [Accepted: 02/13/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Craniofacial asymmetry is a common growth disorder often caused by unilateral chewing. Although an early orthodontic treatment would avoid surgical procedures later in life, the uncertainty of defining the accurate sagittal midplane potentially leads to misdiagnosis and therefore inaccurate orthodontic treatment plans. This novel study aims to 3D-diagnose craniofacial complex malformations in children with unilateral crossbite (UXB) considering a midplane which compensates the asymmetric morphology. METHODS The sagittal midplane of 20 children, fifteen of whom exhibited UXB, was computed by a PCA-based method which compensates the asymmetry mirroring the 3D models obtained from cone-beam computed tomography data. Once determined, one side of the data was mirrored using the computed midplane to visualize the malformations on the hard and soft tissues by 3D-computing the distances between both halves. Additionally, 31 skull's landmarks were manually placed in each model to study the principal variation modes and the significant differences in the group of subjects with and without UXB through PCA and Mann-Whitney U test analyses respectively. RESULTS Morphological 3D-analysis showed pronounced deformities and aesthetic implications for patients with severe asymmetry (jaw deviation > 0.8 mm) in whole craniofacial system, while initial signs of asymmetry were found indistinctly in the mandible or maxilla. We detected significant (p < 0.05) malformations for example in mandibular ramus length (0.0086), maxillary palate width (0.0481) and condylar head width (0.0408). Craniofacial malformations increased the landmarks' variability in the group of patients with UXB over the control group requiring 8 variation modes more to define 99% of the sample' variability. CONCLUSIONS Our findings demonstrated the viability of early diagnosis of craniofacial asymmetry through computing the accurate sagittal midplane which compensates the individual's asymmetrical morphology. Furthermore, this study provides important computational insights into the determination of craniofacial deformities which are caused by UXB, following some empirical findings of previous clinical studies. Hence, this computational approach can be useful for the development of new software in craniofacial surgery or for its use in biomedical research and clinical practice.
Collapse
Affiliation(s)
- Javier Ortún-Terrazas
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain.
| | - Michael J Fagan
- Medical and Biological Engineering, School of Engineering and Computer Science, University of Hull, Hull, United Kingdom
| | - Jose Cegoñino
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Edson Illipronti-Filho
- School of Dentistry, Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil
| | - Amaya Pérez Del Palomar
- Group of Biomaterials, Aragon Institute of Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
8
|
The Effect of Orthognathic Surgery on Soft-Tissue Facial Asymmetry: A Longitudinal Three-Dimensional Analysis. J Craniofac Surg 2020; 31:1578-1582. [PMID: 32282669 DOI: 10.1097/scs.0000000000006403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In modern orthognathic surgery, the functional results cannot disregard a good aesthetic outcome. In this study, a stereophotogrammetric longitudinal analysis of the symmetry of facial thirds was performed in 18 patients affected by Class III skeletal malocclusion, with clinical asymmetry, treated with a bimaxillary osteotomy. Their 3-dimensional facial images were acquired in the preoperative phase and 6, 12, and 24 months after surgery, and compared to those obtained in a control group of 23 subjects with Class I skeletal occlusion, without clinical asymmetry and no history of traumas or alterations at the maxillo-facial area. Images of the hemi-faces of the subjects were divided into thirds (upper, middle, lower), mirrored and superimposed to their contralateral ones; soft-tissue facial symmetry was obtained as the root mean square distance between the hemi-faces in the three thirds.In patients, no significant differences in facial symmetry (root mean square distance) were found among the study time points (analysis of variance, P > 0.05); the lower facial third was more asymmetric than the upper one (Tukey honestly significant difference P < 0.05). Patients were significantly more asymmetric than the control subjects (Student t, P < 0.05). In conclusion, patients with Class III malocclusion exhibited a higher level of facial asymmetry than control subjects; their asymmetry did not change significantly in the different phases of the surgical and orthodontic treatment and throughout a 24-month follow-up. In skeletal Class III patients, bimaxillary osteotomy did not modify the level of asymmetry in any facial third.
Collapse
|
9
|
Vandekerckhove D, Deibel D, Vinayahalingam S, Claeys G, Kwon TG, Bergé S, Xi T. Median Lingual Foramen, a new midmandibular cephalometric landmark. Orthod Craniofac Res 2020; 23:357-361. [PMID: 32096318 PMCID: PMC7496480 DOI: 10.1111/ocr.12372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/03/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Abstract
Purpose In asymmetrical mandibles, it is often challenging to identify the mandibular midline. The median lingual foramen (MLF) is located at the midline of the anterior mandible. The purpose of this study is to evaluate the reproducibility of identifying the MLF compared to conventional landmarks on cone beam computed tomography's (CBCT's) to mark the mandibular midline. Material and Methods Ten symmetrical class II, 10 symmetrical class III, ten asymmetrical class II and 10 asymmetrical class III patients were included. On CBCTs, the cephalometric landmarks menton, pogonion, genial tubercle and MLF were identified twice by two observers. Results A high intra‐ and interobserver reproducibility was found for all landmarks, the highest being the MLF. The gain in accuracy is 0.998 mm, 0.824 mm and 0.361 mm compared to pogonion, genial tubercle and menton, respectively (P‐value <.05). Conclusion MLF is a reliable and reproducible landmark to indicate the midline of the mandible, particularly in Class II asymmetric mandibles.
Collapse
Affiliation(s)
- David Vandekerckhove
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Dionne Deibel
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Gilles Claeys
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tae-Geon Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
10
|
Chen S, Wang L, Li G, Wu TH, Diachina S, Tejera B, Kwon JJ, Lin FC, Lee YT, Xu T, Shen D, Ko CC. Machine learning in orthodontics: Introducing a 3D auto-segmentation and auto-landmark finder of CBCT images to assess maxillary constriction in unilateral impacted canine patients. Angle Orthod 2020; 90:77-84. [PMID: 31403836 PMCID: PMC8087054 DOI: 10.2319/012919-59.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/01/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To (1) introduce a novel machine learning method and (2) assess maxillary structure variation in unilateral canine impaction for advancing clinically viable information. MATERIALS AND METHODS A machine learning algorithm utilizing Learning-based multi-source IntegratioN frameworK for Segmentation (LINKS) was used with cone-beam computed tomography (CBCT) images to quantify volumetric skeletal maxilla discrepancies of 30 study group (SG) patients with unilaterally impacted maxillary canines and 30 healthy control group (CG) subjects. Fully automatic segmentation was implemented for maxilla isolation, and maxillary volumetric and linear measurements were performed. Analysis of variance was used for statistical evaluation. RESULTS Maxillary structure was successfully auto-segmented, with an average dice ratio of 0.80 for three-dimensional image segmentations and a minimal mean difference of two voxels on the midsagittal plane for digitized landmarks between the manually identified and the machine learning-based (LINKS) methods. No significant difference in bone volume was found between impaction ([2.37 ± 0.34] [Formula: see text] 104 mm3) and nonimpaction ([2.36 ± 0.35] [Formula: see text] 104 mm3) sides of SG. The SG maxillae had significantly smaller volumes, widths, heights, and depths (P < .05) than CG. CONCLUSIONS The data suggest that palatal expansion could be beneficial for those with unilateral canine impaction, as underdevelopment of the maxilla often accompanies that condition in the early teen years. Fast and efficient CBCT image segmentation will allow large clinical data sets to be analyzed effectively.
Collapse
|
11
|
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: 10] [Impact Index Per Article: 2.0] [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.
Collapse
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
| |
Collapse
|
12
|
Surgical correction of the midface in craniofacial microsomia. Part 1: A systematic review. J Craniomaxillofac Surg 2018; 46:1427-1435. [DOI: 10.1016/j.jcms.2018.05.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 04/23/2018] [Accepted: 05/22/2018] [Indexed: 12/30/2022] Open
|
13
|
Guo J, Wang T, Han JJ, Jung S, Kook MS, Park HJ, Oh HK. Corrective outcome and transverse stability after orthognathic surgery using a surgery-first approach in mandibular prognathism with and without facial asymmetry. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:S2212-4403(18)30053-1. [PMID: 29545077 DOI: 10.1016/j.oooo.2018.01.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/06/2017] [Accepted: 01/20/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate corrective outcome and transverse stability after orthognathic surgery via a surgery-first approach (SFA) in mandibular prognathism with and without facial asymmetry using 3-dimensional analysis. STUDY DESIGN Twenty-nine patients who received mandibular setback surgery using SFA were divided into 2 groups according to the menton deviation (4 mm): symmetry group (n = 17) and asymmetry group (n = 12). Using computed tomography images obtained before (T0), immediately after (T1), and 6 months after (T2) surgery, time-dependent changes in variables related to facial asymmetry, including maxillary height, ramal length, frontal and lateral ramal inclination, mandibular body length, and mandibular body height, were evaluated. RESULTS Immediately after surgery, the asymmetry group showed significantly decreased discrepancies between the longer and non-longer sides for all variables (P < .05); there were no significant differences in discrepancies between the 2 groups. During the postoperative period, no significant changes in discrepancies were found in any variable in either group. Compared with T0, the asymmetry group showed significantly decreased discrepancies in ramal length, frontal and lateral ramal inclination, and mandibular body length at T2. CONCLUSIONS Variables related to facial asymmetry showed significant improvement after surgical-orthodontic treatment using SFA, and corrected outcomes showed good postoperative stability in both the symmetry and asymmetry groups.
Collapse
Affiliation(s)
- Jinyuan Guo
- Graduate Dental School, Chonnam National University, Gwangju, Republic of Korea
| | - Tongyue Wang
- Department of Oral and Maxillofacial Surgery, Dalian Medical University, Dalian, PR China
| | - Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea.
| | - Seunggon Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Min-Suk Kook
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Hong-Ju Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Hee-Kyun Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| |
Collapse
|
14
|
Piral T, Umana M. Place des endoprothèses chez les patients présentant une asymétrie complexe : à propos d’un cas clinique. Int Orthod 2017; 15:199-207. [DOI: 10.1016/j.ortho.2017.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Umana M, Piral T. The use of endoprotheses for patients with complex asymmetry: A clinical case study. Int Orthod 2017; 15:199-207. [PMID: 28434895 DOI: 10.1016/j.ortho.2017.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Facial asymmetry requires multidisciplinary management. In some cases, predictable problems due to congenital abnormalities can be corrected by early orthodontic treatment. Orthodontics is nevertheless often part of an orthosurgical treatment plan. The solutions are conventional and familiar: maxillomandibular rotation osteotomy and genioplasty. Many cases can be treated in this way, but there is often persistent residual asymmetry due to loss of volume that is not corrected by these techniques. The use of maxillo-acial endoprostheses designed on the basis of three-dimensional craniofacial analyses can rebalance volumes simply and with due regard to the patient's anatomy. This multistage management will be illustrated here through a complex clinical case.
Collapse
Affiliation(s)
- Mónica Umana
- 50, avenue Raymond-Poincaré, 75116 Paris, France.
| | | |
Collapse
|