Korean J Orthod.  2018 May;48(3):143-152. 10.4041/kjod.2018.48.3.143.

Hard- and soft-tissue profiles of the midface region in patients with skeletal Class III malocclusion using cone-beam computed tomography multiplanar-reconstructed image analysis

• Kim B
• Lee HC
• Kim SH
• Kim Y
• Son W
• Kim SS

• KMID: 2418325
• DOI: http://doi.org/10.4041/kjod.2018.48.3.143

Abstract

OBJECTIVE
This study examined cone-beam computed tomography (CBCT)-derived multiplanar-reconstructed (MPR) cross-sections to clarify the salient characteristics of patients with skeletal class III malocclusion with midface deficiency (MD).
METHODS
The horizontal and sagittal plane intersection points were identified for middle-third facial analysis in 40 patients in the MD or normal (N) groups. MPR images acquired parallel to each horizontal plane were used for length and angular measurements.
RESULTS
A comparison of the MD and N groups revealed significant differences in the zygoma prominence among female patients. The convex zygomatic area in the N group was larger than that in the MD group, and the inferior part of the midface in the N group was smaller than that in the MD group for both male and female patients. A significant difference was observed in the concave middle maxillary area among male patients.
CONCLUSIONS
This study was conducted to demonstrate the difference between MD and normal face through MPR images derived from CBCT. Male patients in the MD group had a more flattened face than did those in the N group. Female patients in the MD group showed a concave-shaped lower section of the zygoma, which tended to have more severe MD. These findings indicate that orthognathic surgery to improve skeletal discrepancy requires different approaches in male and female patients.

Keyword

Cone-beam computed tomography; Multiplanar-reconstructed image; Class III malocclusion; Midface deficiency

MeSH Terms

Cone-Beam Computed Tomography*
Female
Humans
Male
Malocclusion*
Orthognathic Surgery
Zygoma

Figure

• 

  Figure 1 Inclusion criteria for the midface deficiency group. A, Soft-tissue profile with the zygoma and ala of the nose located behind the line passing through the eyeball parallel to the natural head position. B, Reference planes: XY plane, the horizontal reference plane; YZ plane, the sagittal reference plane; and ZX plane, the coronal reference plane. C, Planes parallel to each reference plane: UH, MH, LH, OS, MS, and IS. Intersecting points between the horizontal and sagittal planes were identified for middle-third facial analysis and included the S2, S3, M1, M2, M3, I1, I2, and I3.

• 

  Figure 2 Linear lengths are measured from each hard-tissue (HS2, HS3, HM1, HM2, HM3, HI1, HI2, and HI3) and soft-tissue (SS2, SS3, SM1, SM2, SM3, SI1, SI2, and SI3) landmark point to the ZX plane, which paralleled the horizontal reference planes UH, MH, and LH.

• 

  Figure 3 Angular measurements. A, Sagittal maxillary angle (SMA). B, Sagittal zygomatic angle (SZA). C, Transverse zygomatic angle (TZA). D, Middle transverse maxillary angle (MTMA). E, Inferior transverse maxillary angle (ITMA).

• 

  Figure 4 Surface area measurements. A, Zygomatic area (Z-area). B, Middle maxillary area (M-area). C, Inferior maxillary area (I-area).

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