Evaluation of Lip Morphology and Nasolabial Angle in Non-Syndromic Cleft Lip and/Palate and Non-Cleft Individuals

Objective: To investigate the variation between the non-syndromic cleft lip and/or palate (NSCLP) and non-cleft (NC) subjects in relation to the lip morphology (LM) and nasolabial angle (NLA). Materials and Methods: Lateral cephalogram (Late. Ceph.) of 123 individuals (92 NSCLP [29 = bilateral cleft lip and palate (BCLP), 41 = unilateral cleft lip and palate (UCLP), 9 = unilateral cleft lip and alveolus (UCLA), 13 = unilateral cleft lip (UCL)], and 31 NC) who did not undergo any orthodontic treatment were investigated. By WebCeph, an artificial intelligence- (A.I.) driven software, 2 (two) parameters of LM, namely upper lip to E line (LM-1) and lower lip to E line (LM-2), and NLA analysis was carried out for each individual. Multiple tests were carried out for statistical analysis. Results: The mean ± SD observed for LM-1, LM-2, and NLA for NC individuals were 1.56 ± 2.98, 0.49 ± 3.51, and 97.20 ± 16.10, respectively. On the other hand, the mean ± SD of LM-1, LM-2, and NLA for NSCLP individuals were 4.55 ± 4.23, 1.68 ± 2.82, and 82.02 ± 14.66, respectively. No significant variation was observed with respect to gender and side. NSCLP (different types) and NC individuals showed significant disparities in LM-1 and NLA. Conclusion: It can be concluded that parameters of lip morphology such as LM-1, LM-2, and NLA vary among NSCLP and NC individuals.

Association between Crowding and the Effective Maxillary and Mandibular Length among Orthodontic Patients of Kathmandu, Nepal.

Background: During orthodontic consultation, the most frequent major complaint of the patients is dental crowding, which is caused by a disparity between the arch length and tooth size. Objective: The purpose of this study was to evaluate the association between crowding and the effective maxillary and mandibular length in Nepalese orthodontic patients.Methods: The orthodontic records of 390 people (from January 2018 to December 2020) were randomly selected and classified into three skeletal malocclusions based on the ANB angle (Angle formed by point A and point B at the nasion). Subjects with skeletal malocclusions were subdivided into two groups depending on the degree of crowding in the mandibular arch: Group 1 had crowding of < 3mm, and Group 2 had crowding of >3mm. On pretreatment casts, digital vernier calipers (Digimatic, Precise, India) were used to assess dental arch crowding, whereas, on a pretreatment lateral cephalogram, digital cephalometric analysis (Vistadent OC 1.1, USA) was done to quantify effective maxillary and mandibular length. Inter-group comparisons were assessed using a one-way analysis of variance. The correlation was assessed by Pearson’s correlation coefficient (p≤0.05).Results: There was a statistically significant difference in effective maxillary and mandibular length among skeletal malocclusions (p<0.05). Skeletal Class II malocclusion had the greatest mandibular crowding, while skeletal Class III malocclusion had the least. The effective maxillary and mandibular lengths and dental crowding had a significant but weak inverse correlation, whereas a strong but moderate positive correlation existed between the maxillary and mandibular effective lengths (r=0.674) and also between maxillary and mandibular crowding (r=0.631).Conclusion: Effective maxillary length was highest in skeletal class II malocclusion whereas effective mandibular length was highest in skeletal class III malocclusion. The shorter effective maxillary and mandibular lengths showed a weak association with dental crowding.

Uso de las Modalidades Diagnósticas Pertenecientes a la Imagenología Dentofacial en la Odontología Forense. Revisión de Literatura.

Objetivo: Describir el uso de las modalidades diagnosticas pertenecientes a la imagenología dentofacial en la odontología forense. Materiales y métodos: Se realizo una búsqueda en la base de datos de PubMed, Google Académico y SciELO con las palabras clave “Dentofacial imaging”, “Panoramic Radiography”, “Lateral Cephalogram”, “Cone Beam Computed Tomography (CBCT)”, “Digital Radiography”, y “Forensic Dentistry”. Se seleccionaron 48 artículos publicados en ingles, de fechas recientes, buscando información que describiera el uso de las modalidades diagnosticas pertenecientes a la imagenología dentofacial en la odontología forense. Resultados: Las modalidades diagnosticas de la imagenología dentofacial incluyen dentro de las más relevantes para la odontología forense la radiografía panorámica, la radiografía lateral de cráneo, la radiografía posterioanterior de cráneo y la tomografía computarizada de haz cónico. Conclusiones: Estas modalidades, junto a la ejecución de análisis morfométricos, permiten al odontólogo forense la identificación de un cadáver, la estimación de la edad, el sexo e incluso la reconstrucción facial forense con fines identificativos.

Estimating Cervical Vertebral Maturation with a Lateral Cephalogram Using the Convolutional Neural Network

Recently, the estimation of bone maturation using deep learning has been actively conducted. However, many studies have considered hand–wrist radiographs, while a few studies have focused on estimating cervical vertebral maturation (CVM) using lateral cephalograms. This study proposes the use of deep learning models for estimating CVM from lateral cephalograms. As the second, third, and fourth cervical vertebral regions (denoted as C2, C3, and C4, respectively) are considerably smaller than the whole image, we propose a stepwise segmentation-based model that focuses on the C2–C4 regions. We propose three convolutional neural network-based classification models: a one-step model with only CVM classification, a two-step model with region of interest (ROI) detection and CVM classification, and a three-step model with ROI detection, cervical segmentation, and CVM classification. Our dataset contains 600 lateral cephalogram images, comprising six classes with 100 images each. The three-step segmentation-based model produced the best accuracy (62.5%) compared to the models that were not segmentation-based.

Correlation and Correspondence between Skeletal Maturation Indicators in Hand-Wrist and Cervical Vertebra Analyses and Skeletal Maturity Score in Korean Adolescents

This retrospective observational study aimed to examine the correlation and correspondence between skeletal maturation indicators (SMI), cervical vertebral maturation indicators (CVMI), and radius-ulna-short bones (RUS) skeletal maturity scores in Korean adolescents, and to determine whether easily obtainable SMI or CVMI can replace the RUS skeletal maturity score. A total of 1017 participants were included with both hand-wrist radiograph and lateral cephalogram acquired concurrently. From the lateral cephalogram, CVMI was determined; through the hand-wrist radiograph, SMI was categorized, and the RUS skeletal maturity score was evaluated as well. Associations were examined using the Mann–Whitney U test, Spearman’s rank-order correlation analysis, and multiple correspondence analysis. There was no statistically significant difference in chronological age between males and females; however, the SMI, CVMI, and RUS skeletal maturity scores were significantly higher in females. The SMI, CVMI, and RUS skeletal maturity scores showed a statistically significant strong degree of both positive correlation and correspondence. However, a precisely corresponding RUS skeletal maturity score was difficult to obtain for a specific CVMI and SMI stage, implying the absence of a quantitative correlation. In conclusion, detailed evaluation should be conducted using the RUS skeletal maturity score, preferably in cases that require bone age determination or residual growth estimation.

Positional changes in the uvula tip after adenotonsillectomy in children: preliminary result

Background Adenotonsillectomy has become the primary treatment for children with sleep-disordered breathing or obstructive sleep apnea. However, few studies have investigated positional changes in the soft palate or uvula after adenotonsillectomy in children. The present study aimed to evaluate positional changes in the uvula tip using cephalometric analyses after adenotonsillectomy in children. Methods We analyzed 160 pediatric patients from December 2015 to July 2016, with 94 pediatric patients who underwent adenotonsillectomy as the experimental group and 66 children who were treated and followed up with frequent tonsillitis as the control group. Positional changes in the uvula tip after surgery in the adenotonsillectomy group were investigated using lateral cephalograms obtained within 1 month before surgery and 3–4 months after surgery. Two lateral cephalogram intervals for a few months in the control group who did not undergo adenotonsillectomy were analyzed. Results The palatal length (23.92 ± 3.47 vs. 24.46 ± 3.26; p = 0.032), palatal angle (43.13 ± 7.76 vs. 46.12 ± 5.91; p < 0.001), and retrouvula length (15.60 ± 3.51 vs. 16.60 ± 2.97; p = 0.009) were significantly increased on postoperative images relative to those on preoperative images. In the control group, there was a significant change in the palatal angle (2.99 ± 5.85 vs. 0.27 ± 4.14; p < 0.001) and retrouvula length (0.99 ± 3.64 vs. 0.05 ± 1.44; p = 0.025), but not in the palatal length (0.58 ± 2.38 vs. 0.043 ± 1.26; p = 0.065). Conclusion The findings of the present study suggest that the uvula tip is displaced in the anteroinferior direction 3 or 4 months after adenotonsillectomy in children. Thus, clinicians should be aware that the retropalatal space may expand after adenotonsillectomy in the pediatric population.

Determination of Mandibular Symphysis Width in Skeletal Class I Patients with Different Vertical Patterns

Symphysis is an anatomical part of mandible that includes lower incisors and anterior chin. Mandibular symphysis is a contributing factor of facial harmony for esthetics and is a determinant for lower incisor position in orthodontic treatment planning for border line cases. This cross-sectional study was carried out in Orthodontics department, Fatima Memorial Hospital College of Medicine and Dentistry Lahore on a sample size of 90 cases using 95% confidence level. Non probability consecutive sampling technique was used. Symphyseal dimensions were measured on lateral cephalogram. Data collected was entered and analyzed in computer program SPSS version 20. Quantitative outcomes like symphysis dimensions, symphysis width, vertical pattern, and ANB were subjected to ANOVA of significance. Independent T-test was used to make the comparison between males and females on the basis of variables. Results of this study suggested thatC-C’ varies significantly between males and females, whereas the differences in symphysis width LA, and LP between males & females are statistically insignificant (P>0.05). Bone anterior to lower incisor apex varies significantly among various facial profiles with hypo divergent males exhibiting wider chin than normo divergent and hyper divergent subjects. Sexual dimorphism in symphysis width was seen among genders. Keywords: Facial harmony, lower incisor position

1353 Accuracy of Surgical movements in the Le Fort I Osteotomy

Introduction The Le Fort I osteotomy is a surgical procedure planned by a joint orthognathic team aiming to correct skeletal discrepancies of the maxilla, with subsequent soft tissue profile changes of the patient. We undertook a retrospective case series analysis of patients receiving Le Fort I surgery at a UK teaching hospital over the last four years to assess the accuracy of Le Fort I surgical movements, by comparing the actual maxillary movement with planned surgical movements. Method A retrospective analysis of patients receiving Le Fort I surgery over a 4-year period, 2016-2020, was completed. Pre- and post-surgical lateral cephalograms were traced to determine postoperative anterior maxillary movements, and these were compared to the original orthognathic plan. Based on a literature review, we created a locally established standard of surgical movement to be within 2mm of planned movement on the lateral cephalogram trace for a satisfactory outcome. Results 91% of patients undergoing Le Fort I surgery (n = 11) had postoperative maxillary movement within 2mm of the surgical plan, and the mean difference between planned and surgical movements was 1.13mm. Conclusions Our retrospective analysis shows there is good surgical accuracy demonstrated of Le Fort I maxillary advancement movements compared to their original plan. Following this, we will continue to monitor and maintain this high standard for optimal patient outcome.