Sample records for cephalometry

  1. Cephalometry in orthodontic practice

    International Nuclear Information System (INIS)

    Cephalometry is applied in orthodontic practice to: - obtain information on the growth of the skull - assist diagnosis of the relationship between the jaws and abnormalities in dentition - evaluate the results of treatment. The course of the diagnostic procedure with the aid of the Ricketts analysis and evaluation of the treatment results using five superimpositions is demonstrated by means of two examples. (Auth.)

  2. A reflection on radiographic cephalometry: the evaluation of sagittal discrepancy. (United States)

    Duterloo, Herman S


    A critical review is presented of the basic properties and applications of cephalometry as a clinical tool with a focus on the evaluation of sagittal discrepancy. Diagnostic cephalometric assessments are subjective and not based on evidence. To assess individual skeletal and/or facial soft tissue form subjectively, selected norms are used. Norms have been developed for various ethnical groups to improve clinical applicability, but subjectivity remains. That subjectivity precludes application of a modern review system, making the present review a personal account. The cephalometric evaluation of sagittal discrepancy finds its historic origin in the Angle classification. Recent publications try to improve accuracy in classifying sagittal discrepancy. It remains unclear in what sense such efforts influence treatment decisions and/or treatment effect. Almost all selected landmarks are located on or dependent upon periosteal/endosteal bone image contours. Their homology is based on circumstantial reasoning and stability over time, which is implicitly assumed. However, implant growth studies and histological investigations show most landmarks to be unstable, as they are involved in displacement and bone remodelling. These landmarks are therefore heterologous when used for individual evaluation of change over time. Notwithstanding the above-indicated limitations, diagnostic cephalometric assessments are clinically useful and help to develop perceptions of balance and harmony and communication between colleagues and patients. There is no evidence-based method to prefer one particular diagnostic method. Landmark location accuracy and geometric issues do not play a decisive role. The subjective characteristic of diagnostic evaluations limits their power to size/shape comparisons. Structural superimposition is the valid biologically evidence-based method to provide advanced insight in individual growth and/or treatment changes and their variations. PMID:24521748

  3. Practical limitations of cone-beam computed tomography in 3D cephalometry%Practical limitations of cone-beam computed tomography in3D cephalometry

    Institute of Scientific and Technical Information of China (English)

    Janalt Damstra; Zacharias Fourie; Yijin Ren


    3D cone beam computed tomography (CBCT) images offer a unique and new appreciation of the anatomical structures and underlying anomalies not possible with conventional radiographs.However,in almost all aspects of CBCT imaging,from utilization to application,inherent limitations and pitfalls exist.Importantly,these inherent limitations and pitfalls have practical implications which need to be addressed before the potential of this technology can be fully realized.The purpose of this review was to explore the current limitations and pitfalls associated with CBCT imaging to allow for better and more accurate understanding of the possibilities this imaging modality could offer,particularly pertaining to 3D cephalometry.

  4. Applicability of the Ricketts' posteroanterior cephalometry for sex determination using logistic regression analysis in Hispano American Peruvians

    Directory of Open Access Journals (Sweden)

    Ivan Perez


    Full Text Available Background: The Ricketts' posteroanterior (PA cephalometry seems to be the most widely used and it has not been tested by multivariate statistics for sex determination.Objective: The objective was to determine the applicability of Ricketts' PA cephalometry for sex determination using the logistic regression analysis. Materials and Methods: The logistic models were estimated at distinct age cutoffs (all ages, 11 years, 13 years, and 15 years in a database from 1,296 Hispano American Peruvians between 5 years and 44 years of age. Results: The logistic models were composed by six cephalometric measurements; the accuracy achieved by resubstitution varied between 60% and 70% and all the variables, with one exception, exhibited a direct relationship with the probability of being classified as male; the nasal width exhibited an indirect relationship. Conclusion: The maxillary and facial widths were present in all models and may represent a sexual dimorphism indicator. The accuracy found was lower than the literature and the Ricketts' PA cephalometry may not be adequate for sex determination. The indirect relationship of the nasal width in models with data from patients of 12 years of age or less may be a trait related to age or a characteristic in the studied population, which could be better studied and confirmed.

  5. Applicability of the Ricketts’ posteroanterior cephalometry for sex determination using logistic regression analysis in Hispano American Peruvians (United States)

    Perez, Ivan; Chavez, Allison K.; Ponce, Dario


    Background: The Ricketts' posteroanterior (PA) cephalometry seems to be the most widely used and it has not been tested by multivariate statistics for sex determination. Objective: The objective was to determine the applicability of Ricketts' PA cephalometry for sex determination using the logistic regression analysis. Materials and Methods: The logistic models were estimated at distinct age cutoffs (all ages, 11 years, 13 years, and 15 years) in a database from 1,296 Hispano American Peruvians between 5 years and 44 years of age. Results: The logistic models were composed by six cephalometric measurements; the accuracy achieved by resubstitution varied between 60% and 70% and all the variables, with one exception, exhibited a direct relationship with the probability of being classified as male; the nasal width exhibited an indirect relationship. Conclusion: The maxillary and facial widths were present in all models and may represent a sexual dimorphism indicator. The accuracy found was lower than the literature and the Ricketts' PA cephalometry may not be adequate for sex determination. The indirect relationship of the nasal width in models with data from patients of 12 years of age or less may be a trait related to age or a characteristic in the studied population, which could be better studied and confirmed. PMID:27555732

  6. A simulator for maxillo-facial surgery integrating cephalometry and orthodontia

    CERN Document Server

    Bettega, G; Mollard, B; Boyer, A; Raphael, B; Lavallee, S


    Objectives : This paper presents a new simulator for maxillo-facial surgery, that gathers the dental and the maxillo-facial analyses together into a single computer-assisted procedure. The idea is first to propose a repositioning of the maxilla, via the introduction of a 3D cephalometry, applied to a 3D virtual model of the patient's skull. Then, orthodontic data are integrated into this model, thanks to optical measurements of teeth plaster casts. Materials and Methods : The feasibility of the maxillo-facial demonstrator was first evaluated on a dry skull. To simulate malformations (and thus to simulate a "real" patient), the skull was modified and manually cut by the surgeon, in order to generate a given maxillo-facial malformation (with asymmetries in the sagittal, frontal and axial planes). Results : The validation of our simulator consisted in evaluating its ability to propose a bone repositioning diagnosis that will put the skull as it was in its original configuration. A first qualitative validation is...

  7. A comparison between two lateral cephalometry techniques (standard and natural head position

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    Hedayati Z. Assistant Professor. Sang S. DMD


    Full Text Available Statement of Problem: Cephalometric findings are of high importance in making decision about orthodontic treatment plans and orthognathic surgeries. Natural head position (NHP is considered as a useful and exact radiographic technique."nAim: The aim of the present study was to compare two techniques, namely Standard and NHP, in lateral"ncephalometry."nMaterials and Methods: In this cross- sectional study, performed in Shiraz. 138 randomly selected students {70 males .and 68 females, age ranging from (13-15. were evaluated clinically and radiographically. None of them had a history of orthodontic treatment, head and face fracture or surgical operations. Lateral cephalograms were taken in both standard and natural head position techniques, for each student. For statistical analysis, l-lest for paired samples, was done."nResults: This study showed that in anterior-posterior dimension, among angles with significant differences in two techniques, those of standard one were more reliable, whereas in vertical dimension."nstatistical differences showed natural technique as more useful one."nConclusion: Due to the fact that natural cephalometry requires more patient cooperation, more time and a higher complex technique, it is not suggested, except when different clinical and cepholomeiric findings are observed.

  8. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 2: three-dimensional cephalometry. (United States)

    Xia, J J; Gateno, J; Teichgraeber, J F; Yuan, P; Li, J; Chen, K-C; Jajoo, A; Nicol, M; Alfi, D M


    Three-dimensional (3D) cephalometry is not as simple as just adding a 'third' dimension to a traditional two-dimensional cephalometric analysis. There are more complex issues in 3D analysis. These include how reference frames are created, how size, position, orientation and shape are measured, and how symmetry is assessed. The main purpose of this article is to present the geometric principles of 3D cephalometry. In addition, the Gateno-Xia cephalometric analysis is presented; this is the first 3D cephalometric analysis to observe these principles.

  9. Assessment of Soft Tissue Changes by Cephalometry and Two-Dimensional Photogrammetry in Bilateral Sagittal Split Ramus Osteotomy Cases

    Directory of Open Access Journals (Sweden)

    Jan Rustemeyer


    Full Text Available Objectives: We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods.Material and Methods: Twenty-six patients (mean age 25.5, standard deviation (SD 5.2 years with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded.Results: Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007; and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043 compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039.Conclusions: Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another.

  10. [Three-dimensional cephalometry: applications in clinical practice and research]. (United States)

    Faure, Jacques; Oueiss, Arlette; Marchal-Sixou, Christine; Braga, José; Treil, Jacques


    A 3D cephalometric analysis method from scanner acquisition has been developed thanks to a long collaboration between Dr Treil and the Department of Orthodontics in Toulouse III University. It allows a perfect knowledge of maxillo-facial architecture using fourteen landmarks related to the neuromatricial axis of facial growth. These landmarks can be identified without ambiguity. The marking of each tooth relative to dental arches (gravity centre coordinates and torque and tipping of each tooth), and the location of arches relative to maxillo-facial frame are given by the analysis. Description and reconstruction of dental and maxillo-facial anatomy are possible with three levels: maxillo-facial frame, maxillar and mandibular bases and dentoalveolar level. The method not only gives more precise information than conventional cephalometrics in anteroposterior and vertical directions, but it allows transversal analysis and asymmetry measurement. Applications are numerous in research as well as in clinical medicine: analyses of cases border line surgery, surgical set-up, facial asymmetry, analysis of dentoalveolar compensations, definition of therapeutic aims, occlusal analysis and set-up, study of evolution in anthropology-primatology, study of growth etc. This method of description using a pattern of landmarks is perfectly adapted to the last developments of modern research techniques: morphometric geometry with Procustes superimpositions, EDMA, TPS, FEM. PMID:18364213

  11. Radiographic cephalometry analysis of dimensions of condylar processus in persons with mandibular prognathism

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    Čutović Tatjana


    Full Text Available Introduction/Aim. There are numerous factors that influence the formation of condylar processus: the growth and development of cranial base, growth and development of the jaws and alveolar extensions, teething, the way of intercuspidation, the overlap of incisors, functions of masticatory muscles, etc. Considering the fact that the above-mentioned factors significantly differ in persons with different morphological set of the face, we set a hypothesis that dimensions of condylar processus and the mandibular ramus considerably differ in persons with mandibular prognathism compared to eugnatic persons. The aim of this study was to establish the differences in dimensions of condylar processus between the above-mentioned groups. Methods. Six parameters representing the dimensions of the condylar processus were measured on profile teleradiographs of 30 eugnatic persons and 30 paersons with mandibular prognathism: the height of condylar processus, the height of head of the mandible, width of the head, width of the neck, height of the ramus without the condylar processus and the overall height of the ramus. Results. A considerable difference in the values of the parameters was found, as well as the distribution toward the values of reference. It was found that the height of the condylar processus was significantly greater in persons with mandibular prognathism, whereas the width of the head of the mandible, the width of the neck and the height of the ramus without the condylar processus was considerably decreased within the same group. The height of the head of the mandible and the overall height of the ramus was not significantly changed. Conclusion. In persons with mandibular prognathism, morphological features of the condylar processus are changed. The condylar processus lengthens on account of shortening of the lower part of the ramus, and the mentioned lengthening is the most prominent in its condylar neck area which is also the centre of its most intense growth.

  12. Practical limitations of cone-beam computed tomography in 3D cephalometry

    NARCIS (Netherlands)

    Damstra, Janalt; Fourie, Zacharias; Ren, Yijin


    3D cone beam computed tomography (CBCT) images offer a unique and new appreciation of the anatomical structures and underlying anomalies not possible with conventional radiographs. However, in almost all aspects of CBCT imaging, from utilization to application, inherent limitations and pitfalls exis

  13. Radiographic cephalometry analysis of condylar position after bimaxillary osteotomy in patients with mandibular prognathism

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    Miković Nikola D.


    Full Text Available Background/Aim. Postoperative condylar position is a substantial concern in surgical correction of mandibular prognathism. Orthognathic surgery may change condylar position and this is considered a contributing factor for early skeletal relapse and the induction of temporomandibular disorders. The purpose of this study was to evaluate changes in condylar position, and to correlate angular skeletal measurements following bimaxillary surgery. Methods. On profile teleradiographs of 21 patients with mandibular angular and linear parametres, the changes in condylar position, were measured during preoperative orthodontic treatment and 6 months after the surgical treatment. Results. A statistically significant difference in values between the groups was found. The most distal point on the head of condyle point (DI moved backward for 1.38 mm (p = 0.02, and the point of center of collum mandibulae point (DC moved backward for 1.52 mm (p = 0.007. The amount of upward movement of the point DI was 1.62 mm (p = 0.04. Conclusion. In the patients with mandibular prognathism, the condyles tend to migrate upward and forward six months after bimaxillary surgery.

  14. Effects of image enhancement on reliability of landmark identification in digital cephalometry

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    M Oshagh


    Full Text Available Introduction: Although digital cephalometric radiography is gaining popularity in orthodontic practice, the most important source of error in its tracing is uncertainty in landmark identification. Therefore, efforts to improve accuracy in landmark identification were directed primarily toward the improvement in image quality. One of the more useful techniques of this process involves digital image enhancement which can increase overall visual quality of image, but this does not necessarily mean a better identification of landmarks. The purpose of this study was to evaluate the effectiveness of digital image enhancements on reliability of landmark identification. Materials and Methods: Fifteen common landmarks including 10 skeletal and 5 soft tissues were selected on the cephalograms of 20 randomly selected patients, prepared in Natural Head Position (NHP. Two observers (orthodontists identified landmarks on the 20 original photostimulable phosphor (PSP digital cephalogram images and 20 enhanced digital images twice with an intervening time interval of at least 4 weeks. The x and y coordinates were further analyzed to evaluate the pattern of recording differences in horizontal and vertical directions. Reliability of landmarks identification was analyzed by paired t test. Results: There was a significant difference between original and enhanced digital images in terms of reliability of points Ar and N in vertical and horizontal dimensions, and enhanced images were significantly more reliable than original images. Identification of A point, Pogonion and Pronasal points, in vertical dimension of enhanced images was significantly more reliable than original ones. Reliability of Menton point identification in horizontal dimension was significantly more in enhanced images than original ones. Conclusion: Direct digital image enhancement by altering brightness and contrast can increase reliability of some landmark identification and this may lead to more accurate cephalometric analysis.

  15. 正常(牙合)儿童X线头影测量标准值研究%Normal values of cephalometry about children with normal occlusion

    Institute of Scientific and Technical Information of China (English)

    区运运; 兰泽栋; 孙新华



  16. Relação entre cefalometria e análise facial na determinação do tipo de face Relation between cephalometry and facial analysis on the facial type determination

    Directory of Open Access Journals (Sweden)

    Rossana Ribeiro Ramires


    Full Text Available OBJETIVO: correlacionar os achados cefalométricos com os da análise facial realizada por meio de fotografias para classificar o tipo facial, segundo o sexo. MÉTODOS: participaram 105 adultos leucodermas, 34 (32,4% homens e 71 (67,6% mulheres, com idades entre 20 e 40 anos, de uma clínica particular de ortodontia de Belo Horizonte/MG. Os achados da análise cefalométrica para determinação do tipo facial a partir do índice VERT de Ricketts foram comparados com a classificação da face realizada por meio da análise facial clínica baseada na observação de duas fotografias. Para essa análise, participaram três fonoaudiólogos especialistas em motricidade orofacial. RESULTADOS: não houve correspondência satisfatória ao se comparar as duas formas de classificação do tipo facial apresentadas neste estudo. A maioria dos indivíduos masculinos dolicofaciais foi classificada como face média a partir da análise facial, ou seja, quatro entre sete sujeitos (57,14%. Os 11 mesofaciais foram identificados como face média (N=5; 45,45% ou curta (N=4; 36,36% e os 16 braquifaciais como face média (N=9; 56,25% ou curta (N=7; 43,75%. No sexo feminino, observou-se que 11 entre 20, ou seja, 55% dos indivíduos dolicofaciais foram apontados como face média. Dos 26 sujeitos mesofaciais, 16 (61,53% também foram classificados como face média. Com relação aos 25 braquifaciais, 12 (48% foram identificados como face curta e 11 (44%, como média. CONCLUSÃO: a classificação do tipo de face apenas a partir da análise facial realizada por meio de fotografias não foi considerada confiável, se utilizada isoladamente, quando comparada à classificação obtida a partir da análise cefalométrica.PURPOSE: to correlate the cephalometrical findings with the ones from facial analysis performed by means of photographs to classify facial type, according to the gender. METHODS: 105 leukoderm adults took part, 34 male (32.4% and 71 female (67.6% with ages between 20 and 40 years old, in a private orthodontic clinic in Belo Horizonte, MG - Brazil. The cephalometrics analysis findings for determining facial type from the Ricketts VERT index were compared with the facial classification performed by means of clinical facial analysis based on observation of two photographs. For this analysis, three Speech and Language Pathologists specialized in orofacial myology were involved. RESULTS: there was no satisfactory correspondence when comparing the two forms of facial type classification presented in this study. Most of the dolichofacial males were classified as medium face by means of facial analysis, meaning four among seven subjects (57.14%. The eleven mesofacial subjects were identified as medium face (N=5; 45.45% or short (N=4; 36.36% and the 16 braquifacial subjects as medium face (N=9; 56.25% or short (N=7; 43.75%. With females, it was observed that 11 among 20, meaning 55% of the dolichofacial individuals were appointed as medium face. Among the 26 mesofacial subjects, 16 (61.53% were also classified as medium face. Regarding the 25 braquifacial subjects, 12 (48% were identified as short face and 11 (44%, as medium. CONCLUSION: facial type classification based only on facial analysis performed by means of photographs was not considered trustworthy, if used independently, when compared with cephalometrics analysis findings.


    Institute of Scientific and Technical Information of China (English)

    魏明贵; 周正炎; 丁国伟; 王国世; 郭其一; 杨杰


    目的旨在研究用于X线头影测量分析的各标志点的计算机自动识别与定位方法,建立计算机自动定点的X线头影测量分析系统(CACAS).方法应用现代计算机图像处理与模式识别的相关技术,其中包括中值滤波、直方图均衡、基于小波变换的多尺度分析、Canny边缘检测、基于知识的边缘跟踪及可变模板匹配技术等,改善X线头影图像质量,提取软硬组织边缘轮廓,自动定位识别标志点.结果 CACAS系统成功实现了17个标志点的自动识别与定位及面下1/3轮廓描迹.结论本研究建立CACAS系统所运用的技术方法是有效可靠的.

  18. 上腔静脉X线投影测量与患者相关因素的探讨%Studying and analyzing the relationship between X-ray cephalometry of superior vena cava and patient-related factors

    Institute of Scientific and Technical Information of China (English)

    耿才正; 陈姬雅; 王建铭


    Objective The aim of this study was to explore the relationship between the variables (age, sex, height, weight) and the lower segment of superior vena cava on the posteroanterior thorax radiograph, and to improve the in-vitro measurements accuracy of beside PICC. Methods The data of 100 cases adults physical examination were collected in Tai-Zhou hospital. We measnred the distance between the middle of the lower segment of superior vena cava to the inner side of the right clavicle, observed the front rib units which was projected the middle of the lower segment of superior vena cava, and then analyzed the correlation between the data (distance between vertical segment, the front rib units) and the variable (age, sex, height, weight) with IBM SPSS Statistics vl9 software. Results The front rib units planes was no significant correlation with sex. age, height and weight ( r =0. 196~0. 130, P =0. 051~0. 936). The distance between vertical segment was obvious correlation with body height and sex ( r =0. 197, -0. 339, P =0. 049,0. 001) and no significant correlation with age and body weight( r =0. 052, -0. 066, F =0. 604, 0. 512). Conclusion The projection of the lower segment of superior vena cava has the individual differences, which is affected by many factors besides age, sex, height and weight. Thus, it is difficult to improve the in-vitro measurements accuracy of beside PICC by analyzing the age. sex, height and weight of the patient.%目的 探讨成人上腔静脉下段后前位胸片投影是否与性别、年龄、身高、体重相关,以期提高床旁PICC体外测量的准确性.方法 成人体检资料100份,在后前位胸片上测量上腔静脉下段中点至右锁骨内端下缘距离(即横L体外测量法垂直段距离,以下简称“垂直段距离”),上腔静脉下段中点所在前肋肋单元平面,各数据会同性别、年龄、身高、体重,利用IBM SPSS Statistics v19统计软件作Pearson相关分析.结果 上腔静脉下段中点所在前肋肋单元平面与性别、年龄、身高、体重无显著相关(r=-0.196~0.130,P=0.051~0,936);垂直段距离与身高、性别显著相关(r=0.197、-0.339,P=0.049、0.001),与年龄及体重无关(r=0.052、-0.066,P=0.604、0.512).结论 成人上腔静脉下段投影存在个体差异,相关因素复杂,难以通过性别、年龄、身高、体重来提高床旁PICC体外测量的准确性.

  19. Computer aided planning for orthognatic surgery

    CERN Document Server

    Chabanas, M; Payan, Y; Boutault, F; Chabanas, Matthieu; Marecaux, Christophe; Payan, Yohan; Boutault, Franck


    A computer aided maxillofacial sequence is presented, applied to orthognatic surgery. It consists of 5 main stages: data acquisition and integration, surgical planning, surgical simulation, and per operative assistance. The planning and simulation steps are then addressed in a way that is clinically relevant. First concepts toward a 3D cephalometry are presented for a morphological analysis, surgical planning, and bone and soft tissue simulation. The aesthetic surgical outcomes of bone repositioning are studied with a biomechanical Finite Element soft tissue model.

  20. Tooth loss and obstructive sleep apnoea


    Gai Valerio; Pera Paolo; Erovigni Francesco; Graziano Alessandra; Arienti Andrea; Brussino Luisa; Cicolin Alessandro; Bucca Caterina; Mutani Roberto; Preti Giulio; Rolla Giovanni; Carossa Stefano


    Abstract Background Complete tooth loss (edentulism) produces anatomical changes that may impair upper airway size and function. The aim of this study was to evaluate whether edentulism favours the occurrence of obstructive sleep apnoea (OSA). Methods Polysomnography was performed in 48 edentulous subjects on two consecutive nights, one slept with and the other without dentures. Upper airway size was assessed by cephalometry and by recording forced mid-inspiratory airflow rate (FIF50). Exhale...

  1. 锥形束CT三维影像在口腔正畸头影测量中的数据构建和应用%The data reconstruction and application of cone-beam CT three-dimensional impacts in orthodontic cephalometric measurement

    Institute of Scientific and Technical Information of China (English)

    吴海苗; 陈栋; 潘杰; 陈骊


    Objective To investigate methods of three -dimensional images data reconstruction and application in orthodontic cephalometry based on cone-beam CT. Methods Cone-beam CT images data are stored and transmissed by IP SAN.and construction of threee -dimensional impacts and cephalometry are achieved through using Invivo 5.0 software. Results It is feasible to store and transmiss cone-beam CT images data by using IP SAN.Which combined with Invivo 5.0 software can realize three-dimensional data reconstructing and be used for orthodontic application. Conclusion IP SAN is a kind of mature and relatively cheap cone-beam CT technology.and Invivo 5.0 software in orthodontic cephalometry has better clinical value and application prospect.%目的:探索锥形束CT三维影像数据的构建方法及在正畸科头影测量方面的应用价值.方法:通 过IP SAN技术实现锥形束CT图像数据的存储和传输,并利用Invivo 5.0软件实现影像的三维构建和头影测量.结果:IP SAN技术用于锥形 束CT图像数据的存储和传输具有可行性,结合Invivo 5.0软件可以实现影像数据的三维构建并用于正畸科临床.结论:IP SAN技术是一种成熟可靠和相对价廉的锥形束CT影像存储和传输技术,Invivo 5.0软件在正畸科头影测量方面具有较好的临 床价值和应用前景.

  2. Obstructive sleep apnea treatment with dental appliance. (United States)

    Reimão, R; De Gouveia, M M; Pestana, M C; Lopes, S R; Papaiz, E G; Papaiz, L F


    The case of a 40-year-old male patient with obstructive sleep apnea syndrome (OSAS) is reported, with emphasis on treatment with a dental appliance. This therapeutic approach, which has been focused on recent research, has as its objective, the posturing of the mandibule and, consequently, the tongue more anteriorly, thus in turn leading to an increase in the posterior oropharyngeal airway space (PAS). Cephalometry contributed determining in this case whereby enlargement limits were observed in the PAS with mandibular displacement. Clinical and polysomnographic controls showed subjective reduction of the excessive daytime sleepiness and objective decrease in apneas intensity to normal limits. Eight months follow-up evidenced the steady improvement.

  3. Three-dimensional architectural and structural analysis--a transition in concept and design from Delaire's cephalometric analysis. (United States)

    Lee, S-H; Kil, T-J; Park, K-R; Kim, B C; Kim, J-G; Piao, Z; Corre, P


    The aim of this study was to present a systematic sequence for three-dimensional (3D) measurement and cephalometry, provide the norm data for computed tomography-based 3D architectural and structural cephalometric analysis, and validate the 3D data through comparison with Delaire's two-dimensional (2D) lateral cephalometric data for the same Korean adults. 2D and 3D cephalometric analyses were performed for 27 healthy subjects and the measurements of both analyses were then individually and comparatively analyzed. Essential diagnostic tools for 3D cephalometry with modified definitions of the points, planes, and measurements were set up based on a review of the conceptual differences between two and three dimensions. Some 2D and 3D analysis results were similar, though significant differences were found with regard to craniofacial angle (C1-F1), incisal axis angles, cranial base length (C2), and cranial height (C3). The discrepancy in C2 and C3 appeared to be directly related to the magnification of 2D cephalometric images. Considering measurement discrepancies between 2D and 3D Delaire's analyses due to differences in concept and design, 3D architectural and structural analysis needs to be conducted based on norms and a sound 3D basis for the sake of its accurate application and widespread adoption.

  4. Importance of cephalographs in diagnosis of patients with sleep apnea

    Directory of Open Access Journals (Sweden)

    Nimma Vijaya Laxmi


    Full Text Available Introduction: Obstructive sleep apnea (OSA is considered to be a potentially life threatening disorder, which is characterized by repeated collapse of the upper airway during sleep with cessation of breathing. The cephalometric method despite being a static, two-dimensional evaluation of dynamic three-dimensional structures of the head and neck is useful in diagnosing patients with OSA, as they have shown that significant differences exist between asymptomatic controls and patients with OSA. Aims and Objectives: This study is designed to compare and validate the craniofacial morphology in patients with OSA using lateral cephalometry in both upright and supine position. Materials and Methods: Sixty subjects participated in the study of which 30 were patients with OSA diagnosed by questionnaire and 30 were healthy control group with age range of 25–45 years. Results: The study group demonstrated an increased ANB, mandibular plane angles (GoGn-SN, lower anterior facial height which are statistically significant with a significant P < 0.05. Significant decrease in posterior airway space, increased soft palate length, tongue length, and thickness suggesting reduced airway space in supine posture. Conclusion: Evaluation of craniofacial morphology in OSA patients using lateral cephalometry helps in recognizing the morphological changes induced by altered sleep pattern and for appropriate treatment planning.

  5. Craniofacial differences according to AHI scores of children with obstructive sleep apnoea syndrome: cephalometric study in 39 patients

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    Oezdemir, Hueseyin; Mahmutyaziciglu, Kamran; Davsancimath, Halit; Guendogdu, Sadi [Department of Radiology, Medical School, Zonguldak Karaelmas University, Kozlu, 67600, Zonguldak (Turkey); Altin, Remzi; Kart, Levent [Department of Pulmonology, Medical School, Zonguldak Karaelmas University (Turkey); Soeguet, Ayhan; Tomac, Nazan [Department of Paediatrics, Medical School, Zonguldak Karaelmas University (Turkey); Cinar, Fikret; Uzun, Lokman [Department of Otolaryngology, Medical School, Zonguldak Karaelmas University, (Turkey)


    Cephalometry is useful as a screening test for anatomical abnormalities in patients with obstructive sleep apnoea syndrome (OSAS). To evaluate comprehensively the cephalo metric features of children with OSAS, with or without adenotonsillar hypertrophy, and to elucidate the relationship between cephalometric variables and apnoea-hypopnoea index (AHI) severity. The study population consisted of 39 children, aged 4-12 years, with OSAS. Cephalometry was analysed using 11 measurements of the bony structures, their relationships and the size of the airways. Additionally, adenoid and tonsillar hypertrophy were graded. Cranial base angles (BaSN and BaSPNS) were found to correlate with increasing levels of AHI scores (P<0.001). Protrusion of the maxilla (SNA) and mandible (SNB) did not correlate with AHI scores (P>0.05). The length of the mandibular plane (GnGo) and the minimal posterior airway space (MPAS) were inversely correlated with AHI scores (P<0.001). There was positive correlation between MPAS and GnGo (r=0.740, P<0.001), and negative correlation between MPAS and gonial angle (ArGoGn) (r=-0.541, P<0.001). There was significant correlation between cephalometric data and adenotonsillar hypertrophy concerning BaSN, BaSPNS, ArGoGn, GnGoH, BaN-GnGo, MPAS, GnGO and MPH. (orig.)

  6. Natural head position: key position for radiographic and photographic analysis and research of craniofacial complex (United States)

    Verma, Sanjeev Kumar; Maheshwari, Sandhya; Gautam, Sanjay N; Prabhat, KC; Kumar, Shailendra


    The Frankfort horizontal is a useful compromise for studying skulls but not for orienting the natural head position (NHP) in the living because it is normally distributed around a true extracranial horizontal. Nonetheless, orthodontists dealing with living subjects, rather than inert crania, have used this Frankfort horizontal faithfully in cephalometry. Because the cant or inclination of all intracranial reference lines is subjected to biologic variation, they are unsuitable for meaningful cephalometric analysis. Registration of head posture in its natural position has the advantage that an extracranial vertical or a horizontal perpendicular to that vertical can be used as reference line for cephalometric analysis. Purpose of this paper is to provide an updated review of various methods to reproduce and record the NHP. PMID:25756032

  7. Radiographic temporomandibular joint abnormality in adults with micrognathia and juvenile rheumatoid arthritis

    International Nuclear Information System (INIS)

    Radiographic findings of the upper and lower jaw bone of 20 adult patients with micrognathia, bird face, and juvenile rheumatoid arthritis are reported. In all patients a symmetrically underdeveloped mandible with the chin posteriorly positioned was found at cephalometry. Arthritic lesion of the temporomandibular joint, mostly symmetric, with limitation of movement and secondary arthrosis, was observed in all patients. Complete absence of the mandibular head was frequent (75%). The fossa was generally flat, probably due to growth disturbance of the tubercle. Abnormal anterior position of the mandibular head occurred in almost half of the patients. The degree of mandibular growth disturbance seemed to be correlated to the severity of the arthritis, indicating the arthritis to be a causal mechanism of micrognathia. (Auth.)

  8. Obstructive sleep apnea treatment with dental appliance

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    Rubens Reimão


    Full Text Available The case of a 40-year-old male patient with obstructive sleep apnea syndrome (OSAS is reported, with emphasis on treatment with a dental appliance. This therapeutic approach, which has been focused on recent research, has as its objective, the posturing of the mandibule and, consequently, the tongue more anteriorly, thus in turn leading to an increase in the posterior oropharyngeal airway space (PAS. Cephalometry contributed determining in this case whereby enlargement limits were observed in the PAS with mandibular displacement. Clinical and polysomnographic controls showed subjective reduction of the excessive daytime sleepiness and objective decrease in apneas intensity to normal limits. Eight months follow-up evidenced the steady improvement.

  9. Hubungan Postur Kepala dengan Tumbuh Kembang Mandibula pada Penderita Obstruksi Saluran Napas Atas dengan Kebiasaan Buruk Napas Mulut

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    Erliera Erliera


    Full Text Available Objective: To investigate the correlations between head posture and mandible growth in Deuteromalayid OURT (obstruction of the upper respiratory tract patients with mouth breathing habit. Material & Methods: The study used cross sectional design for 64 subjects including 32 OURT patients with mouth breathing habit and 32 normal subjects, all 12 to 15 years old. Lateral cephalometry radiograph was taken for head posture measurements and mandibular growth (ramus height, mandibular length, and mandibular rotation measurements. Results: The fraction of subjects with kifosis head posture in OURT with mouth breathing habit (34.4% was larger than that in normal subjects (28.1%. There is no correlation between head posture and OURT with mouth breathing habit, but there is a correlation between OURT with mouth breathing habit and mandibular rotation. Conclusion: Patients with OURT and mouth breathing habit show more vertical growth of mandible than normal subjects.DOI: 10.14693/jdi.v15i1.78

  10. A novel approach for craniofacial symmetry evaluation: Using the midsagittal Reference line drawn from “Crista Gali” with NHP technique

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    Morteza Ordobazari


    Full Text Available Please cite this article as: Ordobazari M, Naqavi Al-Hosseini AA, Zafarmand H. A novel approach for craniofacial symmetry evaluation: Using the midsagittal Reference line drawn from “Crista Gali” with NHP technique. Novel Biomed 2013;1(2:48-53.Background and objective: The purpose of this study was the determination of midsagittal reference line (MSL for craniofacial asymmetry assessment by drawing a line from Crista gali parallel to the true vertical line in PA cephalometry, using Natural Head Position (NHP technique.Method and Materials: 60 Iranian subjects within the age range of 9-13 years old were selected for this prospective study. Patients referred for orthodontic treatment and ghad no supernumerary or missing teeth, no skeletal anomaly, or any history of orthodontic and jaw surgery with normal occlusion. Posteroanterior cephalometric radiographs (PA Ceph were taken of all subjects with NHP technique. The midsagittal line was also traced parallel to the hanging chain from Crista gali. True horizontal line (THL and true vertical line (TVL were also traced from Crista gali (Cg. Using Cartesian system based upon Cg point (0~0, the craniofacial symmetry was assessed with linear, angular and proportional measurements in PA cephalogam, related to TVL and THL lines, for 10 bilateral (R&L anatomical landmarks. The mean differences of the above measurements in left and right sides were analyzed by T- test.Results: The proportional ratios for all left and right measurements were not statistically significant. This was true for both vertical and horizontal distances. The significant level for MSL drawn from Cg as referred to ANS (0±0.255 and Me points (0.007±0.527 was 0.002 and 0.004, respectively.Conclusion: In posteroanterior cephalometry radiographs taken with NHP method, the MSL drawn from Crista gali is reproducible and reliable up to 96% of the times for facial symmetry diagnosis.

  11. Tooth loss and obstructive sleep apnoea

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    Gai Valerio


    Full Text Available Abstract Background Complete tooth loss (edentulism produces anatomical changes that may impair upper airway size and function. The aim of this study was to evaluate whether edentulism favours the occurrence of obstructive sleep apnoea (OSA. Methods Polysomnography was performed in 48 edentulous subjects on two consecutive nights, one slept with and the other without dentures. Upper airway size was assessed by cephalometry and by recording forced mid-inspiratory airflow rate (FIF50. Exhaled nitric oxide (eNO and oral NO (oNO, were measured as markers of airway and oropharyngeal inflammation. Results The apnoea/hypopnoea index (AHI without dentures was significantly higher than with dentures (17·4 ± 3·6 versus 11·0 ± 2·3. p = 0·002, and was inversely related to FIF50 (p = 0·017 and directly related to eNO (p = 0·042. Sleeping with dentures, 23 subjects (48% had an AHI over 5, consistent with OSA, but sleeping without dentures the number of subjects with abnormal AHI rose to 34 (71%. At cephalometry, removing dentures produced a significant decrease in retropharyngeal space (from 1·522 ± 0·33 cm to 1·27 ± 0·42 cm, p = 0·006. Both morning eNO and oNO were higher after the night slept without dentures (eNO 46·1 ± 8·2 ppb versus 33·7 ± 6·3 ppb, p = 0·035, oNO 84·6 ± 13·7 ppb versus 59·2 ± 17·4 ppb, p = 0·001. Conclusion These findings suggest that complete tooth loss favours upper airway obstruction during sleep. This untoward effect seems to be due to decrease in retropharyngeal space and is associated with increased oral and exhaled NO concentration.


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    Adriana BĂLAN


    Full Text Available The present study evaluates the cranio‐facial growth disorders in a series of patients suffering from pituitary dwarfism, as a result of the therapy with recombinant human growth hormone (rhGH. Included in the study were 15 children diagnosed with pituitary dwarfism in the Endocrinology Clinics of the ”Sf. Spiridon” Hospital of Iasi, subjected to a treatment with rhGH for 2 years. After the application of the therapy, the parameters of general physical development were followed and the dental ortho‐ pantomography and profile cephalometry were analyzed. The results obtained confirm a general physical growth of about 1.3 cm/month in the first year of treatment, followed by values around 1.1 cm/month in the second year. Cranio‐facial development was improved by the increase of both mandibular vertical branch and facial height. At the level of the dental arches, one could observe improved sagital and transversal relations at molar level, as well as a regulating tendency of dental eruption. The therapy with rhGH is thus influent at cranio‐facial level, favourizing the development of maxillaries, regulation of dental eruption and the aesthetic aspects.

  13. Evaluation of craniofacial asymmetry based on cone-beam CT image%应用锥束计算机体层摄影术评价颅颌面的不对称

    Institute of Scientific and Technical Information of China (English)

    张晓芸; 许天民


    Cone-beam CT ( CBCT) was developed for the three-dimensional (3D) imaging of the max-illofacial area and has become popular in dentistry, orthodontics, and maxillofacial surgery. The advantages of CBCT include less radiation exposure (than conventional CT) , less artifacts, and submillimeter spatial resolution. CBCT has been shown to produce accurate 3D images of the craniofacial region and a 1 -to-1 image-to-reality ratio, which has greatly reduced errors of frontal cephalometry and improved our a-bility to diagnose asymmetry. Several new analyses to diagnose asymmetries on 3D images described in recent literature were reviewed, including 3D linear and angular measurements, mirror-image analysis ( superimposition of the mirror image of the anatomically correct part of the anatomy over the deformity) , 3D cephalometric analysis based on constructing an individual coordinate system for each facial unit or element (local coordinate systems) to differentiate them from the world coordinate system ( whole head orientation) , and method of application of asymmetry indices.

  14. Computer-Designed Splints for Surgical Transfer of 3D Orthognathic Planning. (United States)

    Zinser, Max; Zoeller, Joachim


    Advances in computers and imaging have permitted the adoption of three-dimensional (3D) planning protocols in orthognathic surgery, which may allow a paradigm shift when the computer-assisted planning can be transferred properly. The purpose of this investigation was to introduce an innovative clinical protocol using computer-aided designed and computer-aided manufactured (CAD/CAM) surgical splints for surgical transfer of 3D orthognathic planning compared with the classic technique using arbitrary occlusal splints. The clinical protocols consisted of computed tomography (CT) or cone-beam CT (CBCT) maxillofacial imaging, bone segmentation, 3D diagnosis, computer-assisted surgical treatment planning, and CAD/CAM surgical splints (group A) and manufacture of arbitrary occlusal splints (group B) for intraoperative surgical planning transfer. The observed patients underwent bimaxillary osteotomies and, if necessary, an additional genioplasty. Both techniques were evaluated by applying 13 hard tissue parameters to compare the 3D orthognathic planning (T0) with the postoperative result (T1) using 3D cephalometry. The CAD/CAM splints showed significant better precision for the maxilla (ΔT orthognathic planning, which is more precise compared with the conventional arbitrary occlusal splints.

  15. Cephalometric methods of prediction in orthognathic surgery. (United States)

    Kolokitha, Olga-Elpis; Topouzelis, Nikolaos


    Over the past decade the growing number of adult patients seeking for orthodontic treatment made orthognathic surgery popular. Surgical and orthodontic techniques have developed to the point where combined orthodontic and surgical treatment is now feasible to manage dentofacial deformity problems very satisfactorily. The prediction of orthognathic treatment outcome is an important part of orthognathic planning and the process of patient' inform consent. The predicted results must be presented to the patients prior to treatment in order to assess the treatment's feasibility, optimize case management and increase patient understanding and acceptance of the recommended treatment. Cephalometrics is a routine part of the diagnosis and treatment planning process and also allows the clinician to evaluate changes following orthognathic surgery. Traditionally cephalometry has been employed manually; nowadays computerized cephalometric systems are very popular. Cephalometric prediction in orthognathic surgery can be done manually or by computers, using several currently available software programs, alone or in combination with video images. Both manual and computerized cephalometric prediction methods are two-dimensional and cannot fully describe three-dimensional phenomena. Today, three-dimensional prediction methods are available, such as three-dimensional computerized tomography (3DCT), 3D magnetic resonance imaging (3DMRI) and surface scan/cone-beam CT. The aim of this article is to present and discuss the different methods of cephalometric prediction of the orthognathic surgery outcome.

  16. Airway statuses and nasopharyngeal airway use for airway obstruction in syndromic craniosynostosis. (United States)

    Kouga, Takeshi; Tanoue, Koji; Matsui, Kiyoshi


    Syndromic craniosynostosis is associated with a high rate of respiratory difficulty, due mainly to midfacial hypoplasia. Nasopharyngeal airway establishment has been reported as the first-line approach to airway obstruction and may obviate the need for a highly invasive tracheotomy. No previous studies have compared airway obstruction status in syndromic craniosynostosis between cases requiring and not requiring airway managements. We focus on nasopharyngeal airway use and airway status outcomes to assess respiratory difficulty in patients with syndromic craniosynostosis. A retrospective data analysis of 51 cases with syndromic craniosynostosis was carried out. We divided 30 of the 51 cases with lateral pharyngeal x-rays taken before operations affecting airway diameters into 2 groups, one with neither nasopharyngeal airway insertion nor tracheotomy and the other with one or both of these interventions, and the mean diameters for 8 indices related to the pharyngeal space were compared. Cases with respiratory difficulty due to nasopharyngeal stenosis and requiring airway managements comprised a significantly higher proportion of those with Pfeiffer syndrome than patients with Crouzon or Apert syndrome. Comparative examination of lateral x-ray cephalometry between cases with neither nasopharyngeal airway insertion nor tracheotomy and cases with one or both revealed oropharyngeal diameters tended to be smaller in those with interventions. Cases requiring nasopharyngeal airway insertion were able to continue nasopharyngeal airway use for more than 1 year and a considerable number avoided tracheotomy. It may be worth considering an oropharyngeal-bypass nasopharyngeal airway before performing a tracheotomy. PMID:24820706

  17. Morphological changes of the facial skeleton in Class II/1 patients treated with orthodontic functional appliances

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    Dana Festila


    Full Text Available Aim: The aim of this study was to investigate, using lateral cephalometry, the skeletal changes in maxillary bones induced through functional jaw orthopedic therapy. 30 patients with class II division 1 malocclusion and average age of 10.4 years were included in the study. Material and Methods: Cephalometric data were analyzed with the following methods: Burstone, McNamara, Rickets, Tweed and Wits and treatment changes were evaluated overlapping the lateral cephalograms on cranial base with sella registered. Results: The results showed reduced over-jet in average with 2.46 mm, mandibular advancement with a mean value of 2.72 mm and increasing of the total mandibular length with a mean value of 4.17 mm. Although we found an inhibiting in the anterior development of the maxilla with an average of 1.57 degree, the decrease of the anterior-posterior discrepancy was due especially to the mandible. Conclusions: It can be concluded that functional appliances were effective in correcting class II malocclusion. Changes of the position and mandible′s length determined improved facial profile but did not correct it completely because of the chin that moved not only anterior but also downward, as a result of vertical ramus growth.

  18. Evaluation of morphologic changes of mandibular symphysis after chin cup therapy in skeletally Cl III patients

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    Hosseinzadeh Nik T.


    Full Text Available Background and Aim: Chin cup is an orthopedic appliance for treating growing skeletally Cl III patients. The amount of chin forward movement in addition to morphologic changes in bony structure, determines the final profile of treated patients. The aim of this study was to evaluate the amount of morphologic changes of symphysis after chin cup therapy in skeletally Cl III patients.Materials and Methods: In this clinical trial, twenty eight cephalometries before and after chin cup therapy of 14 skeletally Cl III patients were analyzed. Landmarks introduced by Ricketts were determined to evaluate the symphysis and describe its relation to mandible. َAlso four additional measurements regarding the symphysis individually were evaluated and analyzed. Data were analyzed by paired t and pearson tests with P<0.05 as the level of significance.Results: The results showed that the height of symphysis increased after treatment (P=0.02, but its depth decreased (P=0.04. The sysmphysis turned down and back.Conclusion: These findings suggest that in Cl III malocclusions with a prognathic mandible, chin cup therapy creates changes in the horizontal dimension of symphysis morphology, which improves the Cl III profile. If the patient isn't a vertical grower, vertical changes of symphysis would be desirable. In addition, changes in the vertical dimension of the mandible (body and ramus could be observed as a backward and downward rotation.


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    Full Text Available Introduction. The ANB angle has been recognized as a skeletal sagittal discrepancy indicator and has become the most commonly used measurement since that time. It seems this angle is affected by several factors other than the anteroposterior position of maxilla and mandible.
    Methods. Tracing on lateral cephalometry films was done for 110 untreated cases with class I, II, III malocclusions. regression analysis was used to describe the proportion of the distorting factors caused by usual changes in the cranial and facial skeleton.
    Results. ANB mean differences between malocclusion groups was significant. Regression analysis between ANB, SN/MP and SNA angles in all groups was significant. The highest coefficient of determination was found in class I sample and the lowest was found in class II sample.
    Discussion. The results revealed that another factors can influence of ANB angle. These factors are rotation of SN plane, the length of the SN and rotation of jaws. Thus the use of normal range for ANB angle in determination of sagittal position of maxilla and mandible is incorrect and it must substitute with accurate parameters.

  20. Upper airway outcomes following midface distraction osteogenesis: a systematic review. (United States)

    Taylor, B A; Brace, M; Hong, P


    The objective of this paper is to systematically review the airway outcomes following distraction osteogenesis of midface with the goal of (1) deriving clinically oriented insights and (2) identifying gaps in knowledge to stimulate future research. Medline, EMBASE and Cochrane databases were searched and studies were included if subjects of any age had midface retrusion/hypoplasia and underwent midface distraction osteogenesis. Outcome measures of interest were any respiratory or airway associated measures, and reports of adverse events. A total of 368 abstracts were generated from the literature searches; 16 studies met the criteria for data extraction and analysis. All 16 studies were observational. Generally, midface distraction osteogenesis was reported to improve respiratory status and was well tolerated. Specifically, favorable outcomes in cephalometry (9 studies), polysomnography (9 studies), and decannulation rates (8 studies) were reported. In conclusion, upper airway status was improved in most patients who underwent midface distraction osteogenesis, yet long-term results and consistent objective measures are lacking. Studies reviewed were retrospective case series and details regarding patients who did not improve were deficient. A standardized prospective multicenter cohort trial with long-term patient follow up is required.

  1. [Treatment of mandibular condylar hyperplasia in developmental age. Clinical case]. (United States)

    Silvestri, A; Incisivo, V; Mariani, G


    A case of hyperplasia of the mandibular condyle in a growing-up subject, observed at the Department of Maxillo-Facial Surgery of the University of Rome "La Sapienza", is described. Hyperplasia of the mandibular condyle is a facial asymmetry due to the unilateral overdevelopment of the mandibular bone. In this study the authors underline how bone scintigraphy, 3D tomography and electrognatographic analysis, associated with standard radiography and cephalometry, are important methods of diagnosis in order to make an early diagnosis of hyperplasia of the mandibular condyle and differential diagnosis with other pathologies. In particular, bone scintigraphy is a useful screening procedure to detect if the pathology is in an active phase or not. The 3D tomography is used in pre-surgery to evaluate precisely morphological and structural alterations of the craniofacial bones on a tridimentional base. Finally, the electrognatographic test records the mandibular activity both in physiological and pathological conditions. All these instrumental techniques allow to make a diagnosis and lead to a possible therapeutical approach. PMID:11268938

  2. Relevance of anterior mandibular body ostectomy in mandibular prognathism (United States)

    Bansal, Pankaj; Singh, Virender; Anand, S. C.; Bansal, Sumidha


    Purpose: We tried to find out the relevance of anterior mandibular body ostectomy in deformities of the mandible specially prognathism, which is primarily limited to anterior part only. Patients and Methods: Ten patients with skeletal deformity along with malocclusion, which was limited to anterior body of mandible were selected. Selected patients had proper molar interdigitation (even if class 3) and in general had anterior crossbite (except one). All patients had crossed their growth spurts and had no hormonal influence on facial deformity. Specific protocol, including cephelometric analysis cephalometry for orthognathic surgery, prediction tracing and model surgeries were devised. Pre and post-surgical orthodontics and body ostectomy were performed in all patients along with 18-month post-op follow-up. Results: There was significant reduction in prognathism and horizontal dysplasia in all ten patients. Anterior crossbite as well as axis of incisiors over mandibular plane was corrected in all patients due to decrease in length of mandibular body. All patients showed decreased facial height and better lip competence with intact posterior occlusion and no (negligible or transient) sensory loss. Conclusions: Our study could confirm that people whose deformity is limited to the anterior part of mandible with reasonable occlusion posteriorly can get satisfactory cosmetic and functional results through body ostectomy alone rather than going for surgical procedure in the ramal area, which is liable to cause sensory and occlusal disturbances. PMID:24163554

  3. Computer-assisted orthognathic surgery: waferless maxillary positioning, versatility, and accuracy of an image-guided visualisation display. (United States)

    Zinser, Max J; Mischkowski, Robert A; Dreiseidler, Timo; Thamm, Oliver C; Rothamel, Daniel; Zöller, Joachim E


    There may well be a shift towards 3-dimensional orthognathic surgery when virtual surgical planning can be applied clinically. We present a computer-assisted protocol that uses surgical navigation supplemented by an interactive image-guided visualisation display (IGVD) to transfer virtual maxillary planning precisely. The aim of this study was to analyse its accuracy and versatility in vivo. The protocol consists of maxillofacial imaging, diagnosis, planning of virtual treatment, and intraoperative surgical transfer using an IGV display. The advantage of the interactive IGV display is that the virtually planned maxilla and its real position can be completely superimposed during operation through a video graphics array (VGA) camera, thereby augmenting the surgeon's 3-dimensional perception. Sixteen adult class III patients were treated with by bimaxillary osteotomy. Seven hard tissue variables were chosen to compare (ΔT1-T0) the virtual maxillary planning (T0) with the postoperative result (T1) using 3-dimensional cephalometry. Clinically acceptable precision for the surgical planning transfer of the maxilla (orthognathic planning.

  4. Evaluation of Correlation between Some Intra and Extra Cranial Horizontal Cephalometric Parameters

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    K Asadi


    Full Text Available Introduction: Intra-cranial references plans used in cephalometry analysis are not considered as stable points and therefore their validity is low; however they are widely used. The purpose of conducting this study is to investigate correlation rate of a number of horizontal parameters of extra-cranial with common Horizontal analyses. Methods: In this descriptive and periodic study, lateral cephalometric radiography in NHP position for 46 patients (24 women and 22 men in range of 22- 28 years old was prepared; all graphs were prepared by a person using the same device; then after tracing, correlation coefficient was achieved between TH/AB and TH-wist, wylie, wits, TH-wits McNamara, Schwartz, APP-BPP, and Downs. Results: The highest rate of correlation was observed between TH-wits linear parameters and angular parameters of AB/TH (r=0.975 which was statistically significant. ANB parameter had low correlation with Wylie analysis (r=+0.365 that was definitely significant. ANB angular parameters with other horizontal dimension parameters showed the highest correlation with Downs analysis (r=-0.870 and linear parameter APP-BPP (r=+0.730 which were statistically significant too. Conclusions: In this study the highest correlation coefficient was shown between TH/AB and TH-wits, ANB and Downs, Downs and wits, ANB and APP-BPP respectively.

  5. 完全性唇腭裂婴儿期手术对上颌骨发育的影响%The effect of early cleft palate repair on maxillary growth in infantile complete cleft lip and palate children

    Institute of Scientific and Technical Information of China (English)



    Objective: To obsewe the effect of infantile cleft palate repair on maxillary growth in children with complete cleft lip and palate. Methods: 18 children with complete cleft lip and palate were divided into two groups according to whether cleft palate repair was performed or not in infancy. In the one-stage repair group, 10 children received cleft lip and palate repair in infancy, the mean age was (10.15±0.76) years in follow-up. In the cleft lip repair group (10 patients),cleft lip repair was performed without cleft palate surgery in infancy, the mean age of this group was (10.25±0.75) years in follow-up. 20 cases of noncleft children (ages lO) were normal control group. The X-ray cephalometry and dentognathic models of three groups were obtained and compared. Results: The data analysis of cephalometry and dental cast showed that the difference between the two groups had no obvious significance (P>0.05); but compared with the normal group, the cleft lip and palate patients all had the growth inhibition (P<0.05). Conclusion: The cleft palate repair is not the reason of the difference existing;. Earlier cleft palate operation is favorable to functional recovery for infants.%目的:观察婴儿早期行唇腭裂手术对完全性唇腭裂患儿上颌骨发育的近期影响.方法:18例完全性唇腭裂患儿在婴儿期接受唇腭裂手术作为唇腭裂修复组,随访时平均年龄(10.15±0.76)岁;10例未行唇腭裂手术的单纯唇裂患儿为单纯唇腭裂组,随访时平均年龄(10.25±0.75)岁;另20例正常的10岁龄学童作为正常对照组.三组分别取头颅侧位片与上牙颌模型,进行测量分析.结果:两组唇腭裂患儿之间的上颌骨发育无明显差异(P>0.05),与正常对照组比较,均有生长抑制(P<0.05).结论:早期对完全性唇腭裂患儿行唇裂修复术对上颌骨发育的影响不大,还可以使患者获得正常的语言功能.

  6. Cephalic And Prosopic Indices: Comparison In One-Day Newborn Boys In Zahedan

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    Heidari Z


    Full Text Available Background: Cephalometry is one of the important branches of anthropometry that has wide uses in identification, forensic medicine, plastic surgery, orthodontics, archeology and determining the origins of races. This research was investigated to determine the head and face phenotypes among one-day newborn boys in two aborigines of Sistani and Baluchi who were resident in Zahedan. Materials and Methods: The investigation is based on cross-sectional analytical descriptions of 420 newborn aborigine boys (216 Sistani & 204 Baluchi, who were clinically healthy, in Quds hospital in summer 1381, in Zahedan. In this study cephalic and prosopic indices were determined by classical cephalometric. Results: The mean and the standard deviations of cephalic index were 83.67±4.80 and 83.64±4.77 and prosopic index 86.79±5.87 and 86.53±6.76 for Sistani and Baluchi subjects respectively. Based on the cephalic index, the dominant head types in sistani group were hyperbrachycephalic (37% and brachycephalic (37%. In Blachui group, the hyperbrachycephalic (37.3% and brachycephalic (35.3% type were the dominant one. Furthermore, according to the prosopic index. The dominant face type among sistanis was euryprosopic type (42.6%. In Baluchi group, the dominant face type was also euryprosopic (39.2%. Conclusion: This research showed no statistically significant differences in terms of head and face type indices between two aborigines of Zahedan. Based on this cross-sectional study, it seems that there is similarities between the aforementioned groups

  7. Frontal soft tissue analysis using a 3 dimensional camera following two-jaw rotational orthognathic surgery in skeletal class III patients. (United States)

    Choi, Jong Woo; Lee, Jang Yeol; Oh, Tae-Suk; Kwon, Soon Man; Yang, Sung Joon; Koh, Kyung Suk


    Although two dimensional cephalometry is the standard method for analyzing the results of orthognathic surgery, it has potential limits in frontal soft tissue analysis. We have utilized a 3 dimensional camera to examine changes in soft tissue landmarks in patients with skeletal class III dentofacial deformity who underwent two-jaw rotational setback surgery. We assessed 25 consecutive Asian patients (mean age, 22 years; range, 17-32 years) with skeletal class III dentofacial deformities who underwent two-jaw rotational surgery without maxillary advancement. Using a 3D camera, we analyzed changes in facial proportions, including vertical and horizontal dimensions, facial surface areas, nose profile, lip contour, and soft tissue cheek convexity, as well as landmarks related to facial symmetry. The average mandibular setback was 10.7 mm (range: 5-17 mm). The average SNA changed from 77.4° to 77.8°, the average SNB from 89.2° to 81.1°, and the average occlusal plane from 8.7° to 11.4°. The mid third vertical dimension changed from 58.8 mm to 57.8 mm (p = 0.059), and the lower third vertical dimension changed from 70.4 mm to 68.2 mm (p = 0.0006). The average bigonial width decreased from 113.5 mm to 109.2 mm (p = 0.0028), the alar width increased from 34.7 mm to 36.1 mm (p-value = 0.0002), and lip length was unchanged. Mean mid and lower facial surface areas decreased significantly, from 171.8 cm(2) to 166.2 cm(2) (p = 0.026) and from 71.23 cm(2) to 61.9 cm(2) (p orthognathic surgery, and enabled quantitative analysis of changes in frontal soft tissue landmarks and facial proportions that were not possible with conventional 2D cephalometric analysis.

  8. Korelasi indeks morfologi wajah dengan sudut interinsisal dan tinggi wajah secara sefalometri (Cephalometric correlation of facial morphology index with interincisal angle and facial height

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    Pricillia Priska Sianita K


    Full Text Available Background: In a disaster or criminal case, comprehensive information is needed for identification process of each victim. Especially for some cases that only leave skull without any information that could help the identification process, including face reconstruction that will be needed. One way of identifications is specific face characteristic, race, some head-neck measurements, such as facial morphology index, interincisal angle and facial height. Purpose: The aim of study was to determine the correlation of facial morphology index with interincisal angle and facial height through cephalometric measurement. Methods: The samples were cephalogram of 31 subjects (Deutro-Malayid race who met the inclusive criteria. Cephalometric analysis were done to all samples and followed by Pearson Correlation statistical test. Results: The correlation was found between facial morphology index and facial height, but no correlation between facial morphology index and interincisal angle. Conclusion: The study showed that the cephalometric measurement of facial morphology index and facial height could be used as the additional information for identification process.Latar belakang: Dalam bencana alam atau kasus kriminal informasi yang komprehensif diperlukan untuk proses identifikasi masing korban. Khususnya pada beberapa kasus yang hanya meninggalkan tengkorak tanpa informasi yang dapat membantu proses identifikasi, termasuk rekonstruksi wajah yang akan dibutuhkan. Salah satu cara identifikasi karakteristik wajah tertentu, ras, beberapa pengukuran kepala leher, seperti indeks morfologi wajah, sudut interincisal dan tinggi wajah. Tujuan: Penelitian ini bertujuan meneliti korelasi indeks morfologi wajah dengan sudut interincisal dan tinggi wajah melalui pengukuran sefalometrik. Metode: Sampel penelitian adalah cephalogram dari 31 subyek ras Deutro - Malayid ras yang memenuhi kriteria inklusif. Analisis cephalometri dilakukan pada semua sampel dan dilanjutkan

  9. Methods to quantify soft-tissue based facial growth and treatment outcomes in children: a systematic review.

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    Sander Brons

    Full Text Available CONTEXT: Technological advancements have led craniofacial researchers and clinicians into the era of three-dimensional digital imaging for quantitative evaluation of craniofacial growth and treatment outcomes. OBJECTIVE: To give an overview of soft-tissue based methods for quantitative longitudinal assessment of facial dimensions in children until six years of age and to assess the reliability of these methods in studies with good methodological quality. DATA SOURCE: PubMed, EMBASE, Cochrane Library, Web of Science, Scopus and CINAHL were searched. A hand search was performed to check for additional relevant studies. STUDY SELECTION: Primary publications on facial growth and treatment outcomes in children younger than six years of age were included. DATA EXTRACTION: Independent data extraction by two observers. A quality assessment instrument was used to determine the methodological quality. Methods, used in studies with good methodological quality, were assessed for reliability expressed as the magnitude of the measurement error and the correlation coefficient between repeated measurements. RESULTS: In total, 47 studies were included describing 4 methods: 2D x-ray cephalometry; 2D photography; anthropometry; 3D imaging techniques (surface laser scanning, stereophotogrammetry and cone beam computed tomography. In general the measurement error was below 1 mm and 1° and correlation coefficients range from 0.65 to 1.0. CONCLUSION: Various methods have shown to be reliable. However, at present stereophotogrammetry seems to be the best 3D method for quantitative longitudinal assessment of facial dimensions in children until six years of age due to its millisecond fast image capture, archival capabilities, high resolution and no exposure to ionizing radiation.

  10. Craniocervical Posture in Patients with Obstructive Sleep Apnea (United States)

    Piccin, Chaiane Facco; Pozzebon, Daniela; Scapini, Fabricio; Corrêa, Eliane Castilhos Rodrigues


    Introduction  Obstructive Sleep Apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep. Objective  The objective of this study is to verify the craniofacial characteristics and craniocervical posture of OSA and healthy subjects, determining possible relationships with the apnea/hypopnea index (AHI). Methods  This case-control study evaluated 21 subjects with OSA, who comprised the OSA group (OSAG), and 21 healthy subjects, who constituted the control group (CG). Cephalometry analyzed head posture measurements, craniofacial measurements, and air space. Head posture was also assessed by means of photogrammetry. Results  The groups were homogeneous regarding gender (12 men and 9 women in each group), age (OSAG = 41.86 ± 11.26 years; GC = 41.19 ± 11.20 years), and body mass index (OSAG = 25.65 ± 2.46 kg/m2; CG = 24.72 ± 3.01 kg/m2). We found significant differences between the groups, with lower average pharyngeal space and greater distance between the hyoid bone and the mandibular plane in OSAG, when compared with CG. A positive correlation was found between higher head hyperextension and head anteriorization, with greater severity of OSA as assessed by AHI. Conclusion  OSAG subjects showed changes in craniofacial morphology, with lower average pharyngeal space and greater distance from the hyoid bone to the mandibular plane, as compared with healthy subjects. Moreover, in OSA subjects, the greater the severity of OSA, the greater the head hyperextension and anteriorization. PMID:27413397

  11. Collimator with compensated filtration: clinical adaptation for recommendation 4f of the EU about the radiation protection in oral dental radiology; Colimador con filtracion compensada: adaptacion clinica para alcanzar la recomendacion 4F de la Union Europea sobre proteccion radiologica al paciente en radiologia odontologica

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    Alcaraz, M.; Garcia-Vera, C.; Bravo, C. La; Morant, J. J.; Armedo, D. Y.; Canteras, M.


    Recent recommendations by the European Union (2004) for performing lateral cranial cephalometry (LCC) state that collimation should be maximized so that only those tissues necessary are irradiated when performing clinical diagnoses, although the fact that many manufacturers do not incorporate these elements in their equipment design has been recognised (recommendations 4f). Aim: the manufacture and utilization of a collimator with a pre-patient compensating filter for LLC which may be used in most extraoraldental radiology units, as well as determining the reduction in the dose of radiation absorbed by more sensitive tissues exposed to said clinical exploration. Making use of mannequins, phantom and craniums, we constructed a collimator with a compensating filter and established the necessary technical, dosimetric and quality specifications for its clinical use. Subsequently, we studied 16 patients referred for cephalometric study, determining the radiation dose (TLDs) in both the patients (crystalline lens, frontal lobe, parotid/submaxillary/thyroid glands and brain) and in the radiographic film, as well as in different parts of the collimator/filter. Al presented we are aiming for its clinical use by carrying out LCC in another 16 patients referred of orthodontic treatment but with the pre-a patient introduction of the tested collimator with the compensating filter as a substitute for the usual technique. The collimation reduced the field or radiation by some 40% and with that, so too the radiated tissues. The compensating filter reduced the dose in tissues by some 34.2. Our collimator has allowed the radiological image to be obtained with only one third the usual radiation dose. The dose reaching the film shies only between 17% less than in the usual technique and didn't alter its diagnostic capacity. A reduction of 61,6% of the dose administered to the patient is achieved by incorporating the collimator and filter to most radiological equipment without the

  12. A clinical observation on interocclusal labial arch appliance treatment of functional crossbite of transitional dentition%颌间唇弓式活动矫正器治疗替牙期反牙合的临床研究

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    目的介绍一种临床上行之有效的治疗替牙期功能性反牙合的矫治方法。方法选择25例替牙期反牙合的患者。男18例,女7例,平均年龄10.5岁。均为替牙期功能性反牙合,X线头影测量显示部分病例为轻度下颌前突。结果平均疗程为1个月,SNB、ANB、LI-MP经统计学处理有显著性差异。结论颌间唇弓式矫治器治疗儿童早期功能性反牙合效果肯定。与其他矫治器比较,具有结构简单,疗程短的优点。%Objective To introduce an effective clinical appliance for functional crossbite of transitional dentition.Methods Twenty-Five cases of functional crossbite of transtional dentition,18 male cases and 7 female cases.The average age was 10.5 years.X-ray cephalometry showed some cases with light mandibular prognathism.Results Average course of treatment is one month,SNB,ANB and LI-MP showed significant statistical differences.Conclusion Interocclusal labial arch appliance is an effective method for treatment of children's functional crossbite in early stage.It has simpler structure and shorter course of treatment comparing with other appliance.

  13. An analysis of 1018 cases of ultrasonography

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    Kim, Chu Wan; Suh, Jeong Soo; Lee, Kwan Seh; Kim, Ki Hwan; Im, Chung Gie; Chang, Kee Hyun; Yeon, Kyung Mo; Han, Man Chung; Choo, Dong Woon [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    1, transplanted kidney 1. 9. In 8 cases of polycystic disease of kidney, 1 case combined with liver involvement, other 1 case with liver, pancreas, splenic involvement. 10. Ob. and Gyn. fields 122; 1) 57 in Gyn. field -- normal 4, massive ascites 4, overian cyst 21, overian teratodermoid 7, uterine myoma 7, H-mole 6, cervix and rectal cancer follow-up 6, PID with abscess 2. 2) 65 in Ob. field -- normal scan 3, detection of early pregnancy 27, fetal cephalometry and presentation 16, placental localization 11, with normal 6, placenta previa 5, fetal death 5, multiple pregnancy 2. fetal anomaly (anencephaly) 1. 11. Eyeballs and orbit; of 14 cases, 7 cases of retinal detachment, vitreous opacity due to hemorrhage or exudation with clinical contribution in all cases. Exact localization and extent of disease could be done in 2 cases of choroidal melanoma. 12. We could have great diagnostic advantage in various aspects by ultrasonography, and if we use it as a complementary study with other diagnostic methods, we could expect better results under the previous experiences.

  14. Avaliação cefalométrica das alterações verticais e ântero-posteriores em pacientes Classe II esquelética, tratados com aparelho extrabucal de tração cervical ou combinada Cephalometric evaluation of anteroposterior and vertical changes in skeletal Class II patients treated with cervical or combined traction

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    Márlio Vinícius de Oliveira


    Full Text Available OBJETIVO: avaliar cefalometricamente as alterações ântero-posteriores e verticais em pacientes Classe II esquelética (ANB > 5°, tratados com aparelho extrabucal cervical (grupo 1 associado a aparelho fixo do tipo Edgewise ou tratados com aparelho extrabucal de tração combinada (grupo 2 associado ao mesmo. METODOLOGIA: a amostra consistiu-se de 60 radiografias cefalométricas laterais obtidas nas fases pré-tratamento e pós-tratamento de 30 indivíduos leucodermas, sendo 13 do gênero masculino e 17 do feminino. A idade média dos 15 pacientes do grupo 1, no pré-tratamento, era de 10 anos e 7 meses, e no pós-tratamento era de 13 anos e 9 meses. Os 15 pacientes do grupo 2 apresentavam idade média, no pré-tratamento, de 11 anos e 5 meses e no pós-tratamento a idade média era de 14 anos e 9 meses. As medidas cefalométricas iniciais e finais foram analisadas e comparadas pelo teste t de Student. RESULTADOS E CONCLUSÕES: não houve alteração significante no padrão de crescimento facial durante o tratamento em nenhum dos grupos avaliados. Nos pacientes do grupo 2, que possuíam tendência de crescimento vertical (GoGn-SN> 36°, o aparelho extrabucal de tração combinada, mesmo não provocando efeito extrusivo sobre os molares superiores, não foi capaz de diminuir o ângulo do plano mandibular. A maxila apresentou uma restrição no seu deslocamento anterior e verticalmente manteve-se estável. A mandíbula expressou seu crescimento e deslocou-se anteriormente, porém manteve sua inclinação inalterada. A relação maxilomandibular apresentou uma melhora significante com redução sensível do ANB.AIM: To evaluate the antero-posterior and vertical changes in patients with skeletal Class II malocclusions (ANB > 5º by means of the cephalometry. The patients had been treated with either cervical traction device (Group 1 or combined traction device (Group 2 both in association with a Edgewise-type device. METHODS: The sample consisted

  15. Avaliação cefalométrica da posição do osso hióide em crianças respiradoras bucais Cephalometric assessment of the hyoid bone position in oral breathing children

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    Maria Julia Pereira Coelho Ferraz


    Full Text Available MATERIAL E MÉTODOS: em função das relações anatomofuncionais do osso hióide com o complexo craniofacial, realizou-se avaliação cefalométrica da posição do osso hióide em relação ao padrão respiratório. A amostra consistiu de 53 crianças, gênero feminino, com idades médias de 10 anos, sendo 28 respiradoras nasais e 25, bucais. As medidas cefalométricas horizontais, verticais e angulares foram utilizadas com a finalidade de determinar a posição do osso hióide. Estabeleceu-se uma comparação entre os grupos por meio do teste "t" de student, bem como correlação de Pearson entre as variáveis. RESULTADOS: Observou-se que não ocorreram diferenças estatísticas significativas para a posição mandibular e posição do osso hióide e o tipo do padrão respiratório. No Triângulo Hióideo, o coeficiente de correlação de 0,40 foi significativo entre AA-ENP (distância entre vértebra atlas e espinha nasal posterior e C3-H (distância entre a terceira vértebra cervical e osso hióide demonstrando uma relação positiva entre os limites ósseos do espaço aéreo superior e inferior. Para as medidas cranianas sugeriu-se uma relação entre a posição do osso hióide com a morfologia mandibular. CONCLUSÃO: Os resultados permitiram concluir que o osso hióide mantém uma posição estável, provavelmente, para garantir as proporções corretas das vias aéreas e não depende do padrão respiratório predominante.MATERIAL AND METHODS: because of its anatomical and functional relationship with the craniofacial complex, we assessed the cephalometry of the hyoid bone position in relation to the respiratory pattern of these 53 female children, with average age of 10 years; 28 of them are nasal breathers and 25 are oral breathers. Horizontal, vertical and angular cephalometric measures were used in order to determine the hyoid bone location. The Student "t" and the Pearson correlation tests were used in order to compare the groups

  16. O efeito da alteração da posição natural da cabeça (PNC sobre as medidas cefalométricas The effect of the alteration the natural head position (NHP on the cephalometric measurements

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    Paulo Eduardo Negreiros


    Full Text Available Este trabalho objetivou estudar as alterações das grandezas cefalométricas utilizadas em cefalometria, quando a posição natural da cabeça (PNC modifica-se durante a tomada da telerradiografia, sua influência no diagnóstico ortodôntico, sua precisão e reprodutibilidade em tomadas radiográficas sucessivas. Analisou-se 180 telerradiografias, tomadas em norma lateral, de 30 pacientes do gênero feminino com idade média de 21,3 anos obtidas em duas séries de tomadas radiográficas com intervalo de 15 dias entre as séries. Registrou-se em cada série a PNC, a PNC acrescida de 5 graus e a PNC com flexão de 5 graus de cada paciente. Os resultados obtidos demonstraram que as grandezas lineares S-N, ENA-ENP, Co-Gn, Go-Gn, e as angulares SNA, ANB, PP.GoGn, 1.PP, IMPA, 1.1, SN.VER e HF.VER não apresentaram alterações estatisticamente significantes entre as posições estudadas e entre as séries de tomadas radiográficas, mas as de SNB, SN.GoGn, FMA, SN.PP, Ângulo Z e Co-Go apresentaram alterações estatisticamente significantes. Concluiu-se que as medidas angulares e lineares avaliadas não apresentaram alterações significantes quando a PNC modificou-se dentro da faixa de variação angular estudada, o que não conduziu a diagnósticos ou interpretações duvidosas. Devido à baixa variação das angulações dos ângulos SN.VER e HF.VER demonstrou-se que a utilização da Unidade Orientadora de Posicionamento, apresentada neste trabalho, permite a reprodutibilidade da posição natural da cabeça com grande confiabilidade dentro de uma faixa de variação da PNC em + 5º.This work aimed to study the alterations of angular and linear cephalometrics measurements used in cephalometry, when the natural head position (NHP is modified during the taking of cephalometric radiography, its influence in the orthodontic diagnosis, and the reliability and reproducibility of NHP for successive radiographs. One hundred and eighty cephalometrics


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    research group wastreated with a self -tap-ping micro-screw implant as ananchorage .The control group was treated with Nance bow , transpalatal arch or in combination with face bow as strong anchorage .The total treatment time , line spacing and the angle differences be-tween the U1/SN of X-ray cephalometry before and after treatment were compared in two groups .Results ①The-self-tapping micro-screw implant kept stability without looseness .Thesoft tissue surrounding dental implants had no swellings or infections .Patients had no obvious discomfort .②The average periods of treatmentin the research group and the control group treatment were 20 months and 26 months, respectively.③The soft -tissue profilein the re-search group was improved significantly , with 4.26 mm and 4.54 mmof the adductions ofthe upper and lower lips rel-ative to aesthetic plane respectively .The angle of U1/SN was reduced 10.2°.Theadductionsof the upper and lower lipsin the control group relative to aesthetic plane were 2.88 mm and 3.01 mm respectively and there werestatistically significantdifferencesin two groups .There were no remarkableanteroposterior and verticalmovement after correction of maxillary first molars(p>0.05)but the anteroposterior incisor movement in the research group .The movements were statistically significant differences(p<0.01).Conclusion Compared with the traditional anchorage technique , mi-cro-screw implant anchorage can better control teeth movement and shorten the treatment time .

  18. Mandibular distraction osteogenesis for improving respiratory function in patients with micrognathia complicated by obstructive sleep apnea syndrome%下颌骨牵引成骨术矫治小颌畸形伴阻塞性睡眠呼吸暂停综合征患者改善呼吸功能的作用

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    吴国平; 滕利; 孙晓梅; Andrew A.Heggie; Anthony D.Holmes


    BACKGROUND: Obstructive sleep apnea syndrome(OSAS) in patients with serious micrognathia affects the respiratory function and can be life-threatening. Conventional surgical therapies are often highly risky and unsuitable in patients with the craniomaxillofacial skeleton still in development.OBJECTIVE: To assess the value of mandibular distraction osteogenesis in treatment of OSAS in patients with congenital micrognathia and the effect of the surgery on the patients' respiratory functions.DESIGN: A self-controlled study.SETTING: Plastic Surgery Hospital of Peking Union Medical College and Plastic and Maxillofacial Surgery Unit of Royal Children's Hospital of Melbourne, Australia.PARTICIPANTS: Eight consecutive patients with congenital micrognathia who developed OSAS were hospitalized from October 2001 to July 2004 at the Center of Craniomaxillofacial Surgery, Plastic Surgery Hospital of Peking Union Medical College and Plastic and Maxillofacial Surgery Unit of Royal Children's Hospital of Melbourne, Australia. This group included 5 male and 3 female patients aged 4 months to 17 years.METHODS: The 8 patients underwent mandibular distraction osteogenesis,and altogether 16 distractors were placed through extraoral or intraoral incisions for bilateral distraction. The distraction device proceeded at the rate of 1 to 1.5 mm per day and consolidated for 4 to 12 weeks. The follow-up lasted for 2 to 18 months. Each patient was evaluated pre-and postoperatively with cephalometry or polysomnography (PSG).MAIN OUTCOME MEASURES: The distraction distance, posterior airway space, and improvement of the respiratory function of the patients were recorded.RESULTS: Osteotomy and distraction procedures were smooth in all the patients who had good ontogenesis. The average distraction distance was 19.12 mm(ranging from 15 to 25 mm) . The posterior airway space was increased from a mean of 4.5 mm preoperatively to 11 mm after the surgery. Seven patients had normal respiration and sleep

  19. Efeitos dos fios de nivelamento de níquel-titânio e de aço inoxidável na posição dos incisivos inferiores Effects of nickel-titanium and stainless steel leveling wires on the position of mandibular incisors

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    Ricardo Moresca


    : The sample comprised 36 white Brazilians subjects, male and female, mean age of 15 years and 5 months, with Angle Class I and II malocclusion, arranged in two groups. In Group 1 (n=17, the leveling phase was performed with sequence 1, using three archwires (NiTi heat activated 0.016" and 0.019"x0.025" and stainless steel 0.019"x0.025". In Group 2 (n=19, sequence 2 was tested, in which only stainless steel archwires were used (0.014", 0.016", 0.018", 0.020" and 0.019"x0.025" with passive torque in lower incisors. The data were collected using the computerized cephalometry and were compared by Student's t test at significance level of 5%. RESULTS: In Group 1, lower incisors tipped lingually and only the crown presented a lingual movement that was statistically significant (1.6mm. In Group 2, the lower incisors remained unchanged. There was no vertical change in either groups. CONCLUSIONS: Sequence 2 showed better control of the lower incisors and no changes in their position were observed whereas sequence 1 allowed torque expression of brackets prescription with lingual tip of these teeth. Treatment time was shorter using sequence 1. Both biomechanical variations studied showed advantages and disadvantages that should be known and evaluated by the orthodontist during case planning.

  20. Obstrüktif uyku apneli ve horlayan erişkin erkek hastaların dentofasiyal özelliklerinin değerlendirilmesi

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    Ahmet Altay Sahin


    adult male patients with obstructive sleep apnea syndrome (OSAS.

    Materials and Methods: Cephalograms of 80 male patients (60 OSAS, 20 snoring were evaluated. Subjects were grouped as, Group 1: snoring (AHI<5; Group 2: mild OSA (5£ AHI<15;  Group 3: moderate OSA (15£ AHI<30 ; Group 4: severe OSA (AHI ³30. Measurements were made to evaluate hyoid bone position, tongue base and soft palate, craniocervical extension and the airway width. Statistical significance was determined with one-way ANOVA and Duncan test for variables showing normal distribution. Kruskal Wallis test and Mann Whitney U test with Bonferroni correction were used to evaluate the variables that were not normally distibuted.

    Results: No significant differences were found in hyoid bone position, soft palate position, craniocervical extension and the airway width (p>0.05. PNS-V (mm, was significantly different between severe OSA group and the other groups (p<0.05. The other measurements on tongue base showed no difference between groups (p>0.05.

    Conclusions: In this study population, the tongue base was more inferiorly positioned in the severe OSA group whereas the other craniofacial variables showed no difference between groups.

    Key words: Obstructive sleep apnea syndrome, snoring, cephalometry, craniofacial.