Anteroposterior Dysplasia Indicator Research Articles

A structural equation modeling approach to determine the correlation between the vertical and sagittal skeletal patterns and posterior basal bones mismatching in patients with skeletal Class III malocclusion

Matching the maxillomandibular basal bone width is essential to the stability of orthodontic treatment. We aimed to determine the relationship between basal bone width mismatching and the vertical and sagittal skeletal pattern in patients with skeletal Class III malocclusion through shape analysis and structural equation modeling (SEM). Cone-beam computed tomography images were collected from 45 men and 51 women. Width mismatching of the basal bone was determined using generalized Procrustes analysis. Twenty-two parameters from the synthesized cephalogram were measured, followed by factor analysis and SEM. Mismatch occurred at the second molar (men, -4.29 ± 4.32 mm; women, -5.55 ± 4.43 mm) and retromolar regions (men, -8.49 ± 5.11 mm; women: -8.93 ± 5.25 mm). The sum of angles had the largest loading for vertical-1 (extracted from 18 vertical cephalometric measurements) (men, 0.9477; women, 0.9489), followed by MP-SN angle (0.9408) in men and N-Me/S-Go (0.9342) in women. Wits appraisal and anteroposterior dysplasia indicator were largest for Sagittal-1. SEM showed a positive effect of male vertical-1 and 2 on width difference in the retromolar region (P<0.001; B>0). Female vertical-1 had a significant positive effect on DW7 (P<0.001; B= 5.535) and DWR (P= 0.016; B= 3.427) as vertical-2. Sagittal-1 showed a negative correlation with DW7 in both genders (P<0.05; B<0) and with DWR in men. Basal bone width mismatching occurred at the second molar and retromolar regions, especially in low-angle and patients with severe skeletal Class III malocclusion.

Morfología del ángulo mandibular en sujetos con mordida abierta de acuerdo a la relación esquelética: un informe breve en CBCT.

Aim: The purpose of this research was to three-dimensionally evaluate the mandibular angle morphology in open bite subjects with different sagittal skeletal relationships. Material and Methods: Cone beam computed tomography (CBCT) images of 26 subjects (12 men and 14 women) with anterior open bite were evaluated. The sample included 3 groups categorized by their sagittal skeletal relationship (based on ANB angle and anteroposterior dysplasia indicator (APDI)): Class I (n=9), Class II (n=6) and Class III (n=11). The total gonial angle, upper gonial angle, lower gonial angle, intergonial width, interantegonial width and antegonial notch depth were measured. ANOVA and Tukey tests were used for intergroup comparison. The Kruskal Wallis test was also used when necessary. In addition, the Pearson correlation coefficient was calculated to evaluate significant correlations between overbite and antegonial notch depth with gonial angle, Frankfurt mandibular plane angle (FMA) and the palatal plane-mandibular plane (PP-MP). Results: A significant difference was only found on the upper gonial angle between Class II and Class III (p=0.047). The upper gonial angle showed greater values (48°±3°) with the mandibular branch toward backward in Class III subjects and lower values (42.42°±4.39°) with the mandibular ramus leaning forward in subjects with Class II skeletal relationship. Besides, only a statistically significant correlation was found between overbite and the lower gonial angle (r=-0.418, p=0.034). Conclusion: Mandibular angle morphology is similar in anterior open bite subjects with different sagittal skeletal relationships, except for the upper gonial angle which is increased in Class III and decreased in Class II subjects with open bite. Lower gonial angle is negatively correlated with overbite. This difference should be considered by orthodontists when planning their treatments.

Evaluating Diagnostic Validity of Various Sagittal Cephalometric Parameters (a Comparative Retrospective Study)

Objective: The goal of this study was to determine the accuracy and reliability of numerous skeletal analyses for determining the sagittal skeletal pattern. &#x0D; Methods: A total of 105 cephalometric x-rays were used. The Steiner’s ANB angle, anteroposterior dysplasia indicator (APDI), and angle of convexity by Down’s assessed the anteroposterior skeletal pattern. According to the diagnostic results of the majority of the criteria, the samples were divided into three classes: I, II, and III. The analyses' validity and reliability were assessed using Kappa statistics, positive predictive value, and sensitivity. &#x0D; Results: There was a moderate agreement between the ANB angle and the final diagnosis (K= 0.593). The ANB angle demonstrated the highest sensitivity in class II and III groups (1.00). &#x0D; Conclusions: The ANB angle and down's angle of convexity was the most accurate markers for class I and III groups, respectively, while the Down's angle of convexity and APDI were the most accurate indicators for class III group.

Determination of Combination Factor as an Aid in Orthodontic Treatment Planning in Western Region of Saudi Arabian Young Male Population- A Retrospective Cephalometric Study

Introduction: Diagnosis and treatment planning in orthodontics determines the treatment outcome and long term stability. Cephalometric radiography is an essential diagnostic aid in orthodontics and hence numerous studies have been carried out in the past. Aim: To determine the Combination Factor (CF) through evaluation of the mean Overbite Depth Indicator (ODI) and Anteroposterior Dysplasia Indicator (APDI) values in western region of Saudi Arabian young male patients which would act as an aid in orthodontic treatment planning. Materials and Methods: A retrospective cephalometric study was conducted on 80 Saudi Arabian young male patients ranging in age from 7 to 14 years. Data was collected from records derived from the University Dental Hospital. Patients (n=80) were divided into four age groups: ages 7 (n=20), 8-9 (n=20), 10-11 (n=20), and 12-14 (n=20) years. Lateral cephalometric images were hand-traced and measured by one standardised and calibrated investigator. Statistical analysis was done with significance level set at 0.05, assuming that the length of the 95% confidence interval was two. One-way analysis of variance, followed by the Tukey test used to compare the mean ODI and APDI values of different groups. The statistical data were analysed through SPSS version 24 for Windows (IBM SPSS, Chicago, IL, USA). Results: The mean ODI value was 69.2688° and standard deviation 4.66670°, respectively. The overall APDI mean value was 81.7063° and standard deviation 4.18987°, respectively. There were no significant differences in the mean ODI and APDI values among different age groups (p&gt;0.05). Conclusion: This retrospective cephalometric study determined the CF for western region of Saudi Arabian young male population to be 150.96°. This factor can be used as a diagnostic aid for planning orthodontic treatment. When the CF, is under the norm (150.96°), the skeletal pattern tends to improve with dental extractions. A CF higher than the norm (150.96°) will maintain a better relation with a non-extraction treatment.

Cephalometric Predictors of Future need for Orthognathic Surgery in Korean Patients with Unilateral Cleft Lip and Palate Despite Long-term Use of Facemask with Miniplate.

ObjectiveTo investigate the cephalometric predictors of the future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate (UCLP) despite long-term use of facemask with miniplate (FMMP).MethodsThe sample consisted of 53 UCLP patients treated by a single orthodontist using an identical protocol. Lateral cephalograms were taken before commencement of FMMP therapy (T0; mean age, 10.45 years), after FMMP therapy (T1; mean age, 14.72 years), and at follow-up (T2; mean age, 18.68 years). Twenty-eight cephalometric variables were measured. At T2 stage, the subjects were divided into FMMP-Nonsurgery (n = 33, 62.3%) and FMMP-Surgery (n = 20, 37.7%) groups according to cephalometric criteria (point A-nasion-point B [ANB] < –3°; Wits-appraisal < –5 mm; and Harvold unit difference [HUD] > 34 mm for FMMP-Surgery group). Statistical analyses including discrimination analysis were performed.ResultsIn FMMP-Surgery group, the forward position of the mandible at T0 stage was maintained throughout the whole stages and Class III relationship worsened with significant growth of the mandibular body and ramus and counterclockwise rotation of the maxilla and mandible at the T1 and T2 stages. Six cephalometric variables at T0 stage including ANB, anteroposterior dysplasia indicator, Wits-appraisal, mandibular body length, HUD, and overjet were selected as effective predictors of the future need for surgical intervention to correct sagittal skeletal discrepancies.ConclusionsDespite long-term use of FMMP therapy, 37.7% of UCLP patients became candidates for orthognathic surgery. Therefore, differential diagnosis is necessary to predict the future need for orthognathic surgery at early age.

Overbite depth indicator and anteroposterior dysplasia indicator cephalometric norms for African Americans.

To examine normal Overbite Depth Indicator (ODI) and Anteroposterior Dysplasia Indicator (APDI) values in African Americans and to compare them with mean values from white patients. Secondary aims were to compare mean ODI and APDI values among different age, gender, and combined age-gender groups in African American patients. Lateral cephalometric radiographs of 160 African American patients (97 boys and 63 girls; age, 7 to 14 years) with normal occlusion and no history of orthodontic treatment were collected from the Bolton-Brush Growth Center. Cephalometric images were hand traced, and ODI and APDI values were assessed. Two-sample t tests were used to compare mean ODI and APDI values between African American and white patients; and between male and female African American patients. One-way analysis of variance, followed by the Tukey test, was used to compare mean ODI and APDI values among different African American age and combined age-gender groups. Mean ODI and APDI values were significantly lower (P < .0001) in African American than white patients with normal occlusion and no history of orthodontic treatment. Mean ODI and APDI values increased with age in African American patients, and there were no significant gender differences. The mean ODI and APDI values in 7- to 14-year-old African Americans with normal occlusion and no history of orthodontic treatment were 70.9° and 78.1°, respectively, and were significantly lower than the mean values for white patients in the same age range.

Efficiency of ODI and APDI of Kim's cephalometric analysis in a Latin American population with skeletal open bite.

ABSTRACTObjective: The objective of this research was to demonstrate the efficiency of the overbite depth indicator (ODI) and the anteroposterior dysplasia indicator (APDI) from Kim’s cephalometric analysis, regarding the determination of the vertical and sagittal patterns of Latin American individuals. Methods: Two hundred lateral cephalometric radiographs were selected and divided into four study groups, with 50 radiographs each, for carrying out a cross-sectional study. The control group included radiographs of balanced individuals, and the other three groups had lateral cephalometric radiographs of subjects with Class I, II and III malocclusions and with skeletal open bite. After the pilot test was performed to calibrate the investigator, the ODI and APDI were measured. Descriptive statistics were performed and the one-way ANOVA with post-hoc Tukey HSD, or Kruskal-Wallis and Mann-Whitney U-test were used. Also a multiple linear regression was employed.Results: Statistically significant differences were found for the ODI of all groups (p< 0.001), except between Class I group (65.87 ± 4.26) and Class II open bite group (67.19 ± 3.58), both with similar values to each other. For APDI, statistically significant differences were also found for all groups (p< 0.001). However, no statistically significant differences were found between the balanced group (83.18 ± 1.71) and Class I group with skeletal open bite (81.78 ± 2.69). Conclusions: ODI and APDI are reliable indicators to evaluate the sagittal and vertical patterns of an individual, demonstrating their efficiency when a Latin American population was evaluated.

Identification of ‘Point A’ as the prevalent source of error in cephalometric analysis of lateral radiographs

Deviations in measuring dentofacial components in a lateral X-ray represent a major hurdle in the subsequent treatment of dysgnathic patients. In a retrospective study, we investigated the most prevalent source of error in the following commonly used cephalometric measurements: the angles Sella-Nasion-Point A (SNA), Sella-Nasion-Point B (SNB) and Point A-Nasion-Point B (ANB); the Wits appraisal; the anteroposterior dysplasia indicator (APDI); and the overbite depth indicator (ODI). Preoperative lateral radiographic images of patients with dentofacial deformities were collected and the landmarks digitally traced by three independent raters. Cephalometric analysis was automatically performed based on 1116 tracings. Error analysis identified the x-coordinate of Point A as the prevalent source of error in all investigated measurements, except SNB, in which it is not incorporated. In SNB, the y-coordinate of Nasion predominated error variance. SNB showed lowest inter-rater variation. In addition, our observations confirmed previous studies showing that landmark identification variance follows characteristic error envelopes in the highest number of tracings analysed up to now. Variance orthogonal to defining planes was of relevance, while variance parallel to planes was not. Taking these findings into account, orthognathic surgeons as well as orthodontists would be able to perform cephalometry more accurately and accomplish better therapeutic results.

Reliability of overbite depth indicator (ODI) and anteroposterior dysplasia indicator (APDI) in the assessment of different vertical and sagittal dental malocclusions: a receiver operating characteristic (ROC) analysis.

ABSTRACTIntroduction: Differential diagnosis of skeletal and dental relationships is crucial for planning orthodontic treatment. Overbite depth indicator (ODI) and anteroposterior dysplasia indicator (APDI) had been introduced in the past for assessment of vertical and sagittal jaw relationships, respectively. Objective: The objectives of this study were to evaluate the reliability of ODI and APDI in overbite and Angle malocclusions, as well as assess their diagnostic reliability among males and females of different age groups. Material and Methods: This study was conducted using pretreatment dental casts and lateral cephalograms of 90 subjects. For ODI, subjects were divided into three groups based on overbite (normal overbite, open bite and deep bite). Likewise, the same subjects were divided for APDI into three groups, based on Angle's malocclusion classification (dental Class I, II and III malocclusions). Mann-Whitney U test was applied for comparison of study parameters regarding sex and different age groups. The mean values of ODI and APDI were compared among study groups by means of Kruskal-Wallis and post-hoc Dunnet T3 tests. The receiver operating characteristic (ROC) curve was applied to test diagnostic reliability. Results: Insignificant differences were found for ODI and APDI angles, particularly in regards to sex and age. Significant intergroup differences were found in different overbite groups and Angle's classification for ODI and APDI, respectively (p < 0.001). ROC showed 91% and 88% constancy with dental pattern in ODI and APDI, respectively. Conclusions: ODI can reliably differentiate deep bite versus normal overbite and deep bite versus open bite. APDI can reliably differentiate dental Class I, II and III malocclusions.

Reliability of Beta angle in assessing true anteroposterior apical base discrepancy in different growth patterns.

Introduction:Beta angle as a skeletal anteroposterior dysplasia indicator is known to be useful in evaluating normodivergent growth patterns. Hence, we compared and verified the accuracy of Beta angle in predicting sagittal jaw discrepancy among subjects with hyperdivergent, hypodivergent and normodivergent growth patterns.Materials and Methods:Lateral cephalometric radiographs of 179 patients belonging to skeletal Classes I, II, and III were further divided into normodivergent, hyperdivergent, and hypodivergent groups based on their vertical growth patterns. Sagittal dysplasia indicators - angle ANB, Wits appraisal, and Beta angle values were measured and tabulated. The perpendicular point of intersection on line CB (Condylion-Point B) in Beta angle was designated as ‘X’ and linear dimension XB was evaluated.Results:Statistically significant increase was observed in the mean values of Beta angle and XB distance in the vertical growth pattern groups of both skeletal Class I and Class II patients thus pushing them toward Class III and Class I, respectively.Conclusions:Beta angle is a reliable indicator of sagittal dysplasia in normal and horizontal patterns of growth. However, vertical growth patterns significantly increased Beta angle values, thus affecting their reliability as a sagittal discrepancy assessment tool. Hence, Beta angle may not be a valid tool for assessment of sagittal jaw discrepancy in patients exhibiting vertical growth patterns with skeletal Class I and Class II malocclusions. Nevertheless, Class III malocclusions having the highest Beta angle values were unaffected.

Effectiveness of the analysis of craniofacial morphology and pharyngeal airway morphology in the treatment of children with obstructive sleep apnoea syndrome

In general, no consensus has been reached regarding the diagnostic criteria for obstructive sleep apnoea syndrome (OSAS) in children and the criteria for selecting treatment are inconsistent. Therefore, the craniofacial and pharyngeal airway morphology of OSAS in children who had undergone drug therapy (non-op group) and OSAS in children who had undergone both drug therapy and surgical therapy (adenotonsillectomy) (op group) were compared. The purpose of this study was to examine the effectiveness of craniofacial morphology and pharyngeal airway morphology analysis in the treatment of children with OSAS. The craniofacial and pharyngeal airway morphology of the control group, the non-op group and the op group were compared to examine the differences of each group. The comparison used Mann-Whitney's U test. A comparison between the non-op and the op groups showed significant differences in the facial axis, mandibular plane angle, ramus plane to the SN (porion and orbit) point, point Pog (pogonion) to the McNamara line, anteroposterior dysplasia indicator (APDI), D-AD1 [the distance between the posterior nasal spine (PNS) point and the nearest adenoid tissue, measured along the PNS-Ba (basion) point plane], D-AD2 (the distance between the PNS point and the nearest adenoid tissue, measured along a line from the PNS point perpendicular to the S (sella turcica)-Ba point plane), upper pharynx and soft palatal length. The op group showed significantly lower values of APDI than the non-op group, indicating that the op group showed a significant occlusion of class II, and that the mandibular bone was positioned posteriorly relative to the maxillary bone. The op group showed a significant posterior position and backward rotation of the mandibular bone, stenosis of the nasopharyngeal airway and an elongated soft palate compared with the non-op group, and it was speculated that there was a high probability of the necessity of surgical therapy (adenotonsillectomy) when a morphological factor played a major role as a cause of obstructive sleep apnoea. We recommend craniofacial morphology analysis and pharyngeal airway morphology analysis in the diagnosis and treatment planning of OSAS children.

Comparison of Japanese and European overbite depth indicator and antero-posterior dysplasia indicator values

This study evaluated cephalometric differences between 113 Japanese (43 males and 70 females, aged 14.1 ± 5 years) and 106 European subjects (36 males and 70 females, aged 13.5 ± 7.3 years) using two compound angular measurements and their single components: the overbite depth indicator (ODI) for the assessment of vertical skeletal relationships and the antero-posterior dysplasia indicator (APDI) for an evaluation of sagittal dysgnathia. Both populations were assigned to groups representing Angle Classes I, II, and III, and an anterior open bite (AOB) group. Two sample t- and Wilcoxon signed-ranks tests were performed (P < 0.05). The ODI values showed no statistically significant differences between the Japanese and European samples. The Japanese sample showed a significantly smaller APDI but only in the Class II group. In the Japanese Class II and III subjects, the malocclusion patterns were more pronounced than those in the Caucasian sample (overbite, overjet, and APDI).

Anteroposterior dysplasia indicator (APDI) and Overbitedepth indicator (ODI) in a sample of Iraqi adults withdifferent skeletal classes

- The aim of the research was to investigate the effect of the farness (1m,2m,3m )of server player from the base line on forward wavy serving accuracy in volleyball . - The researcher hypothesis that there was no significant differences between different farness (1m,2m,3m ) from the base line on the accuracy of forward wavy serve in volleyball . descriptive method was used for its suitability for the nature of study ,the sample of the study consist of (12) Ninava government team players of volleyball - the forward wavy serve was applied from the three different area (1m,2m,3m). - the data were statistically treated by using (F-test ) and the searcher have concluded the following : - there is no significant difference between different farness (1m,2m,3m ) from the base line in accuracy of forward wave serving in volleyball .

Longitudinal alteration of the occlusal plane and development of different dentoskeletal frames during growth

Valuable information about growth and development in different types of occlusions and skeletal frames can be obtained by analyzing longitudinal data, particularly the functional significance of the occlusal plane; this information is important for understanding the etiology, diagnosis, and treatment of malocclusion. The purpose of this study was to investigate the relationship between the cant of the occlusal plane and mandibular position to establish a functional determinant in the development of different dentoskeletal frames in longitudinal growth samples. Several measurements were analyzed and compared in a total sample of 406 lateral cephalograms of 102 orthodontically untreated white patients taken at different ages of the growing period from the Burlington Growth Centre, Toronto, Ontario, Canada. Regarding changes related to the cant of the occlusal plane, a progressive tendency was seen through the years for consistency (significance and correlation) between maxillary posterior occlusal plane inclination (FH-OP[P] and Mx-OP[P] angles) and mandibular position (SNB angle) reflected in the appearance of a certain type of dentoskeletal frame (APDI and ANB angles). Statistically significant correlations (P <0.0000) were found between the angle of the Frankfort plane-maxillary posterior occlusal plane and the anteroposterior dysplasia indicator, the maxillary posterior occlusal plane angle and the anteroposterior dysplasia indicator, the maxillary posterior occlusal plane angle and the angle of the palatal plane-mandibular plane, the angle of the Frankfort plane-maxillary posterior occlusal plane and the SNB angle, and the maxillary posterior occlusal plane angle and the SNB angle. There is a possible relationship between the inclination of the maxillary posterior occlusal plane and mandibular position, consistent with the etiology of different dentoskeletal frames. Thus, a more comprehensive etiologic approach based on the inclination of the maxillary posterior occlusal plane should be considered in the correction of malocclusion.

Age-related changes in sagittal relationship between the maxilla and mandible

The aim of the study was to assess age-related changes in sagittal jaw relationship during pre-pubertal and pubertal development on the basis of angular [ANB, anteroposterior dysplasia indicator (APDI) and A-B plane angle] and linear (Wits, AF-BF, App-Bpp, and App-Pgpp) measurements. Lateral cephalograms of orthodontically untreated subjects were evaluated at 7, 9, 11, 13 and 15 years of age. Cephalometric standards and age-related changes were determined on the basis of Class I subjects with a good occlusion (n = 18, 10 males and 8 females). With respect to changes related to growth, the main findings were, in both genders, a statistically significant age-related decrease in ANB angle, App-Bpp and App-Pgpp, a significant increase in APDI, but no age-related change in Wits. A reduction of sagittal jaw distance during pre-pubertal and pubertal development was observed arising from a relative dominance of sagittal mandibular growth. For an evaluation of differences concerning jaw relationship in Class II subjects, a group with Class II division 1 malocclusions (n = 17) and a group with Class II division 2 malocclusions (n = 12 were compared with two control groups, i.e. the good occlusion group and a Class I group (n = 37). Conclusions about the sagittal discrepancy in Class II division 1 and Class II division 2 subjects depended on the geometric reference used in the various parameters, and further research is called for with respect to the diagnostic performance of the various measurements. Differences between Class II subjects and controls present at 15 years of age were already established at 7 years of age, but were less pronounced.

Determinants of successful chincup therapy in skeletal class III malocclusion

The purpose of this study was to investigate skeletal characteristics that determine successful chincup therapy in patients with skeletal Class III malocclusions by using longitudinal follow-up data of 40 patients (18 male, 22 female). Lateral cephalometric radiographs were taken before chincup therapy (T0), after chincup therapy (T1), and after fixed orthodontic treatment and retention (T2). From the measurements at T2, the patients were classified into group 1, showing good retention results (n = 21; 9 male, 12 female), or group 2, showing poor results (n = 19; 9 male, 10 female). The differences at each stage and during T0 to T1 and T1 to T2 between the 2 groups were compared by t tests. The major effect of chincup therapy was backward rotation of the mandible in both groups; however, the amount of rotation was greater in group 2. After retention, group 2 showed more forward rotation and forward growth of the mandible than group 1. Cephalometric measurements that showed significant differences in skeletal and dental morphology between the 2 groups at T0 were L1 to occlusal plane ( P < .001), upper gonial angle, AB to occlusal plane angle, AB to mandibular plane angle, ANB, anteroposterior dysplasia indicator, Wits appraisal ( P < .01), articular angle, gonial angle, facial convexity angle, AB to facial plane angle, and L1 to A-Pog ( P < .05). These factors apparently contributed to the difference of long-term results in the 2 groups. It is necessary to evaluate these items in the diagnosis and treatment planning of skeletal Class III malocclusion in growing patients when chincup therapy is being considered.

Overbite depth and anteroposterior dysplasia indicators: the relationship between occlusal and skeletal patterns using the receiver operating characteristic (ROC) analysis.

This study was carried out to investigate the validity of the overbite depth indicator (ODI) and the anteroposterior dysplasia indicator (APDI), based on the cephalometric analysis of 122 Caucasians selected at random for assessment of vertical and sagittal relationships. Considering the occlusion, the sample was divided into three classifications in the sagittal component: 36 cases of neutrocclusion, 54 cases of distocclusion, and 34 cases of mesiocclusion. The sample was also categorized according to the overbite relationship: 54 cases of normal overbite, 34 cases of open bite, and 34 cases of deep overbite. In the sagittal component analysis, the APDI measurement resulted in significant differences between the neutrocclusion, distocclusion, and mesiocclusion groups. In the vertical component analysis, the ODI significantly distinguished between the normal and deep overbite groups, and the open bite and deep overbite groups, but not between the normal overbite and the open bite groups. A receiver operating characteristic (ROC) analysis showed that the APDI matched the anteroposterior molar relationship in 88 per cent, and the ODI matched the amount of incisor overbite in 81 per cent.

Determination of Class II and Class III skeletal patterns: Receiver operating characteristic (ROC) analysis on various cephalometric measurements

Receiver operating characteristic analysis is an excellent method for evaluating and comparing the performance of diagnostic tests. The purpose of this study was to use the receiver operating characteristic analysis to evaluate the diagnostic ability of several cephalometric measurements in determining the presence of Class II and Class III skeletal patterns. Receiver operating characteristic analysis was performed on 976 cases. Fifteen cephalometric measurements were evaluated. A computer software program ROC ANALYZER was used to tabulate the areas under the curves and to perform the statistical comparison between the curves. The results of this study indicated that the Anteroposterior Dysplasia Indicator had the best diagnostic ability in identifying cases with Class II and Class III skeletal patterns. WITS Appraisal and Overjet were highly effective in diagnosing cases with Class II skeletal pattern. WITS Appraisal, Convexity, AB Plane Angle and Overjet also performed well in diagnosing cases with Class III skeletal pattern. (Am J Ortho Dentofacial Orthop 1998;113:538-45.)

A comparative cephalometric study of Class II, Division 1 nonextraction and extraction cases.

1. Cephalometric tracings of thirty Class II, Division 1 cases without extraction and twenty-five Class II, Division 1 cases with extraction were evaluated and statistically compared by means of the overbite depth indicator (ODI) and the anteroposterior dysplasia indicator (APDI). 2. The mean ODI in the nonextraction group, in particular, was significantly higher than that of the extraction group. 3. Three clinical examples were presented to demonstrate the values of ODI and APDI as adjuncts to cephalometric differential diagnosis. 4. With respect to the vertical component it may be concluded that the lower the ODI value from the normal mean a case presents, the greater the incidence of an extraction procedure as a compromise for the poor skeletal pattern. 5. With respect to the horizontal component the initial APDI reading indicates the severity of skeletal discrepancy. When the posttreatment APDI reading falls below the normal mean, a relapse is probable: the lower the figure a case possesses, the greater the chance of relapse. In such incidences an extraction procedure must be provided to ensure the stability of occlusion.

Anteroposterior dysplasia indicator: An adjunct to cephalometric differential diagnosis

1. 1. Cephalograms of 102 children with normal occlusion (Group 1) and 874 children with various malocclusions were analyzed to determine which measurements would produce the highest correlation against the displacement of the molar relationships. 2. 2. Molar displacement was measured directly on the study casts, and an average of the measurements of the right and the left sides was obtained. 3. 3. The malocclusion sample was divided into groups according to molar displacement: 214 neutroclusion cases (Group 2), 624 distoclusion cases (Group 3), and 36 mesioclusion cases (Group 4). 4. 4. The mean value of the anteroposterior dysplasia indicator (APDI) in the normal group was 81.4 degrees, with a standard deviation of 3.79. 5. 5. The APDI reading was obtained by tabulating the facial angle plus or minus the A-B plane angle and plus or minus the palatal plane angle. 6. 6. Among the measurements tested, the APDI was found to show the highest correlation against the molar displacement, with a correlation coefficient value of 0.643. 7. 7. The four variables that produced the highest correlation coefficient values—that is, the ANB angle (−0.495), the A-B plane angle (0.566), the “Wits” appraisal (−0.639), and the APDI (0.643)—were subjected to a study of their frequency distribution patterns. High percentages of overlapping of the two extreme groups (distoclusion and mesioclusion groups) were found in the above variables, with the exception of the APDI. 8. 8. A discussion of the differential diagnostic value of the APDI was presented, together with illustrations and various clinical examples.