A new three-dimensional cephalometric analysis for treatment and retention outcome evaluation of double jaw orthognathic surgery

Publikation: KonferencebidragKonferenceabstrakt til konferenceForskning

  • Omar Mashaly
  • Cécile Leroy
  • ,
  • Janne Ingerslev, Department of Oral and Maxillofacial Surgery, Hospital of South Western Denmark, Esbjerg, DENMARK, Danmark
  • Jens Jørgen Thorn, Department of Oral and Maxillofacial Surgery, Hospital of South Western Denmark, Esbjerg, DENMARK, Danmark
  • Else Marie Pinholt, Institut for Regional Sundhedsforskning, Syddansk Universitet, Danmark
  • Marie Cornelis
  • Paolo Maria Cattaneo
Objective: To develop and validate a comprehensive skeletal landmark-based 3D radiographic analysis of patients who have undergone combined orthodontic / orthognathic surgical treatments. The main goal is to provide a thorough cephalometric 3D evaluation in the following three domains: 1) description of skeletal orientation / deviation after orthodontic decompensation, 2) presentation of the achieved surgical movements and 3) long term assessment of the stability of the surgical outcomes. Methods: This methodological study was based on retrospective material consisting of CBCT scans of 10 randomly selected adult patients with mean age of 24 ±3 years (range,19 -50 years) who had undergone double jaw orthognathic surgery (segmental Le Fort I 3 pieces and BSSO). CBCTs were taken at three time points: 1 week before surgery (T1); 2 weeks after surgery (T2); and at least 2 years after surgery (T3).Twenty bilateral and seven unilateral landmarks were identified three-dimensionally in order to construct different reference planes. Sixty-six outcome measures were proposed, aiming to describe the locus of each jaw segment from different perspectives: 1) linear and angular measurements describing the segments positions in the three planes of space, 2) angular measurements demonstrating the segments spatial positions and movements in the form of pitch, yaw, and roll. All points placements and thus the measurements were repeated twice by one operator and independently performed once by another operator. After checking for normal distribution of the data, intra- and inter-class correlation coefficient (ICC) were calculated, and paired t-tests were used to determine the positional changes of the osteotomized segments at the three different time points. Results: Fourty-two (64%) of the sixty-six proposed outcome measures showed excellent intra- and inter-rater reliability (ICC >0.90). The mandibular outcome measures with poorest ICC were mainly describing the proximal segments roll and the distal segment yaw and roll movements. Likewise, the maxillary posterior segment transverse, yaw and roll measurements scored the lowest. The paired t-test confirmed the expected surgical movements of the osteotomized segments, independently from the type of surgery performed, and the long term stability of the orthognathic surgical outcomes could be assessed. Conclusion: Landmark-based 3D cephalometric analysis offers reproducible outcome measures, when consistent and strict protocols were followed for landmarks selection and definition as well for operator training and calibration.
StatusUdgivet - 2018
BegivenhedThe 6th Mediterranean Orthodontic Congress - Sheraton Montazah Hotel, Alexandra, Egypten
Varighed: 26 okt. 201828 okt. 2018


KonferenceThe 6th Mediterranean Orthodontic Congress
LokationSheraton Montazah Hotel

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