Escaneamento extraoral para análise facial na odontologia
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Data
2023-03-10
Autores
Nogueira, Básia Rabelo
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O diagnóstico correto, feito através de imagens, e o planejamento dos procedimentos de Harmonização Orofacial (HOF) são de extrema importância para o sucesso do tratamento. Scanners faciais que funcionam com a tecnologia de luz estruturada ou fotogrametria podem ser úteis por proporcionarem a captura de imagens que geram modelos 3D de forma confiável, prática e com maior biossegurança. Além de, permitir a extração de medidas antropométricas dos pacientes através de software especifico para aferições quantitativas de volume bem como estimativas de alteração das medidas de antes e depois de tratamentos com HOF. Entretanto, não existe ainda um protocolo definido de escaneamento utilizando a tecnologia mais apropriada. O objetivo desse trabalho foi avaliar e comparar a acurácia de um scanner com tecnologia de fotogrametria, Cloner 3D (Cloner scanning cabin, dOne 3D – Ribeirão Preto – SP – Brasil) comparando-o com um sistema de luz estruturada (Bellus3D Face Camera Pro-Bellus3D, Inc. Los Gatos, CA, USA) e descrever um protocolo de alinhamento e comparação de modelos 3D obtidos durante o tratamento com toxina botulínica (TB) a fim de avaliar qualitativamente as alterações proporcionadas pelo tratamento. Na primeira etapa, onze participantes foram incluídos no estudo. Nove etiquetas adesivas foram utilizadas para identificar os marcos faciais: Trichion (Tri), Glabella (G), Exocanto direito (Exr) e esquerdo (Exl), pronasal (Pn), Subnasal (Sn), Ângulo direito (Chr) e esquerdo (Chl) da boca e Mentoniano (Me). Dois examinadores treinados e calibrados foram responsáveis por realizar sete medidas lineares (Tri-G, Sn-Me, Exr-Exl, Chr-Chl, Exr-Chr, Exl-Chl, Pn-Sn) primeiramente com paquímetro digital e posteriormente em um modelo tridimensional obtido com tecnologia fotogramétrica. As avaliações foram realizadas dividindo os pacientes em dois grupos, com cross-over e wash-out de 7 dias para avaliação da calibração intra-examinador. O coeficiente de correlação intraclasse (ICC), desvio padrão e correlação de Bland Altman foram utilizados para comparar as medidas realizadas. Na segunda etapa, com 10 pacientes, as mesmas medidas faciais foram aferidas utilizando um scanner de luz estruturada e pelo scanner fotogramétrico, pelos dois avaliadores, e então comparadas com as do paquímetro digital. O ICC e correlação de Bland Altman foram utilizados. Após a validação do scanner fotogramétrico, na terceira etapa, o mesmo foi utilizado para o registro de pacientes tratados com TB. Através de um protocolo de alinhamento e comparação de modelos 3D, utilizando um software gratuito, foram gerados mapas de cores indicando a diferença entre as nuvens 3D e analisou-se qualitativamente os resultados. O ICC obtido nas duas primeiras etapas foi excelente (ICC>0,9). O scanner fotogramétrico mostrou acurácia clinicamente aceitável variando em -0,8mm±1,2mm. O scanner fotogramétrico apresentou maior acurácia (-0,664±1,056mm) comparado ao scanner de luz estruturada (-1,010±1,556mm). Com o protocolo adotado na terceira etapa foi possível avaliar qualitativamente os efeitos da TB durante o tratamento.
The correct diagnosis, made through images, and planning of Orofacial Harmonization (HOF) procedures are extremely important for the success of the treatment. Facial scanners that work with structured light technology or photogrammetry can be useful for providing the capture of images that generate 3D models in a reliable, practical way and with greater biosafety. In addition, it is possible the extraction of anthropometric measurements of patients through specific software for quantitative measurements of volume as well as estimates of change in measurements before and after treatments with HOF. However, there is still no defined scanning protocol using the most appropriate technology. The objective of this work was to evaluate and compare the accuracy of a scanner with photogrammetry technology, Cloner 3D (Cloner scanning cabin, dOne 3D – Ribeirão Preto – SP – Brazil) comparing it with a structured light system (Bellus3D Face Camera Pro- Bellus3D, Inc. Los Gatos, CA, USA) and to describe a protocol for aligning and comparing 3D models obtained during treatment with botulinum toxin (BT) in order to qualitatively assess the alterations provided by the treatment. In the first stage, eleven participants were included in the study. Nine adhesive labels were used to identify the facial landmarks: Trichion (Tri), Glabella (G), right (Exr) and left (Exl) exocanthus, pronasal (Pn), Subnasal (Sn), right (Chr) and left ( Chl) Chelion and Mentonian (Me). Two trained and calibrated examiners were responsible for performing seven linear measurements (Tri-G, Sn-Me, Exr-Exl, Chr-Chl, Exr-Chr, Exl-Chl, Pn-Sn) firstly with a digital caliper and later on a model three-dimensional image obtained with photogrammetric technology. The evaluations were carried out by dividing the patients into two groups, with a 7-day cross-over and wash-out to evaluate the intra-examiner calibration. The intraclass correlation coefficient (ICC), standard deviation and Bland Altman correlation were used to compare the measurements taken. In the second stage, with 10 patients, the same facial measurements were taken using a structured light scanner and a photogrammetric scanner, by the two evaluators, and then compared with the digital caliper. The ICC and Bland Altman correlation were used. After validation of the photogrammetric scanner, in the third stage, it was used to register patients treated with TB. Through a protocol of alignment and comparison of 3D models, using free software, color maps were generated indicating the difference between the 3D clouds and the results were qualitatively analyzed. The ICC obtained in the first two steps was excellent (ICC>0.9). The photogrammetric scanner showed clinically acceptable accuracy ranging from -0.8mm±1.2mm. The photogrammetric scanner showed greater accuracy (-0.664±1.056mm) compared to the structured light scanner (-1.010±1.556mm). With the protocol adopted in the third stage, it was possible to qualitatively assess the effects of BT during treatment.
The correct diagnosis, made through images, and planning of Orofacial Harmonization (HOF) procedures are extremely important for the success of the treatment. Facial scanners that work with structured light technology or photogrammetry can be useful for providing the capture of images that generate 3D models in a reliable, practical way and with greater biosafety. In addition, it is possible the extraction of anthropometric measurements of patients through specific software for quantitative measurements of volume as well as estimates of change in measurements before and after treatments with HOF. However, there is still no defined scanning protocol using the most appropriate technology. The objective of this work was to evaluate and compare the accuracy of a scanner with photogrammetry technology, Cloner 3D (Cloner scanning cabin, dOne 3D – Ribeirão Preto – SP – Brazil) comparing it with a structured light system (Bellus3D Face Camera Pro- Bellus3D, Inc. Los Gatos, CA, USA) and to describe a protocol for aligning and comparing 3D models obtained during treatment with botulinum toxin (BT) in order to qualitatively assess the alterations provided by the treatment. In the first stage, eleven participants were included in the study. Nine adhesive labels were used to identify the facial landmarks: Trichion (Tri), Glabella (G), right (Exr) and left (Exl) exocanthus, pronasal (Pn), Subnasal (Sn), right (Chr) and left ( Chl) Chelion and Mentonian (Me). Two trained and calibrated examiners were responsible for performing seven linear measurements (Tri-G, Sn-Me, Exr-Exl, Chr-Chl, Exr-Chr, Exl-Chl, Pn-Sn) firstly with a digital caliper and later on a model three-dimensional image obtained with photogrammetric technology. The evaluations were carried out by dividing the patients into two groups, with a 7-day cross-over and wash-out to evaluate the intra-examiner calibration. The intraclass correlation coefficient (ICC), standard deviation and Bland Altman correlation were used to compare the measurements taken. In the second stage, with 10 patients, the same facial measurements were taken using a structured light scanner and a photogrammetric scanner, by the two evaluators, and then compared with the digital caliper. The ICC and Bland Altman correlation were used. After validation of the photogrammetric scanner, in the third stage, it was used to register patients treated with TB. Through a protocol of alignment and comparison of 3D models, using free software, color maps were generated indicating the difference between the 3D clouds and the results were qualitatively analyzed. The ICC obtained in the first two steps was excellent (ICC>0.9). The photogrammetric scanner showed clinically acceptable accuracy ranging from -0.8mm±1.2mm. The photogrammetric scanner showed greater accuracy (-0.664±1.056mm) compared to the structured light scanner (-1.010±1.556mm). With the protocol adopted in the third stage, it was possible to qualitatively assess the effects of BT during treatment.
Descrição
Palavras-chave
Imageamento Tridimensional, Antropometria, Fotogrametria, Toxinas Botulínicas Tipo A, Imaging, three-dimensional, Anthropometry, Photogrammetry, Botulinum toxins, type A