DOI QR코드

DOI QR Code

Three-dimensional cone beam computed tomography analysis of temporomandibular joint response to the Twin-block functional appliance

  • Jiang, Yuan-yuan (Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University) ;
  • Sun, Lian (Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University) ;
  • Wang, Hua (Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University) ;
  • Zhao, Chun-yang (Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University) ;
  • Zhang, Wei-Bing (Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University)
  • 투고 : 2019.09.02
  • 심사 : 2020.02.08
  • 발행 : 2020.03.25

초록

Objective: To propose a three-dimensional (3D) method for evaluating temporomandibular joint (TMJ) changes during Twin-block treatment. Methods: Seventeen patients with Class II division 1 malocclusion treated using Twin-block and nine untreated patients with a similar malocclusion were included in this research. We collected their cone beam computed tomography (CBCT) data from before and 8 months after treatment. Segmentations were constructed using ITK-SNAP. Condylar volume and superficial area were measured using 3D Slicer. The 3D landmarks were identified on CBCT images by using Dolphin software to assess the condylar positional relationship. 3D models of the mandible and glenoid fossa of the patients were constructed and registered via voxel-based superimposition using 3D Slicer. Thereafter, skeletal changes could be visualized using 3DMeshMetric in any direction of the superimposition on a color-coded map. All the superimpositions were measured using the same scale on the distance color-coded map, in which red color represents overgrowth and blue color represents resorption. Results: Significant differences were observed in condylar volume, superficial area, and condylar position in both groups after 8 months. Compared with the control group (CG), the Twin-block group exhibited more obvious condyle-fossa modifications and joint positional changes. Moreover, on the color-coded map, more obvious condyle-fossa modifications could be observed in the posterior and superior directions in the Twin-block group than in the CG. Conclusions: We successfully established a 3D method for measuring and evaluating TMJ changes caused by Twin-block treatment. The treatment produced a larger condylar size and caused condylar positional changes.

키워드

참고문헌

  1. Baccetti T, Franchi L, Toth LR, McNamara JA Jr. Treatment timing for Twin-block therapy. Am J Orthod Dentofacial Orthop 2000;118:159-70. https://doi.org/10.1067/mod.2000.105571
  2. Jena AK, Duggal R, Parkash H. Skeletal and dentoalveolar effects of Twin-block and bionator appliances in the treatment of Class II malocclusion: a comparative study. Am J Orthod Dentofacial Orthop 2006;130:594-602. https://doi.org/10.1016/j.ajodo.2005.02.025
  3. Lund DI, Sandler PJ. The effects of Twin Blocks: a prospective controlled study. Am J Orthod Dentofacial Orthop 1998;113:104-10. https://doi.org/10.1016/S0889-5406(98)70282-3
  4. Morris DO, Illing HM, Lee RT. A prospective evaluation of Bass, Bionator and Twin Block appliances. Part II--The soft tissues. Eur J Orthod 1998;20:663-4. https://doi.org/10.1093/ejo/20.6.663
  5. Trenouth MJ. Cephalometric evaluation of the Twinblock appliance in the treatment of Class II Division 1 malocclusion with matched normative growth data. Am J Orthod Dentofacial Orthop 2000;117:54-9. https://doi.org/10.1016/S0889-5406(00)70248-4
  6. Varlik SK, Gultan A, Tumer N. Comparison of the effects of Twin Block and activator treatment on the soft tissue profile. Eur J Orthod 2008;30:128-34. https://doi.org/10.1093/ejo/cjm121
  7. Bayram M, Kayipmaz S, Sezgin OS, Kucuk M. Volumetric analysis of the mandibular condyle using cone beam computed tomography. Eur J Radiol 2012;81:1812-6. https://doi.org/10.1016/j.ejrad.2011.04.070
  8. Yildirim E, Karacay S, Erkan M. Condylar response to functional therapy with Twin-Block as shown by cone-beam computed tomography. Angle Orthod 2014;84:1018-25. https://doi.org/10.2319/112713-869.1
  9. Elfeky HY, Fayed MS, Alhammadi MS, Soliman SAZ, El Boghdadi DM. Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance. J Orofac Orthop 2018;79:245-58. https://doi.org/10.1007/s00056-018-0137-1
  10. Liu B, Wang Y, Song F, Liu M, Duan Y, Zhou L. [Cone-beam CT evaluation of the changes in the temporomandibular joint of patients with class II division 1 subdivision malocclusion before and after twin-block treatment]. Hua Xi Kou Qiang Yi Xue Za Zhi 2013;31:610-4. Chinese.
  11. Serbesis-Tsarudis C, Pancherz H. "Effective" TMJ and chin position changes in Class II treatment. Angle Orthod 2008;78:813-8. https://doi.org/10.2319/082707-391.1
  12. Koerich L, Weissheimer A, de Menezes LM, Lindauer SJ. Rapid 3D mandibular superimposition for growing patients. Angle Orthod 2017;87:473-9. https://doi.org/10.2319/072316-574.1
  13. Cevidanes LH, Styner MA, Proffit WR. Image analysis and superimposition of 3-dimensional cone-beam computed tomography models. Am J Orthod Dentofacial Orthop 2006;129:611-8. https://doi.org/10.1016/j.ajodo.2005.12.008
  14. Cevidanes LH, Heymann G, Cornelis MA, DeClerck HJ, Tulloch JF. Superimposition of 3-dimensional cone-beam computed tomography models of growing patients. Am J Orthod Dentofacial Orthop 2009;136:94-9. https://doi.org/10.1016/j.ajodo.2009.01.018
  15. Ruellas AC, Yatabe MS, Souki BQ, Benavides E, Nguyen T, Luiz RR, et al. 3D mandibular superimposition: comparison of regions of reference for voxelbased registration. PLoS One 2016;11:e0157625. https://doi.org/10.1371/journal.pone.0157625
  16. Franchi L, Baccetti T, McNamara JA Jr. Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop 2000;118:335-40. https://doi.org/10.1067/mod.2000.107009
  17. Tecco S, Saccucci M, Nucera R, Polimeni A, Pagnoni M, Cordasco G, et al. Condylar volume and surface in Caucasian young adult subjects. BMC Med Imaging 2010;10:28. https://doi.org/10.1186/1471-2342-10-28
  18. Kinzinger GS, Roth A, Gulden N, Bucker A, Diedrich PR. Effects of orthodontic treatment with fixed functional orthopaedic appliances on the condylefossa relationship in the temporomandibular joint: a magnetic resonance imaging study (Part I). Dentomaxillofac Radiol 2006;35:339-46. https://doi.org/10.1259/dmfr/53048233
  19. Ghafari J, Engel FE, Laster LL. Cephalometric superimposition on the cranial base: a review and a comparison of four methods. Am J Orthod Dentofacial Orthop 1987;91:403-13. https://doi.org/10.1016/0889-5406(87)90393-3
  20. Pancherz H. Treatment of class II malocclusions by jumping the bite with the Herbst appliance. A cephalometric investigation. Am J Orthod 1979;76:423-42. https://doi.org/10.1016/0002-9416(79)90227-6
  21. McNamara JA Jr, Hinton RJ, Hoffman DL. Histologic analysis of temporomandibular joint adaptation to protrusive function in young adult rhesus monkeys (Macaca mulatta). Am J Orthod 1982;82:288-98. https://doi.org/10.1016/0002-9416(82)90463-8
  22. Ruf S, Baltromejus S, Pancherz H. Effective condylar growth and chin position changes in activator treatment: a cephalometric roentgenographic study. Angle Orthod 2001;71:4-11.
  23. Sharma AK, Sachdev V, Singla A, Kirtaniya BC. Skeletal and dentoalveolar changes concurrent to use of Twin Block appliance in class II division I cases with a deficient mandible: a cephalometric study. J Indian Soc Pedod Prev Dent 2012;30:218-26. https://doi.org/10.4103/0970-4388.105014
  24. Sun L, Zhao J, Wang H, Pan Y, Wang L, Zhang WB. Mechanical stress promotes matrix synthesis of mandibular condylar cartilage via the RKIP-ERK pathway. J Mol Histol 2017;48:437-46. https://doi.org/10.1007/s10735-017-9741-4
  25. Atresh A, Cevidanes LHS, Yatabe M, Muniz L, Nguyen T, Larson B, et al. Three-dimensional treatment outcomes in Class II patients with different vertical facial patterns treated with the Herbst appliance. Am J Orthod Dentofacial Orthop 2018;154:238-48.e1. https://doi.org/10.1016/j.ajodo.2017.11.037
  26. Arici S, Akan H, Yakubov K, Arici N. Effects of fixed functional appliance treatment on the temporomandibular joint. Am J Orthod Dentofacial Orthop 2008;133:809-14. https://doi.org/10.1016/j.ajodo.2006.07.035
  27. Mavreas D, Athanasiou AE. Tomographic assessment of alterations of the temporomandibular joint after orthognathic surgery. Eur J Orthod 1992;14:3-15. https://doi.org/10.1093/ejo/14.1.3
  28. Wadhawan N, Kumar S, Kharbanda OP, Duggal R, Sharma R. Temporomandibular joint adaptations following two-phase therapy: an MRI study. Orthod Craniofac Res 2008;11:235-50. https://doi.org/10.1111/j.1601-6343.2008.00436.x
  29. Sarnat BG. Some methods of assessing postnatal craniofaciodental growth: a retrospective of personal research. Cleft Palate Craniofac J 1997;34:159-72. https://doi.org/10.1597/1545-1569_1997_034_0159_smoapc_2.3.co_2
  30. Cevidanes LH, Bailey LJ, Tucker GR Jr, Styner MA, Mol A, Phillips CL, et al. Superimposition of 3D cone-beam CT models of orthognathic surgery patients. Dentomaxillofac Radiol 2005;34:369-75. https://doi.org/10.1259/dmfr/17102411
  31. Gazzani F, Ruellas ACO, Faltin K, Franchi L, Cozza P, Bigliazzi R, et al. 3D comparison of mandibular response to functional appliances: Balters Bionator versus Sander Bite Jumping. Biomed Res Int 2018;2018:2568235.
  32. Souki BQ, Vilefort PLC, Oliveira DD, Andrade I Jr, Ruellas AC, Yatabe MS, et al. Three-dimensional skeletal mandibular changes associated with Herbst appliance treatment. Orthod Craniofac Res 2017;20:111-8. https://doi.org/10.1111/ocr.12154
  33. Ivorra-Carbonell L, Montiel-Company JM, Almerich-Silla JM, Paredes-Gallardo V, Bellot-Arcis C. Impact of functional mandibular advancement appliances on the temporomandibular joint - a systematic review. Med Oral Patol Oral Cir Bucal 2016;21:e565-72.
  34. Baccetti T, Franchi L, McNamara JA Jr, Tollaro I. Early dentofacial features of Class II malocclusion: a longitudinal study from the deciduous through the mixed dentition. Am J Orthod Dentofacial Orthop 1997;111:502-9. https://doi.org/10.1016/S0889-5406(97)70287-7
  35. Burhan AS, Nawaya FR. Dentoskeletal effects of the Bite-Jumping Appliance and the Twin-Block Appliance in the treatment of skeletal Class II malocclusion: a randomized controlled trial. Eur J Orthod 2015;37:330-7. https://doi.org/10.1093/ejo/cju052
  36. Proffit WR, Fields HW, Sarver DM. Contemporary orthodontics. 5th ed. India: Elsevier; 2012.
  37. Voudouris JC, Kuftinec MM. Improved clinical use of Twin-block and Herbst as a result of radiating viscoelastic tissue forces on the condyle and fossa in treatment and long-term retention: growth relativity. Am J Orthod Dentofacial Orthop 2000;117:247-66. https://doi.org/10.1016/S0889-5406(00)70231-9

피인용 문헌

  1. A long-term longitudinal study of the osteoarthritic changes to the temporomandibular joint evaluated using a novel three-dimensional superimposition method vol.11, pp.1, 2020, https://doi.org/10.1038/s41598-021-88940-y