Cephalometric and three-dimensional assessment of the posterior airway space and imaging software reliability analysis before and after orthognathic surgery |
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| Institution: | 1. Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, Switzerland;2. Biostatistics Unit, Institute of Social and Preventive Medicine, University of Zurich, Switzerland;1. Division of Reconstructive Surgery for Oral and Maxillofacial Region, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;2. Division of Oral and Maxillofacial Radiology, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;1. Chief, Division of Dentistry/Oral and Maxillofacial Surgery, Ottawa Hospital, and Assistant Professor, Department of Otolaryngology, University of Ottawa School of Medicine, Ottawa, Ontario, Canada;2. Research Assistant, Queen''s University, Kingston, Ontario, Canada;3. Assistant Professor, Department of Otolaryngology, University of Ottawa School of Medicine, Ottawa, Ontario, Canada;4. Research Assistant, Division of Dentistry/Oral and Maxillofacial Surgery, Ottawa Hospital, Ottawa, Ontario, Canada;1. Radiologist, Department of Oral and Maxillofacial Radiology, Stomatological Hospital, Dalian, China; guest researcher, Oral Maxillofacial Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden;2. Professor, Department of Oral and Maxillofacial Radiology, School and Hospital of Stomatology, Peking University, Beijing, China;3. Associate professor, Department of Oral and Maxillofacial Radiology, Stomatological Hospital, Dalian, China;4. Professor, Department of Orthodontics, Stomatological Hospital, Dalian, China;5. Chair, Oral Maxillofacial Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden;6. Associate professor, Oral Maxillofacial Diagnostics and Surgery, Karolinska Institutet, Huddinge, Sweden;1. Associate professor, Department of Orthodontics, Dental Sciences Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;2. Associate professor, Medical Design and Manufacturing Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;3. Professor and chairman of Dental Sciences Center, Department of Orthodontics, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;4. Associate professor, Department of Radiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey;1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Yemen;2. Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;3. Department of Orthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen;4. Department of Orthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt;5. Department of Orthodontics, Faculty of Dentistry, Faculty of Dentistry, Thamar University, Yemen;6. Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt;7. Ministry of health, Jibla Hospital, Ibb, Yemen;1. Associate Professor, Department of Stomatology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil; Gratis Associate Professor and Research Fellow, Department of Oral and Maxillofacial, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA;2. Associate Professor, Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil;3. Assistant Professor, Department of Oral and Maxillofacial, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA;4. Chief Resident, Department of Oral and Maxillofacial, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA;6. Gamble Professor and Chair, Department of Oral and Maxillofacial, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA |
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| Abstract: | PurposeThis study aimed to compare the reliability of three different imaging software programs for measuring the PAS and concurrently to investigate the morphological changes in oropharyngeal structures in mandibular prognathic patients before and after orthognathic surgery by using 2D and 3D analyzing technique.Material and methodsThe study consists of 11 randomly chosen patients (8 females and 3 males) who underwent maxillomandibular treatment for correction of Class III anteroposterior mandibular prognathism at the University Hospital in Zurich. A set of standardized LCR and CBCT-scans were obtained from each subject preoperatively (T0), 3 months after surgery (T1) and 3 months to 2 years postoperatively (T2). Morphological changes in the posterior airway space (PAS) were evaluated longitudinally by two different observers with three different imaging software programs (OsiriX® 64-bit, Switzerland; Mimics®, Belgium; BrainLab®, Germany) and manually by analyzing cephalometric X-rays.ResultsA significant increase in the upper airway dimensions before and after surgery occurred in all measured cases. All other cephalometric distances showed no statistically significant alterations. Measuring the volume of the PAS showed no significant changes in all cases. All three software programs showed similar outputs in both cephalometric analysis and 3D measuring technique.ConclusionA 3D design of the posterior airway seems to be far more reliable and precise phrasing of a statement of postoperative gradients than conventional radiography and is additionally higher compared to the corresponding manual method. In case of Class III mandibular prognathism treatment with bilateral split osteotomy of the mandible and simultaneous maxillary advancement, the negative effects of PAS volume decrease may be reduced and might prevent a developing OSAS. |
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| Keywords: | Orthognathic surgery Posterior airway CBCT Cephalometry Imaging software |
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