Landmark Identification Error in Posteroanterior Cephalometric Radiography

Leonardi, Rosalia; Annunziata, Alberto; Caltabiano, M

doi:10.2319/0003-3219(2008)078[0761:lieipc]2.0.co;2

Cited by 61 publications

(62 citation statements)

References 10 publications

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“…28 Therefore, no clinical evidence is available on human beings. It has been stated that palatal expansion ''disarticulates'' the maxilla and initiates cellular responses at the circumaxillary sutures.…”

Section: Discussionmentioning

confidence: 99%

Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion

Leonardi¹,

Sicurezza²,

Cutrera³

et al. 2011

The Angle Orthodontist

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Objective: To test the null hypothesis that circumaxillary sutures do not show bony displacement in response to rapid maxillary expansion (RME) therapy. Materials and Methods: Subjects consisted of eight growing patients (two male and six female) with Angle Class I malocclusion, bilateral posterior crossbite, transverse maxillary deficiency, deep palatal vault, and dental crowding at the start of the treatment. A Hyrax palatal expander was used for each patient, and activation protocol required the screw to be turned three times per day (0.25 mm per turn) for an average of 18 days for all subjects. Multislice computed tomography (CT) scans were performed before rapid palatal expansion (time T0) and again at the end of the active expansion phase (time T1) without removing the expander. Measurements were carried out directly on the CT image using the OsiriX Imaging software program. Data were analyzed statistically by using the Wilcoxon signed rank test. Results: All linear measurements showed an increase between T0 and T1 and RME determined a widening of suture; however, sutures far from the maxilla showed a smaller degree of disarticulation. Conclusions: The hypothesis is rejected. Early treatment with RME produced a significant bony displacement by circumaxillary suture opening. The amount of changes of sutures depends on different factors relating to the subjects and varies between different sutures, showing that sutures that articulate directly with the maxilla face a greater influence by the RME compared with those located further away. (Angle Orthod. 2011;81:36-41.)

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Section: Discussionmentioning

confidence: 99%

Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion

Leonardi¹,

Sicurezza²,

Cutrera³

et al. 2011

The Angle Orthodontist

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“…Although cephalograms enable the measurement of basal bone widths at the jugal points and antegonial notches, they provide a poor representation of alveolar bone width, especially in the mandible 56. Additionally, conventional two-dimensional radiographs have some limitations, including image magnification and projection errors, due to the rotation of the head 78. For transverse dental analysis, casts have been used to measure intercanine and intermolar widths between the cusp tips or the fossae.…”

Section: Introductionmentioning

confidence: 99%

Maxillomandibular arch width differences at estimated centers of resistance: Comparison between normal occlusion and skeletal Class III malocclusion

et al. 2017

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ObjectiveTo evaluate the differences in maxillomandibular transverse measurements at either the crown or the estimated center of resistance (CR), and to compare values between normal occlusion and Class III malocclusion groups.MethodsDental casts and computed tomography (CT) data from 30 individuals with normal occlusion and 30 with skeletal Class III malocclusions were evaluated. Using the casts, dental arch widths (DAWs) were measured from the cusp tips, and basal arch widths (BAWs-cast) were measured as the distance between the points at the mucogingival junction adjacent to the respective cusp tips. The BAWs determined from CT (BAWs-CT) images were measured from the estimated CRs of the teeth.ResultsNone of the DAW measurements or maxillomandibular DAW differences showed statistically significant intergroup differences. In contrast, the maxillary BAWs-CT and BAWs-cast were lesser in the Class III malocclusion group than in the normal occlusion group. The mandibular BAWs-CT were significantly greater in the Class III malocclusion group than in the normal occlusion group. Moreover, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements.ConclusionsThe maxillomandibular DAW differences showed no significant intergroup differences. In contrast, the maxillomandibular BAW differences on both CT and cast showed significant intergroup differences in all transverse measurements. The maxillomandibular BAW differences at the estimated CRs, measured using CT or casts, can reveal underlying transverse maxillary basal arch deficiencies in patients with skeletal Class III malocclusions.

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“…However, the four patterns of asymmetry are almost always discernible by visual observation, which helps decrease uncertainty as to where landmarks are located. There have been limited reports on landmark identification on PA cephalograms 45 , but a recent report (Ulkur et al, 2016 46 ) estimates rater reliability to be consistently high at 0.9 to 0.95, or above for most points. Our intrarater reliability had an R 2 value of 0.98, and is similar to Ulkur.…”

Section: Discussionmentioning

confidence: 99%

ENPP1 and ESR1 genotypes associated with subclassifications of craniofacial asymmetry and severity of temporomandibular disorders

Chung

Richards

Nicot

et al. 2017

American Journal of Orthodontics and Dentofacial Orthopedics

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Introduction We investigated if ACTN3, ENPP1, ESR1, PITX1 and PITX2 genes which contribute to sagittal and vertical malocclusion also contribute to facial asymmetries and TMD before and after orthodontic and orthognathic surgery treatment. Methods One hundred seventy four dentofacial deformity patients were diagnosed as symmetric or subdivided into four asymmetric groups according to PA cephalometric measurements. TMD exam diagnosis and Jaw Pain and Function-(JPF) questionnaires assessed presence and severity of TMD. Results Fifty two % of patients were symmetric and forty eight % asymmetric. The asymmetry classification demonstrated significant cephalometric differences between symmetric and asymmetric groups, and across the four asymmetric subtypes: Group 1 - mandibular body asymmetry, Group 2 - ramus asymmetry, Group 3 - atypical asymmetry and Group 4 - “C-shaped” asymmetry. ENPP1 SNP-rs6569759 associated with asymmetry Group 1(p=0.004), and rs858339 with asymmetry Group 3 (p=0.002). ESR1 SNP-rs164321 associated with asymmetry Group 4 (p=0.019). These results are confirmed by Principal Component Analysis (PCA) that showed three principal components explaining almost 80% of the variation seen in the studied group. PC1 and PC2 were associated with ESR1 SNP-rs3020318 (p<0.05). Diagnoses of disc displacement with reduction, masticatory muscle myalgia and arthralgia were highly prevalent in the asymmetry groups and all had strong statistical association to ENPP1 rs858339. The average JPF scores for asymmetric subjects before surgery (JPF=7), were significantly higher than symmetric subjects (JPF=2). Patients with asymmetry Group 3 reported the highest preoperative JPF scores and Group 2 and 3 were most likely to be cured of TMD one year after treatment. Conclusions PA cephalometrics can classify asymmetry into distinct groups; identify probability of TMD and genotype associations. Orthodontic and orthognathic treatment of facial asymmetry is very effective at eliminating TMD in most patients.

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Landmark Identification Error in Posteroanterior Cephalometric Radiography

Cited by 61 publications

References 10 publications

Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion

Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion

Maxillomandibular arch width differences at estimated centers of resistance: Comparison between normal occlusion and skeletal Class III malocclusion

ENPP1 and ESR1 genotypes associated with subclassifications of craniofacial asymmetry and severity of temporomandibular disorders

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