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Duplication of the face
LETTERS TO THE EDITOR J Oral Maxillofac Surg 47:554, 658-659. 1989
of orthognathic surgery. Currently there are several computer software systems that are programmed... :" These opening remarks indicate that the authors a~e indeed familiar with the software that is currently available for orthognathic treatment planning and video imaging. As the article evolves, the authors outline a method of dealing with the geometric and photographic distortion that occurs with such video imaging techniques and proceed to describe a method whereby this can be calibrated. The article then concludes with a comparison of the "Strengths and Weaknesses of Video Imaging." My emotions are mixed for the following reasons: First, I was pleased to see that a team of practitioners are using video imaging for their patient counseling and, at the same time, addressing the accuracy of the surgical treatment objective. On the other hand, I feel the full "message" has not gotten out to the profession of dentistry and, specifically, the specialty of oral and maxillofacial surgery. Dr Mark Conover and I are the developers of a fully integrated, interactive computer system that addresses the entire scope, including cephalometric input, analysis, treatment planning, interfacing of video imaging, and the creation of surgical treatment objectives. As a matter of fact, the Orthognathic Treatment Planner system has already addressed the so-called weaknesses described by the authors. Tooth position and its relationship to the face and soft tissue drape is known. The system also has the capability of precisely referencing and superimposing the tracing as well as the teeth over the video image. The distortional factors have been addressed and have been minimized by a one-to-one scaling algorithm, as well as the use of video photographic equipment that minimizes geometric and image distortion. The system also has the capability of determining proportional soft tissue to hard tissue movements. Some available software products, as described by the authors, may have their shortcomings. However, most of these have already been overcome. I would hope that the authors would avail themselves of the already obtainable software that has few or no weaknesses.
DUPLICATION OF THE FACE
To the Editor:-I read with interest the article by Chidzonga and Shija entitled "Congenital Median Cleft of the Lower Lip, Bifid Tongue With Ankyloglossia, Cleft Palate and Submental Epidermoid Cyst" (J Oral Maxillofac Su;g 46:809, 1988). This case parallels the one I described earlier in the Journal of Maxillofacial Surgery (12:19, 1984) entitled "Duplication of Structures Around the Stomatodeum." This patient also has a bifid tongue, a cleft palate, a hamartoma on the septum, duplication of the lower lip, duplication of the sella turcica, paired sphenold sinuses, a broad skull base, and duplication of the ventral aspect of the foramen magnum, with a tendency of the occipital bone to form an occipital vertebra. The vertebrae CI, C2, and C3 were flat and broad ventrally, and C2 showed two odontoid processes. C2 and C3 were fused. All the abnormalities could be explained by the hypothesis that a duplication of the anterior notochord had occurred during embryologic development. In my opinion, the case described probably also involved duplication of the anterior notochord, because this could explain all the described abnormalities. What the authors called a cleft lower lip was more likely a duplication of the lower lip, supporting my theory. It would be interesting if CT scans of the sella turcica and the occipital bone, as well as the cervical vertebrae, could be made in this case. A.R.M. WITIKAMPF, MD, DDS Utrecht, The Netherlands AVOIDING ABBREVIATIONS, ETC.
To the Editor:-I so enjoyed your editorial on abbreviations in the October issue (J Oral Maxillofac Surg 47:823, 1988). The problem you raise is a constant one and it's part of my discussion under "Standing Orders" every time I have new residents; but I'm afraid as I go through my usualjobation about avoiding neologisms and jottings and abbreviations they look on me, I can see, somewhat pitifully as evidence of a primitive and simple past that could afford the time to spend writing out words in full and declining to be abbreviated.
MELVYN S. WISHAN, DDS, MDS Beverly Hills, California
MVER S. LEONARD, MD, DDS Minneapolis, Minnesota
The author replies:-I would like to make the following comments regarding Dr Wishan's letter:
SELECTING SOFTWARE FOR VIDEO IMAGING
I. The intent of our article was not to present a survey of all software products available in video imaging, but to present our experiences and data with the technology we have chosen to use. This technology was chosen after looking at numerous software programs, including Dr Wishan's product. 2. Dr Wishan has not published any of his work, so while we certainly applaud his efforts, it is difficult to compare any of our findings with his. 3. Publication of an article involves a time lag, and by the time it appears in print many aspects may admittedly be outdated. This is particularly true in fields of endeavor that involve computer software development. We, too, have been working in the past 2 years to overcome the weaknesses described in our report. Continued on page 658
To the Editor:-I read with mixed emotions the article entitled "Video Imaging for Planning and Counseling in Orthognathic Surgery" (Sarver DM, Johnston MW, Matukas VJ, J Oral Maxillofac Surg 46:939, 1988). The article begins with "Computer imaging has received considerable attention lately as a means of predicting results Letters to the Editor are considered for publication (subject to editing and abridgment), provided that they are submitted in duplicate, signed by all authors, typewritten in double spacing, and do not exceed 40 typewritten lines of manuscript text (excluding references). Letters should not duplicate similar material being submitted or published elsewhere. Letters to a recent Journal article must be received within 6 weeks of the article's publication. Receipt ofletters is not acknowledged, correspondents will be notified when a decision is made.
554
of orthognathic surgery. Currently there are several computer software systems that are programmed... :" These opening remarks indicate that the authors a~e indeed familiar with the software that is currently available for orthognathic treatment planning and video imaging. As the article evolves, the authors outline a method of dealing with the geometric and photographic distortion that occurs with such video imaging techniques and proceed to describe a method whereby this can be calibrated. The article then concludes with a comparison of the "Strengths and Weaknesses of Video Imaging." My emotions are mixed for the following reasons: First, I was pleased to see that a team of practitioners are using video imaging for their patient counseling and, at the same time, addressing the accuracy of the surgical treatment objective. On the other hand, I feel the full "message" has not gotten out to the profession of dentistry and, specifically, the specialty of oral and maxillofacial surgery. Dr Mark Conover and I are the developers of a fully integrated, interactive computer system that addresses the entire scope, including cephalometric input, analysis, treatment planning, interfacing of video imaging, and the creation of surgical treatment objectives. As a matter of fact, the Orthognathic Treatment Planner system has already addressed the so-called weaknesses described by the authors. Tooth position and its relationship to the face and soft tissue drape is known. The system also has the capability of precisely referencing and superimposing the tracing as well as the teeth over the video image. The distortional factors have been addressed and have been minimized by a one-to-one scaling algorithm, as well as the use of video photographic equipment that minimizes geometric and image distortion. The system also has the capability of determining proportional soft tissue to hard tissue movements. Some available software products, as described by the authors, may have their shortcomings. However, most of these have already been overcome. I would hope that the authors would avail themselves of the already obtainable software that has few or no weaknesses.
DUPLICATION OF THE FACE
To the Editor:-I read with interest the article by Chidzonga and Shija entitled "Congenital Median Cleft of the Lower Lip, Bifid Tongue With Ankyloglossia, Cleft Palate and Submental Epidermoid Cyst" (J Oral Maxillofac Su;g 46:809, 1988). This case parallels the one I described earlier in the Journal of Maxillofacial Surgery (12:19, 1984) entitled "Duplication of Structures Around the Stomatodeum." This patient also has a bifid tongue, a cleft palate, a hamartoma on the septum, duplication of the lower lip, duplication of the sella turcica, paired sphenold sinuses, a broad skull base, and duplication of the ventral aspect of the foramen magnum, with a tendency of the occipital bone to form an occipital vertebra. The vertebrae CI, C2, and C3 were flat and broad ventrally, and C2 showed two odontoid processes. C2 and C3 were fused. All the abnormalities could be explained by the hypothesis that a duplication of the anterior notochord had occurred during embryologic development. In my opinion, the case described probably also involved duplication of the anterior notochord, because this could explain all the described abnormalities. What the authors called a cleft lower lip was more likely a duplication of the lower lip, supporting my theory. It would be interesting if CT scans of the sella turcica and the occipital bone, as well as the cervical vertebrae, could be made in this case. A.R.M. WITIKAMPF, MD, DDS Utrecht, The Netherlands AVOIDING ABBREVIATIONS, ETC.
To the Editor:-I so enjoyed your editorial on abbreviations in the October issue (J Oral Maxillofac Surg 47:823, 1988). The problem you raise is a constant one and it's part of my discussion under "Standing Orders" every time I have new residents; but I'm afraid as I go through my usualjobation about avoiding neologisms and jottings and abbreviations they look on me, I can see, somewhat pitifully as evidence of a primitive and simple past that could afford the time to spend writing out words in full and declining to be abbreviated.
MELVYN S. WISHAN, DDS, MDS Beverly Hills, California
MVER S. LEONARD, MD, DDS Minneapolis, Minnesota
The author replies:-I would like to make the following comments regarding Dr Wishan's letter:
SELECTING SOFTWARE FOR VIDEO IMAGING
I. The intent of our article was not to present a survey of all software products available in video imaging, but to present our experiences and data with the technology we have chosen to use. This technology was chosen after looking at numerous software programs, including Dr Wishan's product. 2. Dr Wishan has not published any of his work, so while we certainly applaud his efforts, it is difficult to compare any of our findings with his. 3. Publication of an article involves a time lag, and by the time it appears in print many aspects may admittedly be outdated. This is particularly true in fields of endeavor that involve computer software development. We, too, have been working in the past 2 years to overcome the weaknesses described in our report. Continued on page 658
To the Editor:-I read with mixed emotions the article entitled "Video Imaging for Planning and Counseling in Orthognathic Surgery" (Sarver DM, Johnston MW, Matukas VJ, J Oral Maxillofac Surg 46:939, 1988). The article begins with "Computer imaging has received considerable attention lately as a means of predicting results Letters to the Editor are considered for publication (subject to editing and abridgment), provided that they are submitted in duplicate, signed by all authors, typewritten in double spacing, and do not exceed 40 typewritten lines of manuscript text (excluding references). Letters should not duplicate similar material being submitted or published elsewhere. Letters to a recent Journal article must be received within 6 weeks of the article's publication. Receipt ofletters is not acknowledged, correspondents will be notified when a decision is made.
554