Three-Dimensional Cephalometric Landmarking and Frankfort Horizontal Plane Construction: Reproducibility of Conventional and Novel Landmarks.

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.

How do general dental practitioners perceive and deal with orthodontic bonded retainers?

INTRODUCTION: Long-term follow-up and management of orthodontic bonded retainers require a strong collaboration between orthodontists and general dental practitioners (GDPs). This study aimed to evaluate if Eastern French GDPs were aware of bonded retainers' complications and side effects and if they were willing to take part in their long-term follow-up. METHODS: Two-hundred and eighteen randomly selected GDPs were invited to answer an online questionnaire. The initial sections covered their experience and management with bonded retainers. In the final sections, GDPs were asked their opinion on the responsibility for long-term follow-up of patients wearing fixed retainers and on the mutual communication between orthodontists and GDPs. Statistical analysis involved descriptive statistics and Fisher exact tests. RESULTS: Response rate was 32.6% (n = 71). The vast majority of GDPs were familiar with loose retainers, but only 45.2% were willing to repair them. Respondents offering orthodontic services on a regular basis were more likely to insert retainers and repair loose or broken retainers (P < 0.001). Approximately 18.6% of GDPs were aware of third-order side effects encountered with unintentionally active retainers bonded to all 6 anterior teeth. For 88.8% of GDPs, permanent retention was justified, whereas 90% of the dentists refused to be responsible for long-term supervision of fixed retainers. In addition, 67.1% were interested in further training on orthodontic retention, and 92.9% would appreciate clinical guidelines. CONCLUSIONS: Knowledge about the harmful side effects of bonded retainers was evaluated as insufficient among surveyed GDPs. Long-term follow-up of patients wearing bonded retainers raises issues that should be addressed globally by enhancing mutual communication, practitioners' education, and patients' involvement.

Relationship between European postgraduate programme accreditation and national research output: The case of the Network of Erasmus-Based European Orthodontic Postgraduate Programmes (NEBEOP) in orthodontics. A bibliometric study.

AIMS: To assess in each European country the correlation between the number of Network of Erasmus-Based European Orthodontic Postgraduate Programmes (NEBEOP) members and orthodontic research activity. Secondary objectives were to describe and quantify Europe's orthodontic research. MATERIALS AND METHODS: Articles published between 2014 and 2018 in 4 major orthodontic journals (American Journal of Orthodontics and Dentofacial Orthopedics, European Journal of Orthodontics, The Angle Orthodontist, Orthodontics and Craniofacial Research) and oral presentation abstracts of five European Orthodontic Society (EOS) congresses were analysed. For each European country, the total number of orthodontic programmes and NEBEOP memberships were collected. Descriptive statistics were performed, and Spearman correlation coefficients and risk ratios were calculated. RESULTS: 2039 articles and 261 oral presentation abstracts were included. Correlation coefficients between national number of publications, oral presentations, sum of these, all adjusted for population, and number of NEBEOP members in each country were 0.64, 0.65 and 0.62, respectively. Risk ratios were all above 1 and statistically significant for number of NEBEOP memberships per country, indicating positive associations with national orthodontic research productivity. Europe accounted for 30.5% of publications and 68.6% of oral presentations at EOS congresses during this period. European orthodontic research was not evenly distributed, since 9 countries were responsible for around 80% of the output. CONCLUSIONS: A positive association was found between number of NEBEOP programmes and national research activity. These results could be an additional argument to support similar pan-European initiatives and guidelines for postgraduate education, not only in orthodontics but in all other dental specialties.

[Automatic superimpositions of 3-dimensional craniofacial imaging: illustration with a mandibular distraction osteogenesis case]. / Superpositions automatisées d'imageries tridimensionnelles cranio-faciales : illustration par un cas clinique de distraction mandibulaire chirurgicale.

When performed several times over the course of an orthodontic or surgical orthodontic treatment, three-dimensional (3D) imaging like CBCT or CT-Scans can be superimposed. The purpose of this article is to illustrate the implementation of voxel-based 3D superimpositions with a clinical case of mandibular distraction osteogenesis A 13-year old patient underwent a surgical orthodontic treatment with a « 3D ¼ mandibular distractor. He presented a bilateral atrophy of his mandibular condyles due to a staphylococcus aureus bacteremia at birth. 3D general and mandibular regional superimpositions were performed using CT-Scan and CBCT images acquired respectively before and after completion of the distraction osteogenesis. Two superimposition methods were used, one relying on commercially-available software and the other one relying on a series of « open-source ¼ softwares. Using commercially-available software, 3D superimpositions were automatically performed in a few minutes by a sparsely-trained operator. The method relying on « open-source ¼ software asked for more training and time. Results of the superimpositions were presented under various formats. Evaluation of 3D superimposition results is still challenging, as only a qualitative evaluation can be easily performed. In years to come, this interpretation should however become more straightforward for clinicians.

Voxel-based superimposition of Cone Beam CT scans for orthodontic and craniofacial follow-up: Overview and clinical implementation.

INTRODUCTION: The increasing use of three-dimensional (3D) imaging in orthodontics has led to the development of 3D superimposition techniques. These techniques use stable anatomic structures as references in order to compare Cone Beam CT (CBCT) scans of the same subject at different time-points. Three methods have been described in the literature: landmark-based, surface-based and voxel-based 3D superimpositions. OBJECTIVE: This article focuses on the voxel-based approach, which is the most described and the only one that can be fully automatized. The aim of this paper is to offer clinicians a practical tutorial on craniofacial voxel-based 3D superimposition. MATERIAL AND METHODS: We provide an updated overview of the available implementation methods, describing their methodology, validations, main steps, advantages and drawbacks. The historical open-source method is the most widespread for research purposes, but takes around three hours to achieve for an experienced operator. Several commercially-available software perform superimpositions in a few minutes. RESULTS: We used two of the available methods to conduct the superimposition process with three representative clinical cases in order to illustrate the different types of results that can be obtained. CONCLUSIONS: Commercially-available software provide user-friendly and fully automatized superimposition methods, allowing clinicians to perform it easily and helping to reduce human error in image analysis. Still, quantitative evaluation of the results remains the main challenge of this technique.

First premolar extractions in an adolescent presenting a Class I biprotrusion malocclusion with skeletal Class II: A case report.

This case report shows the orthodontic treatment of four first premolar extractions of a 14-year-old teenager presenting a dental Class I malocclusion with a severe retrognathic mandible. It reflects conflicting views on objectives between the orthodontist who takes into account the facial balance and the patient who only desires a tooth alignment.

Prevalence and risk factors of root resorption of adjacent teeth in maxillary canine impaction, among untreated children and adolescents.

OBJECTIVES: The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. SUBJECTS AND METHODS: Sixty subjects (mean age 12.2 years; SD 1.9; range 8-17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. RESULTS: Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26-756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. CONCLUSIONS: Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.