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Open AccessArticle

Computer-Aided Planning in Orthognathic Surgery: A Comparative Study with the Establishment of Burstone Analysis-Derived 3D Norms

1
Division of Craniofacial Orthodontics, Department of Dentistry, Chang Gung Memorial Hospital, Taoyuan City 333, Taiwan
2
Department of Plastic and Reconstructive Surgery, Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City 333, Taiwan
3
Image Lab and Craniofacial Research Center, Chang Gung Memorial Hospital, Taoyuan City 333, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2106; https://doi.org/10.3390/jcm8122106
Received: 20 October 2019 / Revised: 16 November 2019 / Accepted: 26 November 2019 / Published: 2 December 2019
Three-dimensional (3D) computer-aided simulation has revolutionized orthognathic surgery treatment, but scarce 3D cephalometric norms have been defined to date. The purposes of this study were to (1) establish a normative database of 3D Burstone cephalometric measurements for adult male and female Chinese in Taiwan, (2) compare this 3D norm dataset with the two-dimensional (2D) Burstone norms from Caucasian and Singaporean Chinese populations, and (3) apply these 3D norms to assess the outcome of a computer-aided simulation of orthognathic surgery. Three-dimensional Burstone cephalometric analysis was performed on 3D digital craniofacial image models generated from cone-beam computed tomography datasets of 60 adult Taiwanese Chinese individuals with normal occlusion and balanced facial profile. Three-dimensional Burstone analysis was performed on 3D image datasets from patients with skeletal Class III pattern (n = 30) with prior computer-aided simulation. Three-dimensional Burstone cephalometric measurements showed that Taiwanese Chinese males had significantly (p < 0.05) larger anterior and posterior facial heights, maxillary length, and mandibular ramus height than females, with no significant (p > 0.05) difference for facial soft-tissue parameters. The 3D norm dataset revealed Taiwanese Chinese-specific facial characteristics, with Taiwanese presenting (p < 0.05) a more convex profile, protrusive maxillary apical bases, protruding mandible, protruding upper and lower lips, and a shorter maxillary length and lower facial height than Caucasians. Taiwanese had significantly (p < 0.05) larger maxillary projection, vertical height ratio, lower face throat angle, nasolabial angle, and upper lip protrusion than Singaporean Chinese. No significant (p > 0.05) difference was observed between 3D norms and computer-aided simulation-derived 3D patient images for horizontal skeletal, vertical skeletal, and dental measurements, with the exception of two dental parameters (p < 0.05). This study contributes to literature by providing gender- and ethnic-specific 3D Burstone cephalometric norms, which can assist in the multidisciplinary-based delivery of orthodontic surgical care for Taiwanese Chinese individuals worldwide, including orthodontic management, computer-assisted simulation, and outcome assessment. View Full-Text
Keywords: three-dimensional norms; two-dimensional norms; Burstone analysis; orthognathic surgery; simulation; computer-aided simulation three-dimensional norms; two-dimensional norms; Burstone analysis; orthognathic surgery; simulation; computer-aided simulation
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Ho, C.-T.; Denadai, R.; Lai, H.-C.; Lo, L.-J.; Lin, H.-H. Computer-Aided Planning in Orthognathic Surgery: A Comparative Study with the Establishment of Burstone Analysis-Derived 3D Norms. J. Clin. Med. 2019, 8, 2106.

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