@article{Bianchi2023l,

title = {Automated artificial intelligence‐based three‐dimensional comparison of orthodontic treatment outcomes with and without piezocision surgery.},

author = {Gurgel M and Alvarez M.A and Aristizabal J.F and Baquero B and Gillot M and Al Turkestani N and et al},

url = {https://pubmed.ncbi.nlm.nih.gov/38009409/},

doi = {10.1111/ocr.12737},

year  = {2023},

date = {2023-11-27},

journal = {Orthod Craniofac Res},

abstract = {Objective(s): This study aims to evaluate the influence of the piezocision surgery in the orthodontic biomechanics, as well as in the magnitude and direction of tooth movement in the mandibular arch using novel artificial intelligence (AI)-automated tools.



Materials and methods: Nineteen patients, who had piezocision performed in the lower arch at the beginning of treatment with the goal of accelerating tooth movement, were compared to 19 patients who did not receive piezocision. Cone beam computed tomography (CBCT) and intraoral scans (IOS) were acquired before and after orthodontic treatment. AI-automated dental tools were used to segment and locate landmarks in dental crowns from IOS and root canals from CBCT scans to quantify 3D tooth movement. Differences in mesial-distal, buccolingual, intrusion and extrusion linear movements, as well as tooth long axis angulation and rotation were compared.



Results: The treatment time for the control and experimental groups were 13.2 ± 5.06 and 13 ± 5.52 months respectively (P = .176). Overall, anterior and posterior tooth movement presented similar 3D linear and angular changes in the groups. The piezocision group demonstrated greater (P = .01) mesial long axis angulation of lower right first premolar (4.4 ± 6°) compared with control group (0.02 ± 4.9°), while the mesial rotation was significantly smaller (P = .008) in the experimental group (0.5 ± 7.8°) than in the control (8.5 ± 9.8°) considering the same tooth.



Conclusion: The open source-automated dental tools facilitated the clinicians' assessment of piezocision treatment outcomes. The piezocision surgery prior to the orthodontic treatment did not decrease the treatment time and did not influence in the orthodontic biomechanics, leading to similar tooth movements compared to conventional treatment.},

keywords = {computer-assisted, Cone-beam computed tomography (CBCT), Damon system, Dental long axis, Image processing, imaging, self-ligating braces, three-dimensional},

pubstate = {published},

tppubtype = {article}

}

@article{Oh2023,

title = {Cross-sectional data accurately model longitudinal growth in the craniofacial skeleton},

author = {Middleton K.M and Duren D.L and McNult K.P and Oh H and Valiathan M and Sherwood R

},

url = {https://doi.org/10.1038/s41598-023-46018-x},

doi = {10.1038/s41598-023-46018-x},

year  = {2023},

date = {2023-11-07},

urldate = {2023-11-07},

journal = {Sci Rep},

volume = {13},

issue = {19294},

abstract = {Dense, longitudinal sampling represents the ideal for studying biological growth. However, longitudinal samples are not typically possible, due to limits of time, prohibitive cost, or health concerns of repeat radiologic imaging. In contrast, cross-sectional samples have few such drawbacks, but it is not known how well estimates of growth milestones can be obtained from cross-sectional samples. The Craniofacial Growth Consortium Study (CGCS) contains longitudinal growth data for approximately 2000 individuals. Single samples from the CGCS for individuals representing cross-sectional data were used to test the ability to predict growth parameters in linear trait measurements separately by sex. Testing across a range of cross-sectional sample sizes from 5 to the full sample, we found that means from repeated samples were able to approximate growth rates determined from the full longitudinal CGCS sample, with mean absolute differences below 1 mm at cross-sectional sample sizes greater than ~ 200 individuals. Our results show that growth parameters and milestones can be accurately estimated from cross-sectional data compared to population-level estimates from complete longitudinal data, underscoring the utility of such datasets in growth modeling. This method can be applied to other forms of growth (e.g., stature) and to cases in which repeated radiographs are not feasible (e.g., cone-beam CT).},

keywords = {Cone-beam computed tomography (CBCT), craniofacial skeleton, cross-sectional data, longitudinal growth},

pubstate = {published},

tppubtype = {article}

}

@article{Bianchi2023d,

title = {Three-dimensional decision support system for treatment of canine impaction.},

author = {Keener DJ and de Oliveria Ruellas A.C and Aron Aliaga Del Castillo and Arriola-Guillen LE and Bianchi J and Oh H and et al},

url = {https://pubmed.ncbi.nlm.nih.gov/37037759/},

doi = {10.1016/j.ajodo.2023.02.016},

year  = {2023},

date = {2023-10-01},

journal = {Am J Orthod Dentofacial Orthop},

volume = {164},

issue = {4},

pages = {491-504},

abstract = {Introduction: This study aimed to develop a 3-dimensional (3D) characterization of the severity of maxillary impacted canines and to test the clinical performance of this characterization as a treatment decision support tool.



Methods: Cone-beam computed tomography images obtained from 83 patients with 120 impacted maxillary canines were included. Quantitative information on the canine 3D position and qualitative assessment of root damage of adjacent teeth were evaluated. A severity index was constructed on the basis of the quantitative findings. Clinical applicability was tested by comparing clinical diagnosis and treatment planning for conventional records vs the 3D characterization via a 2-part survey.



Results: The average quantitative assessments of impacted maxillary canine position were 6.4 ± 3.6 mm from the midsagittal plane, 11.6 ± 3.1 mm in height relative to the occlusal plane, 31.5° ± 18° of roll, and 48.8° ± 14.3° of pitch. The severity index ranged from 0-13 with a mean score of 4.5 ± 2.2. Overlap with adjacent teeth was the greatest contributor (33%) to the index. Bicortically impacted canines caused the most severe root damage. Cone-beam computed tomography was preferred for assessing root damage and overall severity, whereas conventional imaging was sufficient for height and angulation assessment. The 3D report was very important or important for evaluating root damage, canine position, overall severity, and overlap. The 3D report changed most of the decisions relating to biomechanics, patient education, and treatment time estimate. The decision of exposure and traction vs extraction was changed 22% of the time after the presentation of the 3D report.



Conclusions: The overlap with adjacent teeth frequently contributes the most to the severity index. The 3D report provided relevant clinical information regarding the canine position, damage to adjacent teeth, and the severity index, with a profound impact on the decisions of the clinicians regarding biomechanics, patient education, and treatment time estimate.},

keywords = {canine impaction, Cone-beam computed tomography (CBCT), three-dimensional},

pubstate = {published},

tppubtype = {article}

}

@article{Bianchi2023h,

title = {Three-dimensional comparison between the effects of mandibular advancement device and maxillomandibular advancement surgery on upper airway.},

author = {Gurgel M and Cevidanes L and Costa F and Pereira R and Cunali P and Bittencourt L and et al},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314553/},

doi = {10.1186/s12903-023-03125-5},

year  = {2023},

date = {2023-06-30},

journal = {BMC Oral Health},

volume = {23},

issue = {436},

abstract = {Background

The efficacy of mandibular advancement devices (MAD) and maxillomandibular advancement (MMA) in improving upper airway (UA) patency has been described as being comparable to continuous positive airway pressure (CPAP) outcomes. However, no previous study has compared MAD and MMA treatment outcomes for the upper airway enlargement. This study aimed to evaluate three-dimensionally the UA changes and mandibular rotation in patients after MAD compared to MMA.



Methods

The sample consisted of 17 patients with treated with MAD and 17 patients treated with MMA matched by weight, height, body mass index. Cone-beam computed tomography from before and after both treatments were used to measure total UA, superior/inferior oropharynx volume and surface area; and mandibular rotation.



Results

Both groups showed a significant increase in the superior oropharynx volume after the treatments (p = 0.003) and the MMA group showed greater increase (p = 0.010). No statistical difference was identified in the MAD group considering the inferior volume, while the MMA group showed a significantly gain (p = 0.010) and greater volume (p = 0.024). Both groups showed anterior mandibular displacement. However, the mandibular rotation were statistically different between the groups (p < 0.001). While the MAD group showed a clockwise rotation pattern (-3.97 ± 1.07 and − 4.08 ± 1.30), the MMA group demonstrated a counterclockwise (2.40 ± 3.43 and 3.41 ± 2.79). In the MAD group, the mandibular linear anterior displacement was correlated with superior [p = 0.002 (r=-0.697)] and inferior [p = 0.004 (r = 0.658)] oropharynx volume, suggesting that greater amounts of mandibular advancement are correlated to a decrease in the superior oropharynx and an increase in the inferior oropharynx. In the MMA group, the superior oropharynx volume was correlated to mandibular anteroposterior [p = 0.029 (r=-0.530)] and vertical displacement [p = 0.047 (r = 0.488)], indicating greater amounts of mandibular advancement may lead to a lowest gain in the superior oropharynx volume, while a great mandibular superior displacement is correlated with improvements in this region.



Conclusions

The MAD therapy led to a clockwise mandibular rotation, increasing the dimensions of the superior oropharynx; while a counterclockwise rotation with greater increases in all UA regions were showed in the MMA treatment.},

keywords = {Cone-beam computed tomography (CBCT), mandibular advancement device, Maxillomandibular advancement, Obstructive sleep apnea, Three-dimensional assessment, Upper airway},

pubstate = {published},

tppubtype = {article}

}

@article{Bianchi2022b,

title = {Automatic multi-anatomical skull structure segmentation of cone-beam computed tomography scans during 3D UNETR},

author = {Gillot M and Baquero B and Le C and R Deleat-Besson and Bianchi J and Gurgel M and Yatabe M and Al Turkestani N and Najarian K},

url = {https://pubmed.ncbi.nlm.nih.gov/36223330/},

doi = {10.1371/journal.pone.0275033},

year  = {2022},

date = {2022-10-12},

journal = {PLoS One},

volume = {17},

issue = {10},

abstract = {The segmentation of medical and dental images is a fundamental step in automated clinical decision support systems. It supports the entire clinical workflow from diagnosis, therapy planning, intervention, and follow-up. In this paper, we propose a novel tool to accurately process a full-face segmentation in about 5 minutes that would otherwise require an average of 7h of manual work by experienced clinicians. This work focuses on the integration of the state-of-the-art UNEt TRansformers (UNETR) of the Medical Open Network for Artificial Intelligence (MONAI) framework. We trained and tested our models using 618 de-identified Cone-Beam Computed Tomography (CBCT) volumetric images of the head acquired with several parameters from different centers for a generalized clinical application. Our results on a 5-fold cross-validation showed high accuracy and robustness with a Dice score up to 0.962±0.02. Our code is available on our public GitHub repository.},

keywords = {3d, CBCT, Cone-beam computed tomography (CBCT), multi-anatomical skull structure, structure segmentation},

pubstate = {published},

tppubtype = {article}

}

@article{Bianchi2022,

title = {Three-dimensional craniofacial characteristics associated with obstructive sleep apnea severity and treatment outcomes},

author = {Gurgel M and Cevidanes L and Pereira R and Costa F and Ruellas A and Bianchi J adn Cunali P and Bittencourt L and Junior C.C},

url = {https://pubmed.ncbi.nlm.nih.gov/34273012/},

doi = {10.1007/s00784-021-04066-5},

year  = {2022},

date = {2022-01-01},

journal = {Clinical Oral Investigations},

volume = {26},

issue = {1},

pages = {875-887},

abstract = {Objectives: This study aims to assess craniofacial dimensions in obstructive sleep apnea (OSA) patients treated with a mandibular advancement device (MAD) and to identify anatomic influences on OSA severity and MAD therapy outcomes.



Materials and methods: Twenty patients with OSA were prospectively treated with MAD. Clinical, cone-beam computed tomography, and polysomnography exams were performed before treatment and 4-6 months after achieving the MAD therapeutic position. Polysomnographic exams and three-dimensional maxillary, mandibular, and upper airway (UA) measurements were evaluated. Pearson's correlation and t-tests were applied.



Results: Before MAD treatment, the transverse width measured at the frontomaxillary suture and the angle between the mandibular ramus and Frankfurt horizontal were statistically correlated with apnea and the hypopnea index (AHI), while the gonial angle was correlated with therapeutic protrusion. After MAD treatment, all patients showed a significant AHI reduction and an improvement in minimum oxyhemoglobin saturation. The UA total volume, superior and inferior oropharynx volume, and area were statistically correlated with MAD therapeutic protrusion. The UA total area showed a statistical correlation with the improvement in AHI, and the superior oropharynx volume and area increased significantly.



Conclusions: The transversal frontomaxillary suture width and the mandibular ramus facial angle may influence OSA severity. The gonial angle, volume, and area of all UA regions may indicate the amount of protrusion needed for successful MAD treatment.



Clinical relevance: The craniofacial characteristics reported as important factors for OSA severity and MAD treatment outcomes impact therapy planning for OSA patients, considering individual anatomic characteristics, prognosis, and cost benefits.},

keywords = {Airway management, anatomy, Cone-beam computed tomography (CBCT), mandibular advancement device, obstructive, occlusal splints, sleep apnea},

pubstate = {published},

tppubtype = {article}

}