Nondeviated Side Research Articles

Condylar morphology and position changes after miniscrew-assisted rapid palatal expansion in skeletal Class III malocclusion adult patients with mandibular deviation and unilateral posterior crossbite

BackgroundTo evaluate the morphological and positional changes of mandibular condyle after miniscrew-assisted rapid palatal expansion (MARPE) in skeletal Class III malocclusion adult patients with horizontal mandibular deviation (MD).MethodsThe sample consisted of 15 patients with MD (6 males and 9 females, mean age 21.58 ± 3.12 years). The CBCT scans were taken before and after MARPE immediately. The pre- and post-registered images of the cranial base and mandible were measured, respectively, by Mimics.ResultsAfter expansion, the distance between superior condylar point and the Frankfort horizontal plane on the deviated side and the non-deviated side increased by 0.96 ± 0.60 mm (P = 0.011) and 0.70 ± 0.65 mm (P = 0.046); coronal condylar angle of the deviated side increased by 0.39° ± 0.34 (P = 0.028) and 0.06° ± 0.49 (P = 0.917) on the non-deviated side. No statistically significant differences were found when comparing the condylar position on both sides before and after treatment. The degree of mandibular deviation decreased 0.43 mm (P = 0.270).ConclusionsThis study suggested that for skeletal Class III malocclusion adult patients with horizontal MD, the condyle on the deviated side rotated toward the non-deviated side in the coronal direction; the condylar remodeling occurred mainly on the deviated side after MARPE in the vertical direction.

Three-Dimensional Quantitative Assessment of Condylar Displacement and Adaptive Remodeling in Asymmetrical Mandibular Prognathism Patients After Sagittal Split Ramus Osteotomy.

This study was performed to evaluate the condylar displacement and associated condylar remodeling in class III patients following mandibular setback surgery via sagittal split ramus osteotomy (SSRO). The sample comprised of 26 condyles of 13 subjects (mean age of 21.2±2.6y). We evaluated patients with mandibular prognathism and facial asymmetry who had undergone SSRO for mandibular setback at Korea University Hospital between January 2016 and December 2018. Three-dimensional segmentation of the mandibular condyles was done using the initial cone-beam computed tomography scan and scan taken 12 months postoperatively or later. Quantitative assessments of the 3-dimensional condylar displacement from T0 to T1 and bony remodeling of 8 regions of the condylar head were performed. The correlation between the condylar displacement and condylar head remodeling on the deviated (D) and nondeviated (ND) sides was analyzed. Significant correlations between condylar displacement and surface remodeling were observed in both D and ND condyles. The anteroposterior condylar displacement was significantly different between the D and ND sides (P=0.007). There was no significant difference in condylar remodeling between the 2 sides. Condylar displacement and adaptive remodeling after SSRO varied greatly among individuals. Compared with displacement in the ND condyle, displacement in the D condyle has a greater association with condylar remodeling in both D and ND condyles. There is no significant difference in condylar head remodeling between D and ND condyles.

Condylar and ramus volume in asymmetric and symmetric skeletal class III malocclusion: A cone-beam computed tomography study

Background/purposeAmong the craniofacial structures, the mandible is the only bony structure with movable joints. Each part (including condyle process, coronoid process, and ramus) of mandible would interaction with the muscles and proceed different osteogenesis progress. The objective of this study was to evaluate the mandibles with symmetric and asymmetric skeletal Class III jaw relations by quantifying differences in the condyle process, coronoid process and ramus on CBCT (Cone-beam computer tomography) images. Our hypothesis was that CBCT would reveal no voluminal differences between deviated and non-deviated mandibular segments in asymmetric skeletal Class III. Materials and methodsCBCT imagines were collected from dental department, KMUH and then divided into symmetric Class III group (Menton deviation < 4mm) and asymmetric Class III group (Menton deviation≧4mm). The mandibular structure would be segmented to ramus, condylar and coronoid process. Each volume was measured. Independent t test was used for comparison between groups, and paired t test was applied for comparison between both segmented parts within each group. ResultsSignificant differences between deviation and non-deviation sides in the asymmetric group were found in condylar and ramus segments for volumetric quantitative measurements. There has no significant difference in ramus parts between groups. Significant greater condylar volume was found in non-deviation side of asymmetric group. ConclusionThe results demonstrated that in the side with greater mandible growth potential, the condylar and the ramus volume would be greater as well. CBCT is a useful and accurate modality for quantification and evaluation of mandibular asymmetry.

Comparison of the bite force and occlusal contact area of the deviated and non-deviated sides after intraoral vertical ramus osteotomy in skeletal Class III patients with mandibular asymmetry: Two-year follow-up.

The objectives of this study were to compare the time-dependent changes in occlusal contact area (OCA) and bite force (BF) of the deviated and non-deviated sides in mandibular prognathic patients with mandibular asymmetry before and after orthognathic surgery and investigate the factors associated with the changes in OCA and BF on each side. The sample consisted of 67 patients (33 men and 34 women; age range 15-36 years) with facial asymmetry who underwent 2-jaw orthognathic surgery. OCA and BF were taken before presurgical orthodontic treatment, within 1 month before surgery, and 1 month, 3 months, 6 months, 1 year, and 2 years after surgery. OCA and BF were measured using the Dental Prescale System. The OCA and BF decreased gradually before surgery and increased after surgery on both sides. The OCA and BF were significantly greater on the deviated side than on the non-deviated side before surgery, and there was no difference after surgery. According to the linear mixed-effect model, only the changes in the mandibular plane angle had a significant effect on BF (p < 0.05). There was a difference in the amount of the OCA and BF between the deviated and non-deviated sides before surgery. The change in mandibular plane angle affects the change, especially on the non-deviated side, during the observation period.

Comparison of the bite force and occlusal contact area of the deviated and non-deviated sides after intraoral vertical ramus osteotomy in skeletal Class III patients with mandibular asymmetry: Two-year follow-up

ObjectiveThe objectives of this study were to compare the time-dependent changes in occlusal contact area (OCA) and bite force (BF) of the deviated and non-deviated sides in mandibular prognathic patients with mandibular asymmetry before and after orthognathic surgery and investigate the factors associated with the changes in OCA and BF on each side.MethodsThe sample consisted of 67 patients (33 men and 34 women; age range 15–36 years) with facial asymmetry who underwent 2-jaw orthognathic surgery. OCA and BF were taken before presurgical orthodontic treatment, within 1 month before surgery, and 1 month, 3 months, 6 months, 1 year, and 2 years after surgery. OCA and BF were measured using the Dental Prescale System.ResultsThe OCA and BF decreased gradually before surgery and increased after surgery on both sides. The OCA and BF were significantly greater on the deviated side than on the non-deviated side before surgery, and there was no difference after surgery. According to the linear mixed-effect model, only the changes in the mandibular plane angle had a significant effect on BF (p < 0.05).ConclusionsThere was a difference in the amount of the OCA and BF between the deviated and non-deviated sides before surgery. The change in mandibular plane angle affects the change, especially on the non-deviated side, during the observation period.

The nasal cycle before and after nasal septoplasty.

Septoplasty is one of the most frequently performed operations in patients with septal deviation of the nose. The aim of this surgical intervention is to reduce nasal obstruction and to achieve a physiological nasal breathing. The nasal cycle plays a crucial role in this. The aim of this study was to investigate nasal breathing and the nasal cycle after septoplasty over a long period of time and under everyday conditions. We examined 22 healthy subjects and 19 patients with nasal septal deviation. They participated in two sessions separated by an interval of three months. Shortly after the first session patients received nasal septoplasty. Testing included multiple questionnaires regarding nasal breathing and olfactory function, anterior rhinoscopy, rhinomanometry, acoustic rhinometry, and long-term rhinoflowmetry over 24h. Nasal septoplasty was associated with subjectively improved nasal breathing and nasal patency comparable to that in healthy subjects. The severity of nasal obstruction was reduced. Nasal airflow and the hydraulic diameter increased on the deviated side of the nose while the inspiratory resistance did not significantly change. In addition, the number of phases of the nasal cycle decreased on the nondeviated side. Hence, the surgery was associated with a more even distribution of phases on both sides of the nose. Nasal septoplasty leads to a subjectively satisfactory result in patients with pathological septal deviation of the nose. In particular, septoplasty appears to be accompanied by a more even distribution of the nasal cycle across the two nasal cavities.

Needle orientation for temporomandibular joint arthrocentesis in Koreans

ABSTRACT Objective To investigate the highest opportunity skin puncture point and needle orientation according to facial asymmetry and classification. Methods Computed tomography of 136 patients was analyzed. Horizontal and vertical angles and distances from the canthal-tragal line were investigated to determine the puncture point and needle’s angle. Result All patients’ average points were 7.39 (±2.85) mm anterior to the tragus and 3.44 (±4.18) mm below the canthal-tragal line with an angle of 8.53 (±6.90)° anteriorly and 32.26 (±7.23)° superiorly. Regarding asymmetry, there was a statistical difference in horizontal angle, depth, and canthal-tragal distance between the deviated and non-deviated sides. Especially, vertical distances were 4.44 (±4.66) mm and 2.59 (±4.11) mm in the deviated and non-deviated sides, respectively (p < 0.001). Conclusion In closed-mouth, the puncture point was closer to the tragus and lower than the conventional point. The point in the deviated side should be considered lower than the non-deviated side.

Three-Dimensional Changes in the Mandibular Proximal Segment After Using a Surgery-First Approach in Patients With Class III Malocclusion and Facial Asymmetry.

:This study was performed to evaluate condylar position and angulation after asymmetric mandibular setback between a conventional (CA) and surgery-first approach (SFA) using three-dimensional analysis. The condylar positions of 30 patients with skeletal Class III malocclusion and facial asymmetry who underwent 1-jaw (sagittal split ramus osteotomy) or 2-jaw orthognathic surgery (Le Fort I osteotomy and sagittal split ramus osteotomy) with CA (n = 18) or SFA (n = 12) from 2 university hospitals were studied. The three-dimensional assessment of condylar changes was performed using computed tomography images at the initial time point (T0) and at least 6 months after surgery (T1). Segmentation of condyles and cranial base assessment from cone-beam computed tomography images were performed using ITK-SNAP software (version 3.4.0). Condylar position and angulation changes were calculated using 3D Slicer software (version 4.10.2), and statistical analysis was performed. No significant translational or rotational condylar changes were observed between the deviated and non-deviated sides in each group or between the CA and SFA groups except yaw (p = 0.014). Linear mixed-model analysis and multi-variate analysis showed no significant difference between the CA and SFA groups. Surgery-first approach might not be associated with more harmful effects on the condylar position and angulation changes as compared with CA.

Is distal segment ostectomy essential for stabilization of the condylar position in patients with facial asymmetry?

BackgroundThe purpose of this retrospective study was to evaluate the postoperative change in the position and stability of the mandibular condyle after bilateral sagittal split ramus osteotomy (BSSRO) and BSSRO with distal segmental ostectomy (DSO) in patients with facial asymmetry using 3D computed tomography.MethodsThe condyles of the patient diagnosed with facial asymmetry were divided into the deviated side (DS) and the non-deviated side (NDS). Group I, which was treated with BSSRO only, and Group II, which additionally received DSO along with BSSRO, were superimposed on the condyle using the pre-and postoperative 3D CT. The amount of condylar change in anteroposterior displacement, mediolateral displacement, and rotation was measured. The clinical symptoms of temporomandibular joint were also evaluated before and after surgery for each patient.ResultsBetween Groups I and II, there was no statistically significant difference in the anteroposterior condylar position on both DS and NDS.And also, there was no statistical difference between the two groups in the mediolateral change on DS but, statistically significant difference on NDS. The change in the rotation of the condyle was observed to rotate inward from both condylar heads of Groups I and II, and a statistically significant difference was observed between the two groups on both DS and NDS. Moreover, no difference in clinical temporomandibular joint symptoms was observed after surgery in each DS and NDS condyle of the two groups.ConclusionsAs a result of analyzing the condylar position change of the group treated with BSSRO alone and the group treated with BSSRO and DSO in patients with facial asymmetry, there were statistically significant differences in the mediolateral displacement of NDS and the condyle rotation of NDS and DS. However, the anteroposterior condylar position did not show any difference in the bilateral condyles. In addition, since worsening clinical symptoms of bilateral temporomandibular joint were not observed before and after surgery in both groups, it is concluded that it is not necessary to accompany DSO in patients with facial asymmetry (minimum 3 mm, maximum 7 mm).

Evaluation of facial soft tissue thickness in asymmetric mandibular deformities after orthognathic surgery

ObjectivesThe purpose of this study was to compare differences in facial soft tissue thickness in three-dimensional (3D) images before and after orthognathic surgery in patients with skeletal Class III malocclusion and to obtain a better understanding of the relationship between hard and soft tissue changes after surgery.Materials and methodThe present retrospective study included 31 patients with skeletal Class III malocclusion with mandibular chin deviation greater than 4 mm who had undergone cone-beam computed tomography before and 6 months after surgery. Seven bilateral points were established. Measurements were taken from software-generated multiplanar reconstructions. The predictor variables were timing (pre- and postoperatively) and side (deviated vs. nondedicated). A regression model and correlation analysis were conducted for statistical analysis.ResultsThe difference of bilateral facial soft tissue thickness was statistically significantly different between deviated and nondeviated sides (P < 0.05), with lower values observed on the deviated side. The soft tissue thickness has become nearly symmetric at local regions of the lower thirds of the face after orthognathic surgery. However, most measurements showed a negative correlation between changes in soft tissue thickness and changes in bone tissues.ConclusionsSkeletal Class III malocclusion with facial asymmetry is accompanied by differences in soft tissue thickness when comparing Dev and N-Dev sides of the posterior region of the mandible, where soft tissues are thinner on the Dev side. Soft tissue thickness can compensate for or camouflage the underlying asymmetric mandible. In addition, the asymmetric soft tissue thickness on the lower third of the face can be partially improved by orthognathic surgery, but the amount of soft tissue thickness change is not consistent with that of hard tissue positional change.

Mandibular Stability After Sagittal Split Ramus Osteotomy With Hybrid Technique in Asymmetric Patients.

The hybrid technique after bilateral sagittal split ramus osteotomy is an internal fixation method using monocortical mini-plates and additional bicortical positional screws. In this study, we analyzed the postoperative stability of 23 patients with mandibular asymmetry who underwent bilateral sagittal split ramus osteotomy and hybrid fixation with or without LeFort I osteotomy. Anatomical landmarks of the deviated and non-deviated sides of the jaw were established to measure the angle and distance to the reference plane in three-dimensional cone beam computed tomography images. We analyzed the positional changes and correlations of the reference points at preoperative (T1), postoperative 2 weeks (T2), and postoperative 1 year (T3). There were significant differences in preoperative position of the upper and lower molar cervix alveolar crest to the reference plane (U6-X and L6-X) and the condylion angles between deviated and non-deviated sides. Postoperatively (T2-T3), each reference point had no statistically significant positional change. Pearson correlation coefficient between the amount of menton deviation (ME-X at T1) and positional change of menton after surgery (T2-T3) was 0.30, and P value was 0.168. The hybrid fixation technique is an effective fixation method for achieving postoperative stability for mandibular asymmetry.

Comparison of Subjective and Objective Success of Septoplasty in Patients with Nasal Septum Deviation: A Before and After Study

Objective: Aim of the study is to evaluate the subjective outcomes and objective outcomes postoperatively and investigate correlations between these measurements. Material and Methods: This prospective before and after surgical study was conducted with patients admitted with symptomatic nasal septum deviation (NSD) and who underwent Cottle’s septoplasty. Morphometric diameters of the nasal cavity were measured using a multi-detector computed tomography. Preoperative and postoperative one-month Nasal Obstruction Symptom Evaluation Scale (NOSE) score, acoustic rhinometry (AR), and anterior active rhinomanometry (AAR) measurements were used to evaluate the success of surgery. The correlations between these measurements were also evaluated. Results: The study population consisted of 30 patients, including 19 males and 11 females, with a median age of 27.5 years. There was a statistically significant difference between pre and postoperative NOSE scores, with a mean difference of 53.17 points (p&lt;0.001). There were statistically significant differences between pre and postoperative AR parameters of both the deviated side (DS) and non-deviated side (NDS) of the nose both before and after decongestion. There were statistically significant improvements in all postoperative airflow and airway resistance parameters of the DS of the nose before decongestion when compared to preoperative measurements. There were moderate to large positive correlations between morphometric diameters and differences in NOSE score. Further, there were several statistically significant correlations between differences in AR and AAR measurements and differences in NOSE score. Conclusion: Our findings showed that the objective measurements are strongly correlated with the NOSE score.

Ramal inclination in the frontal plane after bimaxillary orthognathic surgery in skeletal classIII facial asymmetry : Spontaneous changes and stability.

This study aimed to observe spontaneous changes of ramal inclination in the frontal plane (FRI) and its stability in skeletal classIII asymmetry patients corrected with bimaxillary surgery. The correlation between FRI change and surgical skeletal change was also investigated. Forty-nine patients with skeletal classIII facial asymmetry who underwent orthognathic surgery with at least 1° change in FRI after surgery were analyzed. FRI and other factors were measured on frontal and lateral cephalograms before surgery (T1), after surgery (T2), and at follow-up after at least 6months (T3). Correlation analysis was performed to determine pre- and postoperative factors associated with FRI change and stability. FRI increased significantly on the deviated side and decreased on the nondeviated side after surgery. The FRI changes remained stable during follow-up. No correlation between FRI changes and skeletal changes during surgery were found except between the change of FRI during follow-up (T3-T2) and mandibular setback amount (T2-T1), with aweak coefficient of 0.32. The FRI changes after bimaxillary orthognathic surgery in skeletal classIII asymmetry reduced the FRI difference between the deviated and nondeviated side and remained stable for at least 6months after surgery. No clinically significant correlation was found between measured skeletal changes during surgery and FRI changes.

Three-dimensional condylar displacement and remodelling in patients with asymmetrical mandibular prognathism following bilateral sagittal split osteotomy

This study aims to assess the postoperative condylar displacement and the long-term condylar remodelling in patients with mandibular prognathism with transverse asymmetry after bilateral sagittal split ramus osteotomy (BSSRO). Forty-one consecutive patients (82 condyles) with a transverse mandibular asymmetry of more than 4 mm without occlusal canting treated by BSSRO were included. The preoperative (T1), immediate postoperative (T2) and long-term follow-up of an average of 16.2 months (T3) spiral computed tomography scans were gathered and processed to measure the condylar displacement and remodelling based on cranial base voxel-based and rigid regional registrations. The statistical analysis revealed that the majority of condyles (T1–T2) were transitionally displaced forwards, downwards and laterally, and were not fully returned to the preoperative position at T3. Condylar lateral displacement was significantly higher on the deviated side (DS) (P = 0.035). Non-deviated side (NDS) condyles were mainly subjected to upward pitch, medial yaw and medial roll compared with downward pitch, lateral yaw and lateral roll on DS. Condylar remodelling at T3 was observed, with the superior and posterior surfaces commonly subjected to bone resorption, whereas the anterior and medial surfaces were commonly subjected to bone apposition. Condylar volumetric changes were relatively comparable on NDS (3 ± 85.2 mm3) and DS (8.3 ± 111.7 mm3) condyles. Age, amount of preoperative asymmetry and follow-up period were not correlated with the condylar remodelling. Transitional and rotational displacements were to some extent significantly correlated with the condylar remodelling on both sides. Consequently, passive condylar seating without torque might prevent the long-term unfavourable condylar remodelling.

Bilateral Sagittal Split Mandibular Ramus Osteotomy Alters the Temporomandibular Joint.

In this retrospective analysis, we examined temporomandibular joint space volume and condyle position in 10 patients undergoing bilateral sagittal split mandibular ramus osteotomy plus Le Fort I osteotomy to correct mandibular asymmetry. Cone beam computed tomography was used to map temporomandibular joint prior to (T0), immediately after (T1), and at 1 year after surgery (T2). In the deviated side, we detected significant lateral shift of the condyle in 5 patients at T1, and the shift disappeared at T2. In the non-deviated side, we detected significant medial shift of the condyle in all 10 patients at T1; the shift continued in 9 patients at T2. Temporomandibular joint space volume increased significantly at T1 and returned to presurgical volume at T2. In conclusion, there is significant shift in position of condyle in majority of the patients after bilateral sagittal split mandibular ramus osteotomy. The most consistent and persisting change was medial shift on the nondeviated side.

Evidence of Nasal Cooling and Sensory Impairments Driving Patient Symptoms With Septal Deviation.

About 260,000 septoplasties are performed annually in the US to address nasal septal deviation (NSD). Yet, we do not consistently understand what aspects of NSD result in symptoms. Blinded cohort study. Two fellowship-trained surgeons blindly reviewed computerized tomography (CTs) of 10 confirmed NSD patients mixed with 36 healthy controls. All patients were correctly identified, however, 24/36 controls were falsely identified by both surgeons as patients (33.3% specificity), which were grouped as asymptomatic NSD (aNSD), while the remaining controls as non-NSD (healthy). Acoustic rhinometry, rhinomanometry, individual CT-based computational fluid dynamics and nasal sensory testing were applied to address the puzzling questions of why these aNSD had no symptoms and, more fundamentally, what caused symptoms in sNSD patients. aNSD reported no nasal symptoms - Nasal Obstruction Symptom Evaluation score (sNSD: 60.50 ± 13.00; aNSD: 5.20 ± 5.41; non-NSD: 6.66 ± 7.17, P < .05); 22-item Sino-Nasal Outcome Test score (sNSD: 32.60 ± 14.13; aNSD: 10.04 ± 10.10; non-NSD: 9.08 ± 12.42, P < .001). No significant differences in measured nasal resistance, minimum cross-sectional area (MCA), degree of septal deviation, and nasal airflow distributions were found between sNSD and aNSD groups. Only three variables differentiate sNSD versus aNSD: anterior averaged heat flux on deviated side, inferior turbinate peak heat flux on non-deviated side, and nasal cool sensitivity measured by menthol lateralization threshold, with no significant differences among these variables found between the two healthy groups (aNSD vs. non-NSD). These variables by themselves or combined can differentiate sNSD from controls with higher specificity than the physicians (ROC area under the curve=0.84 with 70% sensitivity and 91.6% specificity). This study sheds light on the potential mechanisms of NSD symptomatology: distorted nasal cooling due to NSD exacerbated by poorer nasal mucosal sensitivity. It further supports our previous hypothesis that nasal obstruction complaints do not result directly from obstruction, rather from the capacity of our nose to subjectively sense airflow cooling. 3 Laryngoscope, 132:509-517, 2022.

Automated Real-Time Evaluation of Condylar Movement in Relation to Three-Dimensional Craniofacial and Temporomandibular Morphometry in Patients with Facial Asymmetry.

The aim of this study was to investigate the correlation between craniofacial morphology, temporomandibular joint (TMJ) characteristics, and condylar functional movement in patients with facial asymmetry using an up-to-date automated real-time jaw-tracking system. A total of 30 patients with mandibular asymmetry and prognathism were included. Three-dimensional (3D) craniofacial and TMJ morphometric variables were analyzed in images captured using cone-beam computed tomography. Three-dimensional condylar movements were recorded during the opening, protrusion, and laterotrusion of the jaw and divided into those for deviated and non-deviated sides. Overall functional and morphometric variables were compared between the sides by a paired t-test. Pearson’s correlation analysis and factor analysis were also performed. As a result, significant differences were found between the sides in morphometric and functional variables. The condylar path length was significantly longer and steeper on the deviated side during protrusion and lateral excursion. TMJ morphometric asymmetry, more so than the craniofacial morphologic asymmetry, seemed to be reflected in the functional asymmetry, representing different correlations between the sides, as supported by factor analysis. This study provides evidence explaining why the asymmetric condylar path remained unchanged even after orthognathic surgery for the correction of craniofacial asymmetry.

Three-dimensional assessment of the anterior and inferior loop of the inferior alveolar nerve using computed tomography images in patients with and without mandibular asymmetry

BackgroundThe purpose of this study was to investigate the differences in configuration and dimensions of the anterior loop of the inferior alveolar nerve (ALIAN) in patients with and without mandibular asymmetry.MethodPreoperative computed tomography images of patients who had undergone orthognathic surgery from January 2016 to December 2018 at a single institution were analyzed. Subjects were classified into two groups as “Asymmetry group” and “Symmetry group”. The distance from the most anterior and most inferior points of the ALIAN (IANant and IANinf) to the vertical and horizontal reference planes were measured (dAnt and dInf). The distance from IANant and IANinf to the mental foramen were also calculated (dAnt_MF and dInf_MF). The length of the mandibular body and symphysis area were measured. All measurements were analyzed using 3D analysis software.ResultsThere were 57 total eligible subjects. In the Asymmetry group, dAnt and dAnt_MF on the non-deviated side were significantly longer than the deviated side (p < 0.001). dInf_MF on the non-deviated side was also significantly longer than the deviated side (p = 0.001). Mandibular body length was significantly longer on the non-deviated side (p < 0.001). There was no significant difference in length in the symphysis area (p = 0.623). In the Symmetry group, there was no difference between the left and right sides for all variables.ConclusionIn asymmetric patients, there is a difference tendency in the ALIAN between the deviated and non-deviated sides. In patients with mandibular asymmetry, this should be considered during surgery in the anterior mandible.

Patient-specific CFD simulation of aerodynamics for nasal pathology: a combined computational and experimental study

ABSTRACT The aim of this study was to develop and verify a personalised approach for simulating the aerodynamic flow patterns using patient-specific data of a severe form of nasal obstruction during inspiration. The reconstruction of the 3D geometry of the nasal cavity based on the computer images of a patient diagnosed with the unilateral nasal valve collapse and S-shaped septum deviation was used to perform the Computational Fluid Dynamics (CFD) simulation of airflow. A comparative study of the airflow with standard data (SD) and personal input data (PD) of mass flow rate was carried out. In both cases, the air streamlines went straight along the lower and middle nasal passages on the non-deviated septum side. The peak velocity increased in two cavities, mostly on the septum deviation side, while the peak pressure inversely dropped. . With personal data, the peak velocity and pressure values varied greatly in different parts of the nasal cavity, depending on the particular local anatomy. In a patient with unilateral nasal valve collapse and S-shaped septum deviation, the use of personal data does not have an impact on the streamline’s direction, longitudinal velocity, and pressure distributions but it significantly changed the local velocity and pressure in the nasal cavity.

Comprehensive 3D analysis of condylar morphology in adults with different skeletal patterns \u2013 a cross-sectional study

BackgroundThe correlation between individuals’ condylar morphology and their skeletal pattern is of great interest for treatment strategies ranging from orthodontic orthopaedics to orthognathic surgery. The objective of the present study was to investigate this relationship three-dimensionally.MethodsA total of 111 adult patients (mean age = 27.0 ± 10.2 years) who underwent head computed tomography or cone beam computed tomography scans were included. Based on these data, 3D models of the skull and the condyles were calculated. The craniofacial skeleton was evaluated (1) transversally regarding skeletal symmetry (menton deviation), (2) sagittally regarding skeletal classes (Wits appraisal) and vertically regarding the inclination of the jaws (maxillomandibular plane angle). The condylar morphology was assessed (a) linearly by the condylar width, height and depth; (b) angularly by the antero-posterior and medio-lateral condylar inclination; and (c) volumetrically by the ratio of the condylar volume/mandibular volume (C/Mand).Results(1) Transversal: Asymmetric patients showed significantly higher discrepancies in the volumetric ratio C/Mand on the deviation and non-deviation side compared to symmetric patients. (2) Sagittal: Class III subjects demonstrated longer, more voluminous condyles with higher antero-posterior and medio-lateral inclination angles compared to Class II participants. (3) Vertical: Hyperdivergent subjects had smaller condyles with higher antero-posterior inclination angles than those of hypodivergent subjects. No interactions of skeletal class and vertical relationships regarding condylar morphology were observed.ConclusionsThis study demonstrates a clear correlation between pronounced skeletal patterns and condylar morphology in an adult population. The description of radiographic condyle characteristics in relation to the craniofacial morphology improves orthodontic treatment planning and could be helpful in the diagnosis of temporomandibular joint pathologies.