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Accuracy of two-dimensional pharyngeal airway space prediction for bimaxillary orthognathic surgery

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Abstract

Purpose

The aim of this retrospective study was to evaluate the accuracy of two-dimensional (2D) virtual surgical planning (VSP) of pharyngeal airway space (PAS) in patients submitted to bimaxillary orthognathic surgery.

Methods

This study was conducted with lateral cephalograms acquired through cone-beam computed tomography records of 33 patients, divided into group 1—patients submitted to maxillary advancement and mandibular setback (n = 17) and group 2—patients submitted to maxillomandibular advancement (n = 16). Records were taken 1 to 2 months prior to surgery, which was used to perform the 2D VSP (Tp), and 6 to 8 months after surgery (T1). In Dolphin Imaging software, the anteroposterior size of the PAS was calculated at the level of four craniometric points: A, occlusal plane (Mx), B, and pogonion (Pog). Two previously calibrated examiners performed these measurements. Statistical analyses were conducted using Kendall and t tests at a 5% level of significance.

Results

There was a concordance between the two examiners at all points and times. In group 1, points A and B have statistically significant differences between the PAS measurements performed in Tp and T1, while in group 2, none of the PAS points showed statistically significant differences when comparing Tp to T1.

Conclusions

2D computer-based cephalometric prediction in Dolphin Imaging software offers a good orientation to professionals during the surgical procedure of bimaxillary surgeries since its use is considered clinically relevant in daily practice.

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References

  1. Castro-Silva L, Monnazzi MS, Spin-Neto R, Moraes M, Miranda S, Real Gabrielli MF, Pereira-Filho VA (2015) Cone-beam evaluation of pharyngeal airway space in class I, II, and III patients. Oral Surg Oral Med Oral Pathol Oral Radiol 120:679–683

    Article  PubMed  Google Scholar 

  2. Aboul-Hosn Centenero S, Hernández-Alfaro F (2012) 3D planning in orthognathic surgery: CAD/CAM surgical splints and prediction of the soft and hard tissues results-our experience in 16 cases. J Craniomaxillofac Surg 40:162–168

    Article  PubMed  Google Scholar 

  3. Kolokitha OE, Topouzelis N (2011) Cephalometric methods of prediction in orthognathic surgery. J Maxillofac Oral Surg 10:236–245

    Article  PubMed  PubMed Central  Google Scholar 

  4. Stokbro K, Aagaard E, Torkov P, Bell RB, Thygesen T (2014) Virtual planning in orthognathic surgery. Int J Oral Maxillofac Surg 43:957–965

    Article  PubMed  CAS  Google Scholar 

  5. Mazzoni S, Badiali G, Lancellotti L, Babbi L, Bianchi A, Marchetti C (2010) Simulation-guided navigation: a new approach to improve intraoperative three-dimensional reproducibility during orthognathic surgery. J Craniofac Surg 21:1698–1705

    Article  PubMed  Google Scholar 

  6. Baker SB, Goldstein JA, Seruya M (2012) Outcomes in computer-assisted surgical simulation for orthognathic surgery. J Craniofac Surg 23:509–513

    Article  PubMed  Google Scholar 

  7. Xia JJ, Shevchenko L, Gateno J, Teichgraeber JF, Taylor TD, Lasky RE, English JD, Kau CH, McGrory KR (2011) Outcome study of computer-aided surgical simulation in the treatment of patients with craniomaxillofacial deformities. J Oral Maxillofac Surg 69:2014–2024

    Article  PubMed  PubMed Central  Google Scholar 

  8. Brunetto DP, Velasco L, Koerich L, Araújo MT (2014) Prediction of 3-dimensional pharyngeal airway changes after orthognathic surgery: a preliminary study. Am J Orthod Dentofac Orthop 146:299–309

    Article  Google Scholar 

  9. Burden D, Johnston C, Kennedy D, Harradine N, Stevenson M (2007) A cephalometric study of Class II malocclusion treated with mandibular surgery. Am J Orthod Dentofac Orthop 131:7e8

    Article  Google Scholar 

  10. Resnick CM, Dang RR, Glick SJ, Padwa BL (2017) Accuracy of three-dimensional soft tissue prediction for Le Fort I osteotomy using Dolphin 3D software: a pilot study. Int J Oral Maxillofac Surg 46:289–295

    Article  PubMed  CAS  Google Scholar 

  11. Alves M Jr, Baratieri C, Mattos CT, Brunetto D, Fontes Rda C, Santos JR, Ruellas AC (2012) Is the airway volume being correctly analyzed? Am J Orthod Dentofac Orthop 141:657–661

    Article  Google Scholar 

  12. El H, Palomo JM (2010) Measuring the airway in 3 dimensions: a reliability and accuracy study. Am J Orthod Dentofacial Orthop 137(Suppl):S50.e1–S50.e9

    Google Scholar 

  13. Gokce SM, Gorgulu S, Gokce HS, Bengi O, Sabuncuoglu F, Ozgen F, Bilgic H (2012) Changes in posterior airway space, pulmonary function and sleep quality, following bimaxillary orthognathic surgery. Int J Oral Maxillofac Surg 41:820–829

    Article  PubMed  CAS  Google Scholar 

  14. Uesugi T, Kobayashi T, Hasebe D, Tanaka R, Ike M, Saito C (2014) Effects of orthognathic surgery on pharyngeal airway and respiratory function during sleep in patients with mandibular prognathism. Int J Oral Maxillofac Surg 43:1082–1090

    Article  PubMed  CAS  Google Scholar 

  15. Shin JH, Kim MA, Park IY, Park YH (2015) A 2-year follow-up of changes after bimaxillary surgery in patients with mandibular prognathism: 3-dimensional analysis of pharyngeal airway volume and hyoid bone position. J Oral Maxillofac Surg 73:340.e1–340.e9

    Article  Google Scholar 

  16. Kochar GD, Chakranarayan A, Kohli S, Kohli VS, Khanna V, Jayan B, Chopra SS, Verma M (2016) Effect of surgical mandibular advancement on pharyngeal airway dimensions: a three-dimensional computed tomography study. Int J Oral Maxillofac Surg 45:553–559

    Article  PubMed  CAS  Google Scholar 

  17. Steinhuber T, Brunold S, Gärtner C, Offermanns V, Ulmer H, Ploder O (2018) Is virtual surgical planning in orthognathic surgery faster than conventional planning? A time and workflow analysis of an office-based workflow for single- and double-jaw surgery. J Oral Maxillofac Surg 76:397–407

    Article  PubMed  Google Scholar 

  18. Canellas JV, Barros HL, Medeiros PJ, Ritto FG (2016) Effects of surgical correction of class III malocclusion on the pharyngeal airway and its influence on sleep apnoea. Int J Oral Maxillofac Surg 45:1508–1512

    Article  PubMed  Google Scholar 

  19. Yamashita AL, Iwaki Filho L, Leite PCC, Navarro RL, Ramos AL, Previdelli ITS, Ribeiro MHDM, Iwaki LCV (2017) Three-dimensional analysis of the pharyngeal airway space and hyoid bone position after orthognathic surgery. J Craniomaxillofac Surg 45:1408–1414

    Article  PubMed  Google Scholar 

  20. Kim MA, Kim BR, Youn JK, Kim YJ, Park YH (2014) Head posture and pharyngeal airway volume changes after bimaxillary surgery for mandibular prognathism. J Craniomaxillofac Surg 42:531–535

    Article  PubMed  Google Scholar 

  21. Resnick CM, Inverso G, Wrzosek M, Padwa BL, Kaban LB, Peacock ZS (2016) Is there a difference in cost between standard and virtual surgical planning for orthognathic surgery? J Oral Maxillofac Surg 74:1827–1833

    Article  PubMed  Google Scholar 

  22. Xia J, Samman N, Yeung RW, Wang D, Shen SG, Ip HH, Tideman H (2009) Computer-assisted three-dimensional surgical planning and simulation. 3D soft tissue planning and prediction. Int J Oral Maxillofac Surg 29:250e258

    Google Scholar 

  23. Donatsky O, Bjørn-Jørgensen J, Holmqvist-Larsen M, Hillerup S (1997) Computerized cephalometric evaluation of orthognathic surgical precision and stability in relation to maxillary superior repositioning combined with mandibular advancement or setback. J Oral Maxillofac Surg 55:1071–1079 discussion 1079-80

    Article  PubMed  CAS  Google Scholar 

  24. Gossett CB, Preston CB, Dunford R, Lampasso J (2005) Prediction accuracy of computer-assisted surgical visual treatment objectives as compared with conventional visual treatment objectives. J Oral Maxillofac Surg 63:609–617

    Article  PubMed  Google Scholar 

  25. Chen F, Terada K, Hua Y, Saito I (2007) Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class III skeletal deformities. Am J Orthod Dentofac Orthop 131:372–377

    Article  Google Scholar 

  26. Magro-Filho O, Magro-Ernica N, Queiroz TP, Aranega AM, Garcia IR Jr (2010) Comparative study of 2 software programs for predicting profile changes in Class III patients having double-jaw orthognathic surgery. Am J Orthod Dentofac Orthop 137:452.e1–452.e5

    Google Scholar 

  27. Lee HJ, Suh HY, Lee YS, Lee SJ, Donatelli RE, Dolce C, Wheeler TT (2014) A better statistical method of predicting postsurgery soft tissue response in Class II patients. Angle Orthod 84:322–328

    Article  PubMed  CAS  Google Scholar 

  28. Nadjmi N, Tehranchi A, Azami N, Saedi B, Mollemans W (2013) Comparison of soft-tissue profiles in Le Fort I osteotomy patients with Dolphin and Maxilim softwares. Am J Orthod Dentofac Orthop 144:654–662

    Article  Google Scholar 

  29. Kusnoto B (2007) Two-dimensional cephalometry and computerized orthognathic surgical treatment planning. Clin Plast Surg 34:417–426

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dentistry Department, State University of Maringá, Av. Mandacaru, 1550, Maringá, Paraná, 87080-000, Brazil

    Amanda Lury Yamashita, Lilian Cristina Vessoni Iwaki, Bárbara Aline Gerke, Mariliani Chicarelli & Liogi Iwaki Filho

  2. Department of Oral Diagnosis, Area of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Piracicaba, Sao Paulo, 13414-018, Brazil

    Gustavo Nascimento de Souza Pinto

Authors
  1. Amanda Lury Yamashita
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  2. Lilian Cristina Vessoni Iwaki
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  3. Gustavo Nascimento de Souza Pinto
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  4. Bárbara Aline Gerke
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  5. Mariliani Chicarelli
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  6. Liogi Iwaki Filho
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Correspondence to Amanda Lury Yamashita.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study (retrospective study) formal consent is not required.

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Yamashita, A.L., Iwaki, L.C.V., Pinto, G.N.d. et al. Accuracy of two-dimensional pharyngeal airway space prediction for bimaxillary orthognathic surgery. Oral Maxillofac Surg 22, 197–202 (2018). https://doi.org/10.1007/s10006-018-0693-y

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  • DOI: https://doi.org/10.1007/s10006-018-0693-y

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