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Cephalometric Methods of Prediction in Orthognathic Surgery

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Abstract

Over the past decade the growing number of adult patients seeking for orthodontic treatment made orthognathic surgery popular. Surgical and orthodontic techniques have developed to the point where combined orthodontic and surgical treatment is now feasible to manage dentofacial deformity problems very satisfactorily. The prediction of orthognathic treatment outcome is an important part of orthognathic planning and the process of patient’ inform consent. The predicted results must be presented to the patients prior to treatment in order to assess the treatment’s feasibility, optimize case management and increase patient understanding and acceptance of the recommended treatment. Cephalometrics is a routine part of the diagnosis and treatment planning process and also allows the clinician to evaluate changes following orthognathic surgery. Traditionally cephalometry has been employed manually; nowadays computerized cephalometric systems are very popular. Cephalometric prediction in orthognathic surgery can be done manually or by computers, using several currently available software programs, alone or in combination with video images. Both manual and computerized cephalometric prediction methods are two-dimensional and cannot fully describe three-dimensional phenomena. Today, three-dimensional prediction methods are available, such as three-dimensional computerized tomography (3DCT), 3D magnetic resonance imaging (3DMRI) and surface scan/cone-beam CT. The aim of this article is to present and discuss the different methods of cephalometric prediction of the orthognathic surgery outcome.

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References

  1. Tucker MR (1995) Orthognathic surgery versus orthodontic camouflage in the treatment of mandibular deficiency. J Oral Maxillofac Surg 53:572–578

    Article  PubMed  CAS  Google Scholar 

  2. Bailey LJ, Haltiwanger LH, Blakey GH, Proffit WR (2001) Who seeks surgical-orthodontic treatment: a current review. Int J Adult Orthod Orthognath Surg 16:280–292

    CAS  Google Scholar 

  3. Proffit WR, Turvey TA, Phillips C (2007) The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension. Head Face Med 30:3–21

    Google Scholar 

  4. Proffit WR, White RP Jr (1990) Who needs surgical-orthodontic treatment? Int J Adult Orthod Orthognath Surg 5:81–89

    CAS  Google Scholar 

  5. Musich DR (1994) Orthodontics orthognathic surgery: Principles of combined treatment. In: Graber TM, Vanarsdall RL (eds) Orthodontics: current principles and techniques. Mosby Year Book, St Louis, pp 838–841

    Google Scholar 

  6. Proffit WR, Turvey TA, Phillips C (1996) Orthognathic surgery: a hierarchy of stability. Int J Adult Orthod Orthognath Surg 11:191–204

    CAS  Google Scholar 

  7. Olson RE, Laskin DM (1980) Expectations of patients from orthognathic surgery. J Oral Surg 38:283–295

    PubMed  CAS  Google Scholar 

  8. Mayo KH, Vig KD, Vig PS, Kowalski CJ, Mayo KH (1991) Attitude variables of dentofacial deformity patients: demographic characteristics and associations. J Oral Maxillofac Surg 49:594–602

    Article  PubMed  CAS  Google Scholar 

  9. Finlay PM, Atkinson JM, Moos KF (1995) Orthognathic surgery: patient expectations; psychological profile and satisfaction with outcome. Br J Oral Maxillofac Surg 33:9–14

    Article  PubMed  CAS  Google Scholar 

  10. Athanasiou AE, Melsen B, Eriksen J (1989) Concerns, motivation and experience of orthognathic surgery patients: A retrospective study of 152 patients. Int J Adult Orthod Orthognath Surg 4:47–55

    CAS  Google Scholar 

  11. Ostler S, Kiyak HA, Ostler S (1991) Treatment expectations versus outcomes among orthognathic surgery patients. Int J Adult Orthodon Orthognath Surg 6:247–255

    PubMed  CAS  Google Scholar 

  12. Rivera SM, Hatch JP, Dolce C, Bays RA, Van Sickels JE, Rugh JD (2000) Patients’ own reasons and patient-perceived recommendations for orthognathic surgery. Am J Orthod Dentofacial Orthop 118:134–140

    Article  PubMed  CAS  Google Scholar 

  13. Williams DM, Bentley R, Cobourne MT, Gibilaro A, Good S, Huppa C, Matthews NS, O’Higgins E, Patel S, Newton JT (2009) Psychological characteristics of women who require orthognathic surgery: comparison with untreated controls. Br J Oral Maxillofac Surg 47:191–195

    Article  PubMed  CAS  Google Scholar 

  14. Kiyak HA, Bell R (1991) Psychosocial considerations in surgery and orthodontics. In: Proffit WR, White RP (eds) Surgical-orthodontic treatment. Mosby Year Book, St Louis, pp 71–89

    Google Scholar 

  15. Scott AA, Hatch JP, Rugh JD, Hoffman TJ, Rivera SM, Dolce C, Bays RA (2000) Psychosocial predictors of satisfaction among orthognathic surgery patients. Int JAdult Orthod Orthognath Surg 15:7–15

    CAS  Google Scholar 

  16. Gerzanic L, Jagsch R, Watzke IM (2002) Psychologic implications of orthognathic surgery in patients with skeletal class II or class III malocclusion. Int J Adult Orthod Orthognath Surg 17:75–81

    Google Scholar 

  17. Lazaridou-Terzoudi T, Kiyak HA, Moore R, Athanasiou AE, Melsen B (2003) Long term assessment of psychologic outcomes of orthognathic surgery. J Oral Maxillofac Surg 61:545–552

    Article  PubMed  Google Scholar 

  18. Hugo B, Becker S, Witt E (1996) Assessment of the combined orthodontic- surgical treatment from the patients’ point of view. J Orofac Orthop 57:88–101

    Article  PubMed  CAS  Google Scholar 

  19. Hatch JP, Rugh JD, Clark GM, Keeling SD, Tiner BD, Bays RA (1998) Health-related quality of life following orthognathic surgery. Int J Adult Orthod Orthognath Surg 13:67–77

    CAS  Google Scholar 

  20. Proffit WR, Sarver DM (2003) Treatment planning: Optimizing benefit to the patient In: Proffit WR, White RP Jr, Sarver DM (eds) Contemporary treatment of dentofacial deformity. Mosby Inc, St Louis, pp 172–244

  21. Esperao PT, de Oliveira BH, de Oliveira Almeida MA, Kiyak HA, Miguel JA (2010) Oral health-related quality of life in orthognathic surgery patients. Am J Orthod Dentofacial Orthop 137:790–795

    Article  PubMed  Google Scholar 

  22. Sarver DM (1998) Videocephalometric treatment prediction. In: Sarver DM (ed) Estetics orthodontics and orthognathic surgery. Mosby Inc, St Louis, pp 61–89

    Google Scholar 

  23. Cohen MI (1965) Mandibular prognathism. Am J Orthod 51:368–379

    Article  PubMed  CAS  Google Scholar 

  24. McNeill RW, Proffit WR, White RP (1972) Cephalometric prediction for orthodontic surgery. Angle Orthod 42:154–164

    PubMed  CAS  Google Scholar 

  25. Henderson D (1974) The assessment, management of bony deformities of the middle, lower face. Br J Plast Surg 66:378–396

    Google Scholar 

  26. Worms FW, Isaacson RJ, Spiedel TM (1976) Surgical orthodontic treatment planning: Profile analysis and mandibular surgery. Angle Orthod 46:1–25

    PubMed  CAS  Google Scholar 

  27. Hohl TH, Wolford LM, Epker BN, Fonseca RJ (1978) Craniofacial osteotomies: A photocephalometric technique for the prediction and evaluation of tissue changes. Angle Orthod 48:114–125

    Google Scholar 

  28. Fish LC, Epker BN (1980) Surgical-orthodontic cephalometric prediction tracing. J Clin Orthod 14:36–52

    PubMed  CAS  Google Scholar 

  29. Bench RW, Gugino CF, Hilgers JJ (1977) Bioprogressive therapy: Part 2-principles of the therapy. J Clin Ortodod 11:661–668

    CAS  Google Scholar 

  30. Bench RW, Gugino CF, Hilgers JJ (1977) Bioprogressive therapy: Part 2-principles of the therapy. J Clin Ortodod 11:744–763

    CAS  Google Scholar 

  31. Moshiri F, Jung ST, Sclaroff A, Marsh JL, Gay DW (1982) Orthognathic and craniofacial surgical diagnosis and treatment planning: A visual approach. J Clin Orthod 16:37–59

    PubMed  CAS  Google Scholar 

  32. Harris MC (1972) Soft tissue effects of surgical anterior maxillary retraction, thesis. University of Kentaki, Louisville

  33. Wolford LM, Hilliard FW, Dugan DJ (1985) Surgical treatment objective. A systematic approach to the prediction tracing. Mosby Year Book, St Louis, pp 54–74

    Google Scholar 

  34. Proffit WR (1991) Treatment planning: The search for wisdom. In: Proffit WR, White RP (eds) Surgical orthodontic treatment. Mosby Year Book, St Louis, pp 142–191

    Google Scholar 

  35. Jensen AC, Sinclair PM, Wolford LM (1992) Soft tissue changes associated with double jaw surgery. Am J Orthod Dentofac Orthop 101:266–275

    Article  CAS  Google Scholar 

  36. 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 

  37. Sarver DM (1998) The technology and mechanics of videocephalometrics. In: Sarver DM (ed) Estetics orthodontics and orthognathic surgery. Mosby Inc, St Louis, pp 89–134

    Google Scholar 

  38. Athanasiou AE, Kragskov J (1995) Computerized cephalometric systems. In: Athanasiou AE (ed) Orthodontic cephalometry. Mosby-Wolfe, London, pp 231–239

    Google Scholar 

  39. Bhatia SN, Sowray JH (1984) A computer-aided design for orthognathic surgery. Br J Oral Maxillofac Surg 22:237–253

    Article  PubMed  CAS  Google Scholar 

  40. Engel GA, Quan RE, Chaconas ST (1979) Soft tissue change as a result of maxillary surgery. A preliminary study. Am J Orthod 75:291–300

    Article  PubMed  CAS  Google Scholar 

  41. Harradine NWT, Burnie DJ (1985) Computerized prediction of the results of orthognathic surgery. J Maxillofac Surg 13:245–249

    Article  PubMed  CAS  Google Scholar 

  42. Walters H, Walters HD (1986) Computerized planning of maxillofacial osteotomies: The program and its clinical applications. Br J Oral Maxillofac Surg 24:178–189

    Article  PubMed  CAS  Google Scholar 

  43. Freihofer HPM (1984) Latitude and limitations of midface movements. Br J Oral Maxillofac Surg 22:393–413

    Article  PubMed  CAS  Google Scholar 

  44. Kaipatur N, Al-Thomali Y, Flores-Mir C (2009) Accuracy of computer programs in predicting orthognathic surgery hard tissue response. J Oral Maxillofac Surg 67:1628–1639

    Article  PubMed  Google Scholar 

  45. Seeholzer H, Walker R (1991) Orthodontic and oral surgical treatment planning by computer, for example, the dentofacial planners (I). Quintessenz 42:59–67

    PubMed  CAS  Google Scholar 

  46. Seeholzer H, Walker R (1991) Orthodontic and oral surgical treatment planning by computer, for example, the dentofacial planners (II). Quintessenz 2:257–262

    Google Scholar 

  47. Coursley RRJ, Grant E (2004) The accuracy of preoperative orthognathic predictions. Br J Oral Maxillofac Surg 42:96–104

    Article  Google Scholar 

  48. Power G, Breckon J, Sherriff M, McDonald F (2005) Dolphin imaging software: An analysis of the accuracy of cephalometric digitization and orthognathic prediction. Int J Oral Maxillofac Surg 34:619–626

    Article  PubMed  CAS  Google Scholar 

  49. Kusnoto B (2007) Two-dimensional cephalometry and computerized orthognathic surgical treatment planning. Clin Plast Surg 34:417–422

    Article  PubMed  Google Scholar 

  50. Sarver DM, Johnston MW, Matukas VJ (1988) Video imaging for planning and counseling in orthognathic surgery. J Oral Maxillofac Surg 46:939–945

    Article  PubMed  CAS  Google Scholar 

  51. Talahashi I, Talahashi T, Hamada M, Kawamoto T, Kinoshita Z, Kubo Y, Kakudo K, Shirasu R (1989) Application of video surgery to orthodontic diagnosis. Int j Orthod Orthogn Surg 4:219–222

    Google Scholar 

  52. Sarver DM, Johnston MW (1990) Video imaging: techniques for superimposition of cephalometric radiography and profile images. Int J Adult Orthodon Orthognath Surg 5:241–248

    PubMed  CAS  Google Scholar 

  53. Grubb JE (1992) Computer assisted orthognathic surgical treatment planning: a case report. Angle Orthod 62:227–234

    PubMed  CAS  Google Scholar 

  54. Sarver DM (1998) Videocephalometric treatment prediction. In: Sarver DM (ed) Estetics orthodontics and orthognathic surgery. Mosby Inc, St Louis, pp 89–134

    Google Scholar 

  55. Sarver DM (1993) Video imaging, a computer facilitated approach to communication and planning in orthognathic surgery. Br J Orthod 20:187–191

    PubMed  CAS  Google Scholar 

  56. Phillips C (1984) Photocephalometry: errors of projection and landmark location. Am J Orthod 86:233–243

    Article  PubMed  CAS  Google Scholar 

  57. Rakosi T (2010) Therapeutic diagnosis. In: Racosi T, Graber TM (eds) Orthodontic and dentofacial orthopedic treatment. Thieme, New York, pp 1–17

    Google Scholar 

  58. Pospisil OA (1987) Reliability and feasibility of prediction tracing in orthognathic surgery. J Craniomaxillofac Surg 15:79–83

    Article  PubMed  CAS  Google Scholar 

  59. Konstiantos KA, O’Reilly MT, Close J (1994) The validity of the prediction of soft tissue profile changes after Le Fort I osteotomy using the dentofacial planner (computer software). Am J Orthod Dentofac Orthop 105:241–249

    Article  CAS  Google Scholar 

  60. Eales EA, Newton C, Jones ML, Sugar A (1994) The accuracy of computerized prediction of the soft tissue profile: a study of 25 patients treated by means of the Le Fort I osteotomy. Int J Adult Orthod Orthognath Surg 9:141–152

    CAS  Google Scholar 

  61. Eales EA, Jones ML, Newton C, Sugar AW (1995) A study of the accuracy of predicted soft tissue changes produced by a computer software package (COG 3.4) in a series of patients treated by the Le Fort I osteotomy. Br J Oral Maxillofac Surg 33:362–369

    Article  PubMed  CAS  Google Scholar 

  62. Sameshima GT, Kawakami RK, Kaminishi RM, Sinclair PM (1997) Predicting soft tissue changes in maxillary impaction surgery: A comparison of two video imaging systems. Angle Orthod 67:347–354

    PubMed  CAS  Google Scholar 

  63. Csaszar GR, Brüker-Csaszar B, Niederdellmann H (1999) Prediction of soft tissue profiles in orthodontic surgery with the dentofacial planner. Int J Adult Orthod Orthognath Surg 14:285–290

    CAS  Google Scholar 

  64. Jones RM, Khambay BS, McHugh S, Ayoub AF (2007) The validity of a computer-assisted simulation system for orthognathic surgery (CASSOS) for planning the surgical correction of class III skeletal deformities: single-jaw versus bimaxillary surgery. Int J Oral Maxillofac Surg 36:900–908

    Article  PubMed  CAS  Google Scholar 

  65. Kolokitha OE, Athanasiou AE, Tuncay O (1996) Validity of computerized predictions of dentoskeletal and soft tissue profile changes after mandibular setback and maxillary impaction osteotomies. Int J Adult Orthod Orthognath Surg 11:137–154

    CAS  Google Scholar 

  66. Curtis TJ, Casko JS, Jakobsen JR, Southard TE (2000) Accuracy of a computerized method of predicting soft tissue changes from orthognathic surgery. J Clin Orthod 34:524–530

    PubMed  CAS  Google Scholar 

  67. Jacobson R, Sarver DM (2001) The predictability of maxillary repositioning in Le Fort I orthognathic surgery. Am J Orthod Dentofac Orthop 122:142–154

    Article  Google Scholar 

  68. Kolokitha OE (2007) Validity of a manual soft tissue profile prediction method following mandibular setback osteotomy. Eur J Dent 1:202–211

    PubMed  Google Scholar 

  69. Donatsky O, Bjørn-Jørgensen J, Hermund NU, Nielsen H, Holmqvist-Larsen M, Nerder PH (2010) Immediate postoperative outcome of orthognathic surgical planning, and prediction of positional changes in hard and soft tissue, independently of the extent and direction of the surgical corrections required. Br J Oral Maxillofac Surg (in press)

  70. Kaipatur NR, Flores-Mir C (2009) Accuracy of computer programs in predicting orthognathic surgery soft tissue response. J Oral Maxillofac Surg 67:751–759

    Article  PubMed  Google Scholar 

  71. Harrell WE Jr, Hatcher DC, Bolt RL (2002) In search of anatomic truth: 3-dimensional digital modelling and the future. Am J Orthod Dentofac Orthop 122:325–330

    Article  Google Scholar 

  72. Popat H, Richmond ST (2010) New developments in: three-dimensional planning for orthognathic surgery. J Ortho 37:62–71

    Article  Google Scholar 

  73. Gateno J (2011) New 3-dimensional cephalometric analysis for orthognathic surgery. J Oral Maxillofac Surg 69:606–622

    Article  PubMed  Google Scholar 

  74. Bergensen EO (1980) Enlargement and distortion in cephalometric radiography: compensation tables fro linear measurements. Angle Orthod 50:230–244

    Google Scholar 

  75. Ahlqvist J, Eliasson S, Welander U (1983) The cephalometric projection: part II. Principles of image distortion in cephalography. Dentomaxillofac Radiol 12:101–108

    PubMed  CAS  Google Scholar 

  76. Hwang H-S, Hwang CH, Lee K-H, Kang B-C (2006) Maxillofacial 3- dimensional image for the diagnosis of facial asymmetry. Am J Dentofacial Orthop 130:779–785

    Article  Google Scholar 

  77. Cutting CC, Bookstein FL, Crayson B, Fellingham L, McCarthy JG (1986) Three-dimensional computer assisted design of craniofacial surgical procedures: optimization and interaction with cephalometric and CT-based models. Plast Reconstr Surg 77:877–887

    Article  PubMed  CAS  Google Scholar 

  78. Moss JP, Grindrod SR, Linney AD, Janes D (1988) A computer system for the interactive planning and prediction of maxillofacial surgery. Am J Orthod Dentofac Orthop 94:469–475

    Article  CAS  Google Scholar 

  79. Plooij JM, Maal TJ, Borstlap WA, Kuijpers-Jagtman AM, Berge SJ (2010) Digital three-dimensional image fusion processes for planning and evaluating orthodontics and orthognathic surgery. A systematic review. Int J Oral Maxillofac Surg. doi: 10.1016/j.ijom.2010.10.013

  80. Groeve PD, Schutyser F, Cleynen–Breugel JV, Suetens P (2001) Registration of 3D photographs with spiral CT images for soft tissue simulation in maxillofacial surgery. Lect Notes Comput Sci 2208:991–996

    Article  Google Scholar 

  81. Khambay B, Nebel JC, Bowman J, Walker F, Hadley DM, Ayoub A (2002) 3D stereophotogrammetric image superimposition onto 3DCT scan images: the future of orthognathic surgery. A pilot study. Int J Adult Orthodon Orthognath Surg 17:331–341

    PubMed  Google Scholar 

  82. Maal TJ, Plooij JM, Rangel FA, Mollemans W, Schutyser FA, Berge SJ (2008) The accuracy of matching three-dimensional photographs with skin surfaces derived from cone-beam computed tomography. Int J Oral Maxillofac Surg 37:641–646

    Article  PubMed  CAS  Google Scholar 

  83. Swennen GR, Mollemans W, De Clercq C, Abeloos J, Lamoral P, Lippens F, Neyt N, Casselman J, Schutyser F (2009) A cone-beam computed tomography triple scan procedure to obtain a three-dimensional augmented virtual skull model appropriate for orthognathic surgery planning. J Craniofac Surg 20:297–307

    Article  PubMed  Google Scholar 

  84. Swenner GR, Mollemans W, Schutyser F (2009) Three-dimensional treatment planning of orthognathic surgery in the era of virtual imaging. J Oral Maxillofac Surg 67:2080–2092

    Article  Google Scholar 

  85. Swennen GR, Schutyser FAC (2006) Three-dimensional virtual approach to diagnosis and treatment planning of maxillofacial deformity. In: Bell WH, Guerrero CA (eds) Distraction osteogenesis of the facial skeleton. BC Decker Inc, Hamilton

    Google Scholar 

  86. Mavili ME, Canter HI, Saglam-Aydinatay B, Kamaci S, Kocadereli I (2007) Use of three-dimensional medical modeling methods for precise planning of orthognathic surgery. J Craniofac Surg 18:740–747

    Article  PubMed  Google Scholar 

  87. Ayoub AF, Xiao Y, Khambay B, Siebert JP, Hadley D (2007) Towards building a photo–realistic virtual human face for craniomaxillofacial diagnosis and treatment planning. Int J Oral Maxillofac Surg 36:423–428

    Article  PubMed  CAS  Google Scholar 

  88. Nakasima A, Terajima M, Mori N, Hoshino Y, Tokumori K, Aoki Y, Hashimoto S (2005) Three-dimensional computer-generated head model reconstructed from cephalograms, facial photographs, and dental cast models. Am J Orthod Dentofacial Orthop 127:282–292

    Article  PubMed  Google Scholar 

  89. Van Vlijmen OJ (2010) A comparison between 2D and 3D cephalometry on CBCT scans of human skulls. Int J Oral Maxillofac Surg 39:156–160

    Article  PubMed  Google Scholar 

  90. Kragskov J, Bosch C, Gyldensted C, Sindet-Pedersen S (1997) Comparison of the reliability of craniofacial anatomic landmarks based on cephalometric radiographs and three-dimensional CT scans. Cleft Palate Craniofac J 34:111–116

    Article  PubMed  CAS  Google Scholar 

  91. Bianchi A, Muyldermans L, Di Martino M, Landellotti L, Amadori S, Sarti A, Marchetti C (2010) Facial soft tissue esthetic predictions: validation in craniomaxillofacial surgery with cone-beam computed tomography. J Oral Maxillofac Surg 68:1471–1479

    Article  PubMed  Google Scholar 

  92. Mollemans W, Schutyser F, Nadjmi N, Maes F, Suetens P (2007) Predicting soft tissue deformations for a maxillofacial surgery planning system: from computational strategies to a complete clinical validation. Med Image Anal 11:282–301

    Article  PubMed  CAS  Google Scholar 

  93. Proffit WR (2000) The soft tissue paradigm in orthodontic diagnosis and treatment planning: a new view for a new century. J Esthet Dent 12:46–49

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, GR-54124, Thessaloniki, Greece

    Olga-Elpis Kolokitha & Nikolaos Topouzelis

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  1. Olga-Elpis Kolokitha
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Kolokitha, OE., Topouzelis, N. Cephalometric Methods of Prediction in Orthognathic Surgery. J. Maxillofac. Oral Surg. 10, 236–245 (2011). https://doi.org/10.1007/s12663-011-0228-7

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