Surgical correction of a craniofacial anomaly or dentofacial deformity is a complex procedure, particularly in patients with asymmetries. Even with the focus on post-surgical assessments of hard and soft tissue over the past decades, there are critical areas, such as maxillomandibular rotations and condylar/ramus resorbtion, that can not be evaluated with two-dimensional methods. The objectives of this prospective observational study that incorporates three-dimensional imaging (3-D) techniques are to characterize asymmetries more precisely prior to surgery, quantify areas of instability following facial surgical procedures, and improve pre-operative surgical planning. Since asymmetries are particularly difficult to ascertain and treatment plan, the agreement between clinical assessment of asymmetry location and its 3D characterization will be evaluated. In the 3D characterization, the surface distances between the 3-D models of the """"""""affected"""""""" side of the mandible and the reflected mirror image of the """"""""unaffected"""""""" side will be used to anatomically locate and estimate the asymmetry with two different mirroring techniques. An ancillary question is whether providing this information to surgeons alters the approach to the surgical correction. Surgeons will be trained in the use of 3D surgical simulation and the actual surgical outcome compared to the surgical simulation as one aspect of the validation of this method. In addition, this project will quantitatively assess 3D displacement and rotations of the jaws following orthognathic surgery for correction of asymmetry and Class III skeletal deformities. Voxel-wise rigid registration of the 3D cranial base surfaces will be used to avoid observer-dependent superimposition. The proposed work is multidisciplinary - incorporating treatment of craniofacial and dentofacial deformities, clinical research design and computer imaging. The combination of better planning of surgical treatment and identification of factors that contribute to the most successful treatment has great potential to improve treatment for some of the most difficult facial problems and dysmorphisms in the cranio-maxillofacial region. Involvement in these studies will enhance the candidate's prior training in cranio-maxillofacial problems and 3D imaging, while equipping her with tools to perform meaningful studies centered around patient oriented clinical research.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DE017727-05
Application #
7893870
Study Section
NIDCR Special Grants Review Committee (DSR)
Program Officer
Hardwick, Kevin S
Project Start
2006-08-01
Project End
2011-07-31
Budget Start
2010-08-01
Budget End
2011-07-31
Support Year
5
Fiscal Year
2010
Total Cost
$126,711
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Dentistry
Type
Schools of Dentistry
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
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de Paula, L K; Ruellas, A C O; Paniagua, B et al. (2013) One-year assessment of surgical outcomes in Class III patients using cone beam computed tomography. Int J Oral Maxillofac Surg 42:780-9
de Paula, Leonardo Koerich; Ackerman, James L; Carvalho, Felipe de Assis Ribeiro et al. (2012) Digital live-tracking 3-dimensional minisensors for recording head orientation during image acquisition. Am J Orthod Dentofacial Orthop 141:116-23
Bouwens, Daniel G; Cevidanes, Lucia; Ludlow, John B et al. (2011) Comparison of mesiodistal root angulation with posttreatment panoramic radiographs and cone-beam computed tomography. Am J Orthod Dentofacial Orthop 139:126-32
AlHadidi, Abeer; Cevidanes, L H S; Mol, A et al. (2011) Comparison of two methods for quantitative assessment of mandibular asymmetry using cone beam computed tomography image volumes. Dentomaxillofac Radiol 40:351-7
Cevidanes, Lucia H S; Alhadidi, Abeer; Paniagua, Beatriz et al. (2011) Three-dimensional quantification of mandibular asymmetry through cone-beam computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111:757-70
Motta, Alexandre T; Cevidanes, Lucia H S; Carvalho, Felipe A R et al. (2011) Three-dimensional regional displacements after mandibular advancement surgery: one year of follow-up. J Oral Maxillofac Surg 69:1447-57
Paniagua, Beatriz; Alhadidi, Abeer; Cevidanes, Lucia et al. (2011) MANDIBULAR ASYMMETRY CHARACTERIZATION USING GENERALIZED TENSOR-BASED MORPHOMETRY. Proc IEEE Int Symp Biomed Imaging 2011:1175-1178
Paniagua, Beatriz; Cevidanes, Lucia; Walker, David et al. (2011) Clinical application of SPHARM-PDM to quantify temporomandibular joint osteoarthritis. Comput Med Imaging Graph 35:345-52
Almeida, R C; Cevidanes, L H S; Carvalho, F A R et al. (2011) Soft tissue response to mandibular advancement using 3D CBCT scanning. Int J Oral Maxillofac Surg 40:353-9

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