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1.
Niger J Clin Pract ; 27(5): 647-653, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38842715

RESUMO

BACKGROUND: The occipital spur (OS) can be described as an abnormal elongation of the external occipital protuberance (EOP). The cephalic index (CI) refers to the ratio of width to length in any skull. AIM: The aim of the present study was to evaluate the frequency and types of OS. It also aimed to determine the mean CI and the distribution of skull types using cone beam computed tomography (CBCT). And to determine if there was a relationship between the cephalic index and the presence and types of OS. METHODS: CBCT scans from 523 patients were included in the study. OSs were classified as type 1 (flat), type 2 (crest), and type 3 (spine). Skull length and width were measured on axial sections and the CI was calculated. Based on the cephalic index (CI), skull types were classified as dolichocephalic (CI < 75), mesocephalic (75 < CI < 80), brachycephalic (80 < CI < 85), and hyperbrachycephalic (CI > 85). RESULTS: The most common cranial types in the study group were brachycephalic (44.7%), mesocephalic (28.3%), hyperbrachycephalic (21.2%), and dolichocephalic (5.7%). Regarding the presence of OS, 54.3% of the participants had no OS, 23.1% had flat type, 15.3% had crest type, and 7.2% had spin type OS. There was a statistically significant difference (P < 0.05) in the frequency of OS according to skull type. CONCLUSION: This study, the first to evaluate CI and OS using CBCT, concludes that brachycephaly is the most common cranial type. OS is more common in mesocephalic and dolichocephalic skulls, at older ages, and in males.


Assuntos
Cefalometria , Tomografia Computadorizada de Feixe Cônico , Osso Occipital , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Masculino , Feminino , Osso Occipital/diagnóstico por imagem , Osso Occipital/anatomia & histologia , Adulto , Pessoa de Meia-Idade , Cefalometria/métodos , Adolescente , Adulto Jovem , Criança , Idoso , Pré-Escolar , Crânio/diagnóstico por imagem , Crânio/anatomia & histologia
2.
Dental Press J Orthod ; 29(2): e2423253, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38865515

RESUMO

OBJECTIVE: To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization. METHODS: Seventeen patients aged between 12.5 and 24 years underwent distalization with a customized distalizer. Lateral cephalogram and cast analysis were performed before and after distalization. Linear and angular parameters of the upper first molar, first premolar, and central incisor were assessed. RESULTS: Distalization with the force passing near the center of resistance (CRes) of the upper first molars resulted in distal movement, with minimal distal tipping (2.8 ±â€Š0.45°, p< 0.05). However, distalization passing occlusal to the CRes led to greater distal tipping (13.6 ±â€Š1.63°, p< 0.05). Statistically significant spontaneous distal tipping and distal movement of the upper first premolars occurred, with a mean of 6.2 ±â€Š1.24° (p< 0.05) and 0.68 ±â€Š0.34 mm (p< 0.05), respectively. The positional change of the upper central incisors presented a mean of -0.23 ±â€Š0.1 mm (p> 0.05) and 2.65 ±â€Š1.1° (p< 0.05). Upper first molar intrusion was statistically significant, with a mean of 0.88 ±â€Š0.2 mm (p< 0.05). Upper right and left first molars rotation towards palatal midline presented mean of 4.1 ±â€Š0.19° (p< 0.05) and 3.4  ±â€Š0.1° (p< 0.05), respectively. Additionally, the distance between upper right and left first molars increased significantly, with a mean of 2.54 ±â€Š0.01 mm (p< 0.05). CONCLUSION: The study successfully demonstrated the efficiency of molar distalization without anchorage loss using a customized distalizer anchored on palatal miniscrews.


Assuntos
Parafusos Ósseos , Cefalometria , Dente Molar , Procedimentos de Ancoragem Ortodôntica , Desenho de Aparelho Ortodôntico , Técnicas de Movimentação Dentária , Humanos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Adolescente , Criança , Adulto Jovem , Feminino , Masculino , Maxila/cirurgia , Dente Pré-Molar , Incisivo , Modelos Dentários
3.
BMC Oral Health ; 24(1): 694, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38879479

RESUMO

BACKGROUND: to evaluate the predictability of expansion achieved in patients in early mixed dentition treated with Clear Aligners (CA), analyzing the efficiency of the expansion at the end of the first set of aligners and at the end of the therapy in the upper and lower arch. METHODS: 36 patients (20 F, 16 M; mean age 8.3 ± 1.5 years) were selected retrospectively from the Department of Orthodontics of the Hospital of Rome "Tor Vergata". All subjects were treated with CA with no other auxiliaries than attachments. For each patient a standardized sequential expansion protocol was planned for both arches. Digital dental casts were created at three observation periods from an intraoral scanner: prior to treatment (T0), at the end of the first set of aligners (T1), at the end of treatment (T2). The 3D models in planned position determined by the first Clincheck (CC) were obtained for comparison with T1 and T2. Six linear transversal measurements were used to evaluate the dimensional changes and the predictability of expansion movements, comparing T1-CC and T2-CC. RESULTS: a statistically significant increase within the pre-treatment and the final outcomes for all the variables examined was found. In the upper arch, the greatest level of predictability was detected at the level of the first (46.44%) and second deciduous molar width (44.95%) at T1. The analysis of T2-CC changes showed a significant increase in the percentage of predictability of expansion at the level of the first permanent molars, at mesial (54.86%) and distal (58.92%) width. In the lower arch, a higher percentage of predictability than the upper arch was reported at T1-CC and T2-CC, with the greatest values at the level of second (T1-CC: 48.70%; T2-CC: 75.32%) and first deciduous molar width (T1-CC: 45.71%; T2-CC: 72.75%). CONCLUSIONS: CA can induce significant transversal increments. The predictability of expansion is variable, but it did not exceed the 50% during the first set of aligners. It was necessary to apply refinement set to achieve a good predictability for expansion of about 70%. The expansion in the lower arch was observed to be more predictable than in the upper arch.


Assuntos
Arco Dental , Dentição Mista , Modelos Dentários , Técnica de Expansão Palatina , Humanos , Estudos Retrospectivos , Feminino , Criança , Masculino , Arco Dental/anatomia & histologia , Técnica de Expansão Palatina/instrumentação , Desenho de Aparelho Ortodôntico , Imageamento Tridimensional/métodos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Maxila/anatomia & histologia , Mandíbula/anatomia & histologia , Aparelhos Ortodônticos Removíveis , Previsões , Cefalometria/métodos , Má Oclusão/terapia , Resultado do Tratamento
5.
Medicina (Kaunas) ; 60(5)2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38792929

RESUMO

Background and Objectives: The objective of this retrospective controlled study is to compare class II growing patients who underwent treatment with two different functional appliances: the Fraenkel regulator (FR-2), utilized as the control group, and the elastodontic device "Cranium Occluded Postural Multifunctional Harmonizers" (AMCOP), utilized as the test group. Materials and Methods: The study sample consisted of 52 patients with class II division I malocclusion (30 males, 22 females, mean age 8.6 ± 1.4 years) who were treated with the two different types of appliances: Group 1 (n = 27, mean age 8 [7.00, 9.00] years, 12 females, 15 males) received treatment with AMCOP, while Group 2 (n = 25, mean age 9.2 years [8.20, 10.00], 10 females, 15 males) received treatment with FR-2. The mean treatment duration for Group 1 was 28.00 [21.50, 38.00] months, while for Group 2 it was 23.70 [17.80, 27.40] months. Cephalometric analyses were performed on lateral cephalograms taken before treatment (T1) and after treatment (T2). Results: Significant intragroup differences were observed over time in Group 1 for 1^/PP. Similarly, significant intragroup differences were observed over time in Group 2 for SNB, ANB, and IMPA. Conclusions: Both treatment modalities resulted in the correction of class II malocclusion with dentoalveolar compensation, although the treatment duration with AMCOP tended to be longer on average.


Assuntos
Má Oclusão Classe II de Angle , Humanos , Masculino , Feminino , Criança , Estudos Retrospectivos , Má Oclusão Classe II de Angle/terapia , Aparelhos Ortodônticos Funcionais , Aparelhos Ortodônticos Removíveis , Cefalometria/métodos , Resultado do Tratamento
6.
Dental Press J Orthod ; 29(2): e2423206, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38775599

RESUMO

OBJECTIVE: This study aimed to compare the nasopharynx and oropharynx airway dimensions of Caucasians, Blacks, Japanese, Japanese Brazilians, and Black Caucasians. METHODS: A sample of 216 lateral radiographs of untreated young Brazilian subjects (mean age of 12.94 years; SD 0.88) were divided into five groups: Black Caucasian, Black, Caucasian, Japanese, and Japanese Brazilian. Lateral radiographs were used to measure the oropharynx (from the midpoint on the soft palate to the closest point on the anterior pharyngeal wall) and the nasopharynx (from the intersection of the posterior border of the tongue and the inferior border of the mandible to the closest point on the posterior pharyngeal wall). Analyses of variance (ANOVA) and Tukey's test were performed (p< 0.05). RESULTS: The linear dimension of the oropharynx was similar among the different ethnic groups. Caucasian individuals presented a significantly greater linear dimension of the nasopharynx than Black Caucasian and Black individuals. CONCLUSIONS: All the groups had similar buccopharyngeal values. However, Caucasian individuals had significantly higher values when compared to Black Caucasians and Black individuals.


Assuntos
Povo Asiático , População Negra , Cefalometria , Mandíbula , Nasofaringe , Orofaringe , População Branca , Humanos , Nasofaringe/anatomia & histologia , Nasofaringe/diagnóstico por imagem , Orofaringe/anatomia & histologia , Orofaringe/diagnóstico por imagem , Criança , Masculino , Feminino , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Adolescente , Brasil/etnologia , Língua/anatomia & histologia , Língua/diagnóstico por imagem , Japão/etnologia , Palato Mole/anatomia & histologia , Palato Mole/diagnóstico por imagem , Oclusão Dentária , Etnicidade
7.
Prog Orthod ; 25(1): 19, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38797777

RESUMO

BACKGROUND: Skeletal anterior open bite (SAOB) represents one of the most complex and challenging malocclusions in orthodontics. Orthodontic treatment supported by miniplates enable to reduce the need for orthognathic surgery. Transverse dimension may be affected by intrusion biomechanics. This study aims to assess transverse bone alterations in patients with SAOB who underwent orthodontic treatment with absolute anchorage using four miniplates. METHODS: A total of 32 patients of both sexes, with an average age of 33.8 years, diagnosed with SAOB and treated orthodontically with four miniplates (one in each hemiarch), were selected for this study. Tomographic examinations were performed before (T1) and after (T2) orthodontic treatment. Linear measurements (width of the maxillary base, maxillary alveolar, maxillary root, maxillary dental cusp, mandibular alveolar) and angular measurements (maxillary intermolar angle) were assessed in these images. The Shapiro-Wilks normality tests were applied to verify data distribution, and the paired t-test was used to compare the initial and final measures obtained. RESULTS: Among the evaluated parameters, the maxillary alveolar width, maxillary dental cusp width, mandibular alveolar cusp width, and intermolar angle showed statistically significant differences between T1 and T2 (p < 0.05). However, maxillary base and maxillary root widths showed no significant difference (p > 0.05). CONCLUSIONS: Intrusion and distalization with miniplates in SAOB therapy may lead to significant expansive changes, due to molars cusps width and buccal inclination increase restricted at the alveolar level.


Assuntos
Placas Ósseas , Mandíbula , Mordida Aberta , Procedimentos de Ancoragem Ortodôntica , Humanos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Masculino , Feminino , Mordida Aberta/terapia , Mordida Aberta/diagnóstico por imagem , Adulto , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Cefalometria , Processo Alveolar/diagnóstico por imagem , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem , Desenho de Aparelho Ortodôntico
8.
Head Face Med ; 20(1): 34, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38762519

RESUMO

BACKGROUND: We aimed to establish a novel method for automatically constructing three-dimensional (3D) median sagittal plane (MSP) for mandibular deviation patients, which can increase the efficiency of aesthetic evaluating treatment progress. We developed a Euclidean weighted Procrustes analysis (EWPA) algorithm for extracting 3D facial MSP based on the Euclidean distance matrix analysis, automatically assigning weight to facial anatomical landmarks. METHODS: Forty patients with mandibular deviation were recruited, and the Procrustes analysis (PA) algorithm based on the original mirror alignment and EWPA algorithm developed in this study were used to construct the MSP of each facial model of the patient as experimental groups 1 and 2, respectively. The expert-defined regional iterative closest point algorithm was used to construct the MSP as the reference group. The angle errors of the two experimental groups were compared to those of the reference group to evaluate their clinical suitability. RESULTS: The angle errors of the MSP constructed by the two EWPA and PA algorithms for the 40 patients were 1.39 ± 0.85°, 1.39 ± 0.78°, and 1.91 ± 0.80°, respectively. The two EWPA algorithms performed best in patients with moderate facial asymmetry, and in patients with severe facial asymmetry, the angle error was below 2°, which was a significant improvement over the PA algorithm. CONCLUSIONS: The clinical application of the EWPA algorithm based on 3D facial morphological analysis for constructing a 3D facial MSP for patients with mandibular deviated facial asymmetry deformity showed a significant improvement over the conventional PA algorithm and achieved the effect of a dental clinical expert-level diagnostic strategy.


Assuntos
Algoritmos , Assimetria Facial , Imageamento Tridimensional , Humanos , Assimetria Facial/diagnóstico por imagem , Masculino , Feminino , Imageamento Tridimensional/métodos , Pontos de Referência Anatômicos , Mandíbula/diagnóstico por imagem , Adolescente , Adulto , Adulto Jovem , Cefalometria/métodos , Face/diagnóstico por imagem
9.
Acta Odontol Scand ; 83: 308-316, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38770691

RESUMO

BACKGROUND: The use of cephalometric pictures in dental radiology is widely acknowledged as a dependable technique for determining the gender of an individual. The Visual Geometry Group 16 (VGG16) and Visual Geometry Group 19 (VGG19) algorithms have been proven to be effective in image classification. OBJECTIVES: To acknowledge the importance of comprehending the complex procedures associated with the generation and adjustment of inputs in order to obtain precise outcomes using the VGG16 and VGG19 algorithms. MATERIAL AND METHOD: The current work utilised a dataset including 274 cephalometric radiographic pictures of adult Indonesians' oral health records to construct a gender classification model using the VGG16 and VGG19 architectures using Python. RESULT: The VGG16 model has a gender identification accuracy of 93% for females and 73% for males, resulting in an average accuracy of 89% across both genders. In the context of gender identification, the VGG19 model has been found to achieve an accuracy of 0.95% for females and 0.80% for men, resulting in an overall accuracy of 0.93% when considering both genders. CONCLUSION: The application of VGG16 and VGG19 models has played a significant role in identifying gender based on the study of cephalometric radiography. This application has demonstrated the exceptional effectiveness of both models in accurately predicting the gender of Indonesian adults.


Assuntos
Cefalometria , Humanos , Cefalometria/métodos , Masculino , Feminino , Adulto , Indonésia , Algoritmos
10.
J Dent ; 146: 105056, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38729291

RESUMO

OBJECTIVES: The transition from manual to automatic cephalometric landmark identification has not yet reached a consensus for clinical application in orthodontic diagnosis. The present umbrella review aimed to assess artificial intelligence (AI) performance in automatic 2D and 3D cephalometric landmark identification. DATA: A combination of free text words and MeSH keywords pooled by boolean operators: Automa* AND cephalo* AND ("artificial intelligence" OR "machine learning" OR "deep learning" OR "learning"). SOURCES: A search strategy without a timeframe setting was conducted on PubMed, Scopus, Web of Science, Cochrane Library and LILACS. STUDY SELECTION: The study protocol followed the PRISMA guidelines and the PICO question was formulated according to the aim of the article. The database search led to the selection of 15 articles that were assessed for eligibility in full-text. Finally, 11 systematic reviews met the inclusion criteria and were analyzed according to the risk of bias in systematic reviews (ROBIS) tool. CONCLUSIONS: AI was not able to identify the various cephalometric landmarks with the same accuracy. Since most of the included studies' conclusions were based on a wrong 2 mm cut-off difference between the AI automatic landmark location and that allocated by human operators, future research should focus on refining the most powerful architectures to improve the clinical relevance of AI-driven automatic cephalometric analysis. CLINICAL SIGNIFICANCE: Despite a progressively improved performance, AI has exceeded the recommended magnitude of error for most cephalometric landmarks. Moreover, AI automatic landmarking on 3D CBCT appeared to be less accurate compared to that on 2D X-rays. To date, AI-driven cephalometric landmarking still requires the final supervision of an experienced orthodontist.


Assuntos
Pontos de Referência Anatômicos , Inteligência Artificial , Cefalometria , Humanos , Cefalometria/métodos , Pontos de Referência Anatômicos/diagnóstico por imagem , Revisões Sistemáticas como Assunto , Imageamento Tridimensional/métodos , Aprendizado de Máquina
11.
J Dent ; 146: 105093, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38788916

RESUMO

OBJECTIVES: The aim of this study was to evaluate the influence of palatal vault morphology and screw length on the accuracy of miniscrew insertion in dynamic computer-assisted surgery (d-CAS). METHODS: Twenty-four subjects were allocated into three groups, according to their palatal vault morphology (Group A: medium; Group B: steep/high; Group C: low/flat) and the length of miniscrew used. For each subject, two miniscrews were inserted using a dynamic navigation system. To assess the accuracy of insertion, a postoperative CBCT was performed, and the pre- and post-operative scans were superimposed. Five variables were evaluated: Entry-3D, Entry-2D, Apex-3D, Apex-vertical and angular deviation. Descriptive statistics, Shapiro-wilk, Kruskal-Wallis and Dunn's tests were used for the statistical analysis. The level of significance was P ≤ 0.05. RESULTS: The mean angular deviation values revealed strong discrepancies amongst the groups (Group A:7.11°±5.70°; Group B:13.30°±7.76°; Group C:4.92°±3.15°) and significant differences were found regarding the Apex-3D (P = 0.036) and angular deviations (P = 0.008). A Dunn's test revealed differences in angular deviation between the medium and high/steep palate group (P = 0.004), and between low/flat and high/steep palate group (P = 0.01) but did not confirm any significant difference in the Apex-3D parameter (Group A-B P = 0.10; Group B-C, P = 0.053; Group A-C, P = 1.00). No significant differences were found regarding the length of the miniscrews. CONCLUSIONS: Palatal vault morphology is a factor that influences the accuracy of miniscrew insertion in d-CAS. In subjects with steep and high palatal vaults, insertion accuracy is lower when considering the angular deviation value. Miniscrew length does not influence accuracy. CLINICAL SIGNIFICANCE: Although computer-guided surgery assists the clinician in preventing damage to nearby anatomical structures, individual anatomical variability is a crucial variable. In subjects with a high/steep palate, greater attention should be paid during the planning phase in order to allow for a wide margin from adjacent anatomical structures to achieve better outcomes.


Assuntos
Parafusos Ósseos , Tomografia Computadorizada de Feixe Cônico , Procedimentos de Ancoragem Ortodôntica , Palato , Cirurgia Assistida por Computador , Humanos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Estudos Prospectivos , Cirurgia Assistida por Computador/métodos , Masculino , Feminino , Adulto Jovem , Adulto , Palato/diagnóstico por imagem , Palato/anatomia & histologia , Adolescente , Palato Duro/diagnóstico por imagem , Palato Duro/anatomia & histologia , Palato Duro/cirurgia , Imageamento Tridimensional/métodos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Processamento de Imagem Assistida por Computador/métodos , Cefalometria/métodos
12.
BMC Oral Health ; 24(1): 616, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802759

RESUMO

OBJECTIVES: The aim of our study is to compare the relationship between hand-wrist and cervical vertebra maturation stages with chronological age and to investigate the effect of malocclusion type on the relationship between these methods. MATERIALS AND METHODS: Hand-wrist and cephalometric radiographs of 1000 patients (526 females, 474 males) with a mean age of 13.41 ± 1.83 were analyzed. The methods of Bacetti et al. were used for the cervical vertebra maturation stage, and Björk, Grave and Brown's methods were used for the hand-wrist maturation stage. One-way ANOVA test was applied to compare skeletal classes between them. Tukey post hoc test was used to determine the differences. The relationship between the malocclusion type, cervical vertebra and hand-wrist maturation stages was evaluated with the Spearman correlation test. RESULTS: Spearman's correlation coefficient was 0.831, 0.831 and 0.760 in Class I, II and III females, respectively. In males, it was calculated as 0.844, 0.889 and 0.906, respectively. When sex and malocclusion were not differentiated, the correlation was found to be 0.887. All were statistically significant (P < 0.001). The highest correlation was observed in class III males, while the lowest was found in class III females. CONCLUSION: Cervical vertebrae can be used safely to assess pubertal spurt without hand-wrist radiography. Diagnosing growth and development stages from cephalometric images is important in reducing additional workload and preventing radiation risk.


Assuntos
Determinação da Idade pelo Esqueleto , Cefalometria , Vértebras Cervicais , Má Oclusão , Humanos , Masculino , Feminino , Vértebras Cervicais/diagnóstico por imagem , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Criança , Má Oclusão/diagnóstico por imagem , Má Oclusão Classe I de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/diagnóstico por imagem , Fatores Sexuais , Má Oclusão Classe II de Angle/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Ossos da Mão/diagnóstico por imagem , Ossos da Mão/crescimento & desenvolvimento , Fatores Etários
13.
J Craniofac Surg ; 35(4): 1249-1252, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38691047

RESUMO

OBJECTIVE: This study aimed to evaluate the effect of orthognathic surgery on masseter volume in patients with skeletal Class III malocclusion with facial asymmetry and the effect of masseter volume on stability in orthognathic surgery. METHODS: This research studied 16 patients with Class III malocclusion with facial asymmetry who received combined orthodontic-orthognathic treatment and underwent craniofacial computed tomography (CT) before (T0), 2 weeks after (T1), and 6 months after (T2) surgery. Three-dimensional (3D) CT images were retrospectively analyzed, using 3D volume reconstruction to obtain the masseter volume and examine the impact of the masseter volume on stability in orthognathic surgery. RESULTS: A statistically significant difference ( P < 0.05) in the volume of the masseter was found up to 6 months after orthognathic surgery compared with the preoperative period, and the reduction in the masticatory muscle volume on the lengthened side is greater than on the shortened side ( P < 0.05). The volume of both masseters differed according to facial asymmetry, and the difference was significantly reduced after orthognathic surgery ( P < 0.05). During the period time (T1-T2), cephalometric maxillary marker points were not significantly different ( P > 0.05), and mandibular marker points were significantly anteriorly shifted ( P < 0.05). There was an association between the masseter volume and anterior shift of point B (R > 0.5, P < 0.05), the upward and anterior shifts of the gonion point differed between the lengthened and shortened sides ( P < 0.05). CONCLUSION: The size of the masseter becomes smaller 6 months after orthognathic surgery, and orthognathic surgery improves both bone and soft tissue symmetry. A larger sagittal relapse of mandibular setback occurred in patients with greater masseter volume. Considering these alterations may be helpful in planning orthognathic surgery.


Assuntos
Assimetria Facial , Imageamento Tridimensional , Má Oclusão Classe III de Angle , Músculo Masseter , Procedimentos Cirúrgicos Ortognáticos , Tomografia Computadorizada por Raios X , Humanos , Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe III de Angle/diagnóstico por imagem , Feminino , Masculino , Assimetria Facial/cirurgia , Assimetria Facial/diagnóstico por imagem , Músculo Masseter/diagnóstico por imagem , Músculo Masseter/patologia , Procedimentos Cirúrgicos Ortognáticos/métodos , Estudos Retrospectivos , Adulto , Resultado do Tratamento , Adulto Jovem , Cefalometria , Adolescente
14.
J Craniofac Surg ; 35(4): 1205-1208, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38738880

RESUMO

STUDY DESIGN: Cephalometric scans were compared before and after surgery to assess the degree of correction. Correlations between skeletal movements and survey outcomes were determined using multivariate regression analysis. OBJECTIVE: This study aims to identify relationships between subjective observer-reported improvements in esthetics and emotional appearance with specific surgical movements. METHODS: Ten patients at a single tertiary institution (average age: 18.1 ± 0.8), 9 males and 1 female, underwent orthognathic repair and had comprehensive cephalometric records. Standardized anterior posterior and lateral pre and postoperative photographs of patients were included in a survey to clinicians to assess noncognitive domains on a Likert Scale (1-10). CLEFT-Q was administered to gauge patient satisfaction in categories of appearance, speech, and quality of life. RESULTS: Per clinicians, multiple domains increased including facial attractiveness (4.1 ± 0.7 versus 7.3 ± 0.7, P < 0.001), friendliness (4.5 ± 0.4 versus 7.3 ± 0.5, P < 0.001), confidence (4.1 ± 0.4 versus 7.1 ± 0.4, P < 0.001), and recommendation for surgery decreased (8.9 ± 0.1 versus 3.6 ± 0.5, P < 0.001). Speech distress decreased with increased SNA and convexity, whereas Psychological and Social scores decreased with an increased ANB. Functional eating and drinking scores increased with maxillary depth. CONCLUSIONS: Orthognathic surgery improves many noncognitive domains in patients with cleft lip and palate as assessed by both patients and clinicians on all aspects of facial attractiveness and perception. These findings demonstrate objective bases of skeletal adjustments for perceived improvements in facial appearance and emotion.


Assuntos
Cefalometria , Fenda Labial , Fissura Palatina , Procedimentos Cirúrgicos Ortognáticos , Satisfação do Paciente , Humanos , Feminino , Masculino , Fenda Labial/cirurgia , Fenda Labial/psicologia , Fissura Palatina/cirurgia , Fissura Palatina/psicologia , Procedimentos Cirúrgicos Ortognáticos/psicologia , Adolescente , Qualidade de Vida , Adulto Jovem , Estética , Resultado do Tratamento , Inquéritos e Questionários
15.
BMC Oral Health ; 24(1): 629, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38807098

RESUMO

BACKGROUND: In orthodontics, anterior open bite is a common malocclusion that recurs frequently. Because the causes of anterior open bite are so varied, medical professionals must create customized treatment programs for each patient based on their unique etiology. Through the lowering of the posterior teeth, closure of the anterior teeth gap, and cooperation with intermaxillary traction, the treatment plan outlined in this case study sought to achieve a stable occlusion. CASE PRESENTATION: This case report aims to describe an orthodontic camouflage treatment of a 15-year-old female patient with anterior open bite, arch width discrepancy and a history of temporomandibular joint disorder. The patient was treated with intermaxillary vertical elastics and the multiple edgewise arch wire (MEAW) approach. A satisfactory occlusion with a neutral molar relationship was attained after 29 months of orthodontic therapy. The condylography recording showed that this patient's occlusion tended to be more stable both before and after our treatment. The purpose of this case study is to provide an overview of an orthodontic camouflage treatment for a female patient, who had a history of temporomandibular joint disease, anterior open bite, and arch width disparity. CONCLUSIONS: Our results demonstrated that more attention should be paid to levelling the occlusal plane, intrusion of the molars, decompression of temporomandibular joints and the etiology factors of malocclusion during the orthodontic period for those patients with anterior open bite.


Assuntos
Mordida Aberta , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Adolescente , Mordida Aberta/terapia , Transtornos da Articulação Temporomandibular/terapia , Ortodontia Corretiva/métodos , Cefalometria , Planejamento de Assistência ao Paciente
16.
Clin Oral Investig ; 28(6): 338, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38797781

RESUMO

OBJECTIVES: To clinically compare the effects of broader archwires to standard archwires, using conventional brackets in both cases, on the transverse and incisor changes in maxillary and mandibular arches during leveling and alignment. MATERIALS AND METHODS: Fifty-two patients presenting with crowding were allocated into two groups; one group received the broad Damon archwires while the other received standard 3M OrthoForm III Ovoid archwires. All participants were treated with conventional brackets using similar archwire sequences (0.014, 0.018, 0.016 × 0.022/0.016 × 0.025, 0.019 × 0.025 NiTi/CuNiTi archwires). Digital casts were obtained from alginate impressions before treatment (T0) and six weeks after inserting 0.019 × 0.025 NiTi archwires (T1). Pretreatment (T0) and post-alignment (T1) lateral cephalograms were obtained for each patient. The primary outcomes were the changes in the transverse arch dimensions and incisor inclination. The secondary outcomes were the horizontal and vertical linear changes in incisor position. RESULTS: Complete data were collected for 47 patients. There was a significant increase in arch width during treatment within each group, except for upper inter-molar width in 3M group (P = 0.071). Damon wire induced a statistically significant increase in maxillary inter-second premolar width (P = 0.042), and mandibular inter-first premolar (P = 0.043), inter-second premolar (P = 0.008) and inter-molar widths (P = 0.033) compared to 3M group. The increase in incisor proclination and the linear change in incisor position were significant within each group, with less mandibular incisor proclination (P = 0.004) and horizontal advancement (P = 0.038) in the Damon group. CONCLUSIONS: Damon archwires created a comparatively greater increase in the maxillary inter-second premolar width and the mandibular inter-first premolar, inter-second premolar, and inter-molar widths, and less proclination and horizontal advancement in mandibular incisors. The study provides invaluable evidence that using broad archwires with self-ligating brackets is the reason behind any greater expansion observed in this system rather than the unique mechanical and biological features exerted by the self-ligating system. CLINICAL RELEVANCE: Our results suggest that Damon archwire might be a better alternative compared to the narrower standard archwires that are usually used with conventional brackets, especially in the mandibular arch, in cases where mild to moderate crowding is planned to be resolved with a non-extraction approach. However, as arch expansion in the absence of posterior crossbites raises the question of long-term stability, the reported advantage of the use of wide wires should be interpreted with caution and should be considered in the retention phase, bearing in mind that achieving a good post-treatment occlusion is important for enhancing post-treatment stability.


Assuntos
Cefalometria , Incisivo , Má Oclusão , Desenho de Aparelho Ortodôntico , Braquetes Ortodônticos , Fios Ortodônticos , Humanos , Feminino , Masculino , Má Oclusão/terapia , Adolescente , Níquel/química , Arco Dental , Titânio/química , Resultado do Tratamento , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Cobre
17.
Eur J Orthod ; 46(3)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38700388

RESUMO

BACKGROUND: Magnetic resonance imaging (MRI) is a non-ionizing imaging technique. Using MRI in dentistry may potentially lower the general radiation dose of the examined population, provided MRI can replace various radiation-based images. Furthermore, novel MRI imaging modalities for three-dimensional and two-dimensional cephalometrics have recently been developed for orthodontic diagnosis. OBJECTIVES: This systematic review aimed to determine the diagnostic accuracy and reliability of MRI in orthodontic diagnosis and treatment planning. SEARCH METHODS: An electronic search was conducted on 20 November 2022 in the following databases: PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane. The search was updated on 30 August 2023. Furthermore, a grey literature search was performed in Google Scholar and Open-Grey. SELECTION CRITERIA: This review included descriptive, observational, cohort studies, cross-sectional, case-control studies, and randomized/non-randomized trials related to the research question. The study excluded studies related to patients with syndromes, chronic diseases, craniofacial anomalies, or bone diseases. DATA COLLECTION AND ANALYSIS: The included studies were quality assessed using the "Joanna Brigg's Critical Appraisal Tool for diagnostic test accuracy". The GRADE approach for non-randomized studies was used for strength-of-evidence analysis. RESULTS: Eight of the 10 included studies compared MRI with either cone beam computed tomography or lateral cephalogram and found a high intra- and inter-rater agreement for landmark identification. The risk of bias was high in four studies, moderate in three, and low in three studies. Homogeneity was lacking among the included studies in terms of MRI imaging parameters and sample characteristics. This should be taken into consideration by future studies where uniformity with respect to these parameters may be considered. CONCLUSIONS: Despite dissimilarity and heterogeneity in the sample population and other methodological aspects, all the included studies concluded that MRI enjoyed considerable intra- and inter-examiner reliability and was comparable to current diagnostic standards in orthodontics. Furthermore, the studies agreed on the innovative potential of MRI in radiation-free diagnosis and treatment planning in orthodontics in the future. REGISTRATION: CRD number: CRD420223XXXXX.


Assuntos
Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Reprodutibilidade dos Testes , Planejamento de Assistência ao Paciente , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Cefalometria/métodos , Ortodontia/métodos
18.
Prog Orthod ; 25(1): 20, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38771402

RESUMO

BACKGROUNDS AND OBJECTIVES: The present study was designed to define a novel algorithm capable of predicting female adolescents' cervical vertebrae maturation stage with high recall and accuracy. METHODS: A total of 560 female cephalograms were collected, and cephalograms with unclear vertebral shapes and deformed scales were removed. 480 films from female adolescents (mean age: 11.5 years; age range: 6-19 years) were used for the model development phase, and 80 subjects were randomly and stratified allocated to the validation cohort to further assess the model's performance. Derived significant predictive parameters from 15 anatomic points and 25 quantitative parameters of the second to fourth cervical vertebrae (C2-C4) to establish the ordinary logistic regression model. Evaluation metrics including precision, recall, and F1 score are employed to assess the efficacy of the models in each identified cervical vertebrae maturation stage (iCS). In cases of confusion and mispredictions, the model underwent modification to improve consistency. RESULTS: Four significant parameters, including chronological age, the ratio of D3 to AH3 (D3:AH3), anterosuperior angle of C4 (@4), and distance between C3lp and C4up (C3lp-C4up) were administered into the ordinary regression model. The primary predicting model that implements the novel algorithm was built and the performance evaluation with all stages of 93.96% for accuracy, 93.98% for precision, 93.98% for recall, and 93.95% for F1-score were obtained. Despite the hybrid logistic-based model achieving high accuracy, the unsatisfactory performance of stage estimation was noticed for iCS3 in the primary cohort (89.17%) and validation cohort (85.00%). Through bivariate logistic regression analysis, the posterior height of C4 (PH4) was further selected in the iCS3 to establish a corrected model, thus the evaluation metrics were upgraded to 95.83% and 90.00%, respectively. CONCLUSIONS: An unbiased and objective assessment of the cervical vertebrae maturation (CVM) method can function as a decision-support tool, assisting in the evaluation of the optimal timing for treatment in growing adults. Our novel proposed logistic model yielded individual formulas for each specific CVM stage and attained exceptional performance, indicating the capability to function as a benchmark for maturity evaluation in clinical craniofacial orthopedics for Chinese female adolescents.


Assuntos
Algoritmos , Cefalometria , Vértebras Cervicais , Humanos , Feminino , Adolescente , Vértebras Cervicais/crescimento & desenvolvimento , Vértebras Cervicais/diagnóstico por imagem , Criança , Adulto Jovem , Cefalometria/métodos , Determinação da Idade pelo Esqueleto/métodos , Modelos Logísticos
19.
PLoS One ; 19(5): e0303551, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38771832

RESUMO

The vertical facial profile is a crucial factor for facial harmony with significant implications for both aesthetic satisfaction and orthodontic treatment planning. However, the role of single nucleotide polymorphisms (SNPs) in the development of vertical facial proportions is still poorly understood. This study aimed to investigate the potential impact of some SNPs in genes associated with craniofacial bone development on the establishment of different vertical facial profiles. Vertical facial profiles were assessed by two senior orthodontists through pre-treatment digital lateral cephalograms. The vertical facial profile type was determined by recommended measurement according to the American Board of Orthodontics. Healthy orthodontic patients were divided into the following groups: "Normodivergent" (control group), "Hyperdivergent" and "Hypodivergent". Patients with a history of orthodontic or facial surgical intervention were excluded. Genomic DNA extracted from saliva samples was used for the genotyping of 7 SNPs in RUNX2, BMP2, BMP4 and SMAD6 genes using real-time polymerase chain reactions (PCR). The genotype distribution between groups was evaluated by uni- and multivariate analysis adjusted by age (alpha = 5%). A total of 272 patients were included, 158 (58.1%) were "Normodivergent", 68 (25.0%) were "Hyperdivergent", and 46 (16.9%) were "Hypodivergent". The SNPs rs1200425 (RUNX2) and rs1005464 (BMP2) were associated with a hyperdivergent vertical profile in uni- and multivariate analysis (p-value < 0.05). Synergistic effect was observed when evaluating both SNPs rs1200425- rs1005464 simultaneously (Prevalence Ratio = 4.0; 95% Confidence Interval = 1.2-13.4; p-value = 0.022). In conclusion, this study supports a link between genetic factors and the establishment of vertical facial profiles. SNPs in RUNX2 and BMP2 genes were identified as potential contributors to hyperdivergent facial profiles.


Assuntos
Proteína Morfogenética Óssea 2 , Subunidade alfa 1 de Fator de Ligação ao Core , Face , Polimorfismo de Nucleotídeo Único , Humanos , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Feminino , Masculino , Proteína Morfogenética Óssea 2/genética , Adolescente , Adulto , Adulto Jovem , Genótipo , Cefalometria
20.
Forensic Sci Int ; 359: 111993, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38704925

RESUMO

There are numerous anatomical and anthropometrical standards that can be utilised for craniofacial analysis and identification. These standards originate from a wide variety of sources, such as orthodontic, maxillofacial, surgical, anatomical, anthropological and forensic literature, and numerous media have been employed to collect data from living and deceased subjects. With the development of clinical imaging and the enhanced technology associated with this field, multiple methods of data collection have become accessible, including Computed Tomography, Cone-Beam Computed Tomography, Magnetic Resonance Imaging, Radiographs, Three-dimensional Scanning, Photogrammetry and Ultrasound, alongside the more traditional in vivo methods, such as palpation and direct measurement, and cadaveric human dissection. Practitioners often struggle to identify the most appropriate standards and research results are frequently inconsistent adding to the confusion. This paper aims to clarify how practitioners can choose optimal standards, which standards are the most reliable and when to apply these standards for craniofacial identification. This paper describes the advantages and disadvantages of each mode of data collection and collates published research to review standards across different populations for each facial feature. This paper does not aim to be a practical instruction paper; since this field encompasses a wide range of 2D and 3D approaches (e.g., clay sculpture, sketch, automated, computer-modelling), the implementation of these standards is left to the individual practitioner.


Assuntos
Identificação Biométrica , Antropologia Forense , Humanos , Identificação Biométrica/métodos , Cefalometria/normas , Face/diagnóstico por imagem , Face/anatomia & histologia , Antropologia Forense/métodos , Imageamento Tridimensional , Reprodutibilidade dos Testes , Crânio/diagnóstico por imagem , Crânio/anatomia & histologia
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