A three-dimensional cephalometric analysis of Japanese adults and its usefulness in orthognathic surgery: A retrospective study |
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| Institution: | 1. Graduate School of Dentistry, Osaka University, Suita, Osaka, 5650871, Japan;2. Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, Osaka, 5650871, Japan;3. Kanomi Orthodontic Office, Himeji-City, Japan;1. Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA;2. Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida, Jacksonville, FL, USA;3. Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil;1. Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;2. Joint Research Department of Next-Generation Dental Materials Engineering, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;3. Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, 4–1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Miyagi, Japan;1. Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya, Israel;2. Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel;3. The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel;4. The Institute for Medical Research, Galilee Medical Center, Nahariya, Israel;1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, PR China;2. The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, PR China;1. Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany;2. Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstr. 11, 91054, Erlangen, Germany;3. Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany;4. Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany;5. Department of Oral, Cranio Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60528, Frankfurt am Main, Germany;6. Department of Oral and Maxillofacial Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany;7. Department of Oral and Maxillofacial Surgery, Helios Hospital Schwerin, Wismarsche Str. 393-397, 19049, Schwerin, Germany;8. Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany;9. Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;1. University Medical Center Hamburg-Eppendorf, Department of Oral and Maxillofacial Surgery, Hamburg, Germany;2. Department of Oral and Maxillofacial Surgery, Asklepios Hospital North, Faculty of Medicine, Semmelweis University Campus Hamburg, Hamburg, Germany |
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| Abstract: | This study aimed to establish a three-dimensional (3D) cephalometric analysis of craniofacial morphology and discuss its theoretical usefulness in orthognathic patients.Cone-beam computed tomography (CBCT) images of Japanese subjects with skeletal Class I malocclusion before treatment were selected from among 1000 patients so that samples matched a historic 2D cephalometric cohort with normal occlusion using propensity score matching. In each CBCT image, 67 3D measurements were calculated based on manually identified landmarks. The mean and standard deviation of the measurements were calculated and used as the normative range for each sex. To confirm the usefulness of the 3D measurements, pre- and post-treatment CT data of nine jaw deformity patients who underwent orthognathic surgery with two-dimensional planning (2DP) in the past were used. Pre- and post-treatment CT values were evaluated with a paired t-test as well as a Z-score, which was calculated using the aforementioned normative range, and then categorized into five groups (“deteriorated”, “no improvement”, “over-treatment”, “no change”, “improvement”) with ?1 < Z-score < 1 considered normal.Fifty-six patients were matched to normal skeletal 1 subjects. The normative range of 67 items indicating 3D craniofacial morphology of the Japanese was calculated. Postoperatively, the horizontal position of the pogonion to the mid-sagittal plane significantly decreased (p = 0.043) and “improved”; however, the ramus axis on the right side significantly increased (p = 0.005) and “deteriorated”. Maxillary yaw and the horizontal position of the gonion also tended to “deteriorated”.The normative range for the 3D cephalometric analysis in Japanese has been established. Given findings of deteriorated maxillomandibular yawing after surgery when using conventional 2DP, 3D cephalometric measurements should be used when planning jaw positions after surgery for orthognathic patients. |
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| Keywords: | Three-dimensional (3D) Two-dimensional (2D) Cephalometry Malocclusion Mandible Maxilla Orthognathic surgery |
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