Facial Versus Skeletal Landmarks for Anterior-Posterior Diagnosis in Orthognathic Surgery and Orthodontics: Are They the Same?

Rasmussen, Chad M.; Meyer, P.; Volz, John E.; Ess, James M. Van; Salinas, Thomas J.

doi:10.1016/j.joms.2019.10.007

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…In clinical practice, phenotyping still uses rather rudimentary techniques. Facial assessment is based on subjective impressions or multiple univariate measurements between specific predefined anatomical landmarks on the face 5 – 7 . Classic anthropometric assessment of the soft tissue component has a radiological counterpart named cephalometric assessment.…”

Section: Introductionmentioning

confidence: 99%

Automatic 3D dense phenotyping provides reliable and accurate shape quantification of the human mandible

Verhelst

Matthews

Verstraete

et al. 2021

Sci Rep

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Automatic craniomaxillofacial (CMF) three dimensional (3D) dense phenotyping promises quantification of the complete CMF shape compared to the limiting use of sparse landmarks in classical phenotyping. This study assesses the accuracy and reliability of this new approach on the human mandible. Classic and automatic phenotyping techniques were applied on 30 unaltered and 20 operated human mandibles. Seven observers indicated 26 anatomical landmarks on each mandible three times. All mandibles were subjected to three rounds of automatic phenotyping using Meshmonk. The toolbox performed non-rigid surface registration of a template mandibular mesh consisting of 17,415 quasi landmarks on each target mandible and the quasi landmarks corresponding to the 26 anatomical locations of interest were identified. Repeated-measures reliability was assessed using root mean square (RMS) distances of repeated landmark indications to their centroid. Automatic phenotyping showed very low RMS distances confirming excellent repeated-measures reliability. The average Euclidean distance between manual and corresponding automatic landmarks was 1.40 mm for the unaltered and 1.76 mm for the operated sample. Centroid sizes from the automatic and manual shape configurations were highly similar with intraclass correlation coefficients (ICC) of > 0.99. Reproducibility coefficients for centroid size were < 2 mm, accounting for < 1% of the total variability of the centroid size of the mandibles in this sample. ICC’s for the multivariate set of 325 interlandmark distances were all > 0.90 indicating again high similarity between shapes quantified by classic or automatic phenotyping. Combined, these findings established high accuracy and repeated-measures reliability of the automatic approach. 3D dense CMF phenotyping of the human mandible using the Meshmonk toolbox introduces a novel improvement in quantifying CMF shape.

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Section: Introductionmentioning

confidence: 99%

Automatic 3D dense phenotyping provides reliable and accurate shape quantification of the human mandible

Verhelst

Matthews

Verstraete

et al. 2021

Sci Rep

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“… 20 21 22 However, due to the great skeletal heterogeneity of the skull base, linear or angular measurements passing through the skull base may not be reliable. 23 Other authors, like Andrews, 10 Adams et al, 24 Rasmussen et al, 25 Resnick et al, 26 Gidaly et al, 27 and Tremont and Posnick, 28 concluded that external landmark assessment of the facial profile for the diagnosis of a craniomaxillofacial abnormality and for orthodontic and orthognathic surgery planning with view at improving functions (occlusion, breathing, OSA) and esthetics tends to be more reliable.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Clinical and Craniofacial Changes on the Surgical Outcomes of Lateral Pharyngoplasty in the Treatment of Obstructive Sleep Apnea

Solcia-Filho,

Duarte,

Almeida

et al. 2023

Sleep Sci

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Objective To verify if maxillomandibular retrusion, obesity, and increased neck circumference are factors of worse surgical prognosis for lateral pharyngoplasty in apneic patients. Materials and Methods We evaluated 53 patients with obstructive sleep apnea who underwent lateral pharyngoplasty. Clinical evaluation was performed before the surgical procedure and included the measurement of body mass index (BMI) in kg/m2, neck circumference in centimeters, and a clinical evaluation of the facial profile obtained through the natural position of the oriented head. The polysomnographic evaluation was performed with at a minimum of 6 months after surgery, and polysomnographic results were correlated with the preoperative clinical data. Results The mean age of the patients was 38.8 years; the mean BMI was of 29.28kg/m2, and 84.9% of the sample was composed of men and 15.1% of women. There was a significant reduction in the mean value of the main respiratory parameters verified by polysomnography, such as apnea-hypopnea index (AHI) from 31.60 events per hour to 8.15 (p < 0.001); NadirO2 went from 81% to 85% (p = 0.002) and mean oxyhemoglobin saturation from 94% to 95% (p = 0.024). It was also observed that the greater the maxillomandibular retrusion, the lower the mean reduction of the AHI after surgery. The increase in neck circumference proved to be a factor associated with the surgical outcome, and for each 1-cm decrease in the neck circumference, the chance of surgical success increased 1.2-fold. Conclusion Lateral pharyngoplasty is an efficient surgical obstructive sleep apnea treatment. The lower the neck circumference measurement, the greater the chances of surgical success, and clinically evaluated maxillomandibular retrusion can reduce the magnitude of improvement in respiratory parameters after lateral pharyngoplasty in apneic patients.

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“…The inter‐landmark distances are compared to optimal reference values, which allows the treatment goal to be defined [PP70,Ste60,And15]. The treatment goal can be defined with respect to different sets of landmarks, which inadvertently prioritise different surgical outcomes [RMV*20]. To support the range of clinical methods, we do not rely on specific landmarks, but allow them to be freely chosen.…”

Section: Background and Related Workmentioning

confidence: 99%

“…Orthognathic surgery is planned by an interdisciplinary team of surgeons, orthodontists and technicians. In its first stage, landmarks are identified on the soft‐tissue and bony surface [RMV*20, LYW*21, Rey10]. The inter‐landmark distances are compared to optimal reference values, which allows the treatment goal to be defined [PP70,Ste60,And15].…”

Section: Background and Related Workmentioning

confidence: 99%

Differentiable Simulation for Outcome‐Driven Orthognathic Surgery Planning

Dorda

Peter

Borer

et al. 2022

Computer Graphics Forum

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Algorithms at the intersection of computer graphics and medicine have recently gained renewed attention. A particular interest are methods for virtual surgery planning (VSP), where treatment parameters must be carefully chosen to achieve a desired treatment outcome. FEM simulators can verify the treatment parameters by comparing a predicted outcome to the desired one. However, estimating the optimal parameters amounts to solving a challenging inverse problem. In current clinical practice it is solved manually by surgeons, who rely on their experience and intuition to iteratively refine the parameters, verifying them with simulated predictions. We prototype a differentiable FEM simulator and explore how it can enhance and simplify treatment planning, which is ultimately necessary to integrate simulation-based VSP tools into a clinical workflow. Specifically, we define a parametric treatment model based on surgeon input, and with analytically derived simulation gradients we optimise it against an objective defined on the visible facial 3D surface. By using sensitivity analysis, we can easily explore the solution-space with first-order approximations, which allow the surgeon to interactively visualise the effect of parameter variations on a given treatment plan. The objective function allows landmarks to be freely chosen, accommodating the multiple methodologies in clinical planning. We show that even with a very sparse set of guiding landmarks, our simulator robustly converges to a feasible post-treatment shape.

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Facial Versus Skeletal Landmarks for Anterior-Posterior Diagnosis in Orthognathic Surgery and Orthodontics: Are They the Same?

Cited by 8 publications

References 29 publications

Automatic 3D dense phenotyping provides reliable and accurate shape quantification of the human mandible

Automatic 3D dense phenotyping provides reliable and accurate shape quantification of the human mandible

The Impact of Clinical and Craniofacial Changes on the Surgical Outcomes of Lateral Pharyngoplasty in the Treatment of Obstructive Sleep Apnea

Differentiable Simulation for Outcome‐Driven Orthognathic Surgery Planning

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