Association between intraoral pressure and molar position and inclination in subjects with facial asymmetry

Abstract

Although it has been suggested that an imbalance in buccolingual pressure may play a role in dental compensation of the molars and asymmetry in the mandibular dental arch in subjects with facial asymmetry, it is still unclear whether buccolingual pressure is associated with this phenomenon. Thus, the purpose of this study was to test the null hypothesis that there are no differences in cheek and tongue pressure between the shifted and non-shifted sides in 12 (8 females and 4 males, mean age: 24.9 years) subjects with facial asymmetry defined as 4 mm or more deviation of the midline in the mandibular incisors. The resting buccolingual pressure on the bilateral mandibular first molars was measured simultaneously using four miniature pressure sensors. Moreover, a postero-anterior (PA) cephalogram was used to determine the buccolingual positions and the inclination of the mandibular first molars. Wilcoxon t-, Kruskal-Wallis H-, and Mann-Whitney U-tests and Spearman correlation coefficient by rank were used for statistical analysis. Significance was set at P < 0.05. Cheek pressure was significantly greater on the shifted than that on the non-shifted side, while tongue pressure on the shifted side was significantly less than that on the non-shifted side. On the other hand, tongue/cheek pressure ratio on the shifted side was significantly less than that on the non-shifted side. There were significant differences between the shifted and non-shifted sides in the buccolingual positions and inclination of the mandibular first molars. Regardless of the side, there were significant negative correlations between the buccolingual position of the mandibular first molars and cheek pressure and significant positive correlations between the buccolingual position of the mandibular first molars and tongue/cheek pressure ratio. There were also significant negative correlations between tongue/cheek pressure ratio and inclination of the mandibular first molars on both the shifted and the non-shifted sides. Thus, the present findings reject the null hypothesis. The imbalance in buccolingual pressure in subjects with facial asymmetry appears to be related to dental compensation of the molars and mandibular asymmetry.