Dental and Medical Problems

Dent Med Probl
Impact Factor (IF 2023) – 2.7
Journal Citation Indicator (JCI 2023) - 1.06
Scopus CiteScore (2023) – 4.0 (CiteScore Tracker – 4.9)
Index Copernicus (ICV 2023) – 181.00
MNiSW – 70 pts
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – bimonthly


 

Download original text (EN)

Dental and Medical Problems

2016, vol. 53, nr 3, July-September, p. 320–331

doi: 10.17219/dmp/62979

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Reproducibility of Linear Measurements Performed with 3-D Cone Beam Computed Tomography: Scan Reconstructions in Region of Pterygomaxillary Junction

Reproduktywność pomiarów liniowych wykonywanych w obszarze połączenia szczękowego-skrzydłowego na podstawie rekonstrukcji otrzymanych dzięki badaniu CBCT

Marcin Jędrzejewski1,A,B,C,D, Tomasz Smektała2,A,B,C, Katarzyna Sporniak-Tutak2,A,E,F, Krzysztof Safranow3,C,E, Raphael Olszewski4,A,E,F

1 Department of Dental Surgery, Pomeranian Medical University, Szczecin, Poland

2 Department of Maxillofacial Surgery, Pomeranian Medical University, Szczecin, Poland

3 Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland

4 Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium

Abstract

Background. Pterygomaxillary dysjunction is the most dangerous part of Le Fort I osteotomy. Preoperative evaluation of the patient’s anatomy in 3D imaging software may help to choose an appropriate surgical approach and minimize the risk of the operation.
Objectives. The aim of this study was to evaluate the reproducibility of linear measurements performed at the pterygomaxillary junction using open source software.
Material and Methods. The study population consisted of 101 patients who underwent a CBCT examination for reasons independent of this study. Eight anatomical landmarks in the pterygomaxillary junction were pre-defined to measure the thickness and length of this structure. Linear measurements between the landmarks were performed in duplicate by two independent observers over 14 days. The data was evaluated using Netfabb Basic Studio (Netfabb Company, Parsberg, Germany). An analysis of variance (ANOVA) studied the influence of certain factors (side, observer, and repetition) on the accuracy of the measurements.
Results. The mean value of all the valid measurements was 2.76 mm for thickness and 16.71 mm for the length of the pterygomaxillary junction. ANOVA showed no inter-observer bias. None of the observers reported statistically significantly higher or lower values than the other observer (p > 0.05). The intra-observer reproducibility was better than the inter-observer reproducibility of the measurements. The intraand inter-observer reproducibility analyzed for log-transformed absolute values of differences between the measurements was very good (< 0.5 mm mean difference for linear values reconstructed from the log). The results were from a relatively large population and offered useful and reproducible measurements using open source software during the planning of orthognathic procedures.
Conclusion. The results confirmed the reproducibility of the measurements. This method may be used during the diagnostics and planning of Le Fort I osteotomy. We also propose further evaluation of open-source software programs. Their comparison may help standardize the planning of orthognathic procedures.

Key words

orthognathic surgery, Le Fort I osteotomy, pterygomaxillary separation, preoperative examination

Słowa kluczowe

chirurgia ortognatyczna, osteotomia szczęki typu Le Fort I, separacja szczękowo-skrzydłowa, badanie przedoperacyjne

References (23)

  1. Ow A., Cheung L.K.: Skeletal stability and complications of bilateral sagittal split osteotomies and mandibular distraction osteogenesis: An evidence-based review. J. Oral Maxillofac. Surg. 2009, 67, 2344–2353.
  2. Ruiz L.P., Lara J.C.: Facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible. Int. J. Oral Maxillofac. Surg. 2011, 40, 884–886.
  3. Chrcanovic B.R., Custódio A.L.: Optic, oculomotor, abducens, and facial nerve palsies after combined maxillary and mandibular osteotomy: case report. J. Oral Maxillofac. Surg. 2011, 69, e234–241.
  4. Rai K.K., Shivakumar H.R., Sonar M.D.: Transient facial nerve palsy following bilateral sagittal split ramus osteotomy for setback of the mandible: A review of incidence and management. J. Oral Maxillofac. Surg. 2008, 66, 373–378.
  5. Kanazawa T., Kuroyanagi N., Miyachi H., Ochiai S., Kamiya N., Nagao T., Shimozato K.: Factors predictive of pterygoid process fractures after pterygomaxillary separation without using osteotome in Le Fort I osteotomy. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2013, 115, 310–318.
  6. Nowak R.: Historical outline of orthognathic surgery. Dent. Med. Probl. 2014, 51, 131–135 [in Polish].
  7. Vallino L.: Speech, velopharyngeal function, and hearing before and after orthognathic surgery. J. Oral Maxillofac. Surg. 1990, 48, 1274–1281.
  8. Jędrzejewski M., Smektała T., Sporniak-Tutak K., Olszewski R.: Preoperative, intraoperative, and postoperative complications in orthognathic surgery: a systematic review. Clin. Oral Investig. 2015, 19, 969–977.
  9. Ueki K., Hashiba Y., Marukawa K., Nakagawa K., Okabe K., Yamamoto E.: Determining the anatomy of the descending palatine artery and pterygoid plates with computed tomography in Class III patients. J. Craniomaxillofac. Surg. 2009, 37, 469–473.
  10. Li K.K., Meara J.G., Alexander A. Jr.: Location of the descending palatine artery in relation to the Le Fort I osteotomy. J. Oral Maxillofac. Surg. 1996, 54, 822–827.
  11. Kim J.W., Chin B.R., Park H.S., Lee S.H., Kwon T.G.: Cranial nerve injury after Le Fort I osteotomy. Int. J. Oral Maxillofac. Surg. 2011, 40, 327–329.
  12. Chrcanovic B.R., Custodio A.L.: Optic, oculomotor, abduces, and facial nerve palsies after combined maxillary and mandibular osteotomy: Case report. J. Oral Maxillofac. Surg. 2011, 69, 234–241.
  13. Baddour H.M., Watson J., Erwin B.J.: Life-threatening hemorrhage from a Le Fort I osteotomy. J. Oral Maxillofac. Surg. 1982, 40, 117–124.
  14. Gaia B.F., Pinheiro L.R., Umetsubo O.S., Costa F.F., Cavalcanti M.G.: Validity of three-dimensional computed tomography measurements for Le Fort I osteotomy. Int. J. Oral Maxillofac. Surg. 2014, 43, 197–203.
  15. Gaia B.F., Pinheiro L.R., Umetsubo O.S., Costa F.F., Cavalcanti M.G.: Comparison of precision and accuracy of linear measurements performed by two different imaging software programs and obtained from 3D-CBCT images for Le Fort I osteotomy. Dentomaxillofac. Radiol. 2013, 42, 20120178.
  16. Apinhasmit W., Chompoopong S., Methathrathip D., Sangvichien S., Karuwanarint S.: Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais. Clin. Anat. 2005, 18, 323–329.
  17. Cheung L.K., Fung S.C., Li T., Samman N.: Posterior maxillary anatomy: Implications for Le Fort I osteotomy. Int. J. Oral Maxillofac. Surg. 1998, 27, 346–351.
  18. Gaia B.F., Pinheiro L.R., Umetsubo O.S., Santos Júnior O., Costa F.F., Cavalcanti M.G.: Accuracy and reliability of linear measurements using 3-dimensional computed tomographic imaging software for Le Fort I osteotomy. Br. J. Oral Maxillofac. Surg. 2014, 52, 258–263.
  19. Power G., Breckon J., Sherriff M., McDonald F.: Dolphin Imaging Software: An analysis of the accuracy of cephalometric digitization and orthognathic prediction. Int. J. Oral Maxillofac. Surg. 2005, 34, 619–626.
  20. Periago D.R., Scarfe W.C., Moshiri M., Scheetz J.P., Silveira A.M., Farman A.G.: Linear accuracy and reliability of cone beam CT derived 3-dimensional images constructed using an orthodontic volumetric rendering program. Angle Orthod. 2008, 78, 387–395.
  21. Ueki K., Hashiba Y., Marukawa K., Okabe K., Alam S., Nakagawa K., Yamamoto E.: Assesment of pterygomaxillary separation In Le Fort I osteotomy In class III patients. J. Oral Maxillofac. Surg. 2009, 67, 833–839.
  22. Nagasaka S., Fujimura T., Segoshi K.: Development of a non-radiographic cephalometric system. Eur. J. Orthod. 2003, 25, 77–85.
  23. Olszewski R., Tanesy O., Cosnard G., Zech F., Reychler H.: Reproducibility of osseous landmarks used for computed tomography based three-dimensional cephalometric analyses. J. Craniomaxillofac. Surg. 2010, 38, 214–221.
© Wroclaw Medical University