Search Results (17)

Background/Objectives: Craniovertebral junction (CVJ) stabilization alters complex anatomical relationships that may not be fully characterized by a single radiological parameter. This study evaluated the responsiveness of established CVJ measurements after stabilization and explored the observer reliability and postoperative behavior of separate cranial and caudal anterior atlantodental interval (AADI) measurements. Methods: This retrospective radiological case series included 26 patients who underwent CVJ stabilization between 2000 and 2022. Eleven parameters were measured on preoperative and immediate postoperative mid-sagittal computed tomography (CT) reconstructions by two independent observers, each completing two measurement sessions, with each observer blinded to the other observer’s measurements and to his own previous session. Reliability was evaluated using intraclass correlation coefficients (ICCs), and paired comparisons were adjusted using the Benjamini–Hochberg procedure. Results: Postoperative reductions were observed in odontoid distances from the Chamberlain (q = 0.019), McGregor (q = 0.040), and McRae lines (q = 0.019). Cranial AADI decreased from 5.66 ± 3.31 to 4.17 ± 2.44 mm (q = 0.009), and caudal AADI decreased from 4.81 ± 2.98 to 3.57 ± 2.32 mm (q = 0.019). However, the within-patient cranial–caudal difference score did not change significantly after stabilization (mean change, −0.25 mm; 95% CI, −0.96 to 0.47; p = 0.472; Cohen’s dz = −0.19). Intraobserver ICCs ranged from 0.880 to 0.987, while single-measure interobserver ICCs ranged from 0.784 to 0.899. Conclusions: Established craniometric distances and separate cranial and caudal AADI measurements demonstrated postoperative radiological changes with good-to-excellent observer reliability. In this cohort, segmented AADI and angular parameters showed different patterns of postoperative change; however, their relative responsiveness was not directly compared. Segmented AADI should currently be regarded as an exploratory radiological parameter, as its diagnostic thresholds, clinical validity, and association with patient outcomes have not yet been established. Full article

Background/Objective: Sex estimation from cranial remains is essential in forensic biological profile reconstruction, yet systematic comparisons of statistical classifiers under formally verified assumption conditions remain limited in Thai populations. This study aimed to develop and validate sex estimation models from craniofacial measurements in a Northeastern Thai skeletal sample using DFA, BLR, and SVM, and to examine whether distributional assumption violations influence classifier performance and generalizability under holdout validation. Methods: Eight linear craniometric parameters connecting five osteometric landmarks were measured in 300 adult skeletal specimens (150 males, 150 females) from the Unit of Human Bone Warehouse for Research, Khon Kaen University. Specimens were allocated into a training dataset (n = 200) and a holdout dataset (n = 100). Five multivariate model configurations were developed under direct-entry and stepwise parameter-entry strategies. Formal assumption diagnostics included Shapiro–Wilk normality testing, Levene’s test, Box’s M test, and variance inflation factor analysis. Results: All parameters demonstrated excellent interobserver reliability and significant sex-based differences (p < 0.01), with males recording larger mean values throughout. Apparent multivariate accuracy ranged from 78.0% to 85.5%. Holdout validation revealed consistent performance decline across all five configurations, with accuracy reductions of 3.0 to 9.5 percentage points and AUC reductions of 0.042 to 0.079. The stepwise DFA model showed the smallest overall accuracy decline, although this apparent stability reflected an uneven sex-specific trade-off, with a specificity decline offset by a sensitivity gain, while SVM and DFA direct-entry models showed the largest decline. Conclusions: Craniofacial measurements provide moderate discriminatory capacity for sex estimation in Northeastern Thai skeletal remains. Although univariate assumption violations were observed, DFA’s performance remained comparable to BLR and SVM under the present large, balanced sample; multivariate analysis or distributional assumption-free methods offer practical alternatives where violations are present. Apparent performance alone is insufficient to establish forensic reliability, and holdout validation should be regarded as a necessary component of sex estimation model development. Full article

Although extensively studied in humans, data on the middle cranial fossa foramina remain limited in dogs, despite their different skull morphology and high relevance to veterinary neurology, surgery and oncology. In this retrospective anatomic study, we aimed to fill this gap by presenting the morphometric data of these foramina in domestic dogs of different breeds, ages, body weights, and skull sizes. The study used CBCT images of 40 dogs. Dogs were divided into three groups (small, medium, and large), regardless of sex, body weight, and breed, using neurocranium length. Then, morphological and morphometric analyses of the foramina were performed. The neurocranium length of each group differed significantly from the others (p < 0.001). In each group, the orbital fissure and round and oval foramina were bilaterally located rostrally to caudally and were of similar size (p > 0.05). While the orbital fissure was a canal in 80% of dogs, in dogs with medium and large skull sizes (17.5%), the spinous foramen showed variation, becoming both a foramen and a canal. The opening sizes increased along with the skull size (p < 0.001); the widest opening was the orbital fissure, and the narrowest opening (except for the spinous foramen) was the oval foramen. The findings may guide skull base surgeries, regional anesthesia, and the diagnosis of cranial nerve dysfunctions. Furthermore, a classification based on neurocranial length is anticipated to provide more objective craniometric measurements in animals with diverse head types and body weights. Full article

Background/Objectives: Mandibular asymmetry is a common morphological alteration in orthodontics and orthognathic surgery, generally diagnosed with panoramic radiographs despite their limitations. Automated processing systems offer a promising alternative for improving its detection and analysis. The aim of this study was to develop a pilot computational model to detect and measure mandibular asymmetry in the body and ramus by analyzing anatomical distances in digital panoramic radiographs of adults. Methods: This was a descriptive observational pilot study, carried out on 30 digital panoramic radiographs of young adult patients (15 men, 15 women). Three craniometric points (Condylion, Gonion and Gnathion) were used as references landmarks. An algorithm was implemented in Python^® (v3.12) with OpenCV to extract anatomical coordinates and calculate Euclidean distances (Go-Gn, Co-Go) from pixels to millimeters. Data were statistically analyzed in SPSS (v23.0) using normality tests, paired t-tests, Wilcoxon tests, and Mann–Whitney U tests (p < 0.05). Results: No significant differences were observed in mandibular lengths by sex, with men having greater lengths in both the body (80.63 mm vs. 73.86 mm) and the ramus (55.82 mm vs. 49.15 mm). In addition, significant differences were found in total mandibular ramus measurements (p = 0.023). A classification of asymmetry by severity was proposed (mild: ≤3 mm, moderate: 3–6 mm, severe: >6 mm), with mild asymmetries being the most frequently found. The model showed reliable processing capacity. Conclusions: This pilot study shows the feasibility of using Python for automated measurement of mandibular asymmetry in panoramic radiographs and highlights its future potential for neural network integration and diagnostic-epidemiological use. Full article

Background and Objectives: the mandibular foramen is an essential anatomic landmark in performing various dental and surgical procedures, including inferior alveolar nerve block (IANB). However, its position may vary based on the individual morpho-functional features of the skull and face. This study aims to conduct a personalized assessment of the location of the mandibular foramen in various shapes of skulls, faces, and mandibles. Materials and Methods: this anatomic morphometric cross-sectional study was performed using one hundred and six (n = 106) certified human cadaver heads of both sexes. The cranial index (CI) and Izard’s facial index (FI) were calculated, the linear anatomic parameters of the skull and mandible were measured, the location of the mandibular foramen was identified, and the shapes of the skulls and mandibles were determined. Quantitative statistical data were obtained based on the location of the mandibular foramen, considering different shapes of skulls and faces. Results: there is a significant correlation between the location of the mandibular foramen, the high lengthy index (HLI) of the mandible, and the longitudinal latitude index (LLI) of the mandibular process. Conclusions: personalized assessment of the mandibular foramen based on a comprehensive analysis of craniometric characteristics can contribute to preventing unwanted dental and surgical complications, such as inferior alveolar nerve damage. Full article

This study employs Principal Component Analysis to examine cranial measurements from both extant and fossil specimens spanning 38 species and comprising over 300 individuals within the subfamily Cervinae. Our findings elucidate craniometric distinctions among cervids characterized by varying body sizes and certain evolutionary adaptations. While our results generally corroborate previous assertions regarding the limited craniometric variability among plesiometacarpal deer, they also unveil specific cranial adaptations within certain genera and species. The Principal Component Analysis of craniometric data revealed that giant and large-sized deer display significantly broader ecomorphological diversity in cranial shape compared to small-sized deer. Secondly, small-sized deer exhibit greater uniformity in their cranial shape, appearing densely clustered on the factorial map. Thus, we conclude that body size imposes ecological constraints, limiting the available niches due to eco-physiological factors. This study demonstrates that endemic insular deer do not evolve consistent craniometric features attributable to insular isolation, while the cranial proportions of medium-to-small-sized deer delineate a ubiquitous morphological archetype characteristic of numerous cervid taxa spanning diverse phylogenetic lineages and sharing comparable body sizes. This group of “Dama-like” deer, characterized by similar body size, metabolic rates, ecological needs, and cranial morphometry, is referred to here as the fundamental eco-physiological type, typical of warm regions within the Palearctic and Oriental biogeographic realms. Full article

AI is included in a lot of different systems. In facial surgery, there are some AI-based software programs oriented to diagnosis in facial surgery. This study aims to evaluate the capacity and training of models for diagnosis of dentofacial deformities in class II and class III patients using artificial intelligence and the potential use for indicating orthognathic surgery. The search strategy is from 1943 to April 2024 in PubMed, Embase, Scopus, Lilacs, and Web of Science. Studies that used imaging to assess anatomical structures, airway volume, and craniofacial positions using the AI algorithm in the human population were included. The methodological quality of the studies was assessed using the Effective Public Health Practice Project instrument. The systematic search identified 697 articles. Eight studies were obtained for descriptive analysis after exclusion according to our inclusion and exclusion criteria. All studies were retrospective in design. A total of 5552 subjects with an age range between 14.7 and 56 years were obtained; 2474 (44.56%) subjects were male, and 3078 (55.43%) were female. Six studies were analyzed using 2D imaging and obtained highly accurate results in diagnosing skeletal features and determining the need for orthognathic surgery, and two studies used 3D imaging for measurement and diagnosis. Limitations of the studies such as age, diagnosis in facial deformity, and the included variables were observed. Concerning the overall analysis bias, six studies were at moderate risk due to weak study designs, while two were at high risk of bias. We can conclude that, with the few articles included, using AI-based software allows for some craniometric recognition and measurements to determine the diagnosis of facial deformities using mainly 2D analysis. However, it is necessary to perform studies based on three-dimensional images, increase the sample size, and train models in different populations to ensure accuracy of AI applications in this field. After that, the models can be trained for dentofacial diagnosis Full article

Since human skulls may be used as a benchmark of the evolutionary process, the aim of the present study is to assess the cranial affinity of Sardinian populations from different chronological periods, with a standard index to evaluate its benefits for orthodontic purposes. Craniometric variables from four throughout cephalograms (anterior and lateral) of 72 units from historical Sardinian populations, two prehistoric, one medieval, and one modern were compared to the Bolton standard. A one-way analysis of variance (ANOVA) was performed for means comparison. A hierarchical cluster analysis and the bootstrap technique for the reliability of the dendrogram were used. Length data revealed statistically significant results (p < 0.01). Usually, the medieval population showed higher mean values compared to the other groups; the prehistoric population presented the highest value of Euclidean distance when compared to the medieval; the modern showed no affinity to prehistoric populations nor to the Bolton standard. The length and the breadth of the neurocranium, maxillary–alveolar length, orbital height, maximum cranial breadth, and external palate breadth contributed to the dissimilarity among populations. The dissimilarities in the craniometric measurements of Sardinian populations are remarkable. Therefore, the main outcome showed that the craniometric standards of the Bolton standard are not applicable across the Sardinian population. Full article

Introduction: Forensic identification practice requires a multitude of methods for positive identification, among which the facial reconstruction occupies a high place. For this to be done in the best way possible, it is mandatory that each population have their own database regarding soft tissue thickness. Objective: The present research is focused on creating such a database for the Romanian adult population and on exploring the statistical distribution and correlation of craniometric landmarks, overall, and in groups defined according to sex and weight categories. This might provide support in estimating the values of missing landmarks or other variables (e.g., age, sex) for unidentified bodies. Methods: Twelve craniometric landmarks were measured on 100 cadavers less than 24 h after death. Results and discussions: Of the 12 anatomical landmarks, only one appears to manifest statistically significant differences between sexes, and seven landmarks appear to vary significantly among the weight categories. Additionally, some evidence of interpopulation differences in the average soft tissue thicknesses were observed by the comparison of these data with similar studies from Caucasian groups with different geographic origin. Additionally, correlations between facial landmarks were examined, overall and between sexes. Full article

The diversity of domestic pig breeds and their hybridization increases the variety of phenotypes expressed in hybrids. The aim of this study was to quantify the differences of cranial morphologies between local Lithuanian Indigenous Wattle pigs and theirhybrids with wild boar. A total of sixteen craniometric measurements were performed on the lateral, ventral and dorsal sides of 71 skulls of Lithuanian Indigenous Wattle pigs and their hybrids, including 1/4 wild boar (WB), 1/2 wild boar and 3/4 wild boar genotypes. The weight of the skull was affected by the genotype, live weight and sex of the animal. The size of the skull, particularly related to skull length parameters, increased consistently with the increase of the wild boar proportion in the hybrids. However, the Sus scrofa genotype did not affect the skull height. Clear discrimination was possible between the local Lithuanian breed pigs and their hybrids with different proportions of wild boar and between individual groups of hybrids. The most correct classification was determined on the basis of the overall and length parameters of the crania. This could contribute to better management and utilization of hybrids. Full article

The suitability of CT and 3D scanners for craniometric proposes was tested using digital calipers when determining linear measurements, and a measuring cylinder was used for the accuracy of 3D printing of deer antlers obtained by the CT and 3D scanners. The resolution of digitized objects from a 3D scanner ranged from 0.008 mm to 0.122 mm. For mandibular dimensions, a positive deviation (p < 0.01) from the primary control measurement was recorded. The average antler volume measured with the cylinder was 60.47 cm³ at the first measurement, in the case of the CT scanner 61.62 cm³ and for the 3D scanner 64.76 cm³—both technologies exhibit a positive deviation from the primary measurement. Precise sensing and measurements can be used to evaluate the quality and evolution of wildlife populations, create digital museum collections, or to examine in detail certain traits such as antler and horn development or dentition. Full article

This study aimed to evaluate and measure the occurrence of jaw and palate asymmetry based on 3D-printed stereolithographic models of edentulous elderly people. The analyses were performed on 3D models of the jaws, which were printed using the data (CT) obtained from the CBCT center. The control group consisted of 10 modern adult skulls (7 male and 3 female skulls) owned by the Department of Anthropology of the Wrocław University of Environmental and Life Sciences. The small size of the studied groups did not allow for the performance of the analysis indicating the form of the observed morphological asymmetry—it was impossible to differentiate to indicate whether the examined features showed directional or fluctuating asymmetry. However, it was possible to determine the direction of the morphological asymmetry of the analyzed features. Both in the test group and the control group, it was a right-sided asymmetry. The analysis of the significance of differences in mean values of the asymmetry index showed that the intensity of asymmetry of the anterior part of the superior alveolar arch was significantly greater in the test group. The severity of the asymmetry of the lateral part of the alveolar arch in the tested groups did not differ significantly. The authors concluded that adequate maxillary height does not only influence proper dental prosthesis adhesion but also corresponds with a potential source for correct dental implant placement. We also concluded that the vertical height of the edentulous alveolar process of the mandible is important for adequate prosthesis fixing. In some cases, the bone atrophy and the bone itself are asymmetrical, so planning a prosthesis might be challenging. The adequate placement of implants should include the symmetry of jaw bones because of future masticatory force impact on the bone and the entire masticatory system, including the temporomandibular joint. Full article

Background: Naso-orbito-ethmoido-maxillary (NOEM) fractures are usually the result of a high or moderate intensity impact to the upper midface. These types of fractures are difficult to treat and are frequently misdiagnosed. Craniometric analysis can be of real aid in the treatment of NOEM complex fractures by establishing midfacial proportions. Aim: This study aims to establish the distances between selected anthropometric points and midfacial proportions found in the adult Caucasian population and to determine if any differences exist between genders. Methodology: Measurements between anthropometric points, nasion (N), dacryon (D), infraorbital foramen (IOF), frontomalare orbitale (FMO), rhinion (Rhi) and porion (Po), were made on 3D models obtained using patients’ CT exams. Results: Significant differences were found between genders for the orbital dimensions represented by N–FMO (p = 0.000), N–IOF (p = 0.000), Rhi–FMO (p = 0.000), Rhi–IOF (p = 0.000), nose bridge width N–D (p = 0.001), Rhi–D (p = 0.016), D–D (p = 0.038) and the projection of the nose evaluated by Rhi–Po (p = 0.000), N–Po (p = 0.000), while a t-test showed that there are no significant differences between males and females for the N–Rhi (p = 0.254). Conclusions: The values of these measurements can be utilized during skeletal reconstruction after NOEM fractures, especially for bilateral comminuted fractures where no points of comparison are available. Full article

Background: Mandibular Advancement Devices (MADs), inserted in non-surgical treatments for obstructive sleep apnea and hypopnea syndrome (OSAHS), are used intra-orally during the sleep period, with the aim of promoting mandibular protrusion. The aim of the study is to analyze the changes in the upper airway after the use of an MAD in the treatment of OSAHS. Methods: 60 patients diagnosed with OSAHS, as established by the Sleep Medicine Service, underwent treatment with the Silensor SL device at the Stomatology Service of the University Hospital Center of Coimbra, from January 2018 to January 2019. All patients completed two polysomnographies and two lateral teleradiographies: one before starting treatment (T0) and one after 1 year of treatment (T1). In the lateral teleradiography performed after one year of treatment, the patient had the MAD placed intra-orally. The linear measurements of the airspace proposed by the Arnett/Gunson FAB Surgery cephalometric analysis were measured at four craniometric points: A, MCI, B, Pog. Results: The results demonstrate an anteroposterior airway enlargement in two of the four points studied with the MAD placed intra-orally (B and Pog point). The greatest average increase is observed at point Pog (3 mm), followed by B (1 mm), and finally, point A (0.6 mm). Conclusions: This study proved that there is an improvement in anteroposterior measurements at various points in the upper airways after treatment with MAD. Full article

Surgical removal of mandibular third molars is associated with non-infectious postoperative complications, including pain, swelling, trismus. Intraoral drains are noteworthy because of their ease of application, availability, and effectiveness. This study aimed to evaluate the use of latex and calcium–sodium alginate mouth flat drains on the severity of postoperative complications such as pain, trismus, and edema after surgical removal of mandibular third molars. Ninety patients who underwent surgical removal of wisdom teeth were studied. The patients were divided into three groups. Group A—with a latex flat drain, group B—with a sodium–calcium alginate (Kaltostat) flat drain, and group C—with a wound closed with knotted sutures. Patients were assessed for pain on a VAS scale every day from surgery to postoperative day 7. Before the procedure and on postoperative days 1, 2, and 7, the pain level, edema, and trismus were measured, respectively. Intraoral drainage with a flat drain after mandibular third molar removal does not significantly reduce pain, as measured by the VAS scale, or postoperative swelling, as measured by lines between craniometric points. Intraoral drainage with a latex drain after mandibular third molar removal does not significantly reduce trismus, while intraoral drainage with a calcium–sodium alginate drainage bag significantly increases trismus. Full article