Accuracy of two midsagittal planes in three-dimensional analysis and their measurement in patients with skeletal mandibular deviation: a comparative study

Zheng, Xu; Wang, L.; Zhang, B.; Bai, Xiaofeng; Qin, Ke; Tian, Yawen; Zhao, Runlei; Liu, S.; Wang, J.; Zhao, Zhen-Jin

doi:10.1016/j.bjoms.2018.06.009

Cited by 15 publications

(10 citation statements)

References 20 publications

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“…Between 2005 and 2023, a total of 42 studies were identified, focusing on estimating the mid-sagittal plane in patients with facial asymmetry. Out of the selected 42 studies, eight were computational studies [1,3,[21][22][23][24][25][26]; six were observational [14,15,[27][28][29][30]; 21 studies used retrospective analytical design [4,9,9,12,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]; three were experimental studies [17,48,49], and one study was ambispective in nature [50]. The age range of the patients in all the included studies was 7-57 years.…”

Section: Study Characteristicsmentioning

confidence: 99%

Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry: a systematic review

Ajmera,

Singh,

Leung

et al. 2024

Clin Oral Invest

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Objective To systematically review the literature for mid-sagittal plane establishment approaches to identify the most effective method for constructing the mid-sagittal plane for the evaluation of facial asymmetry. Materials and methods Six electronic databases (PubMed, Medline (via Ovid), EMBASE (via Ovid), Cochrane Library, Web of Science, and Scopus) and grey literature were searched for the studies that computed the mid-sagittal reference plane three-dimensionally, using a combination of MeSH terms and keywords. The methodological quality and the level of evidence for the included studies were analyzed using QUADAS-2 and GRADE, respectively. Results The preliminary search yielded 6746 records, of which 42 articles that met the predefined inclusion criteria were included in the final analysis. All the included articles reported the construction of the mid-sagittal reference plane (MSP) using varied methods. The risk of bias and concerns regarding the applicability of the included studies were judged to be ‘low’. The level of evidence was determined to be ‘low’ for the effectiveness of the technique and ‘moderate’ for the ease of clinical applicability. Conclusion Despite methodological heterogeneity, this review substantiates the comparable efficacy of cephalometric and morphometric MSP construction methods. A fully automated morphometric MSP holds promise as a viable option for routine clinical use. Nevertheless, future prospective studies with an emphasis on the impact, accuracy, and clinical applicability of MSP construction techniques in cases of facial asymmetry are required. Clinical relevance The present review will assist clinicians in selecting the most suitable method for MSP construction, leading to improved treatment planning and ultimately more favorable treatment outcomes.

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Section: Study Characteristicsmentioning

confidence: 99%

Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry: a systematic review

Ajmera,

Singh,

Leung

et al. 2024

Clin Oral Invest

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“…Patients who met the inclusion criteria were then classi ed into groups according to the deviation of the hard tissue menton point from MSP and sagittal skeletal classes. According to the former, following the scheme established by Zheng et al [20], the patients were classi ed into the relative symmetry (RS) group if the deviation was no larger than 2 mm, the moderate asymmetry (MA) group if the deviation was larger than 2 mm but no more than 4 mm, and the severe asymmetry (SA) group if the deviation was larger than 4 mm according to the previous studies [21,22]. Based on the sagittal skeletal patterns which were determined by lateral cephalometric images derived from CBCT images, the subjects were classi ed into skeletal Class I (2° ≤ ANB angle ≤ 5°), Class (ANB angle > 5°), and Class (ANB angle < 2°), in which the ANB angle describes the relative position between the maxilla and mandible as described by Ricketts [23].…”

Section: Radiographical Images and 3d Photographsmentioning

confidence: 99%

3-dimensional analysis of hard- and soft-tissue symmetry in a Chinese population

Zhao

Wang

et al. 2023

Preprint

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Background Facial symmetry severely affects appearance and function. Large numbers of patients seek orthodontic treatment to improve facial symmetry. However, the correlation between hard- and soft-tissue symmetry is still unclear. Our aim was to investigate the hard- and soft-tissue symmetry in subjects with different levels of menton deviation and sagittal skeletal classes with 3D digital analysis and to investigate the relationship between the entire and individual hard- and soft-tissues. Methods A total of 270 adults (135 males and 135 females) consisting of 45 subjects of each sex in each sagittal skeletal classification group. All subjects were further classified into relative symmetry (RS), moderate asymmetry (MA) and severe asymmetry (SA) groups based on the degree of menton deviation from the mid-sagittal plane (MSP). The 3D images were segmented into anatomical structures and mirrored across the MSP. Original and mirrored images were registered by a best-fit algorithm, and the corresponding root mean square (RMS) values and colormap were obtained. The Mann‒Whitney U test and Spearman correlation were conducted for statistical analysis. Results The RMS increased with greater deviations with regard to the deviation of the menton in most of anatomical structures. Asymmetry was represented in the same way regardless of sagittal skeletal pattern. The soft-tissue asymmetry had a significant correlation with dentition in the RS group (0.409), while in the SA group, it was related to the ramus (0.526) and corpus (0.417) in males and was related to the ramus in the MA (0.332) and SA (0.359) groups in females. Conclusions The mirroring method combining CBCT and 3dMD provides a new approach for symmetry analysis. Asymmetry might not be influenced by sagittal skeletal patterns. Soft-tissue asymmetry might be reduced by improving the dentition in individuals with RS group, while among those with MA or SA, whose menton deviation was larger than 2 mm, orthognathic treatment should be considered.

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“…This takes a lot time and requires expertise and suffers from interexpert variability, which can have a substantial effect on targeting in image guided oral and maxillofacial surgery. In previous studies, two manual extracting methods are developed and widely used to construct the MSP of skull in the 3D images [10]- [12]. The first involved the MSP of skull with three points on the midline of the head.…”

Section: Introductionmentioning

confidence: 99%

“…These three points had to be some distance away from each other [13], [14]. The second method was to construct a plane that passed through a point on the midline of the head and was perpendicular to the horizontal plane [10], [15]. In these manual extracting methods, the points of skull are chosen manually from the CT images by doctor and the MSP of the skull is calculated by particular equations.…”

Section: Introductionmentioning

confidence: 99%

“…However, detecting the symmetry plane of skull is difficult due to various noise artifacts, pathologies and tilted head scans [18]. A few algorithms for the detection of MSP of skull have been reported in the literatures in which most of the works are concentrated a geometric plane that separates the two hemispheres of the cerebrum by the interhemispheric fissure in order to detect the symmetry plane of skull, which is estimated as a same symmetry plane passing through those hemispheres [10]. Because the skull symmetry as a constraint has been included as an important anatomical feature for evaluating cerebrum asymmetry.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An Approach to Extraction Midsagittal Plane of Skull From Brain CT Images for Oral and Maxillofacial Surgery

et al. 2019

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To prepare for the oral and maxillofacial surgery for the facial symmetry of patients, midsagittal plane of skull in brain computed tomography (CT) images is calculated with points manually chosen from skull by doctor. But the extracted midsagittal plane of the skull is different by different doctor. Even the extracted midsagittal plane of the same patient is also different by the same doctor in different times. The manually extracting operation usually takes a long time to increase the doctor's workload. Aimed at this problem, a semi-automatic extracting method for midsagittal plane of skull is proposed in this paper. First, the brain tissue is extracted by region growing method and the oriented bounding box (OBB) of the brain tissue is built. Second, the middle symmetry plane of the OBB of brain tissue is extracted as the initial midsagittal plane, which is updated by the mathematical translation and rotation method. Finally, the symmetrical characteristic of the brain tissue based on the updated symmetry plane is calculated by the mutual information method. This procedure is executed iteratively until the symmetrical characteristic of the brain tissue based on the new symmetry plane is no more different from the previous result. The final extracted symmetry plane is the midsagittal plane of skull in brain CT images of the patient. The midsagittal plane which is extracted manually by doctor is used to compare and evaluate the accuracy of this semi-automatic extracting symmetry plane method. The experimental results from both qualitative and quantitative analyses showed that the method can reach or approach the accuracy of manual extracted, but the stable level of this method is significantly higher than the manual method and this method can shorten the operate time to reduce the doctor's workload. INDEX TERMS Oral and maxillofacial surgery, head symmetry plane, oriented bounding box (OBB), mutual information.

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Accuracy of two midsagittal planes in three-dimensional analysis and their measurement in patients with skeletal mandibular deviation: a comparative study

Cited by 15 publications

References 20 publications

Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry: a systematic review

Establishment of the mid-sagittal reference plane for three-dimensional assessment of facial asymmetry: a systematic review

3-dimensional analysis of hard- and soft-tissue symmetry in a Chinese population

An Approach to Extraction Midsagittal Plane of Skull From Brain CT Images for Oral and Maxillofacial Surgery

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