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Objective@#To analyze the ability of micro-implant nails placed in different locations in the posterior region to improve the hard and soft tissues of the labiodental region in patients with gummy smiles to provide a reference for clinicians.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Thirty young female patients with anterior tooth protrusions and gummy smiles were included in the retrospective study; 18 patients had micro-implant nails implanted between the premolars (group A), and 12 patients had implant nails placed between the roots of the premolar and the molar and an intraoperatively placed rocking-chair archwire (group B). The preoperative and postoperative distances from the incisal end of the upper mesial incisors to the lower point of the upper lip (U1-Stms), the vertical distance from the incisal end of the upper mesial incisors to the palatal plane (U1-PP), the vertical distance from the point of the alveolar ridge to the palatal plane (Spr-PP), the distance from the incisal end of the upper mesial incisors to the point of the alveolar margin (U1-Spr), and the vertical distance from the point of the proximal middle buccal cusp of the maxillary first molar to the palatal plane of the maxillary first molar (U6-PP) were measured in the cephalometric lateral radiographs of the two groups; additionally, the amount of hard and soft tissues of the upper anterior region exposedduring smiling and the maximum amount of gingiva exposed during smiling were assessed from the smile photograph.@*Results@#After correction, the lip-dentition relationship improved significantly in both groups, with an average reduction of 2.6 mm in U1-Stms, 2.4 mm in U1-PP, 1.4 mm in Spr-PP, and 0.9 mm in U1-Spr in Group A. In group B, the U1-Stms was reduced by an average of 2.3 mm, the U1-PPs by an average of 1.6 mm, the Spr-PPs by 1.4 mm, and the U1-Spr by 0.2 mm. The difference between pre- and postoperative U6-PP in both groups was not significant (P>0.05). Group A had greater ∆U1-PP and ∆U1-Spr changes than group B(P<0.05). There was no difference between the two groups in terms of ∆U1-Stms or ∆Spr-PP (P>0.05). The amount of soft and hard tissue exposed and maximum amount of gingiva exposed in the upper anterior region of the smile were reduced in 30 patients postoperatively, with group A having anaverage reduction of 70.19% of the preoperative amount of soft and hard tissue exposed in the upper anterior region and an average reduction of 24.12% of the preoperative maximum amount of gingiva exposed, and group B having an average reduction of 76.12% of the preoperative amount of hard and soft tissue exposed in the upper anterior region and an average reduction of 31.88% of the preoperative maximum gingiva exposed after the operation. The difference in the ratio between the two groups was not statistically significant (P>0.05).@*Conclusion@#For patients with proptosis and gummy smiles, placing micro-implant nails between the roots of maxillary premolars can effectively lead to retraction and intrusion of anterior teeth to improve the lip-dentition relationship and improve gummy smile, and placing micro-implant nails between the roots of the maxillary second premolar and the first molar together with the use of rocking chair arches can also achieve a good therapeutic effect.
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BACKGROUND:Traditional lateral cephalometric radiographs always suffer from some problems,such as magnification distortion,left and right overlap inconsistency and so on,while the cone-beam CT can truly display the three-dimensional structure of the craniofacial region.Performing three-dimensional reconstruction of cone-beam CT and then transforming the cone-beam CT in the selected area into the two-dimensional image can make the overlap between the left and right sides consistent and reduce the influence of surrounding tissue structures. OBJECTIVE:To explore the consistency of quantitative analysis of cervical vertebral bone age between two kinds of cone-beam CT transformed two-dimensional images with different integrated thicknesses and traditional lateral cephalometric radiographs. METHODS:The cone-beam CT and lateral cephalometric radiograph data of 118 adolescent orthodontic patients were collected.Firstly,the cone-beam CT image was reconstructed in 3D imaging software.After reconstruction,two types of cone-beam CT images with different integrated thicknesses were selected in the sagittal interface and transformed into two-dimensional images,which were named ICB-1 and ICB-2,respectively.The Zhibeiyun system was used to measure and calculate the angle between the concave base of the second cervical vertebra and the lower edge of the vertebral body(@2),the ratio of the third cervical spine to the posterior height(AH3/PH3),the ratio of height to width of the fourth cervical spine(H4/W4)in lateral cephalometric radiograph,ICB-1,ICB-2 and the cervical vertebral bone age.After an interval of two weeks,20 adolescents were randomly selected to repeat the above measurements.The intraclass correlation coefficient(ICC)method was used to evaluate the repeatability of the three images in measuring cervical bone age.Paired t-test was used to analyze the consistency of cervical bone age measurements between the three images.The Kappa test was used to analyze the consistency of cervical vertebral bone age staging assessment between the three images. RESULTS AND CONCLUSION:(1)ICC of AH3/PH3 in the lateral cephalometric radiograph group was<0.9,and the ICC of other measurement items in each group was>0.9.(2)Paired t-test results showed that there were statistical differences in AH3/PH3 and H4/W4 between the ICB-1 group and lateral cephalometric radiograph group and between the ICB-1 group and ICB-2 group(P<0.05),and there were no statistically significant differences in the other items between the three groups(P>0.05).(3)The Kappa test results showed that the Kappa coefficients of the two groups were all more than 0.8 according to the staging of cervical vertebral bone age in three groups(P<0.001).(4)It is indicated that the repeatability of ICB-1 and ICB-2 in the measurement of cervical vertebral bone age is better than that of lateral cephalometric radiographs.Lateral cephalometric radiographs,ICB-1 and ICB-2 have good consistency in the measurement of cervical vertebral bone age,but considering the integrity of cervical vertebra structure,ICB-2 is more suitable for quantitative analysis of cervical vertebral bone age than ICB-1.
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SUMMARY: Malocclusion is usually treated based on clinical decisions complemented with a cephalometric analysis, allowing the comparison of an individual with standard reference norms. Cephalometric standards have mostly been obtained from Caucasian population, but may not be appropriate for other ethnic groups, becoming a clinically relevant problem in multicultural and multiracial societies. The present study aimed to establish cephalometric norms for Chilean-Latino population, using a representative sample of class I individuals in permanent dentition. A sample of 72 cephalometric x-rays of class I growing individuals (47 women and 25 men) between 10 and 20 years of age with class I occlusion and harmonic profile was obtained from the records of the Universidad de los Andes taken between 2012 and 2019, including 1164 individuals. The radiographs were classified according to their cervical vertebral maturation status, and cephalometrically analyzed, obtaining vertical and sagittal parameters in soft and hard tissues, which were compared with Caucasian cephalometric norms. The statistical analysis was performed using descriptive and inferential statistics (T-test, ANOVA and Bonferroni tests). Cephalometric norms were obtained for hard and soft tissues. Upon comparison with Caucasian norms, the subjects included in the sample present a tendency towards a convex profile, significant incisal proclination, dental protrusion, labial biprotrusion and an acute nasolabial angle. There are cephalometric differences between the Caucasian cephalometric norms and those observed Chilean Latino population, displaying differences at a hard and soft tissue level that should be taken into account for clinical decision making in Orthodontics.
La maloclusión generalmente se trata con base en decisiones clínicas complementadas con un análisis cefalométrico, lo que permite la comparación de un individuo con normas de referencia estándar. Los estándares cefalométricos se han obtenido en su mayoría de población caucásica, pero pueden no ser apropiados para otros grupos étnicos, convirtiéndose en un problema clínicamente relevante en sociedades multiculturales y multirraciales. El presente estudio tuvo como objetivo establecer normas cefalométricas para población chileno-latina, utilizando una muestra representativa de individuos clase I en dentición permanente. Se obtuvo una muestra de 72 radiografías cefalométricas de individuos en crecimiento clase I (47 mujeres y 25 hombres) entre 10 y 20 años de edad con oclusión clase I y perfil armónico de los registros de la Universidad de los Andes tomados entre 2012 y 2019, incluidas 1164 personas. Las radiografías se clasificaron según su estado de maduración vertebral cervical, y se analizaron cefalométricamente, obteniendo parámetros verticales y sagitales en tejidos blandos y duros, que se compararon con normas cefalométricas caucásicas. El análisis estadístico se realizó mediante estadística descriptiva e inferencial (T-test, ANOVA y pruebas de Bonferroni). Se obtuvieron normas cefalométricas para tejidos duros y blandos. En comparación con las normas caucásicas, los sujetos incluidos en la muestra presentan una tendencia hacia un perfil convexo, proinclinación incisal significativa, protrusión dental, biprotrusión labial y un ángulo nasolabial agudo. Existen diferencias entre las normas cefalométricas caucásicas y las observadas en población latina chilena, mostrando diferencias a nivel de tejidos duros y blandos que se deben considerar para la toma de decisiones clínicas en Ortodoncia.
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Humanos , Masculino , Femenino , Niño , Adolescente , Adulto Joven , Cefalometría/normas , Dentición Permanente , Oclusión Dental , Radiografía , Chile , Estudios RetrospectivosRESUMEN
Objetivo: Describir las características craneofaciales, dentoalveolares, de tejido blando, vía aérea y el patrón de actividad muscular determinadas a través de los estudios cefalométricos y electromiográficos de individuos incompetentes labiales y con presencia de anomalías dentomaxilares de 7 a 12 años de edad. Materiales y método: Cuarenta y seis participantes con incompetencia labial fueron sometidos a una toma de radiografía lateral de perfil para el análisis cefalométrico. Para el estudio electromiográfico se consideró el patrón de actividad de los músculos Orbicular superior de los labios, orbicular inferior de los labios y temporal anterior en funciones: reposo, fonoarticulación, deglución, máximo apriete labial. Resultados: Se observó clase II esqueletal y molar, retrusión mandibular, biprotrusión incisal, biprotrusión labial, disminución de vía aérea superior. La mayor actividad muscular fue observada en máximo apriete labial. Conclusión: Los niños y niñas con incompetencia labial y anomalías dentomaxilares presentan alteraciones en las características craneofaciales, dentoalveolares, de tejido blando, vía aérea y actividad muscular determinadas a través de los estudios cefalométricos y electromiográficos.
Objective: To describe craniofacial, dentoalveolar, soft issue and airway features, and the muscular activity, determined through a cephalometric and electromyographic study in individuals with lip incompetence and dentomaxillary anomalies aged 7 to 12 years. Methods: Forty-six participants with lip incompetence underwent lateral profile radiography for cephalometric analysis. For the electromyographic study, the activity of the superior orbicularis oris, inferior orbicularis oris and anterior temporalis muscles was considered in the following functions: rest, speaking, swallowing, and reciprocal compression of the lips. Results: Skeletal and molar class II, mandibular retrusion, labial biprotrusion, incisal biprotrusion, and upper airway dysfunction were found. The highest muscular activity was observed in reciprocal compression of the lips. Conclusion: Children with lip incompetence and dentomaxillary anomalies have alterations in the craniofacial, dentoalveolar, soft issue, and airway features, and in the muscular activity , determined through a cephalometric and electromyographic study.
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Humanos , Masculino , Femenino , Niño , Anomalías Dentarias , Cefalometría , Electromiografía , Labio , Epidemiología Descriptiva , Estudio ObservacionalRESUMEN
SUMMARY: The objective of this study was to evaluate the changes of head and cervical spine posture of skeletal class malocclusion in adolescent with maxillary protraction. Thirty cases of skeletal class malocclusion were randomly selected from the Stomatological Hospital of Shanxi Medical University. High-quality lateral cephalograms were collected including pre- and posttreatment to compare the changes of head and cervical spine posture. Data were processed using SPSS 26.0 statistical software. The paired-t test was used to compare pre- and posttreatment mean angular measurements.A significant difference in the SNA(p<0.001), SNB(p<0.01), and ANB(p<0.001) between T1 and T2 showed an improvement in the sagittal relationships. A significant change was observed in middle cervical spine posture, while upper cervical spine posture variables showed no significant difference after treatment. Skeletal class with maxillary protraction appliance not only led to the improvement of sagittal relationship, but also changed the middle cervical spine posture.
El objetivo de este estudio fue evaluar los cambios en la postura de la cabeza y la columna cervical debido a la maloclusión clase esquelética en adolescentes con protracción maxilar. Treinta casos de maloclusión de clase esquelética fueron seleccionados al azar del Hospital Estomatológico de la Universidad Médica de Shanxi. Se recogieron cefalogramas laterales de alta calidad, incluidos el tratamiento previo y posterior, para comparar los cambios en la postura de la cabeza y la columna cervical. Los datos se procesaron con el software estadístico SPSS 26.0. Se utilizó la prueba t pareada para comparar las medidas angulares medias antes y después del tratamiento. Una diferencia significativa en SNA (p <0,001), SNB (p <0,01) y ANB (p <0,001) entre T1 y T2 mostró una mejora en las relaciones sagitales. Se observó un cambio significativo en la postura de la columna cervical media, mientras que las variables de postura de la columna cervical superior no mostraron diferencias significativas después del tratamiento. La clase esquelética con aparato de protracción maxilar no solo condujo a la mejora de la relación sagital, sino que también cambió la postura de la columna cervical media.
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Humanos , Niño , Postura , Vértebras Cervicales/anatomía & histología , Cabeza/anatomía & histología , Maloclusión de Angle Clase III/terapia , Cefalometría , Puntos Anatómicos de ReferenciaRESUMEN
In 1995 Gebeck & Merrifield studied a successful and unsuccessful treated Class I and Class II's samples; they found a -1.33 mm intrusion in the former and a 0.80 mm extrusion in the latter. The purpose of this article was to perform a cephalometric evaluation of maxillary incisors torque and vertical changes. We studied a sample of 129 patients, 30 males and 99 females, taken from The Charles H. Tweed Foundation Long Term Study, at pretreatment mean age 12.93 years, posttreatment mean age 16.19 years and follow up post retention mean age 29.83 years, a 13.88 years interval. The records were collected from private practitioners across the North American continent who used Standard Edgewise Mechanics and were members of the Charles H. Tweed Foundation. All patients were Class I and II American whites treated with the extraction of 4 premolars. We found an Upper anterior incisal edge to PP vertical linear measurement 28.7 and 29.2 mm, +0.53 mm (p<0.019) from pretreatment to posttreatment. The average Upper 1 to SN angle was 103.2 ° at pretreatment and 100.1° at posttreatment, -3.2° (p<0.000), Upper 1 to PP 111.0° and 108.9°, -2.2° (p<0.000), the three of them statistically significant. Conversely, Upper 1 to commissure was not. The four measurements were also statistically significant posttreatment to follow up, upper anteriors kept losing torque after posttreatment, and less upper anteriors surface was below the commissure. Some torque loss and vertical extrusion can be expected while treating patients with extractions of four premolars, therefore, upper incisor inclination increase and vertical change by itself cannot determine the success of treatment.
En 1995, Gebeck y Merrifield estudiaron muestras de Clase I y Clase II tratadas con éxito y sin éxito; encontraron una intrusión de -1,33 mm en el primero y una extrusión de 0,80 mm en el segundo. El propósito de este artículo fue realizar una evaluación cefalométrica del torque y los cambios verticales de los incisivos maxilares. Estudiamos una muestra de 129 pacientes, 30 hombres y 99 mujeres, tomados del estudio a largo plazo de la Fundación Charles H. Tweed, con una edad media previa al tratamiento de 12,93 años, una edad media posterior al tratamiento de 16,19 años y una edad media de seguimiento posterior a la retención de 29,83 años, con un intervalo de de 13,88 años. Los registros se recopilaron de médicos privados en todo el continente norteamericano que utilizaron Standard Edgewise Mechanics y eran miembros de la Fundación Charles H. Tweed. Todos los pacientes eran blancos americanos Clase I y II tratados con extracción de 4 premolares. Encontramos una medida lineal vertical del borde incisal anterior superior a PP de 28,7 y 29,2 mm, +0,53 mm (p<0,019) desde el pretratamiento hasta el postratamiento. El promedio del ángulo Superior 1 a SN fue de 103,2° en el pretratamiento y 100,1° en el postratamiento, -3,2° (p<0,000), Superior 1 a PP 111,0° y 108,9°, -2,2° (p<0,000), los tres estadísticamente significante. Por el contrario, Superior 1 a la comisura no lo era. Las cuatro mediciones también fueron estadísticamente significativas para el seguimiento después del tratamiento, los dientes anteriores superiores siguieron perdiendo torsión después del tratamiento y se observó menor superficie de los dientes anteriores superiores debajo de la comisura. Se puede esperar cierta pérdida de torque y extrusión vertical al tratar a pacientes con extracciones de cuatro premolares, por lo tanto, el aumento de la inclinación del incisivo superior y el cambio vertical por sí mismos no pueden determinar el éxito del tratamiento.
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Objective:To evaluate and compare the outcomes of maxillary protraction treatment assisted by temporary anchorage devices (TADs) and removable biteplate in cleft lip and palate patients using cephalometric analysis.Methods:Fifty-four cleft lip and palate patients were divided into 3 groups based on different maxillary protraction treatments: bitepalate removable appliance group (group A), maxillary protraction treatment assisted by TADs group (group B) and control group (group C). Lateral cephalograms were taken at the start and the end of maxillary protraction. Skeletal, dental and soft tissue changes were measured using Dolphin software and compared between groups.Results:The average protraction time of groups A and B were (8.51±1.33) and (9.20±1.45) months ( P=0.146), respectively. A point moved forward by 4.08 mm in group A and 4.83 mm in group B were noted, without significant differences between the two groups. Compared to group C, ANB and wits was highly improved after protraction in groups A and B. U6-VRmx increased by 0.46 mm and U1-pp increased by 0.63 mm in group B, both of which were significantly smaller than those of group A (both P<0.05), suggesting that maxillary protraction treatment assisted by TADs could reduce molar advancement and upper incisor protrusion. Conclusions:Both maxillary protraction treatment assisted by TADs and removable biteplate could significantly improve skeletal class Ⅲ malocclusion in unilateral cleft and palate patients. Maxillary protraction treatment assisted by TADs could reduce molar advancement and upper incisor protrusion.
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@#It has been traditionally believed that a 1:1 cortical bone remodeling/tooth movement ratio has been preserved during orthodontic treatment for tooth movement, with the alveolar bone on the tension side growing and the alveolar bone on the pressure side resorbing to maintain the balance of the alveolar bone. However, recent studies have shown that alveolar bone loss has been found in patients who have undergone orthodontic treatment, suggesting that the alveolar bone does not change as the teeth change over time. Whether the morphology of the alveolar bone will change when the anterior teeth are moved has been the clinical focus. The changes of anterior alveolar bone in patients who have undergone tooth extraction after orthodontic treatment were summerized by literature review in this paper. The results of the review showed that the alveolar bone at the lingual/palatal root-cervical site of the anterior root is more prone to bone loss after extensive movement of the anterior teeth. With the development of imaging technology, CBCT is now more commonly used for analysis instead of two-dimensional images for measurement, as its results are more accurate. However, there are few multifactorial studies in which CBCT has been used to assess the morphological changes in the alveolar bone. The focus of future research is to compare the long-term changes in the anterior alveolar bone of patients of different ages based on three-dimensional imaging, and to study the correlation between different skeletal features, tooth movement patterns and alveolar bone remodeling.
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Objective@# To analyze the correlation between third molar agenesis and craniofacial morphology by studying the location and number of congenital missing third molars and results of craniofacial cephalometric measurement. @*Methods@# A total of 123 patients were included, including 64 patients in the control group without congenital third molar absence and 59 patients in the absence group with at least one third molar absent. Cephalometric measurements included FMA, IMPA, AR-Go, GoGn-Sn, Co-A, Co-Gn, ANS-Me, Go-Me, SN-MP, Ar-Go-Me, SNA, SNB, ANB, Y-axis angle, Y-axis length, Ar-Go, Go-Me, MP-OP, FH-PP, FH-OP, a total of 18 bone tissue indicators, U1-SN, U1-L1, U1-NA, L1-NB, U1-APo and L1-APo, a total of 6 dental indicators, and UL-EP, LL-EP and nasolabial angle, a total of 3 soft tissue indicators. The correlation between congenital agenesis of third molars and craniofacial morphology was analyzed. @*Results@# The most common missing location of the third molar occured in the upper jaw and the most common number of missing teeth was one. In control group, Ar-Go-Me and SN-MP were larger (P<0.05), U1-SN, U1-NA, L1-NB, UL-EP and LL-EP were larger (P<0.05), and U1-L1 was smaller (P<0.01). There were no significant differences in Ar-Go and Go-Me between the two groups(P>0.05). @*Conclusion @#Patients with four third molars are more likely to have backward and downward rotation of the mandible and are more likely to develop into a convex facial type than patients with missing third molars, which has a higher correlation with hyperdivergent growth pattern and convex facial type.
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Aim: The objective of this prospective study was to evaluate the accuracy of cephalometric analyses acquired through manualtracing and the Eyes of AITM AI-driven web-based program.Materials and Methods: This prospective study employed randomization conducted via computer software, with a determinedsample size of 150 cases. Inclusion criteria encompassed good quality lateral cephalograms available in both digital and printformats, absence of artifacts that might hinder anatomical point location, and presence of a clear calibration ruler for magnificationdetermination. Exclusion criteria included lateral cephalograms with identifiable motion artifacts, resolution disparity, orcontrast, as well as those exhibiting positional errors indicated by ear rod markers. Each lateral cephalogramunderwent tracing and analysis using the manual method, as well as Eyes of AITM software. Following landmark plotting, linearand angular measurements of Steiner, Downs, McNamara, and Jefferson analyses were calculated.Results: A comparison of thirty-six cephalometric measurements of Steiner, Downs, McNamara, and Jefferson analyses obtainedfrom manual tracing and AI-driven Eyes of AITM revealed a Concordance Correlation Coefficient (CCC) value above 0.76 for all parameters, indicating strong agreement between manual and AI-driven cephalometric measurements. Furthermore, a CCC valueexceeding 0.9 was observed for twenty-eight parameters, indicative of very strong agreement. Conclusion: Automated lateral cephalometric measurements obtained from Eyes of AITM are accurate when compared to manualmeasurements.
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Humanos , Masculino , FemeninoRESUMEN
Background: Cleft lip and palate patients undergo many primary reconstructive surgical procedures which could lead to various changes in the facial morphology with growth. The most common diagnosis is unilateral cleft lip and palate (UCLP) and such patients are more prone to dental caries. Aims: This study aimed to evaluate and compare the lateral cephalometric landmarks, dental caries status, and salivary properties of surgically repaired UCLP children aged 6–15 years with lateral cephalometric landmarks, dental caries status, and salivary properties of noncleft children of the same age group. Materials and Methods: Twelve noncleft patients and 12 surgically repaired UCLP patients were chosen, and cephalometric analysis, salivary analysis, and dental caries status were recorded for both the groups. The data were then compared for both the groups. Statistical Analysis: It was analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. The level of statistical significance was set at 0.05. Results: In surgical repair ULCP children, their was increased prevalance of dental caries along with decrease level of salivary calcium, Phosphorus, flow rate. Also, their was increased level of alkaline phosphatase, total protein level with acidic pH alongwith retruded maxillary complex with Class III malocclusion. Conclusion: Various primary reconstructive surgeries in UCLP children lead to maxillary retrusion with an increased prevalence of dental caries in these patients due to the maintenance of poor oral hygiene
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The cephalometric diagnosis of third molars, as the molar group that heads the list of dental retentions, has been very variable and controversial from the clinical to the most modern radiographic methods. A literature review was carried out from January 2017 to March 2020; consulting articles, theses and texts available in databases; enlisting a total of 33 bibliographical references from which 27 were selected. The selection criteria were the direct relation with the subject, updating level in the last 5 years, as well as their methodological quality. The objective was aimed at describing the theoretical approaches to cephalometric diagnosis of third molar eruption. The review showed that there is a wide variety of studies on cephalometric diagnosis of third molar eruption with different limitations, each one contributing with their own approach to the subject, with isolated aspects on the etiology of the abnormal eruption in foreign contexts, offering measures that do not adjust to the Cuban population, representing 72.2 % in the last 5 years, including texts, not so updated, but which were of essential consultation due to the importance of their contents. It was concluded that the theoretical approaches presented by the literature on cephalometric diagnosis of third molar eruption are distinguished by the use of different foreign methods in diverse populations; highlighting a Cuban method applicable to the local and national context.
El diagnóstico cefalométrico de los terceros molares, como grupo molar que encabeza la lista de retenciones dentales, ha sido muy variable y controvertido desde la parte clínica hasta los métodos radiográficos más modernos. Se realizó una revisión bibliográfica desde enero de 2017 hasta marzo de 2020; y se consultaron artículos, tesis y textos disponibles en bases de datos. Se copiló un total de 33 referencias bibliográficas y de ellas se seleccionaron 27. Los criterios de selección fueron la relación directa con el tema, nivel de actualización en los últimos 5 años, así como su calidad metodológica. El objetivo fue describir las aproximaciones teóricas al diagnóstico cefalométrico de la erupción de terceros molares. La revisión demostró que existe una gran variedad de estudios sobre el diagnóstico cefalométrico de la erupción de terceros molares con diferentes limitaciones, que aportan su propio enfoque al tema, con aspectos aislados sobre la etiología de la erupción anormal en contextos extranjeros, y de este modo ofrecen medidas que no se ajustan a la población cubana, con un 72,2 % en los últimos 5 años, incluyendo textos, no tan actualizados, pero que fueron de imprescindible consulta por la importancia de sus contenidos. Se concluyó que los enfoques teóricos que presenta la literatura sobre el diagnóstico cefalométrico de la erupción de los terceros molares se distinguen por la utilización de diferentes métodos foráneos en diversas poblaciones; y se destaca un método cubano aplicable al contexto local y nacional.
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Ortodoncia , Tercer Molar , DiagnósticoRESUMEN
ABSTRACT@#This study aimed to assess the reliability of the OneCeph application according to personal computer (PC), tablet and smartphone screen size in comparison with Dolphin software on PC as a gold standard. Cephalometric landmarks were identified on 100 digital radiographs. Twenty-four cephalometric measurements were made with Dolphin software as a gold standard comparing with OneCeph application on smartphone (OS), OneCeph on PC (OP) and OneCeph on tablet (OT). All measurements were repeated after four weeks for intra-examiner reliability with intraclass correlation coefficients (ICC). One-way ANOVA and Kruskal Wallis test were done for measurement comparison between methods (Dolphin, OS, OP and OT). Results for OneCeph on smartphone and tablet, 21 measurements were comparable with Dolphin while other three (NLA, H-angle and UL to S-plane) were not. In OneCeph on PC, 20 measurements were comparable with Dolphin while other four (NLA, H-angle, U1 to A-point and UL to S-plane) were not. All different measurements were clinically insignificant except H-angle. Intra-examiner reliability represented ICC above 0.9. In conclusion, OneCeph application on three different screen size is reliable to use for cephalometric measurement. Most of the measurements are comparable with gold standard and adequate to be utilised in clinical routine. OneCeph on smartphone and tablet are advantageous from the portable feature over PC.
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ABSTRACT Objective: The aim of this study was to compare the measurements performed with digital manual (DM) cephalometric analysis and automatic cephalometric analysis obtained from an online artificial intelligence (AI) platform, according to different sagittal skeletal malocclusions. Methods: Cephalometric radiographs of 105 randomly selected individuals (mean age: 17.25 ± 1.87 years) were included in this study. Dolphin Imaging software was used for DM cephalometric analysis, and the WebCeph platform was used for AI-based cephalometric analysis. In total, 10 linear and 12 angular measurements were evaluated. The paired t-test, one-way ANOVA test, and intraclass correlation coefficient tests were used to evaluate the differences between the two methods. The level of statistical significance was set at p< 0.05. Results: Except for SNB, NPog, U1.SN, U1.NA, L1-APog, I/I, and LLE parameters, all other parameters presented significant differences between the two methods (p< 0.05). While there was no difference (p> 0.05) in both SNA and SNB measurements between the two methods in the Class I malocclusion group, there was a difference between both methods in the Class II malocclusion group. Meanwhile, only the SNA in the Class III malocclusion group was different (p< 0.05). The ANB angle differed significantly in all three malocclusion groups. For both methods, all parameters except CoA and CoGn were found to have good correlation. Conclusion: Although significant differences were detected in some measurements between the two cephalometric analysis methods, not all differences were clinically significant. The AI-based cephalometric analysis method needs to be developed for more specific malocclusions.
RESUMO Objetivo: Comparar as medidas realizadas usando análise cefalométrica digital-manual (DM) e análise cefalométrica automatizada por meio de uma plataforma online de inteligência artificial (IA), segundo as diferentes más oclusões esqueléticas sagitais. Métodos: Foram incluídas radiografias cefalométricas de 105 indivíduos selecionados aleatoriamente (idade média: 17,25 ± 1,87 anos). O software Dolphin Imaging foi utilizado para análise cefalométrica DM, e a plataforma WebCeph foi utilizada para análise cefalométrica baseada em IA. No total, foram avaliadas 10 medidas lineares e 12 angulares. O testet pareado, a ANOVA de uma via e o coeficiente de correlação intraclasse foram utilizados para avaliar as diferenças entre os dois métodos. O nível de significância foi estabelecido em p<0,05. Resultados: Com exceção dos parâmetros SNB, NPog, U1.SN, U1.NA, L1-APog, I/I e LIE, todos os outros parâmetros apresentaram valores significativamente diferentes entre os dois métodos (p<0,05). Enquanto não foi encontrada diferença (p>0,05) nas medidas SNA e SNB entre os dois métodos no grupo má oclusão de Classe I, foi encontrada diferença entre os métodos no grupo má oclusão de Classe II. Entretanto, no grupo má oclusão de Classe III somente o SNA foi diferente (p<0,05). O ângulo ANB diferiu significativamente em todos os três grupos de más oclusões. Foi encontrada boa correlação entre os dois métodos para todos os parâmetros, exceto para CoA e CoGn. Conclusão: Embora para algumas medidas tenham sido detectadas diferenças significativas entre os dois métodos de análise cefalométrica, nem todas as diferenças foram clinicamente significativas. O método de análise cefalométrica baseado em IA precisa ser aperfeiçoado, com maior especificidade para cada má oclusão.
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Objective @# To investigate the changes in the sagittal diameter of the upper airway before and after the treatment of skeletal Class Ⅲ malocclusion in adults with microimplant anchorage and class Ⅲ intermaxillary elastics and to provide a reference for clinical treatment. @*Methods @#A total of 35 adult patients with skeletal Class Ⅲ malocclusion were selected to be treated with the straight-wire technique. Microimplant group, 15 cases (group A): patients with severe skeletal Class Ⅲ malocclusion (vertical high angle) were treated with the straight-wire technique combined with microimplant anchorage; class Ⅲ intermaxillary elastics group, 20 cases (group B): Patients with mild or moderate skeletal Class Ⅲ malocclusion (vertical low angle and average angle) were treated with the straight-wire technique combined with class Ⅲ intermaxillary elastics, and cephalometric radiographs obtained before and after treatment in the upper airway in the two groups were measured and analyzed.@*Results @#Changes in cranial and maxillofacial measurements after correction: in group A, (sella-nasion-supramental angle) the SNB angle decreased significantly (P < 0.05), and (subspinale-nasion-supramental angle) the ANB angle increased significantly (P < 0.05). In group B, the SNB angle decreased significantly (P < 0.05), while (subspinale-nasion-subspinale angle) the SNA angle、ANB angle and anterior skull base plane-mandibular plane angle (Sn-MP) angle increased significantly (P < 0.05). Changes in sagittal diameter of the upper airway measurements after corrections: In group A, the width of the glossopharyngeal segment of the upper airway (TB-TPPW) decreased significantly (P < 0.05). In group B, first segment width of the upper airway behind the hard palate (PNS-R) increased significantly (P < 0.05). After correction, the decreased SNB and increased ANB in group A was higher than that in group B, and the difference was statistically significant (P < 0.05). The decreased of TB-TPPW in upper airway of group A was greater than that of group B, and the difference was statistically significant (P < 0.05).@* Conclusions @#In the treatment of skeletal class Ⅲ malocclusion with microimplant anchorage, the sagittal diameter of the glossopharyngeal segment of the upper airway has a negative impact.
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Objective:To compare the teaching effect of flipped classroom approach versus traditional lecture-based approach on the laboratory training course of Orthodontics cephalometric analysis for dental undergraduates. Methods:A total of 60 dental undergraduates who participated in the undergraduate course of Orthodontics were included in the study and randomly divided into experimental group and control group, with 30 students in each group. Flipped classroom approach was performed in the experimental group, while traditional lecture-based approach was used in the control group. Students' recognition towards teaching excellence, theoretical and laboratory performances, and their understanding and application of the key points in orthodontic cephalometric analysis were evaluated. SPSS 22.0 was used for t test and chi-square test. Results:Compared with the control group, students in experimental group gave more favorable rating in learning experience, had better learning motivation and more confidence in understanding and mastering the key points of orthodontic cephalometric analysis, with significant differences ( P<0.05). Besides, they also presented better theoretical and laboratory performances and superior mastery of the key points in the post-class quiz, with significant differences ( P<0.05). Conclusion:Flipped classroom is a promising approach to improve the teaching effect of cephalometric analysis of Orthodontics.
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Objective: The purposes of our research were to establish cephalometric standards for Yemeni adults and to compare them with those of the Caucasians. Material and Methods: 100 Yemeni students (fifty males, mean age of 23.6 ± 2.1 years, and fifty female, mean age of 21.5 ± 3.1 years) with normal occlusions and well-balanced faces were involved in the study. Inclusion criteria were a class I occlusion with minor or no crowding, the whole teeth is present except third molars and no previous orthodontic, orthopedic or maxillofacial surgery treatment. Five angular and eighteen linear measurements were used for the skeletal, dental and soft tissue analysis. All participant's Lateral cephalometric radiographs were evaluated. The average values and standard deviations for all the angles and linear measurements were determined. The differences for each measurement between the Yemeni and Caucasian participants were calculated using unpaired ttests. Results: Yemeni subjects had a more retrognathic mandibular positions (P< 0.05), protrusive mandibular incisors (P< 0.01), more protruded lip positions (P < 0.01), deeper mentolabial sulci (P< 0.01) and a steeper mandibular planes (P< 0.001) compared to the Caucasians. Yemeni females had a larger lower face height than Caucasian females (P< 0.001). Conclusions The study provides specific standards for Yemeni adults and shows that the Yemenis had different skeletal and dentoalveolar cephalometric standards in comparison with Caucasians (AU)
Objetivo: O objetivo de nossa pesquisa foi estabelecer padrões cefalométricos para adultos iemenitas e compará-los com os caucasianos. Material e Métodos: Cem estudantes iemenitas (cinquenta homens, idade média de 23,6 ± 2,1 anos, e cinquenta mulheres, idade média de 21,5 ± 3,1 anos) com oclusões normais e faces bem equilibradas foram envolvidos no estudo. Os critérios de inclusão foram: oclusão de classe I com pouco ou nenhum apinhamento, todos os dentes presentes, exceto terceiros molares e sem histórico de tratamento ortodôntico, ortopédico ou cirurgia maxilo-facial prévio. Cinco medidas angulares e dezoito lineares foram utilizadas para a análise esquelética, dentária e de tecidos moles. Todas as radiografias cefalométricas laterais dos participantes foram avaliadas. Foram determinados os valores médios e desvios padrão para todos os ângulos e medidas lineares. As diferenças para cada medição entre os participantes iemenitas e caucasianos foram calculadas usando testes t não pareados. Resultados: Os indivíduos iemenitas tinham posições mandibulares mais retrognáticas (P <0,05), incisivos inferiores protrusivos (P <0,01), posições dos lábios mais protuberantes (P <0,01), sulcos mentolabiais mais profundos (P <0,01) e planos mandibulares mais inclinados (P <0,001) em comparação com os caucasianos. As mulheres iemenitas tinham uma altura facial inferior maior do que as mulheres brancas (P <0,001). Conclusão:O estudo fornece padrões específicos para adultos iemenitas e mostra que os iemenitas apresentaram padrões cefalométricos esqueléticos e dentoalveolares diferentes em comparação com os caucasianos. (AU)
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Humanos , Masculino , Femenino , Adulto , Radiografía Dental , Cefalometría , Maloclusión Clase I de AngleRESUMEN
The aim of this study was to evaluate the hard and soft tissue profile changes following treatment of functional and mild skeletal class III malocclusion in mixed dentition by means of the Frankel functional regulator (FR-3) appliance, and to reveal the mechanism and effectiveness of treatment with FR-3 appliance. Twenty-six patients (chronological mean age, 8.7±1.4 years; mean treatment duration, 10.3±1.3 months) with functional and mild skeletal class III malocclusion were selected and treated with FR-3 appliances. Lateral cephalogram was taken pre- and post-treatment, and the data was analyzed by paired-samples t test with SPSS22.0 software package. Differences were considered statistically significant at P < 0.05. The results demonstrated that the FR-3 appliance produced a statistically significant decrease in L1-NB, L1-MP, U1-L1 (P<0.01) and an increase greatly in ANB, MP-FH, Y axis, ANSMe, ANS-Me/N-Me and overjet (P<0.01). SNA, SNB were increased significantly (P<0.05). Meanwhile, N'-Sn-Pog', ULSn-SN, LLSiSN increased, S-N'-Si, LL-EP decreased with significant difference (P<0.01). S-N'-Sn, Cm-Sn-UL, UL-EP, Sn-Mes and Ns-Mes increased with significant difference (P<0.05). Therefore it was concluded that after FR-3 treatment, the position of mandible may rotate clockwise backwards and downwards, with the labioversion of upper incisors and linguoversion of lower incisors. Although point A moved mesially, the length and position of the maxilla did not change significantly. With the protrusion of upper lip and the retrusion of lower lip, the relationship among nose, upper lip, lower lip and chin become harmonious, the profile of soft tissue is more coordinated and attractive.
El objetivo de este estudio fue evaluar los cambios en el perfil de los tejidos duros y blandos después del tratamiento de la maloclusión funcional y leve de la clase III esquelética en la dentición mixta mediante el aparato regulador funcional Frankel (FR-3), y revelar el mecanismo y efectividad del tratamiento con el aparato FR-3. Veintiseis pacientes (edad media 8,7 ± 1,4 años; duración media del tratamiento, 10,3 ± 1,3 meses) con maloclusión funcional y leve de clase esquelética III fueron seleccionados y tratados con aparatos FR-3. El cefalograma lateral se tomó antes y después del tratamiento, y los datos se analizaron mediante la prueba t de muestras con el software SPSS22.0. Las diferencias se consideraron estadísticamente significativas a P <0,05. Los resultados demostraron que el dispositivo FR-3 produjo una disminución estadísticamente significativa en L1-NB, L1MP, U1-L1 (P <0,01) y un gran aumento en ANB, MP-FH, eje Y, ANS-Me, ANS -Me / N-Me y overjet (P <0,01). SNA, SNB se incrementaron significativamente (P <0,05). Mientras tanto, N'Sn-Pog', ULSn-SN, LLSi-SN aumentaron, S-N'-Si, LL-EP disminuyeron con una diferencia significativa (P <0,01). S-N'-Sn, Cm-Sn-UL, UL-EP, Sn-Mes y Ns-Mes aumentaron con una diferencia significativa (P <0,05). Por lo tanto, se concluyó que después del tratamiento con FR-3, la posición de la mandíbula puede girar en sentido reloj hacia atrás y hacia abajo, con labioversión de los incisivos superiores y linguoversión de los incisivos inferiores. Aunque el punto A se movió mesialmente, la longitud y la posición del maxilar no cambiaron significativamente. Con la protuberancia del labio superior y la retrusión del labio inferior, la relación entre la nariz, el labio superior, el labio inferior y el mentón se armoniza, el perfil del tejido blando es más coordinado y atractivo.
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Humanos , Masculino , Femenino , Niño , Aparatos Ortodóncicos Funcionales , Dentición Mixta , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/terapia , CefalometríaRESUMEN
ABSTRACT Objective: The aim of this retrospective study was to evaluate the cephalometric and occlusal changes of orthodontically treated Class III malocclusion patients. Methods: The experimental groups comprised 37 Class III patients treated: G1) without (n=19) and G2) with extractions (n=18) . The control group (G3), matched by age and sex with the experimental groups, consisted of 18 subjects with untreated Class III malocclusion. Cephalometric (radiographs) and occlusal (study models) changes were assessed between the beginning (T1) and the end (T2) of treatment. Intergroup comparisons were performed with one-way ANOVA followed by Kruskal-Wallis tests (p< 0.05). Occlusal changes were evaluated by the peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the treatment outcomes were evaluated by the Objective Grading System (OGS) (t-tests). Results: The experimental groups showed a restrictive effect on mandibular anterior displacement and a discrete improvement in the maxillomandibular relationship. Extraction treatment resulted in a greater retrusive movement of the incisors and significant improvements in the overjet and molar relationship in both groups. The PAR indexes were significantly reduced with treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no significant intergroup difference. Conclusions: Orthodontic treatment of Class III malocclusion patients with fixed appliances improved the sagittal relationships, with greater incisor retrusion in the extraction group. Both the extraction and non-extraction treatments significantly decreased the initial malocclusion severity, with adequate and similar occlusal outcomes of treatment.
RESUMO Objetivos: O objetivo desse estudo retrospectivo foi avaliar as alterações cefalométricas e oclusais de pacientes com má oclusão de Classe III tratados ortodonticamente. Método: Os grupos experimentais compreenderam 37 pacientes Classe III tratados: 19 com extrações dentárias (G1) e 18 sem (G2). O grupo controle (G3), compatibilizado em idade e sexo com os grupos experimentais, consistiu de 18 indivíduos com má oclusão de Classe III não tratada. Alterações cefalométricas (radiografias) e oclusais (modelos de estudo) foram avaliadas ao início (T1) e ao fim (T2) do tratamento. Comparações intergrupos foram realizadas com testes ANOVA a um critério e Kruskal-Wallis (p< 0,05). As alterações oclusais foram avaliadas pelo índice PAR (testes ANOVA e Kruskal-Wallis) e os resultados oclusais dos tratamentos, pelo índice Objective Grading System (OGS) (testes t). Resultados: Os grupos experimentais apresentaram um efeito restritivo no posicionamento anterior da mandíbula e uma discreta melhora na relação maxilomandibular. Os tratamentos com extrações resultaram em um maior movimento retrusivo dos incisivos e melhoras significativas no trespasse horizontal e na relação molar em ambos os grupos. Os índices PAR foram reduzidos significativamente com o tratamento, e os índices OGS foram iguais a 25,6 (G1) e 28,6 (G2), sem diferença significativa entre os grupos. Conclusões: O tratamento ortodôntico de pacientes com má oclusão de Classe III com aparelhos corretivos fixos melhorou as relações sagitais, com maior retrusão dos incisivos no grupo com extrações. Ambos os tratamentos, com e sem extrações dentárias, diminuíram significativamente a severidade inicial da má oclusão, com resultados oclusais do tratamento adequados e similares.
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Humanos , Sobremordida , Maloclusión Clase II de Angle , Maloclusión de Angle Clase III/terapia , Maloclusión de Angle Clase III/diagnóstico por imagen , Cefalometría , Estudios Retrospectivos , Resultado del Tratamiento , Mandíbula/diagnóstico por imagenRESUMEN
El 81,3% de una encuesta realizada a 96 ortodoncistas y ortopedistas calificados y técnicos radiólogos consultados informan que ubican la cabeza del paciente en una posición ideal, subjetiva del profesional instruido que lo asiste, ya que muchas de sus fotografías y telerradiografías no son posiciones naturales de la cabeza genuinas. Se ha utilizado la vertical verdadera como parámetro para mediciones, todas angulares, para definir la disposición ánteroposterior del punto A´ (de construcción) para el cuerpo del labio superior, el punto Pg´para el mentón, el Labrale superior y el Labrale inferior para el bermellón de cada labio, con la finalidad de planificar correcciones ortopédicas, ortodóncicas u ortodóncicas-quirúrgicas de acuerdo a la anomalía detectada (AU)