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1.
Forensic Sci Int ; 306: 110092, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31816484

RESUMEN

Metric assessment of human crania can provide forensic practitioners and anthropological researchers with information on an individual's sex and biogeographical ancestry. However, metric methods rely on the ability of users to remain consistent with themselves and others, with any error in the data rendering conclusions invalid. Digital anthropology is a growing sub-field where human remains are digitised using a growing range of methods and technologies. These models have the potential to boost research collaboration and public engagement. However, not all of these digitisation methods have been examined critically to explore the veracity of their use within a research environment. There has also been limited research into the application of digital anthropology to craniometric analysis. This study examined the intra- and inter- observer variation of seven participants taking physical measurements from a human cranial cast with an associated set of reference values. The same measurements were also taken from three digital models of the cranial cast which were created using digital photogrammetry and laser scanning. This data was then compared to the reference values and the physical measurements taken by the lead author. This study found that there was excellent statistical agreement between the reference values and the measurements taken from the cranial cast, both physical and digital. However, the participants still exhibited variation within a range of -18mm and +30mm from the reference values. MANOVA tests showed between-subject effects on nine measurements across the participant data, and 12 measurements between the digital models. However, there is little consistency between this study and the anthropological literature as to which measurements are most prone to between-subject effects. Despite the excellent agreement shown between the reference values and the digital models this study raises a number of methodological questions regarding inter-observer error and the varying levels of data processing present in different digitisation methods.


Asunto(s)
Cefalometría/métodos , Simulación por Computador , Imagen Tridimensional , Cráneo/anatomía & histología , Cráneo/diagnóstico por imagen , Antropología Forense , Humanos , Rayos Láser , Masculino , Variaciones Dependientes del Observador , Fotogrametría , Valores de Referencia
2.
Niger J Clin Pract ; 22(12): 1644-1653, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31793469

RESUMEN

Objectives: To assess the validity of using the calibration ruler for correcting magnification of linear measurements and to explore and compare the vertical and horizontal magnification of four digital cephalometric units. Methods: An acrylic box was imaged at seven sagittal positions using four digital cephalometric units: Orthopantomograph OC100, Orthopantomograph OC200, Sirona Orthophos CD, and Sirona Orthophos DS. The true linear lengths of the phantom, corrected, and uncorrected linear lengths on the images were measured and compared. The validity of measurements using the calibration ruler was assessed. The magnification values and distortion indices were calculated and compared among the four cephalometric units. Results: For linear measurements on the mid-sagittal plane and averaged linear measurements on bilateral symmetric sagittal planes, the bias 1.96 STD of the calibration ruler ranged from 1% to 2% for the four cephalometric testing units. For linear measurements on the single lateral sagittal plane, the bias 1.96 STD ranged from 3% to 6%. The vertical scanning charge-coupled device cephalometric unit produced the greatest distortion, ranging from 1.029 to 0.964. Conclusion: The metal millimeter calibration ruler is an accurate reference for linear measurement magnification correction. Because of unpredictability and machine specificity, the magnification and distortion of a cephalometric unit should be calibrated for the estimation of cephalometric measurement error.


Asunto(s)
Calibración/normas , Cefalometría/métodos , Radiografía Dental Digital/instrumentación , Algoritmos , Cefalometría/normas , Humanos , Ortodoncia/instrumentación , Fantasmas de Imagen , Magnificación Radiográfica , Radiografía Dental Digital/métodos , Radiografía Panorámica , Pantallas Intensificadoras de Rayos X
3.
J Craniomaxillofac Surg ; 47(12): 1868-1874, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31812310

RESUMEN

BACKGROUND: Maxillary advancement may affect speech in cleft patients. AIMS: To evaluate whether the amount of maxillary advancement in Le Fort I osteotomy affects velopharyngeal function (VPF) in cleft patients. METHODS: Ninety-three non-syndromic cleft patients (51 females, 42 males) were evaluated retrospectively. All patients had undergone a Le Fort I or bimaxillary (n = 24) osteotomy at Helsinki Cleft Palate and Craniofacial Center. Preoperative and postoperative lateral cephalometric radiographs were digitized to measure the amount of maxillary advancement. Pre- and postoperative speech was assessed perceptually and instrumentally by experienced speech therapists. Student's t-test and Mann-Whitney's U-test were used in the statistical analyses. Kappa statistics were calculated to assess reliability. RESULTS: The mean advancement of A point was 4.0 mm horizontally (range: -2.8-11.3) and 3.9 mm vertically (range -14.2-3.9). Although there was a negative change in VPF, the amount of maxillary horizontal or vertical movement did not significantly influence the VPF. There was no difference between the patients with maxillary and bimaxillary osteotomy. CONCLUSIONS: The amount of maxillary advancement does not affect the velopharyngeal function in cleft patients.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Osteotomía Maxilar/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteotomía Le Fort/métodos , Habla/fisiología , Insuficiencia Velofaríngea/fisiopatología , Adolescente , Adulto , Cefalometría/métodos , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Femenino , Finlandia , Humanos , Masculino , Avance Mandibular/métodos , Maxilar/anomalías , Maxilar/cirugía , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Trastornos del Habla/fisiopatología , Trastornos del Habla/cirugía , Resultado del Tratamiento , Insuficiencia Velofaríngea/cirugía , Adulto Joven
4.
Isr Med Assoc J ; 12(21): 801-805, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31814343

RESUMEN

BACKGROUND: Sonographic estimation of birth weight may differ among evaluators due to its operator-dependent nature. OBJECTIVES: To compare the accuracy of estimation of fetal birth weight by sonography between ultrasound-certified physicians and registered diagnostic medical technicians. METHODS: The authors reviewed ultrasound examinations that had been performed by either technicians or ultrasound-certified obstetricians between 2010 and 2017, and within 2 days of delivery. Inclusion criteria were: singleton viable pregnancy, details of four ultrasound measurements (abdominal circumference, bi-parietal diameter, head circumference, and femur length), and known birth weight. The estimated fetal weight (EFW) was calculated according to the Hadlock formula, incorporating the four ultrasound measurements. The mean percentage error (MPE) was calculated by the formula: (EFW-birth weight) x100 / birth weight. RESULTS: Technicians performed 9741examinations and physicians performed 352 examinations. The proportion of macrosomic neonates was similar in both groups. Technicians were more accurate than physicians in terms of the MPE, absolute MPE, proportion of estimates that fell within ± 10% of birth weight, and Euclidean distance (P < 0.0001 for all comparisons). They were also more accurate in terms of sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating curve. Furthermore, for fetuses weighing more than 4000 grams the technicians had a lower total false prediction rate. CONCLUSIONS: Medical technicians in our institute performed better than physicians in estimating fetal weight. Further studies are warranted to confirm our findings and better delineate the role of repeat physician's examination after an initial estimation by an experienced technician.


Asunto(s)
Peso al Nacer , Cefalometría/métodos , Ultrasonografía Prenatal , Adulto , Investigación sobre la Eficacia Comparativa , Precisión de la Medición Dimensional , Femenino , Macrosomía Fetal/diagnóstico , Peso Fetal , Edad Gestacional , Humanos , Recién Nacido , Médicos/normas , Valor Predictivo de las Pruebas , Embarazo , Ultrasonografía Prenatal/métodos , Ultrasonografía Prenatal/normas
5.
Rev. Soc. Odontol. La Plata ; 29(57): 11-14, dic. 2019. ilus
Artículo en Español | LILACS | ID: biblio-1050686

RESUMEN

El propósito de este trabajo fue determinar una vinculación entre la permeabilidad de las vías aéreas superiores y la clase II dentaria en pacientes que hayan compleado su crecimiento. Los parámetros utilizados para determinarlos fueorn: el cefalograma de McNamara, en lo que respecta a las vías aéreas superiores y la posición del primer molar superior según la clasificación propuesta por Angle. Los datos para evaluarlo se obtienen mediante una telerradiografía lateral de cráneo o pruebas que pueden realizarse incluso en el consultorio. La muestra del presente trabajo estuvo conformada por 100 telerradiografías de pacientes con clase II dentaria. La obstrucción respiratoria que presentan determinados pacientes podría considerarse como un factor predisponente en el desarrollo y formación de una maloclusión. Aunque no necesariamente todos los insuficientes respiratorios presentan algún tipo de anomalía dentoesqueletal, este vínculo entre forma y función resulta muy importante a la hora del diagnóstico, pronóstico y planificación del tratamiento (AU)


The purpose of this study was to determine a link between upper airways permeability and dental class II in patients who have finished their growth. The paramaeters used for establishing them were: McNamara cephalometrics with regard to the upper airways and the position of the first upper molar according to Angle´s classification. The information to evaluate it was obtained either via lateral teleradiography of the skull or by tests which can be done in the dental office. The sample was composed of 100 teleradiographies of patients with dental class II. The breathing obstruction could be considered a predisposing factor in the increase of formation of a malocclusion. Yet not every insufficient breather has some kind of skeletal tooth anomaly; thus, establishing the link between shape and function is a determining factor at the time of giving the correct diagnosis and prognosis and to decide the best treatment (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Sistema Respiratorio/anatomía & histología , Cefalometría/métodos , Telerradiología , Maloclusión de Angle Clase II , Diente Molar
6.
Niger J Clin Pract ; 22(11): 1530-1538, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31719274

RESUMEN

Background: Bimaxillary protrusion is a common dentofacial condition associated with proclination of maxillary and mandibular incisors in relation to the dental and cranial bases resulting in soft tissue procumbency. The present retrospective study aimed to investigate dental and soft tissue profile changes using cephalometric analysis to evaluate bimaxillary protrusion patients after extraction of the first four premolars and subsequent retraction of the anterior teeth. Materials and Methods: Pre-treatment and post-treatment cephalometric radiographs of 46 Saudi patients (16 males and 30 females), 18-30 years of age with bimaxillary protrusion, were selected based on inclusion criteria. Dental and soft tissue landmarks were traced using the Dolphin® imaging software and statistically analyzed with SPSS® 21 software. Results: The upper and lower incisors retroclined by a mean value of 9.6° and 9.65°, respectively, and an average distance of 4.1 mm. The level of maxillary incisor exposure was reduced by approximately 1.1 mm after treatment. A mean increase of 6.6° in the nasolabial angle was also observed. Multiple regression analysis showed that retraction of both upper and lower incisors by 1 mm would result in a 0.44 mm retraction of the upper and lower lips. Conclusion: A statistically significant increase in the nasolabial angle and upper lip length was found in relation to upper and lower incisor retraction and retroclination. A significant reduction was also evident in the post treatment upper incisor exposure, facial convexity angle and mentolabial sulcus depth.


Asunto(s)
Cefalometría/métodos , Cara/anatomía & histología , Incisivo/anomalías , Maloclusión/terapia , Extracción Dental , Adolescente , Adulto , Diente Premolar/cirugía , Femenino , Humanos , Incisivo/diagnóstico por imagen , Labio/anatomía & histología , Masculino , Maloclusión/etnología , Maxilar , Aparatos Ortodóncicos , Radiografía , Estudios Retrospectivos , Adulto Joven
7.
Am J Orthod Dentofacial Orthop ; 156(4): 453-463, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582117

RESUMEN

INTRODUCTION: Extraction of one mandibular incisor in adolescents and adults can simplify orthodontic treatment in 2 major circumstances: (1) severe crowding of the mandibular but not the maxillary incisors, and (2) mild anterior crossbite with good alignment in both arches. Despite its potential advantages, this method has had limited use in most practices. There have been 3 major objections: (1) the possibility of unsightly black triangles because of loss of interdental papilla height, (2) a possible tooth size discrepancy that would affect occlusal relationships, and (3) patient concerns about a visible extraction site. All 3 objections now can be overcome. METHODS: For 37 consecutively treated single-incisor-extraction patients, preparation of the extraction site for the tooth to be extracted was done by tipping it lingually while simultaneously closing the space in front of it. Treatment outcomes and the effect of age at the time of treatment were evaluated. RESULTS: In patients below age 20, this approach eliminated post-treatment black triangles and almost eliminated partial loss of the interdental papilla. It reduced the previously reported prevalence of these problems in patients aged 20-40 years and did not seem to be helpful in those aged over 40 years. This positive effect was achieved because of maintenance of alveolar crest height that supports the interdental papillae. Tooth size discrepancy caused by incisor extraction was largely compensated by the different labio-lingual orientation of maxillary and mandibular anterior teeth. The extraction space quickly disappeared during extraction site preparation. CONCLUSIONS: The new procedure of extraction site preparation described in this paper offers more favorable outcomes for post-treatment prevalence of black triangles in younger patients but shows limited efficacy in older patients. Camouflage of a mild skeletal Class III problem is the major indication for this extraction pattern. About 3% of Icelandic orthodontic patients appear to be good candidates for this treatment, and this finding should be reasonably generalizable to other populations of European descent.


Asunto(s)
Incisivo/cirugía , Mandíbula/cirugía , Extracción Dental/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Adulto , Anciano , Cefalometría/métodos , Niño , Estética Dental , Femenino , Humanos , Islandia , Incisivo/diagnóstico por imagen , Masculino , Maloclusión de Angle Clase III/terapia , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Fotograbar , Resultado del Tratamiento
8.
Am J Orthod Dentofacial Orthop ; 156(4): 493-501, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582121

RESUMEN

INTRODUCTION: The purpose of this research was to evaluate dental compensation in facial asymmetry and its correlation with skeletal variables using cone-beam computed tomography. METHODS: Sixty adult patients were retrospectively divided into asymmetry (mean age, 21.8 ± 5.4 years) and symmetry groups (mean age, 28.1 ± 4.1 years); both groups comprised 30 patients. Independent and paired t tests were used for comparisons between the asymmetry and symmetry groups and between deviated (Dv) and nondeviated (NDv) sides of the asymmetry group, respectively. Pearson correlation between dental and skeletal variables was performed. RESULTS: The mean value of menton deviation was 9.4 mm in the asymmetry group. Compared with the symmetry group, the direction and amount of dental compensation of the asymmetry group were as follows: 2.5-mm extrusion of the maxillary first molar (UM6) at NDv (P <0.05); 1.8-mm higher position of the mandibular canine (LC) from the mandibular horizontal plane using mental foramen (MHP_mf) at NDv (P <0.05); 6°-more buccoversion of UM6 at Dv; 3.7°-more linguoversion of UM6 at NDv; 4.8°-more buccoversion of the maxillary canine (UC) at Dv; 4.9°-more buccoversion of the mandibular molar (LM6) at NDv; and 2.6°-more linguoversion of LC at Dv. Dental compensation correlated or marginally correlated with skeletal variables of the deviated mandible. CONCLUSIONS: Dental compensations, extrusion of the maxillary molars on the NDv, and buccal tipping of the maxillary teeth and lingual tipping of the mandibular teeth on the Dv, were observed. The mandibular body length was associated with linguoversion of the mandibular molars on the Dv. The ramal inclination was related to the extrusion of the maxillary molars on the NDv.


Asunto(s)
Cefalometría/métodos , Tomografía Computarizada de Haz Cónico/métodos , Asimetría Facial/diagnóstico por imagen , Maloclusión/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Adolescente , Adulto , Estética Dental , Asimetría Facial/fisiopatología , Femenino , Humanos , Imagen Tridimensional/métodos , Masculino , Maloclusión/fisiopatología , Persona de Mediana Edad , Diente Molar/fisiopatología , Estudios Retrospectivos
9.
Am J Orthod Dentofacial Orthop ; 156(4): 502-511, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582122

RESUMEN

INTRODUCTION: The aims of this study were to analyze differences in craniofacial and upper cervical spine morphology, including posterior cranial fossa and growth prediction signs between European and Asian skeletal Class III children, and to analyze associations between morphologic deviations in the upper cervical spine and craniofacial characteristics. METHODS: A total of 60 skeletal Class III children, 19 Danes and 41 Koreans, were included. Upper spine morphology, Atlas dimensions, and craniofacial morphology, including posterior cranial fossa and growth prediction signs, were assessed on lateral cephalograms. Differences and associations were analyzed by multiple linear and logistic regression analyses adjusted for age and gender. RESULTS: In the craniofacial morphology, the inclination of the maxilla (NSL/NL, P <0.05) and the shape of the posterior cranial fossa (s-d, d-p, p-iop; P <0.01 and P <0.0001, respectively) were significantly different between the 2 groups. There was no significant difference in upper cervical spine morphology and Atlas dimensions between the groups. Fusion was significantly associated with the sagittal jaw relationship (P <0.05), and the total upper spine deviations were significantly associated with some growth prediction signs (P <0.05, P <0.01). Atlas dimensions were significantly associated with the prognathia of the mandible (P <0.05), posterior cranial fossa (P <0.01, P <0.0001), and some growth prediction signs (P <0.05, P <0.01). CONCLUSIONS: Upper spine morphology and Atlas dimensions may provide valuable information for predicting jaw growth and craniofacial morphology in Class III malocclusion.


Asunto(s)
Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Cefalometría/métodos , Atlas Cervical/diagnóstico por imagen , Vértebras Cervicales/diagnóstico por imagen , Anomalías Craneofaciales/diagnóstico por imagen , Anomalías Craneofaciales/etnología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/etnología , Adolescente , Atlas Cervical/crecimiento & desarrollo , Vértebras Cervicales/crecimiento & desarrollo , Niño , Dinamarca , Femenino , Humanos , Masculino , República de Corea
10.
J Craniofac Surg ; 30(7): e611-e615, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31478954

RESUMEN

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.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Puntos Anatómicos de Referencia , Cefalometría/métodos , Tomografía Computarizada de Haz Cónico/instrumentación , Humanos , Imagen Tridimensional/métodos , Mandíbula/anatomía & histología , Reproducibilidad de los Resultados , Base del Cráneo/anatomía & histología
11.
Am J Orthod Dentofacial Orthop ; 156(3): 337-344, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474263

RESUMEN

INTRODUCTION: Clinical evaluation of the midface including the paranasal and upper lip regions is highly subjective and complex. Traditional and 3-dimensional cephalometrics were not developed with the clinical appearance of these midfacial areas in mind and are therefore inappropriate surrogates for the clinical appearance of the midface, making them unsuitable as aids in diagnosing dentofacial deformities. The aim of this study was to evaluate traditional as well as newly defined landmarks and measurements and their correlation with clinical appearance of the midface. METHODS: Fifty-two subjects who underwent full-field cone-beam computed tomography were recruited for this study. A single examiner assessed each subject's midfacial region (paranasal and upper lip), and a second examiner obtained traditional and newly defined cephalometric measurements for each subject. Both examiners were blinded to each other's data throughout the study. Statistical analysis was performed to assess the correlations of the traditional and novel cephalometric measurements with clinical midfacial findings. The impact of the soft tissue thickness in the paranasal region was also analyzed. The performance of any classification derived from statistically significant variables was analyzed with the use of micro-F scores and area under the receiver operating characteristic curve (AUC). RESULTS: Both traditional (SNA) and newly defined measurements (SNANS, SNPR, SNNP, SNh) had no statistically significant correlation with clinical paranasal diagnosis. However, in the absence of upper lip procumbency or protrusion, SNNP and SNh had statistically significant correlations with clinical paranasal diagnosis (P = 0.047 and P = 0.003, respectively). For upper lip analysis, both traditional (SNA) and newly defined measurements (SNCEJ) had strong correlations with clinical upper lip diagnosis (P < 0.001). All statistically significant cephalometric variables had good intra- and interobserver reliability (correlation coefficients ≥0.972 and ≥ 0.968, respectively) except SNA, which had a low interobserver reliability (correlation coefficient 0.739). Fitted models for paranasal and upper lip analyses showed low micro-F scores, indicating low precision and recall. However, AUC values of 0.7019 and 0.6362 for the paranasal and upper lip analysis, respectively, suggest improved performance of the model when properly trained with a larger sample size. CONCLUSIONS: Newly defined measurements SNh and SNNP correlated with clinical paranasal diagnosis only in the absence of upper lip procumbency and protrusion. SNA and SNCEJ were strongly correlated with clinical upper lip diagnosis. However, fitted models based on this study sample yielded low micro-F scores, making the fitted models currently unsuitable for anything besides correlation with clinical findings. A larger sample size will be necessary to further clarify the potential roles of these measurements, especially given the reasonable AUC values. The findings of this study demonstrate the highly subjective and relative nature of midfacial diagnosis and the importance of clinical judgment despite the potential utility of some traditional and new measurements.


Asunto(s)
Puntos Anatómicos de Referencia/anatomía & histología , Puntos Anatómicos de Referencia/diagnóstico por imagen , Cefalometría/métodos , Imagen Tridimensional/métodos , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Adolescente , Adulto , Niño , Tomografía Computarizada de Haz Cónico/métodos , Cara/anatomía & histología , Cara/diagnóstico por imagen , Femenino , Humanos , Imagen Tridimensional/estadística & datos numéricos , Labio/anatomía & histología , Labio/diagnóstico por imagen , Modelos Logísticos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto Joven
12.
Am J Orthod Dentofacial Orthop ; 156(3): 375-382, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474267

RESUMEN

INTRODUCTION: The aim of this work was to compare the skeletal and dental outcomes of 1- versus 2-phase treatment in Class II subjects with difficult-to-treat high-angle severe Class II malocclusions. METHODS: The sample of 120 cases was collected from the private offices of 3 experienced clinicians. The following selection criteria were used: (1) ANB ≥6°, (2) SN-GoGn ≥37° or mandibular plane to Frankfort horizontal plane ≥30°; and (3) overjet ≥6 mm. Patients were classified into either the early or the late treatment group according to dental age (early Tx: ≥5 primary teeth; late Tx: otherwise). Thirty-four angular, linear, and proportional measurements were determined for each patient. Statistical significance was assessed with the use of a 2-tailed t test, analysis of covariance test, and chi-square test. RESULTS: The results showed that early 2-phase treatment for severe Class II high-angle patients offered no skeletal anteroposterior advantages over late 1-phase treatment. Severe high-angle Class II patients also showed similar dental anteroposterior outcomes with the use of both approaches. Vertically there was a higher frequency of increased mandibular plane angles and extrusion of upper incisors and lower molars in the late treatment group. CONCLUSIONS: Early 2-phase treatment for severe Class II high-angle patients offered no skeletal or dental advantage over late 1-phase treatment.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Ortodoncia Correctiva/métodos , Adolescente , Cefalometría/métodos , Niño , Femenino , Humanos , Incisivo , Masculino , Mandíbula , Maxilar , Diente Molar , Sobremordida/terapia , Factores de Tiempo , Resultado del Tratamiento
13.
J Craniofac Surg ; 30(7): 2202-2206, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31403514

RESUMEN

PURPOSE: To propose a three-dimensional cephalometric analysis of upper airway (UA) related to its functionality, defining normal reference values in healthy individuals and the relationship between nostril, nasal valve, and minimal cross-sectional area (MCS) in functional upper airway. MATERIALS AND METHODS: The UAs of 20 Class I patients were analyzed with CBCT using Nemoceph 3D-OS and HOROS software, determining linear distances, volumes and cross-sectional areas, including MCS. RESULTS: MCS was mostly located in the middle-upper oropharynx and high hypopharynx. MCS showed moderate correlation with the area of both nares (BNA) (r = 0.60, P = 0.004) and high correlation with the area of both internal nasal valves (BNV) (r = 0.66, P = 0.0016). BNA and BNV showed a moderate correlation (r = 0.445, P = 0.049). A total upper airway (TUA) and functional upper airway (FUA) volumes were established. TUA and FUA showed the strongest statistical correlation (r = 0.82, P = 0.00). A paired samples t test compared the measurement as absolute values of MCS with BNA (t = 0.781, P = 0.44), with BNV (t = -0.12, P = 0.90); and BNA with BNV (t = -0.76, P = 0.45), showed no significant differences. CONCLUSIONS: A functional cephalometric analysis of the UA with stable parameters in cervical spine and normal reference values has been proposed. BNA and BNV could be used as reference to establish the MCS compatible with respiratory health.


Asunto(s)
Cavidad Nasal/diagnóstico por imagen , Nariz/diagnóstico por imagen , Adulto , Cefalometría/métodos , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Hipofaringe , Masculino , Orofaringe , Programas Informáticos
14.
J Craniofac Surg ; 30(5): 1568-1571, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31299770

RESUMEN

INTRODUCTION: Lateral cephalometric radiographs (LCR) have been the standard tool used for cephalometric analysis in craniofacial surgery. Over the past decade, a three-dimensional (3D) revolution in cephalometric analysis and surgical planning has been underway. To date, research has not validated whether cephalometric measurements taken from two-dimensional (2D) and 3D data sources are equivalent and interchangeable. The authors sought to compare angular cephalometric measurements taken with 2D and 3D modalities. METHODS: Sixty-two head CT scans (36 females, 26 males) with an average age of 63 ±â€Š20 years were studied. Twelve cephalometric angular measurements were taken from 3D reconstructed skulls using the software package Mimics 19.0 (Materialize; Leuven, Belgium). These same facial angles were measured from 2D lateral cephalograms reconstructed from the original CT scans using Dolphin 11.9. Measurements taken with both techniques were compared for agreement using a paired t test. Intra-class correlation coefficient assessment was used to determine inter-rater reliability. Statistical significance was set at P < 0.05. RESULTS: Five of the 12 angular measurements (SNA, SNB, MP-FH, U1-SN, and U1-L1) demonstrated statistically significant differences (P < 0.05) between the 2D and 3D analyses. All of these differences were less than the standard deviations for the respective measure. CONCLUSION: The differences between angular cephalometric values obtained from 2D LCRs and 3D CT reconstructions are small. This supports the practices of using 2D and 3D cephalometric data interchangeably in most applications. Clinicians must be selective in which measures they employ to maximize accuracy and care must be taken when measuring dental inclination with lateral cephalograms.


Asunto(s)
Cefalometría/métodos , Adulto , Anciano , Anciano de 80 o más Años , Cara , Femenino , Humanos , Imagen Tridimensional/métodos , Masculino , Persona de Mediana Edad , Radiografía Dental , Reproducibilidad de los Resultados , Cráneo/diagnóstico por imagen , Tomografía Computarizada por Rayos X
15.
J Craniofac Surg ; 30(5): e408-e411, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31299795

RESUMEN

PURPOSE: To know whether there is a correlation between maxillary advancement and the nasolabial angle change allows to preoperatively predict the precise affect a planned maxillary advancement will have over the nasolabial angle. The aim of this study was to determine the relationship between the maxillary advancement and the nasolabial angle. METHODS: The study is a retrospective analysis of 32 patients (12 males and 20 females, mean age 21 ±â€Š3.4 years) who underwent a maxillary advancement. Lateral cephalometric radiographs were taken preoperatively and postoperatively. The lateral cephalograms were traced. Measurements were evaluated statistically using paired sample t-test and Pearson's correlation test. RESULTS: The mean maxillary advancement was 4.81 ±â€Š3.01 mm with a mean vertical change of -0.28 ±â€Š2.80 mm. The nasolabial angle decreased by a mean of 3.78 ±â€Š9.64° with statistical significance of P = 0.03 using a paired sample t-test, however using Pearson's correlation test, no direct correlation between maxillary advancement and the nasolabial angle was found. Furthermore, the study contains a review of the literature from the last 25 years, which shows that in most studies there was no correlation and in some patients even opposite results. CONCLUSION: Maxillary advancement might influence the nasolabial angle; however, preoperatively predicting the influence a maxillary advancement will have over the nasolabial angle is difficult, and further studies need to be conducted.


Asunto(s)
Maxilar/cirugía , Adolescente , Cefalometría/métodos , Femenino , Humanos , Masculino , Radiografía , Estudios Retrospectivos , Adulto Joven
16.
J Craniofac Surg ; 30(5): e469-e474, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31299819

RESUMEN

BACKGROUND: Respiratory system is an important section in development of maxillofacial components and many studies indicated its effect on normal growth of the jaws. The aim of this study is to evaluate upper airway in different skeletal classifications of jaws in lateral cephalogram and its relation to age and gender. MATERIALS AND METHODS: Study samples were 105 digital cephalometric radiographies, 72 females and 33 males. Lateral cephalograms were hand traced and based on Stainer analysis, there were 30 samples in Class I, 30 samples in Class II and 45 samples in Class III subgroup. Vertical linear measurements, horizontal linear measurements, and angular measurement, proportions and space measurements of the airway in the Cephalograms were analyzed by AutoCAD software. RESULTS: Data were analyzed using SPSS software version 20. Two horizontal linear measurement (the hypo pharyngeal airway depth, the nasopharyngeal airway depth) and one space measurement (soft palate space) were significantly different in skeletal classes. Vertical and horizontal linear measurements in the 3 groups were increased significantly in men rather than women. The developmental age of groups showed some significant differences. CONCLUSION: Upper airway dimension is different in different skeletal classes, developmental ages, and gender.


Asunto(s)
Nariz , Cefalometría/métodos , Femenino , Humanos , Maxilares , Masculino , Maloclusión , Nasofaringe , Paladar Blando , Faringe
17.
Am J Orthod Dentofacial Orthop ; 156(1): 113-124, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256824

RESUMEN

Scissor bite often remains unnoticed by patients although it can adversely affect facial symmetry, jaw growth, and mastication. This case report illustrates the efficacy of temporary skeletal anchorage devices (TSADs) and a modified lingual arch in correcting severe scissor bite. A 28-year-old woman presented with severe scissor bite in the mandibular right posterior segment. To treat this condition, TSADs were used for maxillary posterior intrusion and a modified lingual arch for buccally uprighting mandibular posterior teeth. Long-term retention records demonstrate stable treatment results.


Asunto(s)
Oclusión Dental , Maloclusión de Angle Clase II/terapia , Maloclusión de Angle Clase I/terapia , Ortodoncia Correctiva/métodos , Adulto , Cefalometría/métodos , Modelos Dentales , Femenino , Humanos , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase I/cirugía , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/cirugía , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Mandíbula/cirugía , Maxilar/diagnóstico por imagen , Maxilar/patología , Maxilar/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Alambres para Ortodoncia , Ortodoncia Correctiva/instrumentación , Técnica de Expansión Palatina , Planificación de Atención al Paciente , Factores de Tiempo , Resultado del Tratamiento
18.
Am J Orthod Dentofacial Orthop ; 156(1): 148-156, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256828

RESUMEN

This article reports on the technical aspects of using a computer-aided design-computer-aided manufacturing (CAD-CAM) insertion guide for the placement of orthodontic mini-implants used for the purpose of providing anchorage support for maxillary molar distalization. A 10-year-old girl presented with a bilateral full-step Angle Class II molar relationship in the permanent dentition, with anterior arch-length insufficiency and blocked out maxillary canine teeth. The primary treatment objective was to provide an esthetic and functional occlusal outcome, and secondarily to avoid the removal of multiple premolar teeth. The patient was initially treated with an implant-supported distalization device, and the occlusion was subsequently detailed with preadjusted fixed orthodontic appliances. The CAD-CAM procedure facilitates the safe and precise insertion of mini-implants in the anterior palate, potentially broadening the scope of use of palatal mini-implants for less experienced clinicians. The illustrated protocol allows for the insertion of mini-implants and fitting of a prefabricated appliance in a single office appointment.


Asunto(s)
Tornillos Óseos , Diseño Asistido por Computador , Implantes Dentales , Maloclusión de Angle Clase II/terapia , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico/métodos , Técnicas de Movimiento Dental/métodos , Diente Premolar , Cefalometría/métodos , Niño , Diente Canino , Modelos Dentales , Dentición Permanente , Estética Dental , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/cirugía , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Diseño de Aparato Ortodóncico/instrumentación , Aparatos Ortodóncicos Fijos , Alambres para Ortodoncia , Paladar (Hueso)/diagnóstico por imagen , Paladar (Hueso)/cirugía , Planificación de Atención al Paciente , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento
19.
Am J Orthod Dentofacial Orthop ; 156(1): 53-60, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256838

RESUMEN

INTRODUCTION: Pharyngeal airway space (PAS) assessment has been used in the past for a better understanding of orthodontic and surgical outcomes; however, this analysis could be unreliable. Our objective was to evaluate possible changes in the PAS reading in the same patient from their consecutive cone-beam computed tomography (CBCT) scans. METHODS: We evaluated a total of 27 patients' CBCT scans obtained at 2 time points with the use of a standardized acquisition protocol. The mean age at T0 was 31 years (range 17-62 years) and the follow-up records (T1) were taken after 4-6 months. Dolphin Imaging software was used to measure the volumes of the nasopharynx, oropharynx, and hypopharynx. We also evaluated the craniocervical position with the use of a lateral cephalogram. RESULTS: The variables exhibited high intraclass correlation coefficients (ICCs) when measuring the same CBCT scan twice (T0 and T0). However, The ICC between the measurements performed on the first and second CBCT scans (T0 and T1) showed that the only variable with high reproducibility between the 2 scans was cranial base, with an ICC >0.97. Average differences of 682.1 mm3, 2255.3 mm3, and 517.4 mm3 were found for the nasopharynx, oropharynx, and hypopharynx, respectively. Regarding the cephalometric angles, average differences between T0 and T1 scans were 0.6°, 2.7°, and 0.4° for OPT.CVT, OPT.SN, and cranial base, respectively. CONCLUSIONS: Different CBCT exams with equal scanning and patient positioning protocols can result in different 3D PAS readings. A more careful interpretation of CBCT volumetric data to achieve adequate conclusions of the clinical outcomes is necessary.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Tomografía Computarizada de Haz Cónico/normas , Posicionamiento del Paciente/métodos , Posicionamiento del Paciente/normas , Faringe/anatomía & histología , Faringe/diagnóstico por imagen , Adolescente , Adulto , Cefalometría/métodos , Femenino , Estudios de Seguimiento , Humanos , Hipofaringe/anatomía & histología , Hipofaringe/diagnóstico por imagen , Procesamiento de Imagen Asistida por Computador/métodos , Imagen Tridimensional/métodos , Masculino , Persona de Mediana Edad , Nasofaringe/anatomía & histología , Nasofaringe/diagnóstico por imagen , Variaciones Dependientes del Observador , Orofaringe/anatomía & histología , Orofaringe/diagnóstico por imagen , Procedimientos Quirúrgicos Ortognáticos , Valores de Referencia , Reproducibilidad de los Resultados , Programas Informáticos , Adulto Joven
20.
World Neurosurg ; 130: e831-e838, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31295617

RESUMEN

OBJECTIVE: To determine whether cranial metrics consistently differed between patients with moyamoya and age-, sex-, and race-matched controls. METHODS: Patients diagnosed with moyamoya disease by cerebral angiogram were obtained from a prospectively collected database through the Department of Neurosurgery at the University of Kansas Medical Center. Control patients matched by decade of age, sex, and race were collected through a deidentified hospital database by International Classification of Diseases-9 and 10 codes for ischemic stroke to identify patients with computed tomography angiograms. Imaging studies for both groups were analyzed to obtain 6 skull metrics: maximum anterior to posterior distance, maximum biparietal distance, bregma to occiput distance, right carotid canal diameter (CCD), left CCD, and cephalic index. RESULTS: Forty-five patients were identified in each cohort. Measurements of mean anterior to posterior skull diameter, mean biparietal skull diameter, bregma to occiput distances, and calculated cephalic index did not demonstrate a statistically significant difference between patients with moyamoya and control patients. Right carotid canal mean diameter was 4.8 mm for the moyamoya group and 5.4 mm for the control group, with a significant raw mean difference of -0.61 mm (95% confidence interval, -0.95 to -0.27). Left CCD was 4.7 mm for the moyamoya group and 5.5 mm for the control group, resulting in a significant raw mean difference of -0.76 mm (95% confidence interval, -1.09 to -0.43). CONCLUSIONS: This study identified 2 skull parameters as statistically different in patients with moyamoya compared with a matched control group of patients with ischemic stroke: right CCD and left CCD.


Asunto(s)
Cefalometría/métodos , Enfermedad de Moyamoya/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Cefalometría/normas , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto Joven
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