Submental Vertex Research Articles

6417 Submental vertexとCPI計測値との関連性について

6417 Submental vertexとCPI計測値との関連性について

Anthropometric Effect of Mucoperiosteal Nostril Floor Reconstruction in Complete Cleft Lip.

The primary objective of this study was to investigate whether growth impairment in children with cleft lip is caused by reconstructing the nostril floor using lateral nasal and premaxillary mucoperiosteal flaps. The effects on growth and symmetry of tip rhinoplasty at the time of initial repair, as well as cleft sidedness are similarly investigated. An Institutional Review Board approved, retrospective, single-center study at an academic children's hospital from July 2005 to 2010 was designed. Seventy-four patients with unilateral cleft lip ± palate were followed postsurgical repair of the cleft lip deformity. Serial digital photographs from clinical encounters were analyzed. Anthropometric measurements of 10 soft tissue landmarks were extracted from anteroposterior and submental vertex views at serial visits; growth velocities, defined as c = Δd/Δt, were generated using linear mixed models on selected measurements to study time-related changes on growth. The effects on growth and symmetry of primary tip rhinoplasty on perinasal landmarks and nostril floor reconstruction with medial and lateral nasal mucoperiosteal flaps on perioral and perinasal landmarks were analyzed. Proxies for midfacial height (en-al) and maxillary height (al-ch) were used to evaluate the effect of mucoperiosteal dissection, whereas nostril width, height, and angle were used as proxies to evaluate the effects of tip rhinoplasty. Seventy-four patients met the inclusion criteria. Midface height (En-Al) growth velocity was 0.014 mm/month and maxillary height (Al-Ch) was relatively stable at -0.0059 mm/month with no difference between the subgroups. Nostril height growth was -0.0046 mm/month, nostril width was 0.03 mm/mo, and nostril angle -0.09 °/mo showed no difference between patient with or without primary tip rhinoplasty. Patients with complete cleft showed more asymmetry than those with incomplete clefts in lip and maxillary landmarks at T0 (P < 0.001). Mucoperiosteal reconstruction of the nostril floor at the time of lip repair does not affect anthropometric growth velocities over a 5-year follow-up. Within the limitations of the selected landmarks, primary tip rhinoplasty did not significantly improve symmetry at 5 years, but also did not affect the growth of the nose. Patients with complete clefts display more postoperative asymmetry than those with incomplete clefts.

Skeletal and dental effects of tooth-borne versus hybrid devices for mandibular symphyseal distraction osteogenesis

To evaluate and compare, retrospectively, the skeletal and dental effects of mandibular symphyseal distraction osteogenesis (MSDO) achieved through the use of tooth-borne versus hybrid distractors. Pretreatment (T1), predistraction (T2), postdistraction (T3), and posttreatment (T4) orthodontic records were collected and analyzed for 47 patients (20 tooth-borne, 27 hybrid). At each time point, records included intraoral photographs, study models, postero-anterior cephalometric radiographs, and lateral cephalometric radiographs. Submental vertex radiographs were taken at T2, T3, and T4. Changes in a total of 18 measurements were analyzed to compare patients undergoing tooth-borne versus hybrid distraction. The cumulative effects of orthodontics and MSDO produced similar gains in measured arch widths, with a decreased irregularity index in both groups (P > .05). However, there were differences in the timing during which the expansion was achieved. The hybrid distractor group gained space during the distraction phase of treatment. The tooth-borne group showed greater gains during pre- and postdistraction orthodontics. Comparisons of intercanine and interbone marker widths demonstrated a more parallel separation of bone during distraction with the hybrid distractor (P < .001). Distraction with the tooth-borne distractor was disproportionate, with greater separation of the canines in alveolar bone than of the bone markers in basal bone. During postdistraction orthodontics, the tooth-borne distractor group showed statistically greater increases in measurements. Both skeletal and dental expansion was achieved with both appliances. Greater skeletal expansion was achieved with a hybrid distractor. Greater dental expansion was achieved with a tooth-borne distractor.

Orthopedic palatal expansion in the treatment of bilateral congenital choanal atresia: An additional tool in the long term follow up of patients?

Rapid Palatal Expansion (RPE) is an orthodontic procedure commonly used to widen the maxilla. Aim of this study is the description of the effects produced by RPE in two patients affected by Bilateral Congenital Choanal Atresia (BCCA) operated in infancy and who were scheduled for a secondary endoscopical surgical correction. The two cases presented were studied through Postero Anterior and Submental Vertex cephalometric x-rays, and TC-Scans pre and 12 months post expansion. Both nasal and choanal widths were increased 12 months post expansion of an amount which was equivalent to 30% of the defective bony width. Endoscopically the expansion of the lumen was more evident given the associated soft tissue improvement. In both cases secondary surgery was avoided. The cooperation between ENT surgeon and orthodontist may allow for an reduction in the burden of treatment of children affected by BCCA.

A Genome Segment on Mouse Chromosome 12 Determines Maxillary Growth

The primary and modifier genes that regulate normal maxillofacial development are unknown. Previous quantitative trait locus (QTL) analyses using the F2 progeny of 2 mouse strains, DBA/2J (short snout/wide face) and C57BL/6J (long snout/narrow face), revealed a significant logarithm-of-odds (LOD) score for snout length on mouse chromosome 12 at 44 centimorgan (cM). We further sought to validate this locus contributing to anterior-posterior dimensions of the upper mid-face at the D12Mit7 marker in a 44-centimorgan portion of chromosome 12. Congenic mice carrying introgressed DNA from DBA/2J on a C57BL/6J background were selected for submental vertex cephalometric imaging. Results confirmed QTLs, determining that short snout length (P < 0.05) and face width relative to snout length (P < 0.01) were present in the 44-cM region of chromosome 12. We conclude that one or more genes contributing to the shape of the maxillary complex are located near 44 cM of mouse chromosome 12.

Análise anátomo-radiográfica da persistência do Forame de Huschke

OBJETIVO: o objetivo neste trabalho é avaliar e localizar o Forame de Huschke. FORMA DE ESTUDO: anatômico. MATERIAL E MÉTODO: utilizando materiais de contraste como a Guta percha e o sulfato de bário, através de técnicas radiográficas extrabucais, como a panorâmica, submentovértex e a tomografia linear lateral corrigida para a Articulação Têmporo-mandibular, em quatro crânios, onde foi verificada clinicamente a presença do Forame de Huschke. RESULTADO: Os resultados obtidos mostraram que o Forame de Huschke pôde ser observado em crânios secos após a sua evidenciação por meio de material de contraste nestas técnicas radiográficas.

Anatomic and radiograph study of the persistence of Foramen of Huschke

SummaryAim: the aim of this study is to assess and locate the Foramen of Huschke. Study design: anatomical. Material and Method: using contrast material like gutta-percha and barium sulfate, through extraoral radiographs, such as panoramic, submental vertex and corrected saggital linear Temporal Mandibular Joint tomograms in four skulls where we clinically checked the existence of foramen of Huschke. Results: The results proved that the foramen of Huschke can be observed in skulls submitted to contrast using radiographic techniques.

Vector Control in Transportation Osteogenesis

To evaluate the ability to control vectors in the technique of transportation osteogenesis using 4 principles. Sixteen defects measuring approximately 30-180 mm were retrospectively evaluated. Vector control was attempted using a single or combination of the following principles: multiple linear vectors, exaggerated linear distraction ("sausage effect"), braced guided distraction, and reorientation osteotomies. Observations were made regarding the ability to create the desired vectors. Angular deviation from desired vectors was determined and recorded numerically by evaluating either submental vertex or occlusal radiographs, stereolithographic models, or digital radiographs. Radiographic evaluation of symmetry alone was not used to determine the desired vector because a more laterally displaced segment was desirable to maintain favorable facial balance when soft tissue deficiency was pronounced. A subjective evaluation scale was developed to supplement the numerical values. Vector control primarily required the use of 2 or more principles. The most common combination was that of exaggerated linear distraction and reorientation osteotomy. The use of multiple linear vectors, exaggerated linear distraction ("sausage effect"), reorientation osteotomies, and braced guided distraction greatly assisted the operator in achieving the goal of symmetrical reconstruction. Transportation osteogenesis may be considered an effective tool in the box to reconstruct patients. In cases in which vector control is achieved, the advantages of diminishing the volume of bone graft required or achieving final bony reconstruction can outweigh the disadvantages of the technique.

Transverse skeletal and dental asymmetry in adults with unilateral lingual posterior crossbite

This article reports that mandibular skeletal asymmetry is not evident in a group of adults with posterior unilateral crossbite when compared with an adult control group. Furthermore, the authors claim that posterior crossbite is due to increased width of the mandible and not a result of transverse deficiency of the maxilla. This study makes use of posteroanterior (PA) radiographs, in preference to previously used submental vertex radiographs, as used by Lam et al 1 Lam P.H. Sadowsky C. Omerza F. Mandibular asymmetry and condylar position in children with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 1999; 115: 569-575 Abstract Full Text Full Text PDF Scopus (77) Google Scholar to assess facial asymmetry in adolescents and O'Byrn et al 2 O'Byrn B.L. Sadowsky C. Schneider B.J. BeGole E. An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 1995; 107: 394-400 Abstract Full Text Full Text PDF Scopus (108) Google Scholar to evaluate skeletal asymmetry in adults.

A study on the classification and treatment of zygomatic complex fractures

To investigate a new classification and treatment of zygomatic complex fractures (ZCF) by clinical and radiographic studies. Standard radiographs with Waters, submental vertex views had been obtained before and after operation in 206 patients (212 sides) with ZCF. Patients with complicated fractures underwent two and three dimensional CT. Computer-assisted measuring system was used to measure the degree of displacement. ZCF were classified into 3 types and 6 subtypes according to the degree of displacement of segments and facial deformities. Treatment principles were proposed. The results were satisfied through clinical application and measurement of post-operative images. The treatment for ZCF should be selected according to the fracture types. The key of operation is to recover the malar prominence. Remodeling the length and radian of zygomatic arch guarantee the recovery of malar prominence. Zygomatic-sphenoid and zygomatic-maxillary fissures are very important reference marks for reduction and fixation.

Morphological and positional asymmetries of young children with functional unilateral posterior crossbite.

This prospective clinical study evaluated the morphological and positional mandibular asymmetry of young patients with functional unilateral posterior crossbite. The sample included 9 girls and 6 boys (8.8 +/- 1.0 years of age), evaluated at the initiation of treatment and approximately 6 months after the retention phase (1.1 +/- 0.2 years after initiation of treatment). Each patient had a complete unilateral posterior crossbite involving 3 or more posterior teeth, a functional shift from centric relation-intercuspal position, and no signs or symptoms of temporomandibular disorder. A bonded palatal expansion appliance was used to rapidly expand the maxilla (1 month) and retain the treatment changes (6 months). Zonograms were used to assess articular joint spaces, and submental vertex radiographs were used to assess morphological and positional asymmetry. The results showed that the mandible was significantly longer on the noncrossbite side than it was on the crossbite side. The asymmetry was most evident for the ramus and involved both the condylar and the coronoid processes. The posterior and superior joint spaces were larger on the noncrossbite side than they were on the crossbite side. After treatment and retention, the mandible showed no significant morphological asymmetries. Mandibular growth was greater on the crossbite side than it was on the noncrossbite side, and the mandible had been repositioned; the crossbite side had rotated forward and medially toward the noncrossbite side. We concluded that unilateral posterior crossbites produce morphological and positional asymmetries of the mandible in young children, and that these asymmetries can be largely eliminated with early expansion therapy.

A radiographic study of condyle position at various depths of cut in dry skulls with axially corrected lateral tomograms

Fifty dry skulls were evaluated by means of submental vertex radiographs and axially corrected tomograms. The condyles were classified into four groups according to anterior surface and shape as viewed on the submentovertex radiograph. Thirty condyles were classified as having a flat anterior surface, 27 as convex, 19 as concave, and 24 as triangular. The analysis of variance for the depth of cut demonstrated (1) no statistically significant difference between the condyle/fossa relationship at the various depths of cut for the convex, flat, and triangular condyles and (2) a statistically significant difference between the condyle/fossa relationship of the concave condyles. The difference was significant at the p = 0.107 level for the anterior joint space (A), and at the p = 0.0671 level for the posterior joint space (B). The analysis of variance, in regard to the subject variable, demonstrated a statistically significant difference at the p = 0.0001 level for all condyles.

Lateral transcranial radiography of temporomandibular joints. Part II: Image formation studied with computerized tomography

Two series of radiographs of 15 subjects (30 TMJs overall) were compared in order to evaluate the reliability of OLTP carried out with different techniques: individualization of incidence through radioscopy (OLTP/fluo) or through the submental vertex method (OLTP/sub). Reasons for formation of noninterpretable radiographs (prevalently with OLTP/sub) and for diagnostic errors in judging condyle position were evaluated for each technique through a CT scanning study of the same patients. The reasons for the wide range of constancy of results found in OLTP/fluo are also discussed. Overall the study demonstrated reliability of the OLTP carried out with the technique of individualizing the incidence through fluoroscopy.

The effect of gingival fiberotomy on the rate of tooth movement

This study was designed to assess the gingival tissue resistance to remodeling in determining the rate of orthodontic tooth movement. Closed coil spring orthodontic appliances were stretched bilaterally between the first molars and incisors in the maxillary arches of 18 adult rats. The resistance of gingival tissues was eliminated around the randomly chosen first molars by a circumferential fiberotomy procedure. Movements of teeth were measured on submental vertex radiographs against the metallic implants that were placed in zygomatic processes. The data were analyzed by randomized block design analysis of variance. During the 30-day experimental period, the teeth that underwent the fiberotomy procedure moved faster (0.63 mm versus 0.51 mm, P < 0.05), indicating that the resistance of gingival tissues may be a rate-limiting factor in orthodontic tooth movement.

A combined tomographic-cephalometric analysis of the TMJ.

AbstractThe authors designed this analysis to serve as a tool for use in the study of growth and development of the craniomandibular articulation. It integrates an examination of the morphology and function of the temporomandibular joint with dento-skeletal characteristics according to pre-established cephalometric norms. The experimental sample consisted of 30 dental students with normal occlusions. Gnathologic principles, a tomographic study, cephalometric x-rays, submental vertex views, and temporomandibular joint space analysis were all correlated to provide a thorough and detailed approach to study of the joint.

The sphenoid sinus, the neglected nasal sinus.

O. E. Van Alyea stated that "The sphenoid sinus is the most neglected of the nasal sinuses." It is neglected by disease because of its location, by the physician because of its subtle symptoms when diseased, and the surgeon because of its inaccessability. An accurate knowledge and understanding of the anatomy of the area help the physician diagnose and manage problems in this area. Eleven cases are used to illustrate the wide spectrum of pathologic conditions in and about the sphenoid sinus. Only two of the patients were asymptomatic. All of the others had deep-seated, retrobulbar headaches. Eight of 11 patients had cranial nerve involvement. The optic nerve was involved in six cases. The abducens nerve was involved in five of 11 cases and the maxillary nerve in four of 11 cases. Initial roentgenographic examination must include lateral and submental vertex views. The newer techniques of angiography, polytomography, and computerized tomography aid in determining the extent of the pathologic condition and the treatment approach.