This prospective longitudinal study assessed the 3D soft tissue changes following mandibular advancement surgery. Cranial base registration was performed for superimposition of virtual models built from cone beam computed tomography (CBCT) volumes. Displacements at the soft and hard tissue chin (n=20), lower incisors and lower lip (n=21) were computed for presurgery to splint removal (4-6 week surgical outcome), presurgery to 1 year postsurgery (1-year surgical outcome), and splint removal to 1 year postsurgery (postsurgical adaptation). Qualitative evaluations of color maps illustrated the surgical changes and postsurgical adaptations, but only the lower lip showed statistically significant postsurgical adaptations. Soft and hard tissue chin changes were significantly correlated for each of the intervals evaluated: presurgery to splint removal (r=0.92), presurgery to 1 year postsurgery (r=0.86), and splint removal to 1 year postsurgery (r=0.77). A statistically significant correlation between lower incisor and lower lip was found only between presurgery and 1 year postsurgery (r=0.55). At 1 year after surgery, 31% of the lower lip changes were explained by changes in the lower incisor position while 73% of the soft tissue chin changes were explained by the hard chin. This study suggests that 3D soft tissue response to mandibular advancement surgery is markedly variable.

Purpose-To evaluate the association of 3-dimensional changes in the position of the condyles, rami, and chin at splint removal and 1 year after mandibular advancement surgery.Patients and Methods-This prospective observational study used preoperative and postoperative scans of 27 subjects presenting with a skeletal Class II jaw relationship with a normal or deep overbite. An automatic technique of cranial base superimposition was used to assess the positional and/or remodeling changes in the anatomic regions of interest. The displacements were visually displayed and quantified using 3-dimensional color maps. The positive and negative values of surface distances in the color maps indicated the direction of the displacements. Pearson correlation coefficients and a linear model for correlated data were used to evaluate the association between the regional displacements.Results-The postoperative adaptations in the chin position between splint removal and 1 year after surgery were significantly negatively correlated with changes in the borders of the posterior ramus (left, r = −0.73, P ≤ .0001; and right, r = −0.68, P = .00) and the condyles (left, r = −0.53, P = .01; and right, r = −0.46, P = .02), indicating that these structures tended to be displaced in the same direction. Even though the mean condylar displacement with surgery was less than 1 mm, individual displacements greater than 2 mm with surgery were observed for 24% of the condyles. The condylar displacements were maintained at 1 year after surgery for 17% of the condyles.Conclusions-The surface distance displacements indicated that the postoperative adaptations at different anatomic regions were significantly related.Although mandibular advancement surgery is considered a highly stable procedure,1 , 2 postoperative changes, such as rotation, transverse condylar displacements during surgery, 3 -5 and subsequent long-term condylar resorption have been suggested as factors leading to sagittal relapse and anterior bite opening.6 -8 Therefore, the postoperative instability of bilateral sagittal split ramus osteotomy due to displacement of the condyle from its seated position in the glenoid fossa in the 3 planes of space remains an area of concern.9 , 10Recent assessments of 3-dimensional (3D) skeletal changes 1 year after mandibular advancement surgery have shown individual variability in postoperative adaptations, with a greater than 2-mm relapse of the chin position in 28% of the patients, with additional advancement of the chin position in 20% of the patients.11 The use of cone beam computed tomography (CBCT) and 3D superimposition tools now allow assessment of the relationships of the surface adaptations among the dental, skeletal, and soft tissue components that was not possible with 2-dimensional landmark linear or angular measures. These methods have the potential to highlight the associations between the structural changes and the stability of surgical correction.12 , 13The present study investigated whether surface distance displacements with...

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Our data suggest that the growth rate of PAs are influenced by various patient- and tumor-specific characteristics including the age and sex of the patient, the specific subtype of PA, its hormonal activity, its immunohistochemical profile including the mindbomb homolog 1 labeling index status, and its preponderance for different growth directions relative to the pituitary fossa. Furthermore, the pre- and postoperative PA growth rates were correlated, suggesting that postoperative PA growth rates can be predicted, in part, by preoperative growth rates, thus better informing postoperative outcome.

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Introduction: The literature reports the association of external root resorption (ERR) with orthodontic movement. In cases of premolars extractions, orthodontic movement of anterior teeth is usually quite expressive, which are precisely the most susceptible teeth to suffer from ERR. Objective: The aim of this study was to assess the root morphology of maxillary canines and incisors in patients submitted to four premolar extraction and orthodontic retraction of the anterior teeth, by means of 3D surface models superimposition and mapping. Methods: The sample consisted of six adult patients, five female and one male, with a mean age of 23.5 ± 6.5 years, who underwent orthodontic treatment. All patients presented bimaxillary dental protrusion, with indication of maxillary and mandibular first premolar extractions, followed by the retraction of anterior teeth and space closure. Cone beam CT scans were performed before the beginning of the treatment (T0) and right after space closure (T1). 3D models were built at both times and superimposed to identify the root changes for the given period. Results: All average differences were close to zero and, even when evaluating the extreme values, the observed changes were always smaller than the accuracy of the CBCT. Conclusion: A mild resorption trend was observed, although it was not clinically significant, with values lower than the tomography accuracy.

Objective: The present study aimed to evaluate the accuracy of 3D facial soft tissue virtual models produced by two photogrammetry softwares (AgiSoft Photoscan and 3DF Zephyr Free), when compared to those created by cone beam computed tomography (CBCT). Methods: Ten patients were submitted to two sequences of photographs performed with a DSLR camera (with and without the aid of a ring flash) and CBCT scans. Each photo series for each patient was processed with the softwares, and at the end, five models of each patient were generated: 1) CBCT, 2) AAL (Agisoft Ambient Light), 3) AFL (Agisoft Flash Light), 4) ZAL (Zephyr Ambient Light), and 5) ZFL (Zephyr Flash Light). Color coded maps and root-mean-square (RMS) distances were used to compare the photogrammetry models to the CBCT ones. Results: One sample t-test showed significant differences between all methods versus CBCT. The worst results were seen in the ZAL group (discrepancies up to 5.17mm), while the best results were produced by AAL group (discrepancies up to 2.11mm). Conclusions: It can be concluded that this type of virtual facial models are reasonably accurate, although not perfect, and considering its lower biological and financial cost, they may play an important role in specific situations.

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