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3. Determining normal and abnormal lip shapes during movement for use as a surgical outcome measure

Author

Popat, Hashmat

Subjects
RK Dentistry
Abstract

Craniofacial assessment for diagnosis, treatment planning and outcome has traditionally relied on imaging techniques that provide a static image of the facial structure. Objective measures of facial movement are however becoming increasingly important for clinical interventions where surgical repositioning of facial structures can influence soft tissue mobility. These applications include the management of patients with cleft lip, facial nerve palsy and orthognathic surgery. Although technological advances in medical imaging have now enabled three-dimensional (3D) motion scanners to become commercially available their clinical application to date has been limited. Therefore, the aim of this study is to determine normal and abnormal lip shapes during movement for use as a clinical outcome measure using such a scanner. Lip movements were captured from an average population using a 3D motion scanner. Consideration was given to the type of facial movement captured (i.e. verbal or non-verbal) and also the method of feature extraction (i.e. manual or semi-automatic landmarking). Statistical models of appearance (Active Shape Models) were used to convert the video motion sequences into linear data and identify reproducible facial movements via pattern recognition. Average templates of lip movement were created based on the most reproducible lip movements using Geometric Morphometrics (GMM) incorporating Generalised Procrustes Analysis (GPA) and Principal Component Analysis (PCA). Finally lip movement data from a patient group undergoing orthognathic surgery was incorporated into the model and Discriminant Analysis (DA) employed in an attempt to statistically distinguish abnormal lip movement. The results showed that manual landmarking was the preferred method of feature extraction. Verbal facial gestures (i.e. words) were significantly more reproducible/repeatable over time when compared to non-verbal gestures (i.e. facial expressions). It was possible to create average templates of lip movement from the control group, which acted as an outcome measure, and from which abnormalities in movement could be discriminated pre-surgery. These abnormalities were found to normalise post-surgery. The concepts of this study form the basis of analysing facial movement in the clinical context. The methods are transferrable to other patient groups. Specifically, patients undergoing orthognathic surgery have differences in lip shape/movement when compared to an average population. Correcting the position of the basal bones in this group of patients appears to normalise lip mobility.

Published
2012

8. Assessment of Facial Movement

Author

Popat, Hashmat, primary, Richmond, Stephen, additional, Marshall, David, additional, Rosin, Paul L., additional, and Benedikt, Lanthao, additional

Published
2013
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13. The influence of snoring, mouth breathing and apnoea on facial morphology in late childhood: a three-dimensional study

Author

Al Ali, Ala, Richmond, Stephen, Popat, Hashmat, Playle, Rebecca, Pickles, Timothy, Zhurov, Alexei I., Marshall, David, Rosin, Paul L., Henderson, John, and Bonuck, Karen

Subjects
Male, three-dimensional imaging, RK, Cohort Studies, sleep disordered breathing, Imaging, Three-Dimensional, Sleep Apnea Syndromes, Humans, Longitudinal Studies, Child, Respiratory Medicine, Analysis of Variance, Research, Snoring, Mouth Breathing, ALSPAC, apnoea, United Kingdom, respiratory tract diseases, mouth-breathing, Child, Preschool, Face, Female, Anatomic Landmarks
Abstract

Objective: To explore the relationship between the prevalence of sleep disordered breathing (SDB) and face shape morphology in a large cohort of 15-year-old children. Design: Observational longitudinal cohort study Setting: Avon Longitudinal Study of Parents and Children (ALSPAC), South West of England. Participants: Three-dimensional surface laser scans were taken for 4784 white British children from the ALSPAC during a follow-up clinic. A total of 1724 children with sleep disordered breathing (SDB) and 1862 healthy children were identified via parents’ report of sleep disordered symptoms for their children. We excluded from the original cohort all children identified as having congenital abnormalities, diagnoses associated with poor growth and children with adenoidectomy and/or tonsillectomy. Main outcome measures: Parents in the ALSPAC reported sleep disordered symptoms (snoring, mouth breathing and apnoea) for their children at 6, 18, 30, 42, 57, 69 and 81 months. Average facial shells were created for children with and without SDB in order to explore surface differences. Results: Differences in facial measurements were found between the children with and without SDB throughout early childhood. The mean differences included an increase in face height in SDB children of 0.3 mm (95% CI −0.52 to −0.05); a decrease in mandibular prominence of 0.9° (95% CI −1.30 to −0.42) in SDB children; and a decrease in nose prominence and width of 0.12 mm (95% CI 0.00 to 0.24) and 0.72 mm (95% CI −0.10 to −0.25), respectively, in SDB children. The odds of children exhibiting symptoms of SDB increased significantly with respect to increased face height and mandible angle, but reduced with increased nose width and prominence. Conclusions: The combination of a long face, reduced nose prominence and width, and a retrognathic mandible may be diagnostic facial features of SBD that may warrant a referral to specialists for the evaluation of other clinical symptoms of SDB.

Published
2015

15. A Clinical Report of Nonsyndromic Concomitant Hypo-Hyperdontia

Author

Gupta, Siddarth and Popat, Hashmat

Subjects
stomatognathic diseases, stomatognathic system, Article Subject
Abstract

Although hypodontia and supernumerary teeth are often considered as mutually exclusive conditions, this case report presents an unusual case of hypodontia and a supernumerary tooth occurring simultaneously. An adolescent male was referred to the local hospital department regarding upper arch crowding. Plain film radiographs confirmed the congenital absence of both lower lateral incisors in addition to an unerupted conical supernumerary tooth in the maxillary midline. This condition has been called hypo-hyperdontia and in this paper, we discuss the clinical findings and treatment planning considerations in relation to the limited number of previously reported cases. The case report raises awareness of concomitant hypo-hyperdontia and serves to highlight that concomitant anomalies should be excluded when hypodontia or supernumerary teeth are diagnosed.

Published
2013
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19. Factors influencing patient-reported quality of life in pretreatment orthognathic surgery patients.

Author

Stagles, Christopher, Popat, Hashmat, and Rogers, Sheelagh

Subjects
ORTHOGNATHIC surgery, QUALITY of life, ORTHODONTICS, DEMOGRAPHIC surveys, REGRESSION analysis
Abstract

Objective: To investigate the relationship between condition-specific quality of life (QoL) and occlusal/skeletal traits of pretreatment orthognathic surgery patients. Materials and Methods: Patients referred for orthognathic surgery during the 2012-2014 period were asked to complete the Orthognathic Quality of Life Questionnaire (OQLQ) at consultation. Patient demographics, indices of treatment need, occlusal traits, and cephalometric variables were also recorded. Bivariate analyses were carried out between the OQLQ scores and the clinical measurements. Significant variables were added to a multivariate regression model to determine the effect of these predictive factors on OQLQ. Results: One hundred and two patients were recruited. Initial analyses showed that gender and overjet were significantly associated with the overall OQLQ score. Being female increased the overall OQLQ score by 15.6 points when compared to males (95% confidence interval [CI], 7.4-23.8). Females also had significant associations in the social and awareness domains of the OQLQ. The magnitude of overjet away from normal values was associated with poorer overall QoL, with significant relationships in the esthetic and functional domains. The Index of Orthognathic Functional Treatment Need was significantly associated with the functional domain of OQLQ, with patients in category 5 scoring a mean of 10.0 points more than patients in category 4 (95% CI, 2.1-17.8). The Index of Complexity, Outcome and Need and other cephalometric variables were not associated with the OQLQ. Conclusions: Females are more aware of their facial deformity and report a greater social detriment when compared to males. Patients with a higher orthognathic treatment need report greater functional disadvantage. [ABSTRACT FROM AUTHOR]

Published
2016
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25. Determining normal and abnormal lip shapes during movement for use as a surgical outcome measure

Author

Popat, Hashmat

Subjects
stomatognathic diseases, RK
Abstract

Craniofacial assessment for diagnosis, treatment planning and outcome has traditionally relied on imaging techniques that provide a static image of the facial structure. Objective measures of facial movement are however becoming increasingly important for clinical interventions where surgical repositioning of facial structures can influence soft tissue mobility. These applications include the management of patients with cleft lip, facial nerve palsy and orthognathic surgery. Although technological advances in medical imaging have now enabled three-dimensional (3D) motion scanners to become commercially available their clinical application to date has been limited. Therefore, the aim of this study is to determine normal and abnormal lip shapes during movement for use as a clinical outcome measure using such a scanner.\ud Lip movements were captured from an average population using a 3D motion scanner. Consideration was given to the type of facial movement captured (i.e. verbal or non-verbal) and also the method of feature extraction (i.e. manual or semi-automatic landmarking). Statistical models of appearance (Active Shape Models) were used to convert the video motion sequences into linear data and identify reproducible facial movements via pattern recognition. Average templates of lip movement were created based on the most reproducible lip movements using Geometric Morphometrics (GMM) incorporating Generalised Procrustes Analysis (GPA) and Principal Component Analysis (PCA). Finally lip movement data from a patient group undergoing orthognathic surgery was incorporated into the model and Discriminant Analysis (DA) employed in an attempt to statistically distinguish abnormal lip movement.\ud The results showed that manual landmarking was the preferred method of feature extraction. Verbal facial gestures (i.e. words) were significantly more reproducible/repeatable over time when compared to non-verbal gestures (i.e. facial expressions). It was possible to create average templates of lip movement from the control group, which acted as an outcome measure, and from which abnormalities in movement could be discriminated pre-surgery. These abnormalities were found to normalise post-surgery.\ud The concepts of this study form the basis of analysing facial movement in the clinical context. The methods are transferrable to other patient groups. Specifically, patients undergoing orthognathic surgery have differences in lip shape/movement when compared to an average population. Correcting the position of the basal bones in this group of patients appears to normalise lip mobility.

26. Determining normal and abnormal lip shapes during movement for use as a surgical outcome measure

Author

Popat, Hashmat and Popat, Hashmat

Abstract

Craniofacial assessment for diagnosis, treatment planning and outcome has traditionally relied on imaging techniques that provide a static image of the facial structure. Objective measures of facial movement are however becoming increasingly important for clinical interventions where surgical repositioning of facial structures can influence soft tissue mobility. These applications include the management of patients with cleft lip, facial nerve palsy and orthognathic surgery. Although technological advances in medical imaging have now enabled three-dimensional (3D) motion scanners to become commercially available their clinical application to date has been limited. Therefore, the aim of this study is to determine normal and abnormal lip shapes during movement for use as a clinical outcome measure using such a scanner. Lip movements were captured from an average population using a 3D motion scanner. Consideration was given to the type of facial movement captured (i.e. verbal or non-verbal) and also the method of feature extraction (i.e. manual or semi-automatic landmarking). Statistical models of appearance (Active Shape Models) were used to convert the video motion sequences into linear data and identify reproducible facial movements via pattern recognition. Average templates of lip movement were created based on the most reproducible lip movements using Geometric Morphometrics (GMM) incorporating Generalised Procrustes Analysis (GPA) and Principal Component Analysis (PCA). Finally lip movement data from a patient group undergoing orthognathic surgery was incorporated into the model and Discriminant Analysis (DA) employed in an attempt to statistically distinguish abnormal lip movement. The results showed that manual landmarking was the preferred method of feature extraction. Verbal facial gestures (i.e. words) were significantly more reproducible/repeatable over time when compared to non-verbal gestures (i.e. facial expressions). It was possible to create average te

27. Determining normal and abnormal lip shapes during movement for use as a surgical outcome measure

Author

Popat, Hashmat and Popat, Hashmat

Abstract

Craniofacial assessment for diagnosis, treatment planning and outcome has traditionally relied on imaging techniques that provide a static image of the facial structure. Objective measures of facial movement are however becoming increasingly important for clinical interventions where surgical repositioning of facial structures can influence soft tissue mobility. These applications include the management of patients with cleft lip, facial nerve palsy and orthognathic surgery. Although technological advances in medical imaging have now enabled three-dimensional (3D) motion scanners to become commercially available their clinical application to date has been limited. Therefore, the aim of this study is to determine normal and abnormal lip shapes during movement for use as a clinical outcome measure using such a scanner. Lip movements were captured from an average population using a 3D motion scanner. Consideration was given to the type of facial movement captured (i.e. verbal or non-verbal) and also the method of feature extraction (i.e. manual or semi-automatic landmarking). Statistical models of appearance (Active Shape Models) were used to convert the video motion sequences into linear data and identify reproducible facial movements via pattern recognition. Average templates of lip movement were created based on the most reproducible lip movements using Geometric Morphometrics (GMM) incorporating Generalised Procrustes Analysis (GPA) and Principal Component Analysis (PCA). Finally lip movement data from a patient group undergoing orthognathic surgery was incorporated into the model and Discriminant Analysis (DA) employed in an attempt to statistically distinguish abnormal lip movement. The results showed that manual landmarking was the preferred method of feature extraction. Verbal facial gestures (i.e. words) were significantly more reproducible/repeatable over time when compared to non-verbal gestures (i.e. facial expressions). It was possible to create average te

28. Effectiveness of an audience response system on orthodontic knowledge retention of undergraduate dental students--a randomised control trial.

Author

Robson N, Popat H, Richmond S, and Farnell DJ

Abstract

Objective: To determine the effect of an audience response system (ARS) on knowledge retention of dental students and to gauge student perceptions of using the ARS., Design: Randomised control study., Setting: School of Dentistry, Cardiff University., Participants: Seventy four second-year dental students were stratified by gender and randomised anonymously to one of two groups., Methods: One group received a lecture on orthodontic terminology and diagnosis in a traditional didactic format and the other received the same lecture integrated with ARS slides. Students completed an assessment of multiple-choice questions (MCQs) scored out of 20, before and immediately after the lecture. Students were also asked to complete a self-reported questionnaire on their perceptions of ARS., Results: Both groups had statistically significant increases in MCQ scores post-lecture (ARS mean increase 3.6 SD2.0, 95% CI 2.2-3.5 and Didactic mean increase 2.9 SD2.3, 95% CI 2.8-4.3). A mixed-design analysis of variance showed that ARS led to an improved MCQ score (by 0.8 or 25%) compared to the didactic group, although this effect was not significant (P = 0.15). The effect of gender at baseline (P = 0.49), post-lecture (P = 0.73) and increase in MCQ score split by group (P = 0.46) was also not significant. Students reported that the ARS was easy to use, helped them engage with the lecture and encouraged them to work harder., Conclusion: The ARS did not lead to a significant increase in short-term orthodontic knowledge recall of students compared with didactic teaching. However, the use of ARS within orthodontic teaching could make lectures more interactive and engaging.

Published
2015
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29. The orthodontic and surgical management of Zimmerman-Laband syndrome.

Author

Perks T, Popat H, Cronin AJ, Durning P, and Maggs R

Subjects
Abnormalities, Multiple surgery, Cephalometry methods, Craniofacial Abnormalities surgery, Female, Fibromatosis, Gingival surgery, Follow-Up Studies, Hand Deformities, Congenital surgery, Humans, Incisor pathology, Malocclusion surgery, Malocclusion, Angle Class II therapy, Maxilla abnormalities, Maxillary Osteotomy methods, Open Bite surgery, Open Bite therapy, Patient Care Planning, Radiography, Panoramic, Retrognathia surgery, Retrognathia therapy, Vertical Dimension, Young Adult, Abnormalities, Multiple therapy, Craniofacial Abnormalities therapy, Fibromatosis, Gingival therapy, Hand Deformities, Congenital therapy, Malocclusion therapy, Orthodontics, Corrective methods, Orthognathic Surgical Procedures methods
Abstract

Zimmermann-Laband syndrome (ZLS) is a rare autosomal disorder characterized by gingival fibromatosis, abnormalities of the nose and/or ears, hypoplasia of the nails or terminal phalanges of the hands and feet, hyperextensibility of joints, hepatosplenomegaly, hirsutism, and intellectual disability. The characteristics of the syndrome are highly variable and complicated. This paper reports a case of ZLS and the clinical manifestations encountered in relation to the current available literature. The comprehensive management of the patient's dentition is described, focusing on the orthodontic and surgical considerations clinicians should be aware of when treating patients with the syndrome.

Published
2013
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30. Facial movement in 3 dimensions: average templates of lip movement in adults.

Author

Popat H, Richmond S, Marshall D, and Rosin PL

Subjects
Adult, Female, Humans, Male, Reference Values, Reproducibility of Results, Young Adult, Facial Expression, Facial Muscles physiology, Image Processing, Computer-Assisted methods, Imaging, Three-Dimensional methods, Lip physiology, Muscle Contraction physiology, Phonation physiology, Software, Video Recording methods
Abstract

Objective: To construct 3-dimensional (3D) templates of average lip movement based on a group of normal healthy subjects., Study Design: Cross-sectional study., Setting: School of Dentistry, Cardiff University, United Kingdom., Subjects and Methods: One hundred fifteen white subjects were asked to perform 2 reproducible verbal gestures (/puppy/ and /rope/) in a normal relaxed manner. The sequences were captured using a noninvasive, 3D motion scanner (3dMDFace Dynamic System). Mesh-registration software was used to align sequential facial shells to a standardized reference plane. Lip movement during the verbal facial gestures was quantified using the displacement vectors (x, y, z coordinates) of 6 lip landmarks of sequential 3D facial shells subtracted from the reference or rest shell. Descriptive statistics were used to build references for average lip movement, and independent t tests were used to compare lip movement between men and women., Results: Mean reference movements were created for lip opening, lip stretch, and lip purse that corresponded to the visemes /pu/ /ppy/ and /rope/, respectively. There were statistically significant differences in the lip movement between genders for the visemes /pu/ and /ppy/, although when quantified these were found not to be of clinical significance. Men favored left-sided movement and women right-sided movement, although only slightly--again, when quantified, this was considered to be within symmetrical limits., Conclusion: It was possible to quantify and create normal templates of lip movement for the words /puppy/ and /rope/. Men and women show similar standardized lip movements for these 2 words.

Published
2011
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