The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Differences in positions of cone-beam computed tomography landmarks in patients with skeletal Class III facial asymmetry according to midsagittal planes

  • Hyung-Kyu Noh (Department of Orthodontics, School of Dentistry, Kyungpook National University) ;
  • Ho-Jin Kim (Department of Orthodontics, School of Dentistry, Kyungpook National University) ;
  • Hyo-Sang Park (Department of Orthodontics, School of Dentistry, Kyungpook National University)
  • Received : 2023.01.25
  • Accepted : 2023.05.08
  • Published : 2023.07.25
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Abstract

Objective: This study aimed to clarify differences in the positions of cone-beam computed tomography (CBCT) landmarks according to different midsagittal planes (MSPs) in patients with skeletal Class III facial asymmetry. Methods: Pre-treatment CBCT data from 60 patients with skeletal Class III were used. The patients were classified into symmetric (menton deviations of < 2 mm) or asymmetric (menton deviations of > 4 mm) groups. Six MSPs were established based on previous studies, and three-dimensional analyses were performed for the planes in both the groups. The measurement outcomes were compared statistically. Results: A statistically significant interaction (p < 0.01) was observed between MSPs and facial asymmetry. No significant differences were observed among MSPs in the symmetric group. However, significant differences in linear measurements were identified among MSPs in the asymmetric group. Specifically, the upper facial MSP revealed both maxillary and mandibular transverse asymmetries. On the other hand, anterior nasal spine (ANS)-associated MSP could not identify maxillary asymmetry. Furthermore, the menton deviation was approximately 3 mm lower when estimated using the ANS-associated MSP than that using upper facial MSP. Conclusions: The choice of MSP can significantly affect treatment outcomes while diagnosing patients with asymmetry. Therefore, care should be taken when selecting MSP in clinical practice.

Keywords

Acknowledgement

This study was supported by the Kyungpook National University Research Fund (2022).

References

  1. Hajeer MY, Ayoub AF, Millett DT. Three-dimensional assessment of facial soft-tissue asymmetry before and after orthognathic surgery. Br J Oral Maxillofac Surg 2004;42:396-404. https://doi.org/10.1016/j.bjoms.2004.05.006
  2. Damstra J, Fourie Z, De Wit M, Ren Y. A three-dimensional comparison of a morphometric and conventional cephalometric midsagittal planes for craniofacial asymmetry. Clin Oral Investig 2012;16:285-94. https://doi.org/10.1007/s00784-011-0512-4
  3. Shin SM, Kim YM, Kim NR, Choi YS, Park SB, Kim YI. Statistical shape analysis-based determination of optimal midsagittal reference plane for evaluation of facial asymmetry. Am J Orthod Dentofacial Orthop 2016;150:252-60. https://doi.org/10.1016/j.ajodo.2016.01.017
  4. Green MN, Bloom JM, Kulbersh R. A simple and accurate craniofacial midsagittal plane definition. Am J Orthod Dentofacial Orthop 2017;152:355-63. https://doi.org/10.1016/j.ajodo.2016.12.025
  5. Dobai A, Markella Z, Vizkelety T, Fouquet C, Rosta A, Barabas J. Landmark-based midsagittal plane analysis in patients with facial symmetry and asymmetry based on CBCT analysis tomography. J Orofac Orthop 2018;79:371-9. https://doi.org/10.1007/s00056-018-0151-3
  6. Yoon KW, Yoon SJ, Kang BC, Kim YH, Kook MS, Lee JS, et al. Deviation of landmarks in accordance with methods of establishing reference planes in three-dimensional facial CT evaluation. Imaging Sci Dent 2014;44:207-12. https://doi.org/10.5624/isd.2014.44.3.207
  7. Kim TY, Baik JS, Park JY, Chae HS, Huh KH, Choi SC. Determination of midsagittal plane for evaluation of facial asymmetry using three-dimensional computed tomography. Imaging Sci Dent 2011;41:79-84. https://doi.org/10.5624/isd.2011.41.2.79
  8. Kim HJ, Kim BC, Kim JG, Zhengguo P, Kang SH, Lee SH. Construction and validation of the midsagittal reference plane based on the skull base symmetry for three-dimensional cephalometric craniofacial analysis. J Craniofac Surg 2014;25:338-42. https://doi.org/10.1097/SCS.0000000000000380
  9. An S, Lee JY, Chung CJ, Kim KH. Comparison of different midsagittal plane configurations for evaluating craniofacial asymmetry by expert preference. Am J Orthod Dentofacial Orthop 2017;152:788-97. https://doi.org/10.1016/j.ajodo.2017.04.024
  10. Grissom MK, Gateno J, English JD, Jacob HB, Kuang T, Gonzalez CE, et al. Midsagittal plane first: building a strong facial reference frame for computer-aided surgical simulation. J Oral Maxillofac Surg 2022;80:641-50. https://doi.org/10.1016/j.joms.2021.11.016
  11. Lee EH, Yu HS, Lee KJ, Han SS, Jung HD, Hwang CJ. Comparison of three midsagittal planes for three-dimensional cone beam computed tomography head reorientation. Korean J Orthod 2020;50:3-12. https://doi.org/10.4041/kjod.2020.50.1.3
  12. Cho HJ. A three-dimensional cephalometric analysis. J Clin Orthod 2009;43:235-52, discussion 235; quiz 273. https://pubmed.ncbi.nlm.nih.gov/19458456/
  13. Trpkova B, Prasad NG, Lam EW, Raboud D, Glover KE, Major PW. Assessment of facial asymmetries from posteroanterior cephalograms: validity of reference lines. Am J Orthod Dentofacial Orthop 2003;123:512-20. https://doi.org/10.1016/S0889-5406(02)57034-7
  14. Field A. Repeated-measures designs (GLM 4). In: Carmichael M, ed. Discovering statistics using IBM SPSS statistics. 4th ed. London: Sage; 2013. p. 543-90. https://www.sagepub.com/sites/default/files/upm-binaries/52063_00_Field_4e_SPSS_Prelims.pdf
  15. Nagasaka S, Fujimura T, Segoshi K. Development of a non-radiographic cephalometric system. Eur J Orthod 2003;25:77-85. https://doi.org/10.1093/ejo/25.1.77
  16. Kwon TG, Park HS, Ryoo HM, Lee SH. A comparison of craniofacial morphology in patients with and without facial asymmetry--a three-dimensional analysis with computed tomography. Int J Oral Maxillofac Surg 2006;35:43-8. https://doi.org/10.1016/j.ijom.2005.04.006
  17. Williams RP, Rinchuse DJ, Zullo TG. Perceptions of midline deviations among different facial types. Am J Orthod Dentofacial Orthop 2014;145:249-55. https://doi.org/10.1016/j.ajodo.2013.02.034
  18. Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial midline discrepancies on dental attractiveness ratings. Eur J Orthod 1999;21:517-22. https://doi.org/10.1093/ejo/21.5.517
  19. Kim KS, Kim YJ, Lee KH, Kim YH, Kook YA. Level of perception of changed lip protrusion and asymmetry of the lower facial height. Korean J Orthod 2006;36:434-41. https://scienceon.kisti.re.kr/commons/util/originalView.do?cn=JAKO200609906156890&oCn=JAKO200609906156890&dbt=JAKO&journal=NJOU00293807
  20. Noh HK, Park HS. Does maxillary yaw exist in patients with skeletal Class III facial asymmetry? Am J Orthod Dentofacial Orthop 2021;160:573-87. https://doi.org/10.1016/j.ajodo.2020.05.025
  21. Haraguchi S, Takada K, Yasuda Y. Facial asymmetry in subjects with skeletal Class III deformity. Angle Orthod 2002;72:28-35. https://pubmed.ncbi.nlm.nih.gov/11843270/
  22. Posnick JC, Fantuzzo JJ, Orchin JD. Deliberate operative rotation of the maxillo-mandibular complex to alter the A-point to B-point relationship for enhanced facial esthetics. J Oral Maxillofac Surg 2006;64:1687-95. https://doi.org/10.1016/j.joms.2005.11.118
  23. Tyan S, Park HS, Janchivdorj M, Han SH, Kim SJ, Ahn HW. Three-dimensional analysis of molar compensation in patients with facial asymmetry and mandibular prognathism. Angle Orthod 2016;86:421-30. https://doi.org/10.2319/030915-142.1
  24. Ahn J, Kim SJ, Lee JY, Chung CJ, Kim KH. Transverse dental compensation in relation to sagittal and transverse skeletal discrepancies in skeletal Class III patients. Am J Orthod Dentofacial Orthop 2017;151:148-56. https://doi.org/10.1016/j.ajodo.2016.06.031
  25. Kim HJ, Hong M, Park HS. Analysis of dental compensation in patients with facial asymmetry using cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2019;156:493-501. https://doi.org/10.1016/j.ajodo.2018.10.025
  26. Lee JY, Han SH, Ryu HS, Lee HM, Kim SC. Cone-beam computed tomography analysis of transverse dental compensation in patients with skeletal Class III malocclusion and facial asymmetry. Korean J Orthod 2018;48:357-66. https://doi.org/10.4041/kjod.2018.48.6.357
  27. Marianetti TM, Boccieri A, Pascali M. Reshaping of the anterior nasal spine: an important step in rhinoplasty. Plast Reconstr Surg Glob Open 2016;4:e1026. https://doi.org/10.1097/GOX.0000000000001026