scholarly journals Accuracy of Artificial Intelligence-Assisted Landmark Identification in Serial Lateral Cephalograms of Class III Patients Who Underwent Two-Jaw Orthognathic Surgery

Author(s):  
Mihee Hong ◽  
Inhwan Kim ◽  
Jin-Hyoung Cho ◽  
Kyung-Hwa Kang ◽  
Minji Kim ◽  
...  

Abstract To compare the accuracy of artificial intelligence-assisted landmark identification in serial lateral cephalograms of Class III patients who underwent two-jaw orthognathic surgery using a convolutional neural network (CNN) algorithm. 3,188 lateral cephalograms of Class III patients were allocated into the training and validation sets (3,004 cephalograms of 751 patients) and test set (184 cephalograms of 46 patients; subdivided into the genioplasty and non-genioplasty groups, n=23 per group)]. Each patient in the test set had four cephalograms: initial (T0), pre-surgery [T1, presence of orthodontic brackets (OBs)], post-surgery [T2, presence of OBs and surgical plates and screws (S-PS)], and debonding [T3, presence of S-PS and fixed retainers (FR)]. Statistical analysis was performed using mean errors of 20 landmarks between human gold standard and the CNN model. The total mean error was 1.17 mm without significant difference among four time-points. Before and after surgery, ANS, A point, and B point showed an increased error, while Mx6D and Md6D showed a decreased error. No difference in errors existed at B point, Pogonion, Menton, Md1C, and Md1R between the genioplasty and non-genioplasty groups. The CNN model can be used for landmark identification in serial cephalograms despite presence of OB, S-PS, FR, genioplasty, and bone remodeling.

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Mohamad Nagi Bou Wadi ◽  
Karina Maria Salvatore Freitas ◽  
Daniel Salvatore Freitas ◽  
Rodrigo Hermont Cançado ◽  
Renata Cristina Gobbi de Oliveira ◽  
...  

Objective. The aim of this study was to compare the profile attractiveness between orthodontic camouflage of the Class III malocclusion and the predictive tracing simulating orthognathic surgery evaluated by dentists and laypeople. Settings and sample population. The sample consisted of 21 patients (9 male; 12 female) with Class III malocclusion treated with orthodontic camouflage and Class III intermaxillary elastics. Material and Methods. The mean initial age of the patients was 24.38 years (SD 3.32), and the mean ANB angle was −1.91° (SD 0.83°). Patients presented skeletal Class III and normal growth patterns. Initial and final lateral cephalograms of each patient were used. The initial cephalogram was used to perform the treatment simulation of orthognathic surgery, and its silhouette was compared to the silhouette obtained from the final cephalogram after Class III orthodontic camouflage. A subjective analysis of profile attractiveness was performed by 47 laypeople and 60 dentists, with scores from 1 (less attractive) to 10 (most attractive). Mann–Whitney tests were used to compare profile attractiveness between the orthodontic treatment and the predictive tracing groups and between dentists and laypeople. Results. The predictive tracing of orthognathic surgery showed to be statistically significantly more attractive (mean score 4.57, SD 2.47) than that of the Class III camouflage orthodontic treatment (mean score 4.22, SD 2.40), with a mean numerical but significant difference of 0.35 (SD 2.01) (P<0.001). Laypeople were more critical than dentists in evaluating profile attractiveness, but numerical difference between the groups was also small. Conclusion. The profile silhouette of predictive tracing simulating orthognathic surgery showed to be more attractive than that of Class III camouflage orthodontic treatment; however, differences were small but statistically significant. Laypeople showed to be more critical than dentists.


2020 ◽  
Vol 6 (1) ◽  
pp. 01-05
Author(s):  
Richmond Gomes

Background: Lupus Nephritis (LN) is one of the most common and serious manifestations in Systemic Lupus Erythematosus (SLE) patients that causes significant morbidity and mortality. Certain biomarkers for LN are sometimes able to assess treatment response of lupus nephritis. Objective: To compare serum complement levels (C3 & C4) as markers of treatment response of LN and their relation to the LN class in renal biopsy. Methods: This prospective observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2018 to August 2019. Twenty seven patients who were diagnosed with lupus nephritis after kidney biopsy were included in this study. Serum complement levels (C3 & C4), 24 hours urinary total protein (24-hr UTP) and anti-double-stranded DNA (anti-ds DNA) were measured in all patients at baseline, 3 months and 6 months after treatment. These biomarker values before and after treatment were compared between the treatment response and non response groups. Results: Serum C3 levels were significantly different in patients of proliferative lupus nephritis (Class III & Class IV) than non proliferative lupus nephritis (Class V) at baseline (0.47 ± 0.32 vs0.89 ± 0.43g/l, p = 0.009) and levels changed significantly 6 months after treatment (p <0.001) and likewise for Serum C4 levels (0.10 ± 0.06 vs0.24 ± 0.26g/l, p = 0.040). Serum C3 levels were also found to correlate significantly with SLEDAI and renal SLEDAI. No significant difference was observed for 24-hr UTP levels at baseline between remission and non-remission groups. Conclusion: Serum C3 & C4 levels may be utilized as serological biomarkers to predict and monitor the treatment response of lupus nephritis.


2021 ◽  
Author(s):  
Monique Cimão dos Santos ◽  
Lilian Cristina Vessoni Iwaki ◽  
José Valladares-Neto ◽  
Maristela Sayuri Inoue-Arai ◽  
Adilson Luiz Ramos

ABSTRACT Objectives The objectives were to evaluate and compare the presence of bone dehiscence before and after orthognathic surgery. Materials and Methods In this retrospective study, 90 cone-beam computed tomography (CBCT) scans from 45 patients were evaluated. Class II (n = 23) and Class III (n = 22) orthodontic patients who were being prepared for orthognathic surgery were measured. CBCT scans were obtained about 30 days prior to (T0) and 6 months after (T1) double jaw orthognathic surgery. The distance between the cemento-enamel junction (CEJ) and the alveolar bone crest was assessed at the buccal and lingual surfaces of all teeth, on both sides and arches, except for the second premolars and the second and third molars. A total of 1332 sites were measured for Class II (644) and Class III (688) patients. The software used was OsiriX (version 3.3 32-bit). Data were compared with Wilcoxon and McNemar tests at the 5% level. Results Bone dehiscence before surgery was present in 26% and 15% of the Class II and III groups, respectively. The presence of dehiscence increased to 31% in the Class II and 20% in the Class III patients after surgery (P &lt; .05). Conclusions The prevalence of dehiscence increased slightly in Class II and Class III surgical-orthodontic patients after orthognathic surgery. Temporary vascular supply reduction and oral hygiene difficulties may explain these results; however, more studies are needed.


2016 ◽  
Vol 87 (2) ◽  
pp. 269-278 ◽  
Author(s):  
Chang-Hoon Lee ◽  
Hyun-Hee Park ◽  
Byoung-Moo Seo ◽  
Shin-Jae Lee

ABSTRACT Objective: To examine the current trends in surgical-orthodontic treatment for patients with Class III malocclusion using time-series analysis. Materials and Methods: The records of 2994 consecutive patients who underwent orthognathic surgery from January 1, 2004, through December 31, 2015, at Seoul National University Dental Hospital, Seoul, Korea, were reviewed. Clinical data from each surgical and orthodontic treatment record included patient's sex, age at the time of surgery, malocclusion classification, type of orthognathic surgical procedure, place where the orthodontic treatment was performed, orthodontic treatment modality, and time elapsed for pre- and postoperative orthodontic treatment. Results: Out of the orthognathic surgery patients, 86% had Class III malocclusion. Among them, two-jaw surgeries have become by far the most common orthognathic surgical treatment these days. The age at the time of surgery and the number of new patients had seasonal variations, which demonstrated opposing patterns. There was neither positive nor negative correlation between pre- and postoperative orthodontic treatment time. Elapsed orthodontic treatment time for both before and after Class III orthognathic surgeries has been decreasing over the years. Conclusion: Results of the time series analysis might provide clinicians with some insights into current surgical and orthodontic management.


2016 ◽  
Vol 21 (5) ◽  
pp. 67-74 ◽  
Author(s):  
Waqar Jeelani ◽  
◽  
Mubassar Fida ◽  
Attiya Shaikh ◽  
◽  
...  

ABSTRACT Introduction: Pubertal growth peak is closely associated with a rapid increase in mandibular length and offers a wide range of therapeutic modifiability. Objective: The aim of the present study was to determine and compare the mean ages of onset and duration of pubertal growth peak among three skeletal classes. Methods: A retrospective cross-sectional study was conducted using lateral cephalograms of 230 subjects with growth potential (110 males, 120 females). Subjects were categorized into three classes (Class I = 81, Class II = 82, Class III = 67), according to the sagittal relationship established between the maxilla and the mandible. The cervical vertebral maturation stage was recorded by means of Baccetti's method. The mean ages at CS3 and CS4 and the CS3-CS4 age interval were compared between boys and girls and among three skeletal classes. Results: Pubertal growth peak occurred on average four months earlier in girls than boys (p = 0.050). The average duration of pubertal growth peak was 11 months in Class I, seven months in Class II and 17 months in Class III subjects. Interclass differences were highly significant (Cohen's d > 0.08). However, no significant difference was found in the timing of pubertal growth peak onset among three skeletal classes (p = 0.126 in boys, p = 0.262 in girls). Conclusions: Girls enter pubertal growth peak on average four months earlier than boys. Moreover, the duration of pubertal growth peak is on average four months shorter in Class II and six months longer in Class III subjects as compared to Class I subjects.


2017 ◽  
Vol 17 (1) ◽  
pp. 23-28
Author(s):  
Ieva Gavare ◽  
Ilga Urtane ◽  
Gundega Jakobsone ◽  
Laura Neimane

Summary Introduction. Although severe root resorption is rare, it is a side effect of orthodontic treatment which affects tooth prognosis. Patients with severe dentofacial deformity, for whom orthodontic treatment and orthognathic surgery was done at the age of 18 and later, had long duration orthodontic treatment and orthognathic surgery, and are at a high risk of root resorption. The impact of orthognathic surgery on root resorption has not been sufficiently studied, and therefore is an interesting topic to research. Aim of the Study. To identify the risk factors for apical root resorption of maxillary incisors and canines as a result of orthodontic and surgical treatment of Class III malocclusion involving LeFort I osteotomy. Material and methods. The root lengths of upper incisors and canines were measured on cone beam computer tomography (CBCT) scans obtained from a database of orthognathic surgery patients. As a criteria for root resorption was chosen the difference in root lengths between different time points. The measurements were performed using the scans taken before orthodontic treatment (T1), before surgery (T2), and after post surgery orthodontic treatment (T3), of 28 subjects, aged 20.5 ± 3.81 years, with the mean presurgery treatment time of 19.9 ± 8.8 months, and post-surgery time of 7.1 ± 3.1 months. Changes in root lengths during different time spans were correlated with treatment duration, the initial crown/root ratio, and the severity of dentofacial deformity (Wits appraisal, ANB angle, and overjet). Results. During T1 - T2 the roots of the lateral incisors shortened by a maximum of 0.78 ± 0.83 mm (p < 0.001), at a rate of 0.04 mm per month. During T2 - T3 the lengths of the central incisor roots decreased most by 0.49 ± 0.52 (p < 0.001) at a rate of 0.07 mm per month. The resorption speed for canines increased from 0.03 mm to 0.1 mm per month before and after surgery. There were statistically significant correlations between the crown-root ratio and the incisor root length (r = 0.319 for lateral and r = 303 for central, both p<0,05) and for canines (r = 482, p<0.01). The associations between the shortened root length, in different time spans for different teeth, and the severity of malocclusion were inconsistent. Conclusions. Overall, the shortened root length during combined orthodontic and surgical treatment might not be clinically significant. After surgery, the rate of root resorption (mm per month) increased, especially for canines. The teeth with initially shorter roots showed more resorption during treatment.


2021 ◽  
Vol 12 ◽  
Author(s):  
Zewen Wang ◽  
Lin Cai ◽  
Yahan Chen ◽  
Hongming Li ◽  
Hanze Jia

This study aims to evaluate the practical application value of the teaching method under the guidance of educational psychology and artificial intelligence (AI) design, taking the deep learning theory as the basis of teaching design. The research objects of this study involve all the teachers, students, and students' parents of Ningbo Middle School. The questionnaires are developed to survey the changes in the performance of students before and after the implementation of the teaching design and the satisfaction of all teachers, students, and parents to different teaching methods by comparing the two results and the satisfaction ratings. All objects in this study volunteer to participate in the questionnaire survey. The results suggest the following: (1) the effective return rates of the questionnaires to teachers, students, and parents are 97, 99, and 95%, respectively, before implementation; whereas those after implementation are 98, 99, and 99%, respectively. Comparison of the two return results suggests that there was no significant difference statistically (P &gt; 0.05). (2) Proportion of scoring results before and after implementation is given as follows: the proportions of levels A, B, C, and D are 35, 40, 15, and 10% before implementation, respectively; while those after implementation are 47, 36, 12, and 5%, respectively. After the implementation, the proportion of level A is obviously higher than that before the implementation, and the proportions of other levels decreased in contrast to those before the implementation, showing statistically obvious differences (P &lt; 0.05). (3) The change in the performance of each subject after 1 year implementation is significantly higher than that before the implementation, and the change in the average performance of each subject shows an upward trend. In summary, (1) the comparison on the effective return rate of the satisfaction survey questionnaire proves the feasibility of its scoring results. (2) The comparison of the survey scoring results shows that people are more satisfied with the new educational design teaching method. (3) The comparison of the change in the performance of each subject before and after the implementation indirectly reflects the drawbacks of partial subject education, indicating that the school should pay the same equal attention to every subject. (4) Due to various objective and subjective factors, the results of this study may be different from the actual situation slightly, and its accuracy has to be further explored in the future.


2020 ◽  
Author(s):  
Amin Golshah ◽  
Fatemeh Dehdar ◽  
Mohammad Moslem Imani ◽  
Nafiseh Nikkerdar

Abstract Background: Considering the increasing popularity of electronic learning, particularly smartphone learning, and its reportedly optimal efficacy for instruction of complicated topics, this study aimed to compare the efficacy of smartphone learning versus lecture-based learning for instruction of cephalometric landmark identification.Methods: This quasi-experimental interventional study evaluated 53 dental students (4 th year) in two groups of intervention (n=27; smartphone instruction using an application) and control (n=26, traditional lecture-based instruction). Two weeks after the instructions, dental students were asked to identify four landmarks namely the posterior nasal spine (PNS), orbitale (Or), articulare (Ar) and gonion (Go) on lateral cephalograms. The mean coordinates of each landmark identified by orthodontists served as the reference point and the mean distance from each identified point to the reference point was reported as the mean consistency while the standard deviation of this mean was reported as precision of measurement. Data were analyzed using SPSS version 18 via independent sample t-test.Results: No significant difference was noted between the two groups in identification of PNS, Ar or Go (P>0.05). However, the mean error rate in identification of Or was significantly lower in smartphone group compared with the traditional learning group (P=0.020).Conclusions: Smartphone learning had a comparable, and even superior, efficacy to lecture-based learning for instruction of cephalometric landmark identification, and is recommended to enhance the instruction of complicated topics.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Neda Eslami ◽  
Farid Sharifi ◽  
Athar Nasseri ◽  
Arezoo Jahanbin

Background: There is great controversy regarding the effect of MBT and Damon bracket systems on dental arch dimensions and incisor position. Objectives: We aimed to study the effects of two different brackets (MBT and Damon) on dental arch dimensions and incisors position after orthodontic treatment. Methods: In this retrospective study, the records of 20 patients who underwent orthodontic treatment with MBT or Damon bracket systems were studied. All patients had class I skeletal and dental malocclusion and were treated without extraction. The patients were treated either with Damon or MBT bracket systems (n = 10). Lateral cephalograms were traced using the Dolphin software to determine the position of incisors. In addition, transverse dimensions of dental arches were measured on occlusal photographs. Fishers’ exact test, independent-test, Man-Whitney, paired t-test, and Wilcoxon were used for statistical analysis. P < 0.05 was set as significant. Results: There was no significant difference between the two groups regarding age, sex, and initial values of the variables studied. U1-Apog (mm), upper inter-canine, lower inter-second premolar distance showed a significant difference before and after treatment in the Damon system. However, no significant difference was observed between initial and post-treatment values in the MBT group. L1-Apog (°), IMPA (°), maxillary inter-first and second premolars, inter-canine, and mandibular inter-canine distance was higher in the Damon system after treatment compared to MBT. Changes of the upper and lower transverse dimensions of the dental arches and the incisor positional did not reveal a notable difference in the Damon and MBT systems (P > 0.05). Conclusions: There was no significant difference regarding changes in dental arches and incisor positions between the Damon and MBT systems.


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