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Mladenovic M, Freezer S, Dreyer C, Meade MJ. The orthodontic extraction of second premolars: The influence on airway volume. Am J Orthod Dentofacial Orthop 2024:S0889-5406(24)00112-4. [PMID: 38678455 DOI: 10.1016/j.ajodo.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION The extraction of second premolars and associated changes in the volume of the airway have not been previously explored. This retrospective study aimed to compare the volumetric changes of the airway preorthodontic and postorthodontic treatment in relevant extraction and control samples and to identify variables that may influence the outcome. METHODS Cone-beam computed radiography scans of 54 patients with second premolar extraction and 59 nonextraction patients treated in a private orthodontic practice were matched for crowding. The average age for both samples was 15 years. The images were individually landmarked and measured by applying volumetric, linear, and angular parameters. The results were analyzed using repeated measures, such as variance analysis, correlation testing, and regression statistical analyses. RESULTS There was a statistically significant increase in the airway volume for both groups (P <0.05). The difference in increase between the groups was not statistically significant. Seven variables demonstrated a collectively significant effect on changes to airway volume (F[7,112] = 38.48; P <0.001; r2 = 0.701), with 70% of the variation predicted by the variables. Multiple regression analyses indicated that changes to the area of minimum constriction (B = 32.45; t = 11.95; P <0.001) and changes to airway length (B = 94.75; t = 7.79; P <0.001) had a statistically significant effect on airway volume. CONCLUSIONS The volume of the airway increased in both the extraction and nonextraction samples. The biggest contributors to the increase were an increase in airway length and an increase in the area of minimum constriction, which likely occurred as a result of natural growth.
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Affiliation(s)
- Miodrag Mladenovic
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Simon Freezer
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Craig Dreyer
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Maurice J Meade
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
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Ahn HJ, Byun SH, Baek SH, Park SY, Yi SM, Park IY, On SW, Kim JC, Yang BE. A Comparative Analysis of Artificial Intelligence and Manual Methods for Three-Dimensional Anatomical Landmark Identification in Dentofacial Treatment Planning. Bioengineering (Basel) 2024; 11:318. [PMID: 38671740 PMCID: PMC11048285 DOI: 10.3390/bioengineering11040318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
With the growing demand for orthognathic surgery and other facial treatments, the accurate identification of anatomical landmarks has become crucial. Recent advancements have shifted towards using three-dimensional radiologic analysis instead of traditional two-dimensional methods, as it allows for more precise treatment planning, primarily relying on direct identification by clinicians. However, manual tracing can be time-consuming, mainly when dealing with a large number of patients. This study compared the accuracy and reliability of identifying anatomical landmarks using artificial intelligence (AI) and manual identification. Thirty patients over 19 years old who underwent pre-orthodontic and orthognathic surgery treatment and had pre-orthodontic three-dimensional radiologic scans were selected. Thirteen anatomical indicators were identified using both AI and manual methods. The landmarks were identified by AI and four experienced clinicians, and multiple ANOVA was performed to analyze the results. The study results revealed minimal significant differences between AI and manual tracing, with a maximum deviation of less than 2.83 mm. This indicates that utilizing AI to identify anatomical landmarks can be a reliable method in planning orthognathic surgery. Our findings suggest that using AI for anatomical landmark identification can enhance treatment accuracy and reliability, ultimately benefiting clinicians and patients.
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Affiliation(s)
- Hee-Ju Ahn
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sae-Hoon Baek
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sang-Yoon Park
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sang-Min Yi
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - In-Young Park
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
- Department of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
| | - Sung-Woon On
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hallym University Dongtan Sacred Heart Hospital, Hawseong 18450, Republic of Korea
| | - Jong-Cheol Kim
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Mir Dental Hospital, Daegu 41940, Republic of Korea
| | - Byoung-Eun Yang
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea; (H.-J.A.); (S.-H.B.); (S.-H.B.); (S.-Y.P.); (S.-M.Y.); (J.-C.K.)
- Department of Artificial Intelligence and Robotics in Dentistry, Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea; (I.-Y.P.); (S.-W.O.)
- Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, Republic of Korea
- Dental Artificial Intelligence and Robotics R&D Center, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
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Mladenovic M, Freezer S, Dreyer C, Meade MJ. Influence of second premolar extractions on the volume of the oral cavity proper: a control comparative cone-beam computed tomography volumetric analysis study. Angle Orthod 2024; 94:31-38. [PMID: 38145620 DOI: 10.2319/031023-164.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/01/2023] [Indexed: 12/27/2023] Open
Abstract
OBJECTIVES To compare the pre- and postorthodontic treatment volumetric changes of the oral cavity proper (OCP) in extraction and nonextraction patients and to identify influencing variables. MATERIALS AND METHODS Pre- and posttreatment cone-beam computed tomography (CBCT) scans of patients undergoing orthodontic treatment with fixed labial appliances and who satisfied the inclusion criteria were individually landmarked. Linear, angular, and volumetric measurements were determined. Descriptive statistics, repeated measure analyses of variance, correlations, and stepwise regression statistical analyses were applied. RESULTS The CBCT scans of 54 patients who underwent the extraction of second premolars and/or extraction of second primary molars associated with agenic second premolars, and 59 nonextraction patients matched for crowding, were assessed. The mean age for both groups was 15 years. There was a statistically significant increase in the volume of the OCP for both the extraction and nonextraction groups, with the nonextraction group demonstrating a larger increase in the volume of the OCP. Gender, age, changes in mandibular and maxillary arch length, and changes in mandibular and maxillary intermolar width all influenced the change in the OCP volume. CONCLUSIONS The volume of the OCP increased in growing patients with and without the extraction of the second premolars and/or extraction of second primary molars associated with agenic second premolars. Patients who did not have extractions as part of their orthodontic treatment demonstrated a greater overall increase in OCP volume.
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Sánchez-Ayala A, Sánchez-Ayala A, Kolodzejezyk RC, Urban VM, Lagravère MÓ, Campanha NH. A three-dimensional method to calculate mechanical advantage in mandibular function : Intra- and interexaminer reliability study. J Orofac Orthop 2023; 84:321-339. [PMID: 35254453 DOI: 10.1007/s00056-022-00378-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Masticatory muscles are physically affected by several skeletal features. The muscle performance depends on muscle size, intrinsic strength, fiber direction, moment arm, and neuromuscular control. To date, for the masticatory apparatus, only a two-dimensional cephalometric method for assessing the mechanical advantage, which is a measure for the ratio of the output force to the input force in a system, is available. This study determined the reliability and errors of a three-dimensional (3D) mechanical advantage calculation for the masticatory system. METHODS Using cone-beam computed tomography images from teenage patients undergoing orthodontic treatments, 36 craniofacial landmarks were identified, and the moment arms for seven muscles and their load moment arms (biomechanical variables) were determined. The 3D mechanical advantage for each muscle was calculated. This procedure was repeated by three examiners. Reliability was verified using the intraclass correlation coefficient (ICC) and the errors by calculating the absolute differences, variance estimator and coefficient of variation (CV). RESULTS Landmark coordinates demonstrated excellent intra- and interexaminer reliability (ICC 0.998-1.000; p < 0.0001). Intraexaminer data showed errors < 1.5 mm. Unsatisfactory interexaminer errors ranged from 1.51-5.83 mm. All biomechanical variables presented excellent intraexaminer reliability (ICC 0.919-1.000, p < 0.0001; CV < 7%). Interexaminer results were almost excellent, but with lower values (ICC 0.750-1.000, p < 0.0001; CV < 10%). However, the muscle moment arm and 3D mechanical advantage of the lateral pterygoid muscles had ICCs < 0.500 (p < 0.05) and CV < 30%. Intra- and interexaminer errors were ≤ 0.01 and ≤ 0.05, respectively. CONCLUSIONS Both landmarks and biomechanical variables showed high reliability and acceptable errors. The proposed method is viable for the 3D mechanical advantage measure.
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Affiliation(s)
- Alejandro Sánchez-Ayala
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Alfonso Sánchez-Ayala
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil.
| | - Rafaela Cristina Kolodzejezyk
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Vanessa Migliorini Urban
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Manuel Óscar Lagravère
- Department of Dentistry, University of Ponta Grossa, Avenida General Carlos Cavalcanti n° 4748, Bloco M, Sala 64A, 84030-900, Ponta Grossa, Paraná, Brazil
| | - Nara Hellen Campanha
- Orthodontic Graduate Program, University of Alberta, 116 St & 85 Ave, T6G 2R3, Edmonton, Alberta, Canada
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Farouk K, Eissa O, Ghoneima A, El-Bedwehi A, Abdel-Fattah E, Hussein F, El-Bialy T. Treatment effects of Herbst appliance in skeletal Class II cases during pre-pubertal and post-pubertal periods: a cone-beam computed tomographic study. Sci Rep 2023; 13:11342. [PMID: 37443323 PMCID: PMC10344919 DOI: 10.1038/s41598-023-37394-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
In the present study, Thirty-six Class patients II (A condition in which the upper jaw is larger than the lower jaw) were randomly selected and assigned to one of two groups based on their maturation stage: the pre-pubertal group (18 patients, mean age 9.15 ± 1.5 years) and post-pubertal group (18 patients, mean age 16.3 ± 1.0 years). All patients were treated with a metallic splint-supported Herbst IV appliance (An appliance that acts like artificial joint working between the upper and power jaws that keeps the lower jaw in a forward position, thus improving the Class II condition). Pretreatment (T1) and post-Herbst IV treatment (T2) scans were obtained for both groups. Dental and skeletal measurements were made on the scans and statistically analyzed using paired and independent t-tests. The study hypothesis was that; the dentoskeletal changes in Class II malocclusion treatment using Herbst appliance in the Pre-pubertal is more than the Post-pubertal growth stage due to the remaining growth potential for the pre-pubertal patients. The comparison between the two groups revealed statistically significant differences in horizontal skeletal parameters in the lower jaw only, while other readings were similar.
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Affiliation(s)
- Khaled Farouk
- Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt.
- Faculty of Medicine and Dentistry, 7-020D Katz Group Centre for Pharmacy and Health Research University of Alberta, Edmonton, Canada.
| | - Osama Eissa
- Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Ahmed Ghoneima
- Department of Orthodontics and Oral Facial Genetics, School of Dentistry, Indiana University, Indianapolis, USA
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
| | - Ashraf El-Bedwehi
- Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Ezzat Abdel-Fattah
- Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Farouk Hussein
- Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Tarek El-Bialy
- Faculty of Medicine and Dentistry, 7-020D Katz Group Centre for Pharmacy and Health Research University of Alberta, Edmonton, Canada
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Duangsuwan J, Raocharernporn S, Thiradilok S, Manopatanakul S. Computerized three-dimensional cephalometric template for Thai adults. Heliyon 2023; 9:e15077. [PMID: 37095961 PMCID: PMC10121791 DOI: 10.1016/j.heliyon.2023.e15077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/04/2023] Open
Abstract
Cephalometry is essential in several fields of study. These include health science, anthropology, and forensic studies. Furthermore, cephalometric norms are essential for numerous disciplines in the health sciences, such as clinical anatomy, plastic surgery, pediatrics, pediatric dentistry, orthodontics, oral and maxillofacial surgery, and forensic medicine. Three-dimensional (3D) cephalometric templates offer an advanced but simple method for these specialties. This study aimed to establish cephalometric norms by developing 3D templates for Thai adults, based on cephalometric landmark coordinates obtained from skull cone-beam computed tomography (CBCT) scans of individuals with normal skeletal patterns. Full-head CBCT scans of 45 individuals (20 men and 25 women) were obtained from the archive. All had a Class I molar relationship with minor crowded teeth. The scans were captured in a normal head position, and the coordinates of 21 important cephalometric landmarks were identified using Slicer 4.10.2 software. Manual affine transformation of all landmarks was used to transfer medical image coordinates (Digital Imaging and Communications in Medicine [DICOM] or Right-Anterior-Superior [RAS] systems) to Cartesian universal coordinates. Intraclass correlation coefficients (ICC) and Bland-Altman (BA) plots were used to assess inter- and intra-examiner reliability (ICC = 0.961-1.000, BA mean errors = -0.1 mm). Important cephalometric measurements were compared to the most relevant and recent study with a sample size of 200. Most measurements showed no statistical difference (one-sample t-test, p > 0.05). Independent samples t-tests revealed that there was no statistically significant difference in the X and Y axes; however, most mean coordinates between men and women in the Z-axis coordinates were statistically significant. Consequently, 3D cephalometric templates were generated separately for adult Thai men and women using landmark coordinates. Although they are available for all disciplines at no cost through QR codes, these templates should be used with care, especially for the upper and lower incisor angulation. The application and future development of each specialty are also described here.
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Hennocq Q, Bongibault T, Bizière M, Delassus O, Douillet M, Cormier-Daire V, Amiel J, Lyonnet S, Marlin S, Rio M, Picard A, Khonsari RH, Garcelon N. An automatic facial landmarking for children with rare diseases. Am J Med Genet A 2023; 191:1210-1221. [PMID: 36714960 DOI: 10.1002/ajmg.a.63126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/31/2023]
Abstract
Two to three thousand syndromes modify facial features: their screening requires the eye of an expert in dysmorphology. A widely used tool in shape characterization is geometric morphometrics based on landmarks, which are precise and reproducible anatomical points. Landmark positioning is user dependent and time consuming. Many automatic landmarking tools are currently available but do not work for children, because they have mainly been trained using photographic databases of healthy adults. Here, we developed a method for building an automatic landmarking pipeline for frontal and lateral facial photographs as well as photographs of external ears. We evaluated the algorithm on patients diagnosed with Treacher Collins (TC) syndrome as it is the most frequent mandibulofacial dysostosis in humans and is clinically recognizable although highly variable in severity. We extracted photographs from the photographic database of the maxillofacial surgery and plastic surgery department of Hôpital Necker-Enfants Malades in Paris, France with the diagnosis of TC syndrome. The control group was built from children admitted for craniofacial trauma or skin lesions. After testing two methods of object detection by bounding boxes, a Haar Cascade-based tool and a Faster Region-based Convolutional Neural Network (Faster R-CNN)-based tool, we evaluated three different automatic annotation algorithms: the patch-based active appearance model (AAM), the holistic AAM, and the constrained local model (CLM). The final error corresponding to the distance between the points placed by automatic annotation and those placed by manual annotation was reported. We included, respectively, 1664, 2044, and 1375 manually annotated frontal, profile, and ear photographs. Object recognition was optimized with the Faster R-CNN-based detector. The best annotation model was the patch-based AAM (p < 0.001 for frontal faces, p = 0.082 for profile faces and p < 0.001 for ears). This automatic annotation model resulted in the same classification performance as manually annotated data. Pretraining on public photographs did not improve the performance of the model. We defined a pipeline to create automatic annotation models adapted to faces with congenital anomalies, an essential prerequisite for research in dysmorphology.
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Affiliation(s)
- Quentin Hennocq
- Imagine Institute, INSERM UMR 1163, Paris, France.,Département de chirurgie maxillo-faciale et chirurgie plastique pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Faculté de Médecine, Université de Paris Cité, Paris, France
| | | | | | | | | | - Valérie Cormier-Daire
- Fédération de médecine génomique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Jeanne Amiel
- Fédération de médecine génomique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Stanislas Lyonnet
- Fédération de médecine génomique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Sandrine Marlin
- Fédération de médecine génomique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Marlène Rio
- Fédération de médecine génomique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Arnaud Picard
- Département de chirurgie maxillo-faciale et chirurgie plastique pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Faculté de Médecine, Université de Paris Cité, Paris, France
| | - Roman Hossein Khonsari
- Département de chirurgie maxillo-faciale et chirurgie plastique pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou, Faculté de Médecine, Université de Paris Cité, Paris, France
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de Bataille C, Bernard D, Dumoncel J, Vaysse F, Cussat-Blanc S, Telmon N, Maret D, Monsarrat P. Machine Learning Analysis of the Anatomical Parameters of the Upper Airway Morphology: A Retrospective Study from Cone-Beam CT Examinations in a French Population. J Clin Med 2022; 12:84. [PMID: 36614885 PMCID: PMC9820916 DOI: 10.3390/jcm12010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
The objective of this study is to assess, using cone-beam CT (CBCT) examinations, the correlation between hard and soft anatomical parameters and their impact on the characteristics of the upper airway using symbolic regression as a machine learning strategy. Methods: On each CBCT, the upper airway was segmented, and 24 anatomical landmarks were positioned to obtain six angles and 19 distances. Some anatomical landmarks were related to soft tissues and others were related to hard tissues. To explore which variables were the most influential to explain the morphology of the upper airway, principal component and symbolic regression analyses were conducted. Results: In total, 60 CBCT were analyzed from subjects with a mean age of 39.5 ± 13.5 years. The intra-observer reproducibility for each variable was between good and excellent. The horizontal soft palate measure mostly contributed to the reduction of the airway volume and minimal section area with a variable importance of around 50%. The tongue and the position of the hyoid bone were also linked to the upper airway morphology. For hard anatomical structures, the anteroposterior position of the mandible and the maxilla had some influence. Conclusions: Although the volume of the airway is not accessible on all CBCT scans performed by dental practitioners, this study demonstrates that a small number of anatomical elements may be markers of the reduction of the upper airway with, potentially, an increased risk of obstructive sleep apnea. This could help the dentist refer the patient to a suitable physician.
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Affiliation(s)
- Caroline de Bataille
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - David Bernard
- Institute of Research in Informatics (IRIT) of Toulouse, CNRS—UMR5505, 31062 Toulouse, France
- RESTORE Research Center, Department of Oral Medicine, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse University Hospital (CHU), Batiment INCERE, 4bis Avenue Hubert Curien, 31100 Toulouse, France
| | - Jean Dumoncel
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
| | - Frédéric Vaysse
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - Sylvain Cussat-Blanc
- Institute of Research in Informatics (IRIT) of Toulouse, CNRS—UMR5505, 31062 Toulouse, France
- Artificial and Natural Intelligence Toulouse Institute ANITI, 31013 Toulouse, France
| | - Norbert Telmon
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, CEDEX 9, 31059 Toulouse, France
| | - Delphine Maret
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - Paul Monsarrat
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
- RESTORE Research Center, Department of Oral Medicine, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse University Hospital (CHU), Batiment INCERE, 4bis Avenue Hubert Curien, 31100 Toulouse, France
- Artificial and Natural Intelligence Toulouse Institute ANITI, 31013 Toulouse, France
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9
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Feng B, Yu X, Wang Y, Ouyang W, Wu F, Yu M, Chen Q. Using the anterior cranial base to provide a reliable reference plane for patients with or without facial asymmetry. Am J Orthod Dentofacial Orthop 2022; 162:e230-e245. [PMID: 36055884 DOI: 10.1016/j.ajodo.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION This study aimed to investigate the midsagittal reference plane (MSP) reliability derived from the 3-dimensional characteristics of patients with or without facial asymmetry in the anterior cranial base (ACB). METHODS We divided the cone-beam computed tomography (CBCT) images of 60 adult patients into maxillofacial symmetry and asymmetry groups. The ACB models were 3-dimensionally constructed, and then symmetrical characteristics were evaluated with surface asymmetry for each group. The reliability of the MSP derived from the symmetry of the anterior cranial base (MSPACB) was assessed in comparison with the true craniofacial symmetry plane determined using the morphometric method. RESULTS The ACB was symmetrical, as demonstrated by slight surface asymmetry. The MSPACB was reliable for maxillofacial asymmetrical analysis as the intraobserver and interobserver measurements using the MSPACB were of excellent agreement, and there was no significant difference between MSPACB and morphometric method in asymmetrical measurements in both groups. The MSPACB remained stable (maximum deviation <0.32 mm) when cranial landmark identification errors (1 mm and 4 mm) were simulated. CONCLUSIONS MSPACB is reliable for patients with or without facial asymmetry in maxillofacial asymmetry analysis, which is beneficial to patients with severe midfacial asymmetry or trauma when conventional landmarks are displaced or disappear. When using MSPACB for patients with cranial malformations or those whose ACBs differ from normal dimensions, caution should be taken.
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Affiliation(s)
- Bin Feng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Xiaowen Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Yang Wang
- Department of Oral Medical Imaging, West China School of Stomatology, Sichuan University, and State Key Laboratory of Oral Diseases, Chengdu, China
| | - Wangtao Ouyang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Fuli Wu
- School of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China.
| | - Mengfei Yu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China.
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
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Dot G, Schouman T, Chang S, Rafflenbeul F, Kerbrat A, Rouch P, Gajny L. Automatic 3-Dimensional Cephalometric Landmarking via Deep Learning. J Dent Res 2022; 101:1380-1387. [PMID: 35982646 DOI: 10.1177/00220345221112333] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The increasing use of 3-dimensional (3D) imaging by orthodontists and maxillofacial surgeons to assess complex dentofacial deformities and plan orthognathic surgeries implies a critical need for 3D cephalometric analysis. Although promising methods were suggested to localize 3D landmarks automatically, concerns about robustness and generalizability restrain their clinical use. Consequently, highly trained operators remain needed to perform manual landmarking. In this retrospective diagnostic study, we aimed to train and evaluate a deep learning (DL) pipeline based on SpatialConfiguration-Net for automatic localization of 3D cephalometric landmarks on computed tomography (CT) scans. A retrospective sample of consecutive presurgical CT scans was randomly distributed between a training/validation set (n = 160) and a test set (n = 38). The reference data consisted of 33 landmarks, manually localized once by 1 operator(n = 178) or twice by 3 operators (n = 20, test set only). After inference on the test set, 1 CT scan showed "very low" confidence level predictions; we excluded it from the overall analysis but still assessed and discussed the corresponding results. The model performance was evaluated by comparing the predictions with the reference data; the outcome set included localization accuracy, cephalometric measurements, and comparison to manual landmarking reproducibility. On the hold-out test set, the mean localization error was 1.0 ± 1.3 mm, while success detection rates for 2.0, 2.5, and 3.0 mm were 90.4%, 93.6%, and 95.4%, respectively. Mean errors were -0.3 ± 1.3° and -0.1 ± 0.7 mm for angular and linear measurements, respectively. When compared to manual reproducibility, the measurements were within the Bland-Altman 95% limits of agreement for 91.9% and 71.8% of skeletal and dentoalveolar variables, respectively. To conclude, while our DL method still requires improvement, it provided highly accurate 3D landmark localization on a challenging test set, with a reliability for skeletal evaluation on par with what clinicians obtain.
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Affiliation(s)
- G Dot
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Institute of Technology, Paris, France.,Universite Paris Cite, AP-HP, Hopital Pitie Salpetriere, Service de Medecine Bucco-Dentaire, Paris, France
| | - T Schouman
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Institute of Technology, Paris, France.,Medecine Sorbonne Universite, AP-HP, Hopital Pitie-Salpetriere, Service de Chirurgie Maxillo-Faciale, Paris, France
| | - S Chang
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Institute of Technology, Paris, France
| | - F Rafflenbeul
- Department of Dentofacial Orthopedics, Faculty of Dental Surgery, Strasbourg University, Strasbourg, France
| | - A Kerbrat
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Institute of Technology, Paris, France
| | - P Rouch
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Institute of Technology, Paris, France
| | - L Gajny
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers Institute of Technology, Paris, France
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11
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Hierl KV, Krause M, Kruber D, Sterker I. 3-D cephalometry of the the orbit regarding endocrine orbitopathy, exophthalmos, and sex. PLoS One 2022; 17:e0265324. [PMID: 35275980 PMCID: PMC8916626 DOI: 10.1371/journal.pone.0265324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/01/2022] [Indexed: 01/04/2023] Open
Abstract
Purpose This study aimed at evaluating the orbital anatomy of patients concerning the relevance of orbital anatomy in the etiology of EO (endocrine orbitopathy) and exophthalmos utilizing a novel approach regarding three-dimensional measurements. Furthermore, sexual dimorphism in orbital anatomy was analyzed. Methods Orbital anatomy of 123 Caucasian patients (52 with EO, 71 without EO) was examined using computed tomographic data and FAT software for 3-D cephalometry. Using 56 anatomical landmarks, 20 angles and 155 distances were measured. MEDAS software was used for performing connected and unconnected t-tests and Spearman´s rank correlation test to evaluate interrelations and differences. Results Orbital anatomy was highly symmetrical with a mean side difference of 0.3 mm for distances and 0.6° for angles. There was a small albeit statistically significant difference in 13 out of 155 distances in women and 1 in men concerning patients with and without EO. Two out of 12 angles showed a statistically significant difference between female patients with and without EO. Regarding sex, statistically significant differences occurred in 39 distances, orbit volume, orbit surface, and 2 angles. On average, measurements were larger in men. Concerning globe position within the orbit, larger distances to the orbital apex correlated with larger orbital dimensions whereas the sagittal position of the orbital rim defined Hertel values. Conclusion In this study, little difference in orbital anatomy between patients with and without EO was found. Concerning sex, orbital anatomy differed significantly with men presenting larger orbital dimensions. Regarding clinically measured exophthalmos, orbital aperture anatomy is an important factor which has to be considered in distinguishing between true exophthalmos with a larger distance between globe and orbital apex and pseudoexophthalmos were only the orbital rim is retruded. Thus, orbital anatomy may influence therapy regarding timing and surgical procedures as it affects exophthalmos.
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Affiliation(s)
| | - Matthias Krause
- Department of Oral & Maxillofacial Plastic Surgery, Leipzig University, Leipzig, Germany
| | - Daniel Kruber
- Department of Informatics and Media, Leipzig University of Applied Sciences, Leipzig, Germany
| | - Ina Sterker
- Department of Ophthalmology, Leipzig University, Leipzig, Germany
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12
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Coudert P, Lainé G, Pointillart V, Damade C, Boissiere L, Vital JM, Bouyer B, Gille O. Tomodensitometric bone anatomy of the intervertebral foramen of the lower cervical spine: measurements and comparison of foraminal volume in healthy individuals and patients suffering from cervicobrachial neuralgia due to foraminal stenosis. Surg Radiol Anat 2022; 44:883-890. [PMID: 35477797 DOI: 10.1007/s00276-022-02941-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Degenerative foraminal stenosis of the cervical spine can lead to cervicobrachial neuralgias. Computed tomography (CT)-scan assists in the diagnosis and evaluation of foraminal stenosis. The main objective of this study is to determine the bony dimensions of the cervical intervertebral foramen and to identify which foraminal measurements are most affected by degenerative disorders of the cervical spine. These data could be applied to the surgical treatment of this pathology, helping surgeons to focus on specific areas during decompression procedures. METHODS A descriptive study was conducted between two groups: an asymptomatic one (young people with no evidence of degenerative cervical spine disorders) and a symptomatic one (experiencing cervicobrachial neuralgia due to degenerative foraminal stenosis). Using CT scans, we determined a method allowing measurements of the following foraminal dimensions: foraminal height (FH), foraminal length (FL), foraminal width in its lateral part ((UWPP, MWPP and IWPP (respectively Upper, Medial and Inferior Width of Pedicle Part)) and medial part (UWMP, MWMP and IWMP (respectively Upper, Medial and Inferior Width of Medial Part)), and disk height (DH). Foraminal volume (FV) was calculated considering the above data. Mean volumes were measured in the asymptomatic group and compared to the values obtained in the symptomatic group. RESULTS Both groups were made up of 10 patients, and a total of 50 intervertebral discs (100 intervertebral foramina) were analyzed in each group. Comparison of C4C5, C5C6 and C6C7 levels between both groups showed several significant decreases in foraminal dimensions (p < 0.05) as well as in foraminal volume (p < 0.001) in the symptomatic group. The most affected dimensions were UWPP, MWPP, UWMP, MWMP and FV. The most stenotic foraminal areas were the top of the uncus and the posterior edge of the lower plate of the overlying vertebra. CONCLUSION Using a new protocol for measuring foraminal volume, the present study refines the current knowledge of the normal and pathological anatomy of the lower cervical spine and allows us to understand the foraminal sites most affected by degenerative stenosis. Those findings can be applied to foraminal stenosis surgeries. According to our results, decompression of the foramen in regard of both uncus osteophytic spurs and inferior plate of the overlying vertebra might be an important step for spinal nerves release.
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Affiliation(s)
- P Coudert
- Department of Spine Surgery, Hôpital Pellegrin, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - G Lainé
- Department of Neurosurgery, University Hospital of Bordeaux, Place Amélie Raba-Léon, Bordeaux, France.
| | - V Pointillart
- Department of Spine Surgery, Hôpital Pellegrin, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - C Damade
- Department of Spine Surgery, Hôpital Pellegrin, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - L Boissiere
- Department of Spine Surgery, Hôpital Pellegrin, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - J M Vital
- Department of Spine Surgery, Hôpital Pellegrin, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - B Bouyer
- Department of Spine Surgery, Hôpital Pellegrin, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - O Gille
- Department of Spine Surgery, Hôpital Pellegrin, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
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Xu W, Lu R, Hu Y, Cao L, Wang T, Tan H, Meng X, Ming Y, Zheng L. Reliability of cone beam CT for morphometry of nasolabial soft tissue in patients with skeletal class III malocclusion: A qualitative and quantitative analysis. J Xray Sci Technol 2022; 30:195-206. [PMID: 34719475 DOI: 10.3233/xst-211018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To assess reliability of cone-beam CT (CBCT) for nasolabial soft tissue measurements in patients with skeletal class III malocclusion based on 3-dimensional (3D) facial scanner results. METHODS CBCT and 3D facial scan images of 20 orthognathic patients are used in this study. Eleven soft tissue landmarks and 15 linear and angular measurements are identified and performed. For qualitative evaluation, Shapiro-Wilk test and Bland-Altman plots are applied to analyze the equivalence of the measurements derived from these two kinds of images. To quantify specific deviation of CBCT measurements from facial scanner, the latter is set as a benchmark, and mean absolute difference (MAD) and relative error magnitude (REM) for each variable are also calculated. RESULTS Statistically significant differences are observed in regions of nasal base and lower lip vermilion between two methods. MAD value for all length measurements are less than 2 mm and for angular variables < 8°. The average MAD and REM for length measurements are 0.94 mm and 5.64%, and for angular measurements are 2.27° and 3.78%, respectively. CONCLUSIONS The soft tissue results measured by CBCT show relatively good reliability and can be used for 3D measurement of soft tissue in the nasolabial region clinically.
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Affiliation(s)
- Wenjie Xu
- Department of 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
| | - Rui Lu
- Department of 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
| | - Yun Hu
- Department of 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
| | - Li Cao
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Tao Wang
- Department of Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Tan
- Department of 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
| | - Xuehuan Meng
- Department of 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
| | - Ye Ming
- Department of 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
| | - Leilei Zheng
- Department of 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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Dot G, Rafflenbeul F, Kerbrat A, Rouch P, Gajny L, Schouman T. Three-Dimensional Cephalometric Landmarking and Frankfort Horizontal Plane Construction: Reproducibility of Conventional and Novel Landmarks. J Clin Med 2021; 10:5303. [PMID: 34830583 DOI: 10.3390/jcm10225303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/21/2022] Open
Abstract
In some dentofacial deformity patients, especially patients undergoing surgical orthodontic treatments, Computed Tomography (CT) scans are useful to assess complex asymmetry or to plan orthognathic surgery. This assessment would be made easier for orthodontists and surgeons with a three-dimensional (3D) cephalometric analysis, which would require the localization of landmarks and the construction of reference planes. The objectives of this study were to assess manual landmarking repeatability and reproducibility (R&R) of a set of 3D landmarks and to evaluate R&R of vertical cephalometric measurements using two Frankfort Horizontal (FH) planes as references for horizontal 3D imaging reorientation. Thirty-three landmarks, divided into “conventional”, “foraminal” and “dental”, were manually located twice by three experienced operators on 20 randomly-selected CT scans of orthognathic surgery patients. R&R confidence intervals (CI) of each landmark in the -x, -y and -z directions were computed according to the ISO 5725 standard. These landmarks were then used to construct 2 FH planes: a conventional FH plane (orbitale left, porion right and left) and a newly proposed FH plane (midinternal acoustic foramen, orbitale right and left). R&R of vertical cephalometric measurements were computed using these 2 FH planes as horizontal references for CT reorientation. Landmarks showing a 95% CI of repeatability and/or reproducibility > 2 mm were found exclusively in the “conventional” landmarks group. Vertical measurements showed excellent R&R (95% CI < 1 mm) with either FH plane as horizontal reference. However, the 2 FH planes were not found to be parallel (absolute angular difference of 2.41°, SD 1.27°). Overall, “dental” and “foraminal” landmarks were more reliable than the “conventional” landmarks. Despite the poor reliability of the landmarks orbitale and porion, the construction of the conventional FH plane provided a reliable horizontal reference for 3D craniofacial CT scan reorientation.
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Kim JH, An S, Hwang DM. Reliability of cephalometric landmark identification on three-dimensional computed tomographic images. Br J Oral Maxillofac Surg 2021; 60:320-325. [PMID: 34690019 DOI: 10.1016/j.bjoms.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/04/2021] [Indexed: 12/31/2022]
Abstract
Our aims were to evaluate the reliability of three-dimensional (3D) cephalometric landmark identification in 3D images, and to propose an improved protocol for determining these landmarks. Computed tomographic (CT) images of 13 landmarks were obtained. One that did not show any artifacts, asymmetry in maxillofacial structures, or bony defects, was selected. Two orthodontic practitioners identified 3D cephalometric landmarks 10 times at one-week intervals. The distances of 26 landmarks were measured on the basis of three reference planes (coronal, horizontal, and sagittal). Ten mean (SD) measurements from each examiner were calculated, and the maximum and minimum values and the difference from the 10 measurements of each one were measured at a 95% confidence interval. Interexaminer differences for the three planes were found in the upper right first molar, point A, both gonions, left orbitale, and both porions. The lower right first molar, foramen magnum, gnathion, nasion, and pogonion showed interexaminer differences in two planes. Menton, basion, posterior nasal spine, upper and lower left first molar, and right mental foramen showed interexaminer differences in only one plane. With reference to intraexaminer differences, poor repeatability was observed for gonion, orbitale, condylion, and porion. Reliable 3D landmarks are the meeting point of sutures, distinct structures at converging planes, landmarks positioned in the midline, distinct anatomical structures such as the mental foramen, and teeth using multiplanar views.
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Affiliation(s)
- Jung-Hoon Kim
- Department of Orthodontics, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
| | - SangIn An
- Private Practice, Seoul, Republic of Korea
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Kochhar AS, Nucci L, Sidhu MS, Prabhakar M, Grassia V, Perillo L, Kochhar GK, Bhasin R, Dadlani H, d’Apuzzo F. Reliability and Reproducibility of Landmark Identification in Unilateral Cleft Lip and Palate Patients: Digital Lateral Vis-A-Vis CBCT-Derived 3D Cephalograms. J Clin Med 2021; 10:jcm10030535. [PMID: 33540549 PMCID: PMC7867146 DOI: 10.3390/jcm10030535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients. METHODS Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OBA, OBB, OBC). Statistical analysis was performed using descriptive and inferential statistics with paired t-tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A p-value less than 0.05 was considered as significant at a 95% confidence level. RESULTS When comparing, the plotting of points posterior nasal spine (PNS) (p < 0.05), anterior nasal spine (ANS) (p < 0.01), upper 1 root tip (p < 0.05), lower 1 root tip (p < 0.05), malare (p < 0.05), pyriforme (p < 0.05), porion (p < 0.01), and basion (p < 0.05) was statistically significant. CONCLUSION In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms.
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Affiliation(s)
- Anuraj Singh Kochhar
- Former Consultant Orthodontist Max Hospital Gurgaon, Haryana 122001, India
- Correspondence:
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (L.N.); (V.G.); (L.P.); (F.d.)
| | - Maninder Singh Sidhu
- Department of Orthodontics & Dean, Research & Development Faculty of Dental Sciences, SGT University Gurugram, Haryana 122505, India; (M.S.S.); (M.P.)
| | - Mona Prabhakar
- Department of Orthodontics & Dean, Research & Development Faculty of Dental Sciences, SGT University Gurugram, Haryana 122505, India; (M.S.S.); (M.P.)
| | - Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (L.N.); (V.G.); (L.P.); (F.d.)
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (L.N.); (V.G.); (L.P.); (F.d.)
| | - Gulsheen Kaur Kochhar
- Department of Pediatric & Preventive Dentistry, National Dental College & Hospital, Punjab 140507, India;
| | - Ritasha Bhasin
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G1G6, Canada;
| | - Himanshu Dadlani
- Senior Consultant Department of Dentistry (Periodontology), Max Hospital, Gurgaon, Haryana 122001, India;
| | - Fabrizia d’Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (L.N.); (V.G.); (L.P.); (F.d.)
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Kissel P, Mah JK, Bumann A. Modern 3D cephalometry in pediatric orthodontics-downsizing the FOV and development of a new 3D cephalometric analysis within a minimized large FOV for dose reduction. Clin Oral Investig 2021; 25:4651-70. [PMID: 33492515 DOI: 10.1007/s00784-021-03779-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Dose reduction achieved by downsizing the field of view (FOV) in CBCT scans has brought no benefit for pediatric orthodontics, until now. Standard 2D or 3D full-size cephalometric analyses require large FOVs and high effective doses. The aim of this study was to compare a new 3D reduced-FOV analysis using the Frankfurt horizontal (FH) plane as reference plane with a conventional full-size analysis using the Sella-Nasion (S-N) plane as reference plane. MATERIALS AND METHODS Thirty-eight CBCT data sets were evaluated using full- and reduced-FOV analysis. The measurements of a total of 20 skeletal and dental standard 3D full-size variables were compared with the measurements of 22 corresponding 3D reduced-FOV variables. Statistical analysis was performed to prove mathematic relation between standard and alternative variables. Regression analyses were carried out. RESULTS Coefficients of determination (R2) between 0.15 and 0.95 (p < 0.001-0.055) were described. All variables showed obvious relations of different strength except for SNA and its alternative Po_R-Or_R-A (°) (R2 = 0.15, p = 0.055), but a second variable Ba_A (mm) showed stronger relation (R2 = 0.28, p = 0.003). CONCLUSIONS All standard variables related to the reference plane S-N could be described with alternative variables related to the FH. Further research should define more reliable landmarks for coordinate systems and reference points. CLINICAL RELEVANCE Minimized large FOVs meet the demand of 3D cephalometric analyses and enable the application of CBCT scans in pediatric orthodontic patients in many specific indications. Dose reduction is accompanied by increasing access to all the advantages of 3D imaging over 2D imaging.
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Trevisiol L, Lanaro L, Favero V, Lonardi F, Vania M, D'Agostino A. The effect of subspinal Le Fort I osteotomy and alar cinch suture on nasal widening. J Craniomaxillofac Surg 2020; 48:832-838. [PMID: 32736835 DOI: 10.1016/j.jcms.2020.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 05/11/2020] [Accepted: 06/20/2020] [Indexed: 10/24/2022] Open
Abstract
The aim of this retrospective study was to evaluate the relationships between upper jaw movements and nasal soft-tissue changes in patients who have undergone subspinal Le Fort I osteotomy combined with alar cinch suture. Single and multivariate linear regression analyses were used to examine the relationships between greatest inter-alar width (GAW) and maxillary advancement, maxillary impaction, and rotational movements. The database of our referral hospital was searched for patients who had undergone upper jaw surgery with a subspinal LFI osteotomy to correct dentoskeletal deformities between April 2012 and June 2016. Thirty-eight of the patients (15 men and 23 women) who were identified were eligible for inclusion. The average change in inter-alar width (ΔGAW) was +1.7 ± 1.2 mm. GAW increased by 0.3 mm (p < 0.0001) for each millimetre of maxillary advancement, and increased by 0.5 mm (p < 0.0001) for each millimetre of maxillary impaction. GAW increased by 0.2 mm for each degree of counterclockwise rotation of the occlusal plane (p < 0.0001). An analysis of our data compared with the current literature confirmed that subspinal Le Fort I combined with alar cinch suture reduced alar base widening.
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Affiliation(s)
- Lorenzo Trevisiol
- Maxillofacial Department, University of Verona, Maxillofacial and ENT Surgery, Policlinico G. B. Rossi piazzale L. Scuro, 37134 Verona, Italy
| | - Luca Lanaro
- Maxillofacial Department, University of Verona, Maxillofacial and ENT Surgery, Policlinico G. B. Rossi piazzale L. Scuro, 37134 Verona, Italy
| | - Vittorio Favero
- Maxillofacial Department, University of Verona, Maxillofacial and ENT Surgery, Policlinico G. B. Rossi piazzale L. Scuro, 37134 Verona, Italy
| | - Fabio Lonardi
- Maxillofacial Department, University of Verona, Maxillofacial and ENT Surgery, Policlinico G. B. Rossi piazzale L. Scuro, 37134 Verona, Italy
| | - Michele Vania
- Maxillofacial Department, University of Verona, Maxillofacial and ENT Surgery, Policlinico G. B. Rossi piazzale L. Scuro, 37134 Verona, Italy
| | - Antonio D'Agostino
- Maxillofacial Department, University of Verona, Maxillofacial and ENT Surgery, Policlinico G. B. Rossi piazzale L. Scuro, 37134 Verona, Italy.
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Davami K, Talma E, Harzer W, Lagravère MO. Long term skeletal and dental changes between tooth-anchored versus Dresden bone-anchored rapid maxillary expansion using CBCT images in adolescents: Randomized clinical trial. Int Orthod 2020; 18:317-329. [PMID: 32245745 DOI: 10.1016/j.ortho.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to determine long-term skeletal and dental changes in tooth-anchored versus Dresden bone-anchored rapid maxillary expansion using CBCT images in adolescents. MATERIALS AND METHODS In all, 29 adolescent patients (11-17 years of age) needing skeletal expansion were randomly allocated to two different groups treated by either a Dresden bone-anchored expander or a conventional hyrax expander. Patients included did not have previous orthodontic treatment, were non-syndromic and had all teeth present in mouth. CBCT images were taken before expansion and two or more years after expansion. An independent T-test was used to determine the statistical significance between treatment groups and paired T-test was used to compare the results before and after expansion in each group. RESULTS Neither treatment group showed overall long-term different skeletal and dental changes in the transverse, anterior-posterior and vertical planes (P<0.05). Both treatment groups showed mild asymmetric skeletal expansion, but these were clinically insignificant. CONCLUSIONS Both expanders had similar skeletal and dental results. The greatest changes were in the transverse plane. Changes in vertical and anterior-posterior were negligible.
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Affiliation(s)
| | - Elissa Talma
- University of Minas Gerais, Structural Engineering School, Minas Gerais, Brazil
| | - Winfried Harzer
- Technical University of Dresden, department of Orthodontics, Fetscherstr. 72, D-01307 Dresden, Germany
| | - Manuel O Lagravère
- University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Orthodontic Graduate Program, ECHA 5-524, 11405-87 Ave, T6G 1C9 Edmonton, AB, Canada.
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Lee EH, Yu HS, Lee KJ, Han SS, Jung HD, Hwang CJ. Comparison of three midsagittal planes for three-dimensional cone beam computed tomography head reorientation. Korean J Orthod 2020; 50:3-12. [PMID: 32042715 PMCID: PMC6995832 DOI: 10.4041/kjod.2020.50.1.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/08/2019] [Accepted: 09/10/2019] [Indexed: 11/20/2022] Open
Abstract
Objective This study compared three prominent midsagittal planes (MSPs) to identify the MSP that best approximates the true symmetrical MSP. Methods Forty-three patients (mean age, 23.0 ± 8.20 years) were grouped as follows: group 1 consisted of 10 patients with skeletal Class I and a menton (Me) deviation of < 2 mm; group 2, 11 patients with skeletal Class III and a Me deviation < 2 mm; group 3, nine patients with skeletal Class III and a Me deviation of 2 to less than 4 mm; and group 4, 13 patients with skeletal Class III and an Me deviation ≥ 4 mm. The candidate MSPs were established by three-dimensional (3D) cone beam computed tomography (CBCT) reorientation methods (RMs): (1) the MSP perpendicular to the Frankfort horizontal (FH) plane while passing through the crista galli and basion; (2) the MSP including the nasion, incisive foramen, and basion; (3) the MSP including the nasion, anterior nasal spine, and posterior nasal spine. The mean absolute distances (MADs) to the MSPs were calculated from the coordinates of 1,548 points on 129 CBCT images. The differences in the values of the 3D coordinates among RMs were compared. Results The MADs of the three RMs showed significant differences (p < 0.05). Most of the differences in values of the coordinates were not significant among RMs. Conclusions Although the differences in distance among the three MSPs were minor, the MSP perpendicular to the FH plane while passing through the crista galli and basion best approximated the true symmetrical MSP.
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Affiliation(s)
- Eon-Hwa Lee
- Department of Orthodontics, Korea University Anam Hospital, Seoul, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics and The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics and The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hwi-Dong Jung
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Chung-Ju Hwang
- Department of Orthodontics and The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
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Yatabe M, Prieto JC, Styner M, Zhu H, Ruellas AC, Paniagua B, Budin F, Benavides E, Shoukri B, Michoud L, Ribera N, Cevidanes L. 3D superimposition of craniofacial imaging-The utility of multicentre collaborations. Orthod Craniofac Res 2019; 22 Suppl 1:213-220. [PMID: 31074129 DOI: 10.1111/ocr.12281] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/18/2023]
Abstract
Clinical applications of 3D image registration and superimposition have contributed to better understanding growth changes and clinical outcomes. The use of 3D dental and craniofacial imaging in dentistry requires validate image analysis methods for improved diagnosis, treatment planning, navigation and assessment of treatment response. Volumetric 3D images, such as cone-beam computed tomography, can now be superimposed by voxels, surfaces or landmarks. Regardless of the image modality or the software tools, the concepts of regions or points of reference affect all quantitative of qualitative assessments. This study reviews current state of the art in 3D image analysis including 3D superimpositions relative to the cranial base and different regional superimpositions, the development of open source and commercial tools for 3D analysis, how this technology has increased clinical research collaborations from centres all around the globe, some insight on how to incorporate artificial intelligence for big data analysis and progress towards personalized orthodontics.
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Affiliation(s)
- Marilia Yatabe
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | | | - Martin Styner
- University of North Carolina, Chapel Hill, North Carolina
| | - Hongtu Zhu
- University of North Carolina, Chapel Hill, North Carolina
| | - Antonio Carlos Ruellas
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | | | | | - Erika Benavides
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Brandon Shoukri
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Loic Michoud
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Nina Ribera
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Lucia Cevidanes
- Department for Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, Michigan
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Liberton DK, Verma P, Contratto A, Lee JS. Development and Validation of Novel Three-Dimensional Craniofacial Landmarks on Cone-Beam Computed Tomography Scans. J Craniofac Surg 2019; 30:e611-e615. [PMID: 31478954 PMCID: PMC7500863 DOI: 10.1097/scs.0000000000005627] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
As cone-beam computed tomography (CBCT) scans become increasingly common, it is vital to have reliable 3-dimensional (3D) landmarks for quantitative analysis of craniofacial skeletal morphology. While some studies have developed and used 3D landmarks, these landmark sets are generally small and derived primarily from previous 2-dimensional (2D) cephalometric landmarks. These derived landmarks lack information in parts of the skull such as the cranial base, which is an important feature for cranial growth and development. The authors see a real need for development and validation of 3D landmarks, particularly bilateral landmarks, across the skull for improved cephalometric analysis. The primary objective of this study is to develop and validate a set of 61 3D anatomical landmarks on the face, cranial base, mandible, and teeth for use in clinical and research studies involving CBCT imaging. Each landmark was placed 3 times by 3 separate trained observers on a set of 10 anonymized CBCT patient scans. Intra-rater and inter-rater estimates of consistency and agreement were calculated using the intraclass correlation coefficient. Measurement error was calculated per landmark and per X, Y, and Z landmark coordinate. The authors had high ICC estimates within rates, indicating high consistency, and high ICC estimates among raters, indicate good agreement across raters. Overall measurement error for each landmark and each X, Y, and Z coordinate was low. Our results confirm the accuracy of novel 3D landmarks including several on the cranial base that will serve researchers and clinicians for use in future studies involving 3D CBCT imaging and craniofacial development.
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Affiliation(s)
- Denise K. Liberton
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Payal Verma
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
- University of Cincinnati College of Medicine, Division of Oral & Maxillofacial Surgery, Cincinnati, Ohio, United States of America
| | - Anthony Contratto
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
- University of Missouri - Kansas City School of Dentistry, Kansas City, Missouri, United States of America
| | - Janice S. Lee
- Craniofacial Anomalies and Regeneration Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, United States of America
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Juerchott A, Freudlsperger C, Zingler S, Saleem MA, Jende JME, Lux CJ, Bendszus M, Heiland S, Hilgenfeld T. In vivo reliability of 3D cephalometric landmark determination on magnetic resonance imaging: a feasibility study. Clin Oral Investig 2020; 24:1339-49. [DOI: 10.1007/s00784-019-03015-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
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Cattaneo PM, Yung AKC, Holm A, Mashaly OM, Cornelis MA. 3D landmarks of Craniofacial Imaging and subsequent considerations on superimpositions in orthodontics-The Aarhus perspective. Orthod Craniofac Res 2019; 22 Suppl 1:21-29. [PMID: 31074143 DOI: 10.1111/ocr.12299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE (a) To evaluate intra- and inter-observer reliability in landmarks placement along the three planes of space on cone-beam computed tomography (CBCT) data sets; (b) To evaluate whether the reliability of each landmark differs in CBCT scans characterized by two different voxel dimension and quality. SETTING AND SAMPLE POPULATION A total of 84 scans were used in this study: 49 scans were taken with the NewTom 3G, and 35 scans were taken with the NewTom 5G. The scans were characterized by an isotropic voxel dimension of 0.36 and 0.30 mm for the NewTom 3G and the NewTom 5G, respectively. METHODS A total of 13 landmarks were placed according to the corresponding definitions in 3D, also presented in this study: Foramen Spinosum (R/L), Nasion, Sella, Gonion (R/L), Pogonion, Menton, A point, Anterior nasal spine, Posterior nasal spine, Basion, Cribriform Plate (CR). Intra- and inter-observer reliability and Intra-class correlation coefficients (ICC) ICC for landmarks identification were assessed. Five reference and registration planes based on the above-mentioned landmarks were also presented. RESULTS ICC both for the intra- and inter-observer measurements had a score larger than 0.9 in all directions, except in the sagittal direction for CR. Regarding intra- and inter-observer reliability, only N, S, and Ba scored well in all directions. CONCLUSIONS Most of the landmarks analysed displayed a high reliability along at least 2 directions. The choice of landmarks to define registration and superimposition planes must be carefully selected, as the reliability of these planes is inherited from the one of the landmarks defining them.
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Affiliation(s)
- Paolo M Cattaneo
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Augustine K C Yung
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Annemarie Holm
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Omar M Mashaly
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Marie A Cornelis
- Section of Orthodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Sam A, Currie K, Oh H, Flores-Mir C, Lagravére-Vich M. Reliability of different three-dimensional cephalometric landmarks in cone-beam computed tomography : A systematic review. Angle Orthod 2018; 89:317-332. [PMID: 30423256 DOI: 10.2319/042018-302.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Conventional two-dimensional (2D) cephalometric radiography is an integral part of orthodontic patient diagnosis and treatment planning. One must be mindful of its limitations as it indeed is a 2D representation of a vaster three-dimensional (3D) object. Issues with projection errors, landmark identification, and measurement inaccuracies impose significant limitations, which may now be overcome with the advent of cone-beam computed tomography (CBCT). A systematic review of the reliability of different 3D cephalometric landmarks in CBCT imaging was conducted. MATERIALS AND METHODS Electronic database searches were administered until October 2017 using PubMed, MEDLINE via OvidSP, EBMR and EMBASE via OvidSP, Scopus, and Web of Science. Google Scholar was used as an adjunctive search tool. RESULTS Thirteen articles considering CBCT scans of human subjects from preexisting data sets were selected and reviewed. Most of the studies had methodological limitations and were of moderate quality. Because of their heterogeneity, key data from each could not be combined and were reported qualitatively. Overall, in 3D, midsagittal plane landmarks demonstrated greater reliability compared with bilateral landmarks. A minimum number of dental landmarks were reported, although most were recommended for use. CONCLUSIONS Further research is required to evaluate the reliability of 3D cephalometric landmarks when evaluating 3D craniofacial complexes.
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Southerden P, Haydock RM, Barnes DM. Three Dimensional Osteometric Analysis of Mandibular Symmetry and Morphological Consistency in Cats. Front Vet Sci 2018; 5:157. [PMID: 30050911 PMCID: PMC6052099 DOI: 10.3389/fvets.2018.00157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 06/21/2018] [Indexed: 11/14/2022] Open
Abstract
Objectives: The aim of this study was to describe a number of anatomical reference points which can be used to measure mandibular morphology and assess the degree of mandibular symmetry in a group of normal cats. Comparisons were then made between cats to evaluate correlations between morphological measurements and degree of inter-cat variation. This will provide data valuable evaluating and developing techniques for caudal mandibular fracture repair. Methods: Twenty-seven mixed breed cats (26 Domestic Shorthaired and 1 Domestic Longhaired) with no history of head trauma, intact undamaged mandibles, both mandibular fourth premolars and first molars present which had a full skull CT scan were included in this study. Anatomical reference points were defined on maximum intensity projections of multiplanar reconstruction of the mandibles and measurements taken. The ratios between paired right and left measurements, and the ratio of jaw widths at the coronoid process and mandibular foramen were calculated. All analyses were performed using R version 3.3.3 and the multcomp library. Results: None of the right:left ratios were detected as being significantly different from 1 and the coefficient of variation values were all very small showing that when cats deviate from the mean ratio they do so by only a small amount. Measurements analyzed to determine how consistent individual measurements were between cats showed that the most consistent measurement was the lateral ramus inclination angle. The least consistent measurements were ramus height and jaw width at the mental foramen. The correlation between pairs of measurements of the right and left ramus was analyzed and demonstrated a strong correlation between the height, width and length of the ramus. Conclusions: This study has demonstrated a low level of asymmetry between contralateral mandibles in cats, a high level of consistency in the dimensions of mandibles between cats and a strong correlation between the height, width and length of the ramus.
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Affiliation(s)
- Peter Southerden
- Department of Dentistry and Oral Surgery, Eastcott Veterinary Referrals, Swindon, United Kingdom
| | - Richard M Haydock
- The WALTHAM Centre for Pet Nutrition, Melton Mowbray, United Kingdom
| | - Duncan M Barnes
- Department of Orthopaedic Surgery, Eastcott Veterinary Referrals, Swindon, United Kingdom
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Ed-Dhahraouy M, Riri H, El Moutaoukkil A, Bourzgui F, Ezzahmouly M, El Maghri M. Une nouvelle méthodologie pour la détection automatique des points en céphalométrie 3D : étude pilote. Int Orthod 2018; 16:328-337. [DOI: 10.1016/j.ortho.2018.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ed-Dhahraouy M, Riri H, Ezzahmouly M, Bourzgui F, El Moutaoukkil A. A new methodology for automatic detection of reference points in 3D cephalometry: A pilot study. Int Orthod 2018; 16:328-337. [PMID: 29628421 DOI: 10.1016/j.ortho.2018.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to develop a new method for an automatic detection of reference points in 3D cephalometry to overcome the limits of 2D cephalometric analyses. MATERIALS AND METHODS A specific application was designed using the C++ language for automatic and manual identification of 21 (reference) points on the craniofacial structures. Our algorithm is based on the implementation of an anatomical and geometrical network adapted to the craniofacial structure. This network was constructed based on the anatomical knowledge of the 3D cephalometric (reference) points. RESULTS The proposed algorithm was tested on five CBCT images. The proposed approach for the automatic 3D cephalometric identification was able to detect 21 points with a mean error of 2.32mm. DISCUSSION In this pilot study, we propose an automated methodology for the identification of the 3D cephalometric (reference) points. A larger sample will be implemented in the future to assess the method validity and reliability.
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Affiliation(s)
- Mohammed Ed-Dhahraouy
- Laboratory of Research in Optimization, Emerging System, Networks and Imaging(LAROSERI) Computer Department, Faculty of science, Chouaïb Doukkali University, Ben Maâchou Road, 24000 El Jadida, Morocco
| | - Hicham Riri
- Laboratory of Research in Optimization, Emerging System, Networks and Imaging(LAROSERI) Computer Department, Faculty of science, Chouaïb Doukkali University, Ben Maâchou Road, 24000 El Jadida, Morocco
| | - Manal Ezzahmouly
- Laboratory of Research in Optimization, Emerging System, Networks and Imaging(LAROSERI) Computer Department, Faculty of science, Chouaïb Doukkali University, Ben Maâchou Road, 24000 El Jadida, Morocco
| | - Farid Bourzgui
- Department of Dentofacial Orthopedics, Faculty of Dental Medicine, Hassan II University of Casablanca, Abou Al Alaa Zahar street, BP 9157, 21100 Mers Sultan Casablanca, Morocco.
| | - Abdelmajid El Moutaoukkil
- Laboratory of Research in Optimization, Emerging System, Networks and Imaging(LAROSERI) Computer Department, Faculty of science, Chouaïb Doukkali University, Ben Maâchou Road, 24000 El Jadida, Morocco
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Ponce-Garcia C, Lagravere-Vich M, Cevidanes LHS, de Olivera Ruellas AC, Carey J, Flores-Mir C. Reliability of three-dimensional anterior cranial base superimposition methods for assessment of overall hard tissue changes: A systematic review. Angle Orthod 2017; 88:233-245. [PMID: 29189039 DOI: 10.2319/071217-468.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review was to synthesize the available literature concerning the reliability of three-dimensional superimposition methods when assessing changes in craniofacial hard tissues. MATERIALS AND METHODS Four electronic databases were searched. Two authors independently reviewed potentially relevant articles for eligibility. Clinical trials, cohort, case-control, and cross-sectional studies that evaluated the reliability of three-dimensional superimposition methods on the anterior cranial base were included. RESULTS Six studies fulfilled the inclusion criteria. Four studies used the voxel-based registration method, one used the landmark-based method and one used the surface-based method. Regarding reliability, the voxel-based studies showed on average a difference of 0.5 mm or less between images. The optimized analysis using a six-point correction algorithm in the landmark-based method showed 1.24 mm magnitude of error between images. CONCLUSIONS Although reliability appears to be adequate, the small sample size and high risk of bias among studies make available evidence still insufficient to draw strong conclusions.
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Gupta A, Kharbanda OP, Balachandran R, Sardana V, Kalra S, Chaurasia S, Sardana HK. Precision of manual landmark identification between as-received and oriented volume-rendered cone-beam computed tomography images. Am J Orthod Dentofacial Orthop 2017; 151:118-31. [PMID: 28024764 DOI: 10.1016/j.ajodo.2016.06.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate the effect of the orientation of cone-beam computed tomography (CBCT) images on the precision and reliability of 3-dimensional cephalometric landmark identification. METHODS Ten CBCT scans were used for manual landmark identification. Volume-rendered images were oriented by aligning the Frankfort horizontal and transorbital planes horizontally, and the midsagittal plane vertically. A total of 20 CBCT images (10 as-received and 10 oriented) were anonymized, and 3 random sets were generated for manual landmark plotting by 3 expert orthodontists. Twenty-five landmarks were identified for plotting on each anonymized image independently. Hence, a total of 60 images were marked by the orthodontists. After landmark plotting, the randomized samples were decoded and regrouped into as-received and oriented data sets for analysis and comparison. Means and standard deviations of the x-, y-, and z-axis coordinates were calculated for each landmark to measure the central tendency. Intraclass correlation coefficients were calculated to analyze the interobserver reliability of landmark plotting in the 3 axes in both situations. Paired t tests were applied on the mean Euclidean distance computed separately for each landmark to evaluate the effect of 3-dimensional image orientation. RESULTS Interobserver reliability (intraclass correlation coefficient, >0.9) was excellent for all 25 landmarks for the x-, y-, and z-axes on both before and after orientation of the images. Paired t test results showed insignificant differences for the orientation of volume-rendered images for all landmarks except 3: R1 left (P = 0.0138), sella (P = 0.0490), and frontozygomatic left (P = 0.0493). Also midline structures such as Bolton and nasion were plotted more consistently or precisely than bilateral structures. CONCLUSIONS Orientation of the CBCT image does not enhance the precision of landmark plotting if each landmark is defined properly on multiplanar reconstruction slices and rendered images, and the clinician has sufficient training. The consistency of landmark identification is influenced by their anatomic locations on the midline, bilateral, and curved structures.
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31
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Friedrich RE, Bruhn M, Lohse C. Cone-beam computed tomography of the orbit and optic canal volumes. J Craniomaxillofac Surg 2016; 44:1342-9. [DOI: 10.1016/j.jcms.2016.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/25/2016] [Accepted: 06/02/2016] [Indexed: 11/17/2022] Open
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Aksoy S, Kelahmet U, Hincal E, Oz U, Orhan K. Comparison of linear and angular measurements in CBCT scans using 2D and 3D rendering software. BIOTECHNOL BIOTEC EQ 2016. [DOI: 10.1080/13102818.2016.1174077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Secil Aksoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - Umay Kelahmet
- Department of Orthodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - Evren Hincal
- Department of Mathematics, Faculty of Arts & Sciences, Near East University, Mersin, Turkey
| | - Ulas Oz
- Department of Orthodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Abstract
For patients with facial asymmetry, complete and precise diagnosis, and surgical treatments to correct the underlying cause of the asymmetry are significant. Conventional diagnostic radiographs (submento-vertex projections, posteroanterior radiography) have limitations in asymmetry diagnosis due to two-dimensional assessments of three-dimensional (3D) images. The advent of 3D images has greatly reduced the magnification and projection errors that are common in conventional radiographs making it as a precise diagnostic aid for assessment of facial asymmetry. Thus, this article attempts to review the newly introduced 3D tools in the diagnosis of more complex facial asymmetries.
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Affiliation(s)
- Gopi Akhil
- Department of Orthodontics, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | | | - Subramani Raja
- Department of Orthodontics, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Kumaresan Janardhanan
- Department of Orthodontics, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
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Abstract
OBJECTIVES In contrast to two-dimensional planar images, a measuring point is hardly repeatedly determined in a CBCT image when alveolar bone loss is assessed. Thus, the aim of the present study was to propose a six-site measuring method, which is closely related to anatomical structure, for the evaluation of alveolar bone loss in CBCT images. METHODS 150 measuring points in 11 molars and 14 premolars from 6 patients (2 males and 4 females) were included. CBCT images of the teeth were acquired prior to periodontal surgery. Four observers measured the distances between cemento-enamel junctions and the apical bases of the periodontal bone defect at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual/palatal, mid-lingual/palatal and disto-lingual/palatal sites in CBCT images. Direct measurements of the six sites were correspondingly obtained in the subsequent periodontal surgeries. Differences between the distances measured in the CBCT images and during the surgery were analysed. Interobserver and intraobserver variances were tested. RESULTS No statistically significant difference was found between the surgical and CBCT measurements (p = 0.84). Diagnostic coincidence rates of four observers were 86.7%, 87.3%, 88.7% and 88.0%, respectively. The interobserver (p = 0.95) and intraobserver (p = 0.30) variances were not significant. CONCLUSIONS The six-site measuring method validated in the present study may be a useful three-dimensional measuring method for the evaluation of periodontal disease.
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Affiliation(s)
- Yu-Jiao Guo
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Zhi-pu Ge
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Ruo-han Ma
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Jian-xia Hou
- 2 Department of Periodontology, Outpatient Center, Peking University, School and Hospital of Stomatology, Beijing, China
| | - Gang Li
- 1 Department of Oral and Maxillofacial Radiology, Peking University, School and Hospital of Stomatology, Beijing, China
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Lisboa CDO, Masterson D, da Motta AFJ, Motta AT. Reliability and reproducibility of three-dimensional cephalometric landmarks using CBCT: a systematic review. J Appl Oral Sci 2015; 23:112-9. [PMID: 26018303 PMCID: PMC4428454 DOI: 10.1590/1678-775720140336] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/23/2014] [Indexed: 11/22/2022] Open
Abstract
Objective : The aim of this study was to review the reliability and reproducibility of 3D-CBCT (cone beam computed tomography) cephalometric landmark identification. Methods : Electronic databases (Pubmed, Scopus, Web of Science) were searched for papers published from 1998 to October 2014. Specific strategies were developed for each database, with the guidance of a librarian. Two reviewers independently analyzed the titles and abstracts for inclusion. The articles that met the inclusion and exclusion criteria were selected for full-text reading, and the selected articles went through methodological quality evaluation. After the exclusion of repeated articles, the titles of the remaining ones were read and 1,328 of them were excluded. The abstracts of 173 articles were read, of which 43 were selected, read in full and submitted to the inclusion and exclusion criteria. Fourteen articles or studies with reliable methodology and reproducibility remained. The data were collected, organized into figures and analyzed for determination of the reliability and reproducibility of the three-dimensional cephalometric landmarks. Results : Overall, the landmarks on the median sagittal line and dental landmarks had the highest reliability, while the landmarks on the condyle, porion and the orbitale presented lower levels of reliability. Point S must be marked in the multiplanar views associated with visualization in 3D reconstruction. Further studies are necessary for evaluating soft tissue landmarks.
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Affiliation(s)
| | - Daniele Masterson
- Library of the Health Science Center, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Hellak AF, Kirsten B, Schauseil M, Davids R, Kater WM, Korbmacher-Steiner HM. Influence of maxillary advancement surgery on skeletal and soft-tissue changes in the nose - a retrospective cone-beam computed tomography study. Head Face Med 2015; 11:23. [PMID: 26152559 PMCID: PMC4495703 DOI: 10.1186/s13005-015-0080-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 06/30/2015] [Indexed: 11/10/2022] Open
Abstract
Objectives Surgical correction of skeletal maxillary retroposition is often associated with changes in the morphology of the nose. Unwanted alar flaring of the nose is observed in many cases. The aim of the present study was therefore to investigate the influence of surgical advancement of the maxilla on changes in the soft-tissue morphology of the nose. Having a coefficient that allows prediction of change in the nasal width in Caucasian patients after surgery would be helpful for treatment planning. Materials and methods All 33 patients included in this retrospective study were of Caucasian descent and had skeletal Class III with maxillary retrognathia. They were all treated with maxillary advancement using a combination of orthodontic and maxillofacial surgery methods. Two cone-beam computed tomography (CBCT) datasets were available for all of the study's participants (16 female, 17 male; age 24.3 ± 10.4 years): the first CBCT imaging was obtained before the planned procedure (T0) and the second 14.1 ± 6.4 months postoperatively (T1). Morphological changes were recorded three-dimensionally using computer-aided methods (Mimics (Materialise NV, Leuven/Belgium), Geomagic (Geomagics, Morrisville/USA)). Statistical analysis was carried out using SPSS 21 for Mac. Results The mean sagittal advancement of the maxilla was 5.58 mm. The width of the nose at the alar base (Alb) changed by a mean of + 2.59 mm (±1.26 mm) and at the ala (Al) by a mean of + 3.17 mm (±1.32 mm). Both of these changes were statistically highly significant (P = 0.000). The increase in the width of the nose corresponded to approximately half of the maxillary advancement distance in over 80 % of the patients. The nasolabial angle declined by an average of −6.65° (±7.71°). Conclusions Maxillary advancement correlates with a distinct morphological change in nasal width. This should be taken into account in the treatment approach and in the information provided to patients.
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Affiliation(s)
- Andreas F Hellak
- Department of Orthodontics, University Hospital, Georg-Voigt-Strasse 3, Marburg, 35039, Germany.
| | | | - Michael Schauseil
- Department of Orthodontics, University Hospital, Georg-Voigt-Strasse 3, Marburg, 35039, Germany.
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Wikner J, Hanken H, Eulenburg C, Heiland M, Gröbe A, Assaf AT, Riecke B, Friedrich RE. Linear accuracy and reliability of volume data sets acquired by two CBCT-devices and an MSCT using virtual models: a comparative in-vitro study. Acta Odontol Scand 2015; 74:51-9. [PMID: 25936361 DOI: 10.3109/00016357.2015.1040064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To discriminate clinically relevant aberrance, the accuracy of linear measurements in three-dimensional (3D) reconstructed datasets was investigated. MATERIALS AND METHODS Three partly edentulous human skulls were examined. Landmarks were defined prior to acquisition. Two CBCT-scanners and a Quad-slice CT-scanner were used. Actual distances were physically measured with calipers and defined as a reference. Subsequently, from digital DICOM datasets, 3D virtual models were generated using maximum intensity projections (MIPs). Linear measurements were performed by semi-automated image analysis. Virtual and analogue linear measurements were compared using repeated measurements in a mixed model (p ≤ 0.05). RESULTS No significant difference was found among all of the digital measurements when compared to one another, whereas a significant difference was found in matched-pairs analysis between CBCT and calipers (p = 0.032). All digitally acquired data resulted in lower mean values compared to the measurements via calipers. A high level of inter-observer reliability was obtained in the digital measurements (inter-rater correlation = 0.988-0.993). CONCLUSIONS The reconstructed datasets led to highly consistent values among linear measurements. Yielding sub-millimeter precision, these modalities are assumed to reflect reality in a clinically irrelevant altered manner. During data acquisition and evaluation, a maximum of precision must be achieved.
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Affiliation(s)
- Johannes Wikner
- a 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf , Hamburg, Germany
| | - Henning Hanken
- a 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf , Hamburg, Germany
| | - Christine Eulenburg
- b 2 Medical Biometry and Epidemiology, University Medical Center Hamburg Eppendorf , Hamburg, Germany
| | - Max Heiland
- a 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf , Hamburg, Germany
| | - Alexander Gröbe
- a 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf , Hamburg, Germany
| | - Alexandre Thomas Assaf
- a 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf , Hamburg, Germany
| | - Björn Riecke
- a 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf , Hamburg, Germany
| | - Reinhard E Friedrich
- a 1 Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf , Hamburg, Germany
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Gupta A, Kharbanda OP, Sardana V, Balachandran R, Sardana HK. A knowledge-based algorithm for automatic detection of cephalometric landmarks on CBCT images. Int J Comput Assist Radiol Surg 2015; 10:1737-52. [DOI: 10.1007/s11548-015-1173-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/10/2015] [Indexed: 11/25/2022]
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39
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Abstract
BACKGROUND Three-dimensional cephalometric analyses are getting more attraction in orthodontics. The aim of this study was to compare two softwares to evaluate three-dimensional cephalometric analyses of orthodontic treatment outcomes. MATERIALS AND METHODS Twenty cone beam computed tomography images were obtained using i-CAT(®) imaging system from patient's records as part of their regular orthodontic records. The images were analyzed using InVivoDental5.0 (Anatomage Inc.) and 3DCeph™ (University of Illinois at Chicago, Chicago, IL, USA) software. Before and after orthodontic treatments data were analyzed using t-test. RESULTS Reliability test using interclass correlation coefficient was stronger for InVivoDental5.0 (0.83-0.98) compared with 3DCeph™ (0.51-0.90). Paired t-test comparison of the two softwares shows no statistical significant difference in the measurements made in the two softwares. CONCLUSIONS InVivoDental5.0 measurements are more reproducible and user friendly when compared to 3DCeph™. No statistical difference between the two softwares in linear or angular measurements. 3DCeph™ is more time-consuming in performing three-dimensional analysis compared with InVivoDental5.0.
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Affiliation(s)
- Dena Sawchuk
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Canada
| | - Adel Alhadlaq
- Division of Orthodontics, Faculty of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Thamer Alkhadra
- Division of Orthodontics, Faculty of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Terry D Carlyle
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Canada
| | - Budi Kusnoto
- Department of Orthodontics, College of Dentistry, Orthodontic Graduate Program Clinic, University of Illinois, Chicago, USA
| | - Tarek El-Bialy
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Canada
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