Normal orbit skeletal changes in adolescents as determined through cone-beam computed tomography
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RESEARCH
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Normal orbit skeletal changes in adolescents as determined through cone-beam computed tomography B. Lee1, C. Flores-Mir1 and M. O. Lagravère1,2*
Abstract Background: To determine three-dimensional spatial orbit skeletal changes in adolescents over a 19 to 24 months observation period assessed through cone-beam computed tomography (CBCT). Methods: The sample consisted of 50 adolescents aged 11 to 17. All were orthodontic patients who had two CBCTs taken with an interval of 19 to 24 months between images. The CBCTs were analyzed using the third-party software Avizo. Sixteen anatomical landmarks resulting in 24 distances were used to measure spatial structural changes of both orbits. Reliability and measurement error of all landmarks were calculated using ten CBCTs. Descriptive and t-test statistical analyses were used to determine the overall changes in the orbits. Results: All landmarks showed excellent reliability with the largest measurement error being the Y-coordinate of the left most medial point of the temporalis grooves at 0.95 mm. The mean differences of orbital changes between time 1 and time 2 in the transverse, antero-posterior and vertical directions were 0.97, 0.36 and 0.33 mm respectively. Right to left most antero-inferior superior orbital rim distance had the greatest overall transverse change of 4.37 mm. Right most posterior point of lacrimal crest to right most postero-lateral point of the superior orbital fissure had the greatest overall antero-posterior change of 0.52 mm. Lastly, left most antero-inferior superior orbital rim to left most antero-superior inferior orbital rim had the greatest overall vertical change of 0.63 mm. Conclusions: The orbit skeletal changes in a period of 19–24 months in a sample of 11–17 year olds were statistically significant, but are not considered to be clinically significant. The overall average changes of orbit measurements were less than 1 mm. Keywords: Orbit, Cone-beam computed tomography, Growth, Orthodontics
Background The orbit is a complex structure composed of seven bones. These bones include the frontal, lacrimal, ethmoidal, maxillary, zygomatic, sphenoid and palatine bones [1]. The orbit itself is considered to be a fourwalled unit where each wall has its own clinically important structures [2]. Due to the orbit’s association with the eye globe and surrounding structures, proper understanding of orbital growth can be beneficial to different fields of medicine and dentistry. Applications include preoperative planning for orbit reconstruction, orbital * Correspondence: [email protected] 1 Department of Dentistry, University of Alberta, Edmonton, Canada 2 Department of Medicine and Dentistry, School of Dentistry, University of Alberta, 5524 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton T6G 1C9, Canada
rehabilitation to promote normal orbital growth, forensic identification and orthodontic diagnosis and treatment planning [3–5]. The latter because of the concept that intraorbital measurements are presumed to be stable after
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