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1.
J Craniofac Surg ; 33(4): e376-e382, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-36041093

RESUMO

OBJECTIVE: To evaluate the accuracy of intentional change of the frontal ramal inclination (FRI) from virtual to actual orthognathic surgery. MATERIALS AND METHODS: A total of 16 patients who underwent orthognathic surgery for correction of facial asymmetry and took cone-beam computed tomography 2 to 3 weeks before surgery (T0) and 3 days after surgery (T1A) were selected. After reorientation of cone-beam computed tomography, the digital imaging and communications in medicine data was converted to StereoLithography format for the merging with dental cast scan using R2GATE software (MegaGen Implant, Daegu, Republic of Korea). During virtual surgery using Geomagic Freeform Plus software (3D Systems, Rock Hill, SC), bilateral FRI discrepancy was corrected (T1V) and 3D-printed surgical wafers and customized metal plates were manufactured using 3D printer (Meg-printer II, MegaGen Implant, Daegu, Republic of Korea) and computer numerical control milling machine (ARDEN, TPS Korea Ltd., Gwangju, Republic of Korea) accordingly. During surgery, FRI correction was done using surgical guide and customized plates. The difference between preoperative and virtually corrected FRI (Δ T1V - T0) and the difference between preoperative and actually surgically corrected FRI (Δ T1A - T0) were measured, and the achieved FRI correction in percentage ([Δ T1A - T0]/[Δ T1V - T0] × 100) was calculated. RESULTS: The mean absolute value of virtual FRI correction (Δ T1V - T0) and actual FRI correction (Δ T1A - T0) were 3.0° and 2.9°, respectively (n = 32). In the increased (medial rotation) FRI group, mean virtual and actual correction amount were 3.2° and 2.8° (n = 17), whereas in the decreased (lateral rotation) group, mean virtual and actual correction amount were -2.7° and -3.1°, respectively (n = 15). No statistically significant difference between virtual and actual measurements were present in either group. The mean achievement rate was 102.8%. Tendency of undercorrection (91.2%) in the increased FRI group and overcorrection (116.0%) in the decreased FRI group were noted. DISCUSSION: With virtual planning and computer-aided design and computer-aided manufacturing-made customized plates, it is possible to correct FRI during orthognathic surgery of patients with facial asymmetry.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cirurgia Assistida por Computador , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/cirurgia , Humanos , Imageamento Tridimensional/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Cirurgia Assistida por Computador/métodos
2.
BMC Oral Health ; 22(1): 277, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799192

RESUMO

BACKGROUND: Facial symmetry is becoming increasingly important in today's orthodontic treatment. But the asymmetrical boundary is not clearly demarcated. Stereophotogrammetry has a clear advantage in measuring facial asymmetry. The aim of this study was to quantify the facial asymmetry by three-dimensional (3D) technology as well as to study whether the evaluation by non-experts about facial asymmetry was consistent with the analysis by 3D technology. METHODS: The facial symmetry of 330 patients was evaluated by 10 non-experts. 3D facial images were taken using 3dMD stereophotogrammetry equipment. The original face and its mirror shell were divided into 7 regions and the surface matching was measured in the whole face and all regional areas. The degree of symmetry was calculated by the software 3-matic STL 9.0. The difference between the two groups was analyzed by Independent-Samples T Test and the diagnostic efficiency of symmetry degree was analyzed by ROC curve analysis. The consistency between the symmetric degree and the result of evaluation was analyzed by Pearson correlation analysis. RESULTS: The ROC analysis revealed significant diagnostic values in the determination of the facial asymmetry of lip, chin, cheek and lateral mandible areas. The cut-off values of symmetry degree were between 60 and 80%. The evaluation was middle correlation with the symmetric degree of the whole face. CONCLUSIONS: The chin and lateral mandible contribute most significantly to the facial symmetry. The objective measurement of facial symmetry, 3D technology, is reliable.


Assuntos
Assimetria Facial , Fotogrametria , Cefalometria/métodos , Face/anatomia & histologia , Face/diagnóstico por imagem , Assimetria Facial/diagnóstico por imagem , Humanos , Imageamento Tridimensional/métodos , Fotogrametria/métodos , Tecnologia
3.
Medicina (Kaunas) ; 58(7)2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35888588

RESUMO

Background and Objectives: We aimed to develop a cranial suture traction therapy program, a non-surgical therapeutic method for facial asymmetry correction. Materials and Methods: Six experts, including rehabilitation medicine specialists, oriental medical doctors, dentistry specialists, five experts, including Master's or doctoral degree holders in skin care and cosmetology with more than 10 years of experience in the field, 4 experts including educators in the field of skin care, a total of 15 people participated in the validation of the development of the cranial suture traction therapy program in stages 1 to 3. Open questions were used in the primary survey. In the second survey, the results of the first survey were summarized and the degree of agreement regarding the questions in each category was presented. In the third survey, the degree of agreement for each item in the questionnaire was analyzed statistically. Results: Most of the questions attained a certain level of consensus by the experts (average of ≥ 4.0). The difference between the mean values was the highest for the third survey at 0.33 and was the lowest between the second and third surveys at 0.47. The results regarding the perceived degree of importance for each point of the evaluation in both the second and third stages of the cranial suture traction therapy program were verified using the content validity ratio. The ratio for the 13 evaluation points was within the range of 0.40-1.00; thus, the Delphi program for cranial suture traction therapy verified that the content was valid. Conclusions: As most questions attained a certain level of consensus by the experts, it can be concluded that these questions are suitable, relevant, and important. The commercialization of the cranial suture traction treatment program will contribute to the correction and prevention of facial dislocations or asymmetry, and the developed treatment will be referred to as cranial suture traction therapy (CSTT).


Assuntos
Suturas Cranianas , Tração , Técnica Delfos , Assimetria Facial/terapia , Humanos , Inquéritos e Questionários
4.
Orthod Fr ; 93(2): 169-186, 2022 06 01.
Artigo em Francês | MEDLINE | ID: mdl-35818283

RESUMO

Introduction: Positional plagiocephaly (PP) is characterized by an asymmetrical flatness of the posterior part of the skull which may involve the frontal part of the skull and the face. The aim is to assess whether children and adolescents with PP have more occlusal and skeletal asymmetries and whether the need for orthodontic treatment is greater than in the healthy population. Material and Method: A comparative cross-sectional epidemiological study was carried out. One hundred children and adolescents were included: 50 in the PP group and 50 in the control group. The need for orthodontic treatment was assessed by the Index of Orthodontic Treatment Need (IOTN). The mandibular and dental asymmetries were measured on lateral cephalometry by two indexes: index of mandibular asymmetry (IMA) and index of dental asymmetry (IDA) respectively. Chi and Student independence tests were performed with a threshold of 5%. Results: The tests are significant for IMA (p = 0.02) and IOTN (p = 0.000012). IDA is insignificant. Discussion: Orthosurgical treatment of mandibular laterognathies by mandibular recentering sometimes creates mandibular asymmetry, while the shift is basal. We must be able to act early on the vault of the skull to hope to obtain a consecutive effect on the base and therefore on the position of the glenoid cavities. Management by manual therapy and early cranial orthosis could be estimated. Conclusion: The need for orthodontic treatment is significantly greater in PP. Unlike mandibular asymmetry, dental asymmetry is not significantly greater than in the control group, testifying to the adaptive capacities of the organism.


Introduction: Les plagiocéphalies positionnelles (PP) sont caractérisées par un aplatissement asymétrique de la partie postérieure du crâne pouvant impliquer la partie frontale du crâne et la face. L'objectif de cet article était d'évaluer si les enfants et les adolescents atteints de PP ont davantage de dissymétries occlusales et squelettiques, et si le besoin de traitement orthodontique est plus important que dans la population saine. Matériel et méthode: Une étude épidémiologique transversale comparative a été menée. Cent enfants et adolescents ont été inclus : 50 dans le groupe PP et 50 dans le groupe témoin. Le besoin de traitement orthodontique a été évalué par l'Index of Orthodontic Treatment Need (IOTN). La dissymétrie squelettique et dentaire a été évaluée radiologiquement par deux indices : l'Index of Mandibular Asymmetry (IMA) et l'Index of Dental Asymmetry (IDA). Des tests d'indépendance du Chi et Student ont été effectués avec un seuil de 5 %. Résultats: L'IMA (p = 0,02) et l'IOTN (p = 0,000012) sont significatifs. L'IDA est non significatif. Discussion: Le traitement ortho-chirurgical des latéromandibulies par recentrage mandibulaire crée parfois une dissymétrie mandibulaire, alors que le décalage est basal. Il faudrait pouvoir agir précocement sur la voûte du crâne pour espérer obtenir un effet consécutif sur la base et donc sur la position des cavités glénoïdes. Une prise en charge par thérapies manuelles et orthèse crânienne précoce pourrait être évaluée. Conclusion: Le besoin de traitement orthodontique est significativement plus important en cas de PP. Contrairement à la dissymétrie mandibulaire, la dissymétrie dentaire n'est pas significativement plus importante que dans le groupe témoin, témoignant des capacités adaptatives de l'organisme.


Assuntos
Plagiocefalia não Sinostótica , Adolescente , Cefalometria , Criança , Estudos Transversais , Assimetria Facial/diagnóstico , Assimetria Facial/terapia , Humanos , Mandíbula , Plagiocefalia não Sinostótica/diagnóstico , Plagiocefalia não Sinostótica/terapia
5.
J Craniofac Surg ; 33(5): e495-e497, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35758422

RESUMO

ABSTRACT: Parry-Romberg syndrome (PRS) is a rare disorder resulting in disfiguring facial asymmetry. Ocular manifestations can result in complex strabismus. There were limited reports on the treatment of PRS with coexisting strabismus. We present a multistaged surgical approach to manage the facial asymmetry and strabismus.


Assuntos
Hemiatrofia Facial , Estrabismo , Adolescente , Face , Assimetria Facial/etiologia , Assimetria Facial/cirurgia , Hemiatrofia Facial/complicações , Hemiatrofia Facial/cirurgia , Feminino , Humanos , Estrabismo/complicações , Estrabismo/cirurgia
6.
J Popul Ther Clin Pharmacol ; 29(1): e82-e86, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35686899

RESUMO

Post traumatic condylar hyperplasia condition is an increase in the total number of cells due to increased activity, which exist only as long as the activity or the stimulus is applied. When it is removed, the tissue returns to the normal state; however, a secondary structural alteration in the general architecture due to accompanying degeneration may render a complete return to the normal state impossible. Mandibular asymmetry following condylar injury is poorly documented as a cause of facial asymmetry. leFort1 (low-level fracture) osteotomies and bilateral sagittal mandibular osteotomies, which are comprehensive surgical plans, correct the facial deformity together with the occlusion. An innovation of new clinical concepts has been used in the correction of facial deformity in 11 patients with post-traumatic condylar hyperplasia condition (syndrome) by applying a new modified allo plastic material (subperiosteal acrylic implant).


Assuntos
Assimetria Facial , Côndilo Mandibular , Assimetria Facial/etiologia , Assimetria Facial/patologia , Assimetria Facial/cirurgia , Humanos , Hiperplasia/complicações , Hiperplasia/patologia , Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia
7.
Int J Pediatr Otorhinolaryngol ; 159: 111207, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35716419

RESUMO

AIM: It was aimed to determine the change of facial asymmetry resulting from nasal septal deviation (SD) depending on age, gender, degree of deviation and the affected area besides the effect of SD on somatotype and craniofacial morphology. MATERIALS AND METHODS: 171 volunteers (90 males, 81 females), 27 individuals aged 9-13, 44 individuals aged 14-18, 44 individuals aged 19-23 and 56 individuals in control group participated in the study conducted in otorhinolaryngology polyclinic.11 photometric, 16 anthropometric measurements were taken from the participants. RESULTS: SD affects facial asymmetry formation, although not statistically significant compared to healthy individuals asymmetry rates (p˃0.05). It was determined that the degree of SD affected asymmetry only between the ages of 14-18 (in adolescence) and the development of asymmetry in all SD patients was not statistically dependent on age and gender (p˃0.05). Photometric measurements demonstrated asymmetries in horizontally-extending parameters of 1/3 middle part of face. There was no statistically significant difference in the cranial anthropometric measurements of the upper and lower 1/3 of the face compared to the control group (p˃0.05). The order of the most asymmetrical parameters is Alare-Zygion, Alare-Subnasale, Cheilion-Gonion, Exocanthion-Cheilion, Midsagittal plane-Zygion, Zygion-Cheilion, Zygion-Gonion, Subalare-Cheilion, Glabella-Exocanthion. In all participants were determined that endomorph somatotype was dominant in female and mesomorph somatotype was dominant in male besides SD did not affect somatotype and somatotype did not alter with age. CONCLUSION: The development of facial asymmetry due to SD is not affected by age and gender furthermore SD does not affect craniofacial asymmetry and somatotype.


Assuntos
Assimetria Facial , Deformidades Adquiridas Nasais , Adolescente , Assimetria Facial/diagnóstico , Assimetria Facial/etiologia , Feminino , Testa , Humanos , Masculino , Septo Nasal , Crânio
8.
Arch Oral Biol ; 141: 105489, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35772255

RESUMO

OBJECTIVE: The aim of this study was to use the cone beam computed tomography (CBCT) to study the relationships between the lip-line and mandible deformity. DESIGN: CBCT data of 20 patients with jaw deformity (experimental group) and 20 patients without mandible deformity (control group) were selected. Use three-dimensional cephalometry to measure the reconstructed images of CBCT data simulated by the Materialise Interactive Medical Image Control System (Mimics), mark the related points, lines and planes of the three-dimensional craniomaxillofacial structure, and measure relevant distances and angles. The T-test, Pearson correlation analysis and Linear regression were used to analyze the characteristics of the lip-line and jaw deformity. RESULTS: There was a significant difference in the lip-line between mandible deformity group and control group. Significant positive correlations could been found among the lip-line cant, the occlusal plane cant, the mandibular plane cant and the degree of mandible deformity (r=0.964, 0.942, 0.611, P < 0.01). A linear relationship was found between the left lip-line cant Y and the menton deviation X [the mandible deflection to the right was defined as positive, and the left lip-line below frankfort horizontal was viewed as positive] as Y= 0.340 + 0.505X. CONCLUSIONS: The lip-line of patients with jaw deformity was inclined, and the lip-line cant was positively correlated with the degree of mandible deformity, and there was a certain linear relationship between the two, which could provide a theoretical reference for clinicians to diagnose and treat patients with mandible deformity.


Assuntos
Assimetria Facial , Anormalidades Maxilomandibulares , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional/métodos , Lábio/anatomia & histologia , Lábio/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Maxila
9.
J Oral Rehabil ; 49(9): 915-923, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35583904

RESUMO

BACKGROUND: Unilateral posterior crossbite, one of the most frequent malocclusions, is often associated with functional lateral shift of the mandible. Although the effects of functional lateral shift on the mandible and temporomandibular joint have been examined in various animal experiments, cranial and maxillary changes have received less attention. OBJECTIVE: The aim of this study was to investigate the effects of functional lateral shift on the craniofacial complex in growing rats. METHODS: Eighty 5-week-old male Sprague-Dawley rats were randomly divided into an experimental group (n = 40), which received an oblique guide appliance that shifted the mandible to the left during closure, and a control group (n = 40). The rats were scanned by cone-beam computed tomography at 3 days and 1, 2, 4 and 8 weeks. The dimensions of the mandibular bone, condyle, maxilla and cranium were measured. RESULTS: The mandibles of rats in the experimental group were smaller than those of the rats in the control group and were asymmetrical. The condyles of the rats in the experimental group were thinner than those of the control rats. The condylar length on the ipsilateral side was shorter and wider than that on the contralateral side from 4 to 8 weeks. No significant differences in cranial length or height were observed between the experimental and control groups. The height of the upper first molar and alveolar bone on the contralateral side was significantly smaller than that on the ipsilateral side and in the controls from 4 to 8 weeks. CONCLUSION: Functional shift in the mandible produces morphological asymmetries in the mandible and maxillary region and may cause bilateral condylar degenerative changes.


Assuntos
Assimetria Facial , Má Oclusão , Animais , Assimetria Facial/complicações , Crescimento e Desenvolvimento , Masculino , Mandíbula/diagnóstico por imagem , Côndilo Mandibular/diagnóstico por imagem , Ratos , Ratos Sprague-Dawley
10.
Shanghai Kou Qiang Yi Xue ; 31(1): 62-66, 2022 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-35587671

RESUMO

PURPOSE: To evaluate the clinical effect of combined orthodontic and orthognathic treatment with invisible aligner technique without brackets in skeletal Class Ⅲ patients with facial asymmetry. METHODS: A total of 24 skeletal Class Ⅲ patients with facial asymmetry treated with combined orthodontic and orthognathic treatment during the past 4 years were reviewed. Patients in the experimental group(n=12) were treated with invisible aligner technique without brackets, while patients in the control group(n=12) were treated with traditional fixed orthodontic technique for pre- and post-operative orthodontic treatment respectively. The cephalometric parameters and satisfaction questionnaire scores of the two groups before and after treatment were compared and analyzed with SPSS 20.0 software package for t test and Wilcoxon rank sum test, respectively. RESULTS: After treatment, the cephalometric parameters of SNA, SNB, ANB, U1-SN and L1-MP values were changed significantly(P<0.05), but there was no significant difference between the values of experimental group and the control group(P>0.05). The scores of aesthetics, comfort, portability, masticatory and speech function in the experimental group were significantly higher than those in the control group(P<0.05). The satisfaction scores of the two groups were both 8.8±0.5(P>0.05). CONCLUSIONS: Skeletal Class Ⅲ patients with facial asymmetry could obtain good clinical effect by using invisible aligner technique. The patients were satisfied with the aesthetics, comfort and the effect of combined invisible orthodontic and orthognathic treatment.


Assuntos
Má Oclusão Classe III de Angle , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Estética Dentária , Assimetria Facial/terapia , Humanos , Má Oclusão Classe III de Angle/terapia , Procedimentos Cirúrgicos Ortognáticos/métodos , Resultado do Tratamento
11.
Artigo em Chinês | MEDLINE | ID: mdl-35511614

RESUMO

Objective:To assess the presentation of allergic fungal rhinosinusitis(AFRS) in children and the role of long-term comprehensive therapy of endoscopic surgery combined with drug therapy. Methods:The 3 children with AFRS were routinely examined by nasal endoscopy, CT scan, MRI scan and allergen detection before surgery, and mycological and histomathological examination were performed on the secretions in the sinus and the mucosa of the affected sinuses. All the 3 patients underwent endoscopic surgery, preoperative and postoperative treatment with oral and nasal corticosteroid, nasal irrigation, and individualized anti-allergy therapy and immunotherapy. The patients were followed up for 3 to 12 months. Results:All 3 children had nasal polyps and headache, and 2 children had exophthalmos and facial asymmetry. There were typical CT and MRI findings on imaging. Serum total IgE were all elevated, and 2 cases were positive for fungal SIgE. All 3 children underwent endoscopic surgery. Fungal hyphae and spores were found in 1 child, and other fungi tests were positive in another 2 children. Postoperative facial asymmetry was relieved spontaneously, and mucosal swelling and polypoid changes were observed in 2 children. Conclusion:AFRS is a specific type of chronic rhinosinusitis that is not uncommon in children. Early diagnosis, prompt operation, standardized treatment and long-term follow-up are very important in the diagnosis and treatment of AFRS in children.


Assuntos
Micoses , Pólipos Nasais , Rinite Alérgica , Sinusite , Criança , Doença Crônica , Assimetria Facial , Humanos , Micoses/diagnóstico , Micoses/microbiologia , Micoses/terapia , Pólipos Nasais/cirurgia , Rinite Alérgica/cirurgia , Sinusite/diagnóstico
12.
J Craniomaxillofac Surg ; 50(6): 504-514, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35599043

RESUMO

The aim of the current study was to evaluate the effect of the use of computer-guided surgical templates in association with mandibular distraction osteogenesis to correct mandibular asymmetry. In the study group a simulation process was conducted to restore the exact position of the chin skeletally by planning the osteotomy orientation, distractor vector, pin positions, and distraction distance calculation. The Control group was treated with conventional distraction in which an oblique osteotomy was done, and distraction was performed until the midline coincided. Patients were randomly allocated into two groups, study and control. The study included (12) young patients; ten males participated and two females (average age 14 ± 6 years) (Range = 6-23 years)). There was a statistically significant (P = 0.02) improvement in smile orientation in the study with 63.7% ± 19% improvement compared to control, which had only 37% ± 14%. There was a statistically significant (P = 0.02) improvement in ramus height in the study with 93% ± 9% improvement compared to control, which had only 74% ± 16%. There was a non-significant (P = 0.2) improvement in chin deviation in the study with 42% ± 26% improvement compared to control, which had only 25% ± 15%. The secondary outcome results showed that there was statistically significant (P = 0.0001) improvement in smile orientation post distraction 50% ± 21%, there was statistically significant (P= P=0.002) improvement of ramus height post distraction osteogenesis 82% ± 16%, and there was statistically significant (P = 0.0001) improvement in chin deviation 33% ± 22% post distraction osteogenesis. Overall, the current research recommends the use of computer planned distraction instead of conventional planned distraction in order to achieve better symmetry. Distraction failed in correction of chin asymmetry; thus, the authors recommend performing genioplasty post distraction after the patient reaches puberty for more optimum results regarding the chin.


Assuntos
Osteogênese por Distração , Adolescente , Adulto , Criança , Queixo/cirurgia , Computadores , Assimetria Facial/cirurgia , Feminino , Mentoplastia , Humanos , Masculino , Mandíbula/cirurgia , Osteogênese por Distração/métodos , Adulto Jovem
13.
Am J Orthod Dentofacial Orthop ; 162(3): 394-402, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35562291

RESUMO

INTRODUCTION: Facial asymmetry is common and can be clinically related to dental malocclusion, facial bone development, muscular imbalance, and soft tissues thickness, which should be assessed during diagnosis to choose proper treatment options. This study aimed to quantify the amount of symmetry/asymmetry in previously defined symmetrical and asymmetrical subjects, analyzing full-face 3-dimensional images. METHODS: Seventy-six orthodontic patients' 3-dimensional face images were obtained with the 3dMD Trio-system (Atlanta, Ga) and processed with the Geomagic Control (64-bit; 3D Systems, Rock Hill, SC) software. Patients were divided into symmetrical and asymmetrical groups through a surface-based technique. Sixteen facial landmarks were positioned, an asymmetry index was calculated for each landmark, and an evaluation diagram of facial asymmetry was created through the asymmetry index mean and standard deviation of symmetrical and asymmetrical landmarks. RESULTS: The asymmetry index mean varied from 0.05 to 1.51 in the symmetrical group and from 0.05 to 2.84 in the asymmetrical group. This study suggests that landmarks located in the lower third of the face have a greater asymmetry index than other landmarks. CONCLUSIONS: The landmark-based technique does not exhibit statistically significant differences among asymmetrical and symmetrical patients for some landmarks. This approach provides useful information about the localization and the extension of asymmetry, in which bilateral landmarks showed a higher amount of asymmetry than median landmarks.


Assuntos
Assimetria Facial , Fotogrametria , Pontos de Referência Anatômicos , Cefalometria , Assimetria Facial/diagnóstico por imagem , Ossos Faciais , Humanos , Imageamento Tridimensional/métodos , Fotogrametria/métodos , Software
14.
Am J Orthod Dentofacial Orthop ; 161(5): 698-707, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35473835

RESUMO

INTRODUCTION: This study aimed to develop an automatic pipeline for analyzing mandibular shape asymmetry in 3-dimensions. METHODS: Forty patients with skeletal Class I pattern and 80 patients with skeletal Class III pattern were used. The mandible was automatically segmented from the cone-beam computed tomography images using a U-net deep learning network. A total of 17,415 uniformly sampled quasi-landmarks were automatically identified on the mandibular surface via a template mapping technique. After alignment with the robust Procrustes superimposition, the pointwise surface-to-surface distance between original and reflected mandibles was visualized in a color-coded map, indicating the location of asymmetry. The degree of overall mandibular asymmetry and the asymmetry of subskeletal units were scored using the root-mean-squared-error between the left and right sides. These asymmetry parameters were compared between the skeletal Class I and skeletal Class III groups. RESULTS: The mandible shape was significantly more asymmetrical in patients with skeletal Class III pattern with positional asymmetry. The condyles were identified as the most asymmetric region in all groups, followed by the coronoid process and the ramus. CONCLUSIONS: This automated approach to quantify mandibular shape asymmetry will facilitate high-throughput image processing for big data analysis. The spatially-dense landmarks allow for evaluating mandibular asymmetry over the entire surface, which overcomes the information loss inherent in conventional linear distance or angular measurements. Precise quantification of the asymmetry can provide important information for individualized diagnosis and treatment planning in orthodontics and orthognathic surgery.


Assuntos
Assimetria Facial , Imageamento Tridimensional , Tomografia Computadorizada de Feixe Cônico/métodos , Assimetria Facial/diagnóstico por imagem , Ossos Faciais , Humanos , Imageamento Tridimensional/métodos , Mandíbula/diagnóstico por imagem
15.
Orthop Surg ; 14(6): 1235-1240, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35466518

RESUMO

BACKGROUND: Ponticulus posticus (PP) occurs frequently and may cause symptom series, including vertebrobasilar insufficiency, migraine, hearing loss, and Barré-Liéou syndrome. However, few studies to date have described surgical treatment of PP. We report a rare case of a patient who suffered from torticollis, facial asymmetry, localized pain, and Barré-Liéou syndrome in connection with PP. We also review the pertinent literature, focusing on surgical treatment for symptoms due to PP. CASE PRESENTATION: A 23-year-old male presented with the chief complaint of continuous significant dizziness to the point of losing consciousness while rotating his head to the right. Plain radiographs and computed tomography (CT) scans of the cervical spine showed a С1 anomaly with the formation of complete PP on the left (dominant) side, with acute-angled, С-shaped kinking of the vertebral artery. Resection of PP via the posterior midline was performed successfully. The patient had satisfactory postoperative relief from localized pain and Barré-Liéou syndrome, but there were no obvious changes in the torticollis and facial asymmetry observed during the 3-month follow-up period. CONCLUSIONS: This case is a rare presentation of torticollis, facial asymmetry, localized pain, and Barré-Liéou syndrome in connection with one-sided complete PP. This tetrad indicates that PP may affect the patient earlier than expected. In such situations, early diagnosis and timely surgical treatment may significantly improve patients' quality of life and avoid the development of torticollis and face asymmetry.


Assuntos
Atlas Cervical , Síndrome Simpática Cervical Posterior , Torcicolo , Adulto , Atlas Cervical/anormalidades , Atlas Cervical/diagnóstico por imagem , Atlas Cervical/cirurgia , Assimetria Facial/etiologia , Assimetria Facial/cirurgia , Humanos , Masculino , Dor , Qualidade de Vida , Torcicolo/diagnóstico por imagem , Torcicolo/etiologia , Torcicolo/cirurgia , Adulto Jovem
16.
Chin Med J (Engl) ; 135(8): 971-976, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35442230

RESUMO

BACKGROUND: Hemifacial microsomia (HFM), which involves multiple sites with different levels of severity, is the second most common congenital craniofacial deformity after cleft lip and palate. However, three-dimensional (3D) measurements of mandibular deformities have not yet been studied in detail. The objective of this study is to investigate the method of 3D measurements of mandibular deformities in HFM patients. METHODS: A total of 48 HFM patients were included in this study. All clinical treatment for patients was performed in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences at Peking Union Medical College from June 2006 to June 2020. The patients' 3D computerized tomography scan data were processed using medical imaging software, following four iterative steps: 3D reconstruction, mirroring, differential analysis, and partition. RESULTS: The characteristics of the mandibular bone in HFM patients are mainly presented as follows: (1) compared to the normal side, the part of the bone body that extends from the ascending ramus to the pogonion (Po-NB) is analyzed using a dynamic process: less fullness-fullness-more fullness; (2) absences were frequently observed among the angular zones, that is, the height of the ascending ramus is deficient. CONCLUSIONS: HFM is a complicated condition with numerous variations in clinical presentation. We employed both 3D image reconstruction and computerization image processing techniques to investigate asymmetrical mandibular deformity in HFM patients in detail and with great accuracy. This will be of great use to clinicians for disease management.


Assuntos
Fenda Labial , Fissura Palatina , Síndrome de Goldenhar , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/cirurgia , Síndrome de Goldenhar/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Mandíbula/anormalidades , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia
17.
Cient. dent. (Ed. impr.) ; 19(1): 17-32, ene.-abr. 2022. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-202825

RESUMO

Objetivo: El propósito de este trabajo fueconocer la similitud estadística que existeentre la altura facial ideal propuesta en elmétodo cefalométrico Silva (MCS) y la altura facial obtenida utilizando el rectángulo áureo (o Rectángulo de Euclides).Método: Se utilizaron 100 imágenes cefalométricas de pacientes ortodónticosdel Departamento de Ortodoncia de laUniversidad Latinoamericana, campusValle de la Ciudad de México, de ambossexos, seleccionando aquellas que tuvieron características aptas para el trazadocefalométrico en cuestión, siendo ubicadas 85 de éstas en el programa Keynote(Apple®), realizando MCS y el trazado delRectángulo de Euclides, cuya correlaciónse estableció con el coeficiente de correlación de Pearson.Resultados: El análisis de Pearson obtuvo un resultado de correlación importante(r)=0.69058966Conclusiones: Los resultados estadísticos demuestran que la altura facial medida con el método cefalométrico Silva ycon el rectángulo de Euclides arrojan unacorrelación importante pero no perfecta(AU)


Objective: The purpose of this work wasto know the statistical similarity that existsbetween the ideal facial height proposedin the Silva cephalometric method (SCM)and the facial height obtained using thegolden rectangle (or Euclid’s Rectangle).Method: 100 cephalometric images oforthodontic patients of the Departmentof Orthodontics of the Latin AmericanUniversity, Valle campus in Mexico City,of both sexes were used, selecting thosethat had characteristics suitable for thecephalometric tracing in question, 85of these being located in the Keynoteprogram (Apple®), performing SCMand plotting the Euclid Rectangle, thecorrelation of which was established withPearson’s correlation coefficient.Results: Pearson’s analysis obtainedan important correlation result(r) = 0.69058966Conclusions: The statistical results showthat the facial height measured with thecephalometric method and the Euclideanrectangle shows an important but notperfect correlation(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Ossos Faciais/anatomia & histologia , Assimetria Facial/diagnóstico por imagem , Cefalometria/métodos , Interpretação Estatística de Dados
18.
Ophthalmic Plast Reconstr Surg ; 38(5): 483-489, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35353779

RESUMO

PURPOSE: To analyze facial asymmetry in children with unilateral congenital ptosis. METHODS: This is a retrospective review of pediatric patients undergoing ptosis repair between January 1, 2017, and December 31, 2020. Charts were reviewed to ensure a diagnosis of idiopathic unilateral congenital ptosis. Sex, age, laterality, margin to reflex distance 1, levator function, and surgical intervention were collected.Clear preoperative photos without head turn were included. Using the ImageJ software ( nih.gov ), landmarks of the periorbital region, midface, and lower face were marked, and measurements between these landmarks were taken.Two-tailed Student t tests were used to compare measurements between the ptotic and non-ptotic sides. Relationships between different measurements on the same side of the face were analyzed using paired-variable regressions. RESULTS: Forty-four patients with unilateral congenital ptosis were included. The surgical management consisted of Mullerectomy in 9 of 44 (20%), levator resection in 15 of 44 (34%), and frontalis suspension in 20 of 44 (46%) patients. The side of the face with blepharoptosis was found to more often have smaller margin to reflex distance 1 ( p < 0.001), smaller margin to reflex distance 2 ( p < 0.005), smaller horizontal palpebral fissure ( p < 0.05), shorter midface height ( p < 0.001), and a more inferiorly displaced lateral canthus (canthal angle, p < 0.001) relative to the non-ptotic side of the face. The mean head tilt of patients with right sided ptosis (1.37° right tilt) was statistically significantly different from those with left sided ptosis (0.85° left tilt; p = 0.04). CONCLUSIONS: In children with unilateral congenital ptosis, the ptotic side of the face was found to be the nondominant side of the face. Patients were also found to have ipsilateral head tilt.


Assuntos
Blefaroplastia , Blefaroptose , Blefaroptose/congênito , Blefaroptose/diagnóstico , Blefaroptose/cirurgia , Criança , Pálpebras/cirurgia , Assimetria Facial/diagnóstico , Assimetria Facial/etiologia , Humanos , Margens de Excisão , Músculos Oculomotores , Estudos Retrospectivos
19.
Clin Oral Investig ; 26(7): 4947-4966, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35320382

RESUMO

OBJECTIVE: The present study aimed to determine the site and severity of maxillomandibular asymmetry before and after orthognathic surgery in asymmetric patients. MATERIALS AND METHODS: Presurgery and postsurgery cone beam computed tomography (CBCT) data of 21 facial asymmetry patients (7 males and 14 females, mean age: 23.0 ± 3.36 years) with soft tissue chin deviation ≥ 3 mm who had undergone bimaxillary surgery were evaluated. Seven midline and twenty bilateral hard tissue landmarks were identified for the evaluation of facial asymmetry and outcomes were assessed against age- and gender-matched control subjects. RESULTS: In the asymmetry group, bilateral landmarks exhibited significant deviation in the mandible and midface regions. Before surgery, asymmetry was more severe at the mandibular midline and sites close to it, in the asymmetry group. Bimaxillary surgery proved to be highly effective, with a significant correction of the menton to a clinically normal value (2.90 mm, p < 0.001). After surgery, significant residual asymmetry was observed at the mental foramen (p = 0.001) in the R-L direction. Moreover, significant asymmetry persisted at the sigmoid notch (p = 0.001) in the S-I direction. CONCLUSIONS: Mandibular midline landmarks and chin peripheral regions contribute significantly to overall facial asymmetry characteristics. Despite significant correction after bimaxillary surgery, asymmetry persisted at several sites, thereby requiring secondary correction. Comprehensive 3D presurgical planning is central for asymmetry correction in a single surgery. CLINICAL RELEVANCE: The present study specifies the location of residual asymmetry sites and advocates the correction of those sites during initial surgery.


Assuntos
Má Oclusão Classe III de Angle , Procedimentos Cirúrgicos Ortognáticos , Adulto , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/cirurgia , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Estudos Retrospectivos , Adulto Jovem
20.
BMJ Case Rep ; 15(3)2022 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-35338041

RESUMO

A female patient in her early 20s, with a known diagnosis of hemifacial microsomia (unilateral microtia and mandibular hypoplasia) accompanied with an unoperated cleft palate, came for an infected mandibular distraction plate removal. The anticipated difficult airway and lack of enough literature about what to expect in such a scenario, along with the psychological impact on the patient, made this case challenging and thought-provoking. Inability to perform the awake tracheal intubation because of the uncooperative patient, along with the difficult fibreoptic owing to narrowed nostrils, offered an extra set of challenges.


Assuntos
Fissura Palatina , Síndrome de Goldenhar , Micrognatismo , Adulto , Fissura Palatina/complicações , Fissura Palatina/cirurgia , Assimetria Facial/etiologia , Assimetria Facial/cirurgia , Feminino , Síndrome de Goldenhar/complicações , Síndrome de Goldenhar/diagnóstico , Síndrome de Goldenhar/cirurgia , Humanos , Mandíbula/cirurgia
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