Cephalometric Parameters Research Articles

Comparison of clinical efficiency between pendulum and distal jet appliance - A randomized control trial

The study was to compare the clinical efficiency of Pendulum and distal jet appliances using both cephalometric parameters as well as dental cast analysis at two-time intervals T1-pre-treatment and T2-post-distalization. 10 patients with Angle's Class II malocclusion were enrolled in the study. The patients were divided into two groups: pendulum group & distal jet group (n = 5) for intra oral molar distalization. Lateral cephalogram and dental cast were obtained at T1 and T2. Molar distalization of 4.4 ± 1.1 mm in 4.68 ± 0.67 months in pendulum group and of 3.8 ± 0.4 mm in 5.84 ± 0.7 months in distal jet group. Relative intrusion of upper incisors was found to be more in pendulum group as compared to distal jet group. Mesial tipping of premolars and distal tipping of first molar was observed with both the groups. The transverse expansion at the level of first molars was significantly more in distal jet group as compared to pendulum group. Thus, Pendulum and distal jet appliances were found to be equally effective clinically in distalizing the maxillary molars, although the distalization period was shorter in pendulum group as compared to distal jet group owing to more distal tipping of maxillary first molars in pendulum group. The expansion was significantly more in distal jet group compared to the pendulum group which could be beneficial for patients who have Class II malocclusion with mild posterior crossbite.

Perception of facial esthetics and cephalometric correlations in Class II patients: a comparison between two-phase and one-phase treatments

An effective orthodontic treatment should not only aim for satisfactory occlusal outcomes but also consider its impact on facial esthetics. The study aims to evaluate and compare the perception of profile esthetics of skeletal Class II patients treated with two orthodontic modalities: (1) Two-phase approach involving functional appliances followed by fixed appliances with premolar extractions, or (2) One-phase approach using fixed appliances with premolar extractions. Additionally, the study aims to evaluate the correlation between the perceived esthetics and the corresponding cephalometric measurements. The study included 40 skeletal Class II adolescents who underwent either two-phase (n = 20, mean age = 12.38 ± 1.18) or one-phase (n = 20, mean age = 12.53 ± 0.79) orthodontic treatments. Eighty profile silhouettes (pre- and post-treatment) were assessed by 64 raters, including 23 orthodontists, 21 general dental practitioners, and 20 laypersons. The raters used a visual analog scale (VAS) to access profiles, upper and lower lips, and chin esthetics. At pre-treatment, all three groups of raters gave significantly lower scores to the profile silhouettes of the two-phase group compared to the one-phase group (P < 0.01); however, after treatment, they rated the two-phase group significantly higher (P ≤ 0.001). The two-phase group exhibited greater improvements in profile and upper and lower lip esthetics as perceived by all raters (P ≤ 0.001). Furthermore, cephalometric results revealed greater reductions in SNA, ANB, Wits appraisal, and G’-Sn-Pog’ in the two-phase group compared to the one-phase group (P < 0.05). Five cephalometric parameters (SNB, SNPog, overjet, overbite, and UL-SnPog’) demonstrated significant correlations with VAS scores given by orthodontists (P < 0.05). In conclusion, the two-phase group showed greater subjective and objective improvements in facial esthetics than the one-phase group. Additionally, the anteroposterior mandibular position and upper lip protrusion may be the primary cephalometric parameters correlated with subjective facial profile perceptions.

Assessment of variations in upper and lower gonial angle in children with mouth breathing habit

Background: Mouth breathing is one of the most common deleterious oral habits in children. The habitual position of muscles inside and outside the mouth will affect dental development. Mouth breathing influences skeletal growth and thereby affects the cephalometric parameters. The present study aimed to assess if there is any variation in upper and lower gonial angles in children with mouth breathing habit. Methods: The 33 patients in the age group of 8 to 12 years reporting to the Department of Pediatric and Preventive Dentistry with chief complaint of mouth breathing was selected for the study based on inclusion and exclusion criteria. Lateral cephalograms of these children were taken with a digital panoramic system under standard exposure factors, as recommended by the manufacturer. Upper and lower gonial angles were determined on the lateral cephalograms. The values obtained were tabulated and subjected to statistical evaluation. Results: The mean upper and lower gonial angles were seen to increase from the normal in children with mouth breathing habit. However, independent sample t test showed no statistically significant difference in upper and lower gonial angles with a p value of 0.598 in upper gonial angle and 0.714 in lower gonial angle. Contusions: Early detection of the changes in the upper and lower gonial angles can help a pediatric dentist in effectively framing a treatment plan in children with mouth breathing habit, to prevent further deterioration in the dental and skeletal structures and be able to correct the already occurred unfavourable changes in them.

Prediction of a Cephalometric Parameter and Skeletal Patterns from Lateral Profile Photographs: A Retrospective Comparative Analysis of Regression Convolutional Neural Networks.

Background/Objectives: Cephalometric analysis has a pivotal role in the quantification of the craniofacial skeletal complex, facilitating the diagnosis and management of dental malocclusions and underlying skeletal discrepancies. This study aimed to develop a deep learning system that predicts a cephalometric skeletal parameter directly from lateral profile photographs, potentially serving as a preliminary resource to motivate patients towards orthodontic treatment. Methods: ANB angle values and corresponding lateral profile photographs were obtained from the medical records of 1600 subjects (1039 female and 561 male, age range 3 years 8 months to 69 years 1 month). The lateral profile photographs were randomly divided into a training dataset (1250 images) and a test dataset (350 images). Seven regression convolutional neural network (CNN) models were trained on the lateral profile photographs and measured ANB angles. The performance of the models was assessed using the coefficient of determination (R2) and mean absolute error (MAE). Results: The R2 values of the seven CNN models ranged from 0.69 to 0.73, and the MAE values ranged from 1.46 to 1.53. Among the seven models, InceptionResNetV2 showed the highest success rate for predictions of ANB angle within 1° of range and the highest performance in skeletal class prediction, with macro-averaged accuracy, precision, recall, and F1 scores of 73.1%, 78.5%, 71.1%, and 73.0%, respectively. Conclusions: The proposed deep CNN models demonstrated the ability to predict a cephalometric skeletal parameter directly from lateral profile photographs, with 71% of predictions being within 2° of accuracy. This level of accuracy suggests potential clinical utility, particularly as a non-invasive preliminary screening tool. The system's ability to provide reasonably accurate predictions without radiation exposure could be especially beneficial for initial patient assessments and may enhance efficiency in orthodontic workflows.

Comparative evaluation of commercially available AI-based cephalometric tracing programs

ObjectivesCompare the accuracy and diagnostic concordance of three commercially available AI-based lateral cephalometric tracing software.Materials and methodsSixty-three lateral cephalometric radiographs were analyzed using semi-automatic (Dolphin Imaging Systems LLC) and AI-based software programs (WebCeph™, Cephio, and Ceppro DDH Inc.). Intra- and inter-observer reliability were assessed for human expert measurements, and repeated-measures one-way ANOVA was used to compare the AI and human expert measurements. The diagnostic performance was evaluated using sensitivity and specificity tests.ResultsHuman expert reliability was excellent (ICC > 0.9) for most cephalometric parameters. Compared to human experts, significant differences were observed for all three AI-based cephalometric programs (WebCeph™ – 10 of 11, Cephio – 7 of 11, and Ceppro DDH Inc. – 7 of 11 cephalometric measurements). Variations exceeding two units were noted for most parameters, and differences in defining the sagittal and vertical skeletal patterns, dental, and soft tissue characteristics were observed.ConclusionAll three AI-based tracing programs showed inaccuracies compared to human expert measurements and lacked reliability in measuring key cephalometric parameters. Clinicians should exercise caution when relying solely on AI-based analyses for orthodontic treatment planning and assessment.

Vertical Dimension Control in Two Different Treatment Protocols: Invisalign First and Bite Block-A Retrospective Study.

The aim of the present study was to compare the vertical dimension changes, before and after treatment, in two groups of growing patients, one group treated with clear aligner therapy versus a group treated with Quad-helix and bite-block therapy. The studied sample was composed of n. 40 patients (20 females and 20 males with a mean age of 8.6 ± 1.8 years), enrolled from the Department of Orthodontics at Policlinico of Rome Tor Vergata. The original sample was randomly divided into two groups: Group IF (Invisalign First) and Group BB (Quad-helix and bite block). Pre- (T0) and post-treatment (T1 after 12 months) lateral cephalograms were collected from all the selected patients. Nine cephalometric parameters, both angular and linear, were measured and recorded for each cephalogram. No statistically significant changes were found between both the IF and BB groups at T0, while statistically significant changes were observed in both groups (BB and IF) between T0 and T1 (after 12 months of active therapy), p < 0.005. Both therapies were able to control the patient's vertical condition. To date, the use of conventional appliances seems to have slightly better efficacy in controlling the vertical dimension than aligner therapy.

Comparison of semi and fully automated artificial intelligence driven softwares and manual system for cephalometric analysis

BackgroundCephalometric analysis has been used as one of the main tools for orthodontic diagnosis and treatment planning. The analysis can be performed manually on acetate tracing sheets, digitally by manual selection of landmarks or by recently introduced Artificial Intelligence (AI)-driven tools or softwares that automatically detect landmarks and analyze them. The use of AI-driven tools is expected to avoid errors and make it less time consuming with effective evaluation and high reproducibility.ObjectiveTo conduct intra- and inter-group comparisons of the accuracy and reliability of cephalometric tracing and evaluation done manually and with AI-driven tools that is WebCeph and CephX softwares.MethodsDigital and manual tracing of lateral cephalometric radiographs of 54 patients was done. 18 cephalometric parameters were assessed on each radiograph by 3 methods, manual method and by using semi (WebCeph) and fully automatic softwares (Ceph X). Each parameter was assessed by two investigators using these three methods. SPSS was then used to assess the differences in values of cephalometric variables between investigators, between softwares, between human investigator means and software means. ICC and paired T test were used for intra-group comparisons while ANOVA and post-hoc were used for inter-group comparisons.ResultsTwelve out of eighteen variables had high intra-group correlation and significant ICC p-values, 5 variables had relatively lower values and only one variable (SNO) had significantly low ICC value. Fifteen out of eighteen variables had minimal detection error using fully-automatic method of cephalometric analysis. Only three variables had lowest detection error using semi-automatic method of cephalometric analysis. Inter-group comparison revealed significant difference between three methods for eight variables; Witts, NLA, SNGoGn, Y-Axis, Jaraback, SNO, MMA and McNamara to Point A.ConclusionThere is a lack of significant difference among manual, semiautomatic and fully automatic methods of cephalometric tracing and analysis in terms of the variables measured by these methods. The mean detection errors were the highest for manual analysis and lowest for fully automatic method. Hence the fully automatic AI software has the most reproducible and accurate results.

Impact of maxillary expansion on the sagittal skeletal and dental parameters of growing Class II patients: A systematic review with meta-analysis.

A "spontaneous" correction of the Class II malocclusion has been described after maxillary expansion (ME) treatment. The aim of the present review was to systematically summarize changes in the sagittal dentoskeletal parameters of growing Class II patients after ME. The study protocol was developed according to the PRISMA statement and registered in PROSPERO before literature search, data extraction and analysis. The PICO model was followed in the definition of the research question, search strategies and study selection criteria. Randomized and non-randomized studies on the sagittal effects of ME published in English language without date restrictions were electronically searched across the Cochrane Library, Scopus and MEDLINE/PubMed databases. Changes in sagittal dentoskeletal cephalometric parameters were analysed. The risk of bias in randomized and nonrandomized studies was assessed using the Rob2 and ROBINS-I tools, respectively. A narrative synthesis was performed, focusing on the investigated population, intervention, comparison, and main outcomes. Pairwise meta-analyses were used to compare the outcomes assessed in subjects who underwent ME versus untreated subjects. Ten studies met the inclusion criteria, four were included in the pairwise meta-analyses due to the presence of a control group. Slight but significant improvements in OVJ (MD: -0.36; 95%; CI [-0.69 to -0.01]; p = .04) and 6/6 molar relation (MD: 1.5; 95%; CI [0.69 to 1.61]; p < .0001) were found in patients who underwent ME compared with untreated subjects, whereas no improvement in skeletal parameters was observed. However, the limitations of a small body of moderate-quality evidence and possible confounding factors should be considered. Evidence on the sagittal skeletal and dental effects of ME in Class II patients is still ambiguous, suggesting the need for more clinical trials, including appropriate control subjects, randomization and blinding during outcome assessment.

Lateral cephalometric parameters among Arab skeletal classes II and III patients and applying machine learning models

BackgroundThe World Health Organization considers malocclusion one of the most essential oral health problems. This disease influences various aspects of patients’ health and well-being. Therefore, making it easier and more accurate to understand and diagnose patients with skeletal malocclusions is necessary.ObjectivesThe main aim of this research was the establishment of machine learning models to correctly classify individual Arab patients, being citizens of Israel, as skeletal class II or III. Secondary outcomes of the study included comparing cephalometric parameters between patients with skeletal class II and III and between age and gender-specific subgroups, an analysis of the correlation of various cephalometric variables, and principal component analysis in skeletal class diagnosis.MethodsThis quantitative, observational study is based on data from the Orthodontic Center, Jatt, Israel. The experimental data consisted of the coded records of 502 Arab patients diagnosed as Class II or III according to the Calculated_ANB. This parameter was defined as the difference between the measured ANB angle and the individualized ANB of Panagiotidis and Witt. In this observational study, we focused on the primary aim, i.e., the establishment of machine learning models for the correct classification of skeletal class II and III in a group of Arab orthodontic patients. For this purpose, various ML models and input data was tested after identifying the most relevant parameters by conducting a principal component analysis. As secondary outcomes this study compared the cephalometric parameters and analyzed their correlations between skeletal class II and III as well as between gender and age specific subgroups.ResultsComparison of the two groups demonstrated significant differences between skeletal class II and class III patients. This was shown for the parameters NL-NSL angle, PFH/AFH ratio, SNA angle, SNB angle, SN-Ba angle. SN-Pg angle, and ML-NSL angle in skeletal class III patients, and for S-N (mm) in skeletal class II patients. In skeletal class II and skeletal class III patients, the results showed that the Calculated_ANB correlated well with many other cephalometric parameters. With the help of the Principal Component Analysis (PCA), it was possible to explain about 71% of the variation between the first two PCs. Finally, applying the stepwise forward Machine Learning models, it could be demonstrated that the model works only with the parameters Wits appraisal and SNB angle was able to predict the allocation of patients to either skeletal class II or III with an accuracy of 0.95, compared to a value of 0.99 when all parameters were used (“general model”).ConclusionThere is a significant relationship between many cephalometric parameters within the different groups of gender and age. This study highlights the high accuracy and power of Wits appraisal and the SNB angle in evaluating the classification of orthodontic malocclusion.

VARIABILITY REGULARITIES OF THE CEPHALOMETRICAL PARAMETERS OF THE HUMAN FETAL SKULL

The purpose of the study – to find out the regularities of the age dynamics of cephalometricparameters and critical periods of the development of the skull of human fetuses.Material and methods. 60 preparations of skulls and 63 computer tomograms of theheads of human fetuses aged from 4 to 10 months of intrauterine development werestudied. A complex of morphological research methods was applied, which includedanthropometry, morphometry, three- dimensional reconstruction and statistical analysis.Linear and angular parameters of the skull were measured, and their ratios, characterizingthe constitutional and cephalometric parameters of the individual (cranial and facialindices), were determined. Results. The analysis of absolute cephalometric parameters (longitudinal, transversediameters, skull circumference, height dimensions) demonstrated the predominanceof logarithmic dynamics of their changes in human fetuses, that is explained by theiraccelerated growth during the 4th month of intrauterine development and a slowdownduring the 7th month with subsequent acceleration in the 8th month of prenatal development.A straight trend line is characteristic of the V-S height (distance from the Sella turcica tothe highest point of the skull), which is explained by the accelerated growth of the anteriorand posterior cranial fossae, while the sphenoid bone and the region of anterior fontanelledevelop in a consistent direction and pace. The linear pattern of growth is typical for theforamen magnum, hard palate, length of the orbit, body and ramus of the mandible, aswell as for relative cephalometric parameters that show a wide range of morphometricvariability. Analysis of the scatter diagram using the method of weighted least squaresdistances showed a decrease in the angle of the front part of the cranial base until the5th month of intrauterine development, followed by an increase in the 7th-8th months ofprenatal development. Multivariate regression analysis of the relationship between fetalage, cranial index and the value of the angle of the front part of the cranial base showedpronounced anatomical variability, which depended on the craniotype. Before the end ofintrauterine development, the N-S-Ba angle increases, but at the beginning of the fetal periodof ontogenesis, it decreases. It has the smallest values in dolichocephals compared to othercraniotypes. The largest values of this angle are found in mesocephals at the beginning of thefetal period, and in brachiocephals and mesocephals at the end of intrauterine development.Conclusions. 1. Critical periods of skull development in the fetal period of humanontogenesis are the 4-5th and 7-8th months, during which uneven changes in absoluteand relative craniometric parameters are observed. 2. The value of the angle of the frontpart of the cranial base can be a diagnostic and prognostic indicator in combinationwith the cranial index, which characterize the craniotype of the individual, during themonitoring of the normal development of the skull and brain of the fetus.

The Efficacy of the RME II System Compared with a Herbst Appliance in the Treatment of Class II Skeletal Malocclusion in Growing Patients: A Retrospective Study.

(1) Background: The objective of this study was to evaluate the efficacy of the Rapid Maxillary Expander (RME) II System compared to a Herbst appliance and a control group in the treatment of class II skeletal malocclusions in growing patients. (2) Methods: A total of 30 class II patients treated using the RME II System (group R) were compared with 30 patients treated with a Herbst appliance (group H) and 30 untreated class II children (group C). Cephalograms were compared at the start (T0) and after 24 months (T1). Nine cephalometric parameters were analyzed: SN-MP, SN-PO, ANB, AR-GO-ME, AR-GO-N, N-GO-ME, SN-PP, LFH, CO-GN, 1+SN, IMPA, OVERJET, and OVERBITE. Since the variables failed the normality test, a Wilcoxon test was performed for a pairwise comparison of the cephalometric measurements taken at T0 (pre-treatment) and at T1 (post-treatment). ANOVA with Tukey post hoc correction was used to evaluate the differences among the groups. (3) Results: ANOVA showed a statistically significant difference for all analyzed variables except for AR-GO-ME, AR-GO-N, and N-GO-ME. Post hoc Tukey's HSD test showed the following difference: the SN-PO angle in group H was 3.59° greater than in group R; the LFH in group H was 4.13 mm greater than in group R. The mandibular length (CO-GN) in group H was 3.94 mm greater than in group R; IMPA in group H was 6.4° greater than in group R; and the ANB angle in group H was 1.47° greater than in group R. (4) Conclusions: The RME II System is an effective therapeutic device for class II skeletal malocclusion treatment in growing patients.

Clinical effects of twin-block combined with maxillary expansion on the upper airway in adolescents with Class II malocclusion.

Class II malocclusion, particularly class II division 1, poses a significant orthodontic challenge with implications for both aesthetics and health. This study aimed to explore the impact of twin-block (TB) combined with maxillary expansion treatment (TB-ME) on upper airway dimensions and inflammatory profiles in adolescents with skeletal Class II Division 1 malocclusion in adolescent. Ninety-two eligible patients were randomly assigned to two groups: TB-ME treatment and traditional McLaughlin Bennett Trevisi (MBT) straight-wire orthodontic treatment (Control). Cephalometric lateral X-ray scans were conducted before and after treatment to assess skeletal changes, including SNA, ANB, and SNB angles, which are essential to assess the anteroposterior relationships of the maxilla and mandible to the cranial base. We also measured the upper airway volumes and areas. Concentrations of inflammatory factors including intercellular adhesion molecule 1 (ICAM-1), matrix metallopeptidase 2 (MMP2), and interleukin 8 (IL-8) of gingival crevicular fluid analysis (GCF) were detected by enzyme-linked immunosorbent assay. TB-ME treatment induced significant improvement in cephalometric parameters, including a decrease in SNA and ANB angles and an increase in SNB angle. Upper airway volumes and areas increased significantly in both groups, with TB-ME showing greater improvements. GCF analysis revealed a reduction in ICAM-1, MMP2, and IL-8 concentrations in the TB-ME group compared to the Control group. TB-ME treatment demonstrates multifaceted improvements in skeletal malocclusion, upper airway dimensions, and inflammatory profiles in adolescents with class II division 1 malocclusion, showing the promise of TB-ME in addressing the complexities associated with class II malocclusion.

Assessment and Correlation of Dentofacial Morphology and Lateral Cephalometric Parameters with Smile Characteristics in Lateral and Oblique View: Short Study

Aim: This study evaluated and established correlations between the dentofacial morphology of Angle’s Cl II and Cl I malocclusions, lateral cephalometric parameters, and smile characteristics assessed through lateral and oblique smile views. Methods: A sample of 20 random patients (&gt;15 years, with prior orthodontic treatment) were selected for this study according to their arrival at the department. The selected individuals were grouped according to Angle’s classification of malocclusion, i.e., Angle’s Cl I and Angle’s Cl II malocclusion. Pretreatment records were taken for the study, including lateral cephalogram and extra-oral smile photographs (one lateral smiling and one oblique smiling). In the lateral cephalogram, skeletal, dental, and facial parameters were recorded, and in lateral and oblique smile views, lateral smile index, commissure angle, and incisal displays were recorded. Results: The results showed no significant difference in most cephalometric parameters except for UFH/LFH, which was higher in Angle’s Cl II. Additionally, smile analysis revealed significant differences between the two groups. In addition, significant differences were found in the incisal display, which was greater in Angle’s Cl II malocclusion. Conclusion: Smile characteristics differ between Angle Cl I and Cl II malocclusions. There was a significant difference in lateral and oblique smile parameters when Angle’s malocclusions classified as Cl I and Cl II were evaluated. Lateral and oblique smile index decreased from Cl I to Cl II malocclusion, whereas lateral and oblique smile commissure angle and lateral smile incisor display increased in Cl II malocclusion.

Genetic Insights into Skeletal Malocclusion: The Role of the FBN3 rs7351083 SNP in the Romanian Population.

Background and Objectives: irregularities in the growth and development of the jawbones can lead to misalignments of maxillary and mandibular structures, a complex condition known as skeletal malocclusion, one of the most common oral health problems. Skeletal malocclusions, particularly Class II and Class III, can significantly affect facial appearance, chewing efficiency, speech, and overall oral health, often requiring orthodontic treatment or surgery to correct. These dentofacial anomalies are influenced by genetic and environmental factors and exhibit diverse phenotypic expressions. Materials and Methods: in this study, we investigated the correlation between the rs7351083 SNP of the FBN3 gene that encodes a member of the fibrillin protein family and malocclusion risk in a group of 57 patients from Romania. Results: the results shed light on the relationship between the selected genetic marker and the investigated dentofacial disorder, revealing a positive association between the reference allele (A) and Class II and that the alternate allele (G) is associated with Class III. Conclusions: cephalometric analysis revealed no significant differences among genotypes, suggesting that while genetic factors are implicated in malocclusion, they may not directly affect cephalometric parameters or that the sample size was too small to detect these differences. The discovery of an A > T transversion in one individual with a Class II deformity underscores the genetic diversity within the population and the necessity of comprehensive genotyping to uncover rare genetic variants that might influence craniofacial development and the risk of malocclusion. This study highlights the need for larger studies to confirm these preliminary associations.

Relationship between Cephalometric and Ultrasonic Airway Parameters in Adults with High Risk of Obstructive Sleep Apnea.

Background/Objectives: Polysomnography and cephalometry have been used for studying obstructive sleep apnea (OSA) etiology. The association between craniofacial skeleton and OSA severity remains controversial. To study OSA's etiology, cephalometry, fiberoptic pharyngoscopy, polysomnography, and sleep endoscopy have been used; however, airway obstructions cannot be located. Recent research suggested ultrasonography for OSA screening and upper airway obstruction localization. Thus, this study aims to investigate the relationship between specific craniofacial cephalometric and ultrasonic airway parameters in adults at high risk of OSA. Methods: To assess craniofacial structure, lateral cephalograms were taken from thirty-three adults over 18 with a STOP-Bang questionnaire score of three or higher and a waist-to-height ratio (WHtR) of 0.5 or higher. Airway parameters were assessed through submental ultrasound. Results: NSBA correlated with tongue base airspace width, while MP-H correlated with oropharynx, tongue base, and epiglottis airspace width. SNA, SNB, and NSBA correlated with tongue width at the oropharynx. At tongue base, ANB and MP-H correlated with tongue width. SNB and NSBA were associated with deep tissue thickness at the oropharynx, while MP-H correlated with superficial tissue thickness at velum and oropharynx. Conclusions: Cephalometric parameters (SNA, SNB, ANB, NSBA, and MP-H) were correlated with ultrasonic parameters in the velum, oropharynx, tongue base, and epiglottis.

Assessment of Nasal Aesthetic Parameters in Patients with Unilateral Cleft Lip and Palate – A Retrospective Study

Objectives To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to correlate the deviating cephalometric parameters with two aesthetic scoring systems. Design A retrospective study. Setting Dental college and hospital. Participants Pre-treatment lateral cephalograms and extra oral photographs of 20 adult patients with repaired UCLP presenting for orthodontic treatment. 20 patients with age and type of malocclusion matched control were selected. Main Outcome The nasal cephalometric parameters of patients with UCLP and a control group were compared. The nasolabial region of patients with cleft lip and palate (CLP) was scored using Asher McDade Aesthetic Index (AMAI) and Cleft Aesthetic Rating Scale (CARS). The scoring was done by six different groups assessors to study their perception of the nasolabial region. Correlation between cephalometric parameters and the aesthetic scores was done. Results The study found significant differences in nasal length ( P = .003) and depth ( P &lt; .001) between UCLP and the non-cleft control group. In the aesthetic assessment, orthodontist gave the least scores, while layman group scored the highest. The CARS nose aesthetic scores showed statistically significant high, negative correlation with the nasal length ( P = .01). Conclusion The cephalometric parameters and the aesthetic indices can be aid the orthodontists in the assessment of nasolabial aesthetics and additionally refer for further definitive rhinoplasty to improve the patient's overall facial aesthetics.

Modeling of individual teleroentgenometric indicators using the "Cephalometrics for orthognathic surgery" method in Ukrainian young women with a wide face type and orthognathic bite

The study of individual normative cephalometric parameters in individuals of different sexes and ages is important for the "Cephalometrics for orthognathic surgery method", as it allows to accurately diagnose abnormalities and develop personalized treatment plans. This contributes to achieving better aesthetic results, reducing the risk of complications and increasing the effectiveness of surgical interventions. Taking into account age, sex, and face type helps predict long-term changes and adapt the treatment plan to obtain optimal results. In addition, it improves assessment accuracy and standardizes evidence-based approaches, making it easier to compare results between clinics. Thus, individual regulatory parameters are key to successful orthognathic surgery. The purpose of the study is to build and analyze regression models of teleroentgenometric indicators using the "Cephalometrics for orthognathic surgery" method in Ukrainian young women with a wide face type. 25 Ukrainian young women with an orthognathic bite and a wide face type underwent a cephalometric study using the "Cephalometrics for orthognathic surgery" (COGS-method) method. For the correct modeling of cephalometric parameters, their division into three groups was applied (Dmitriev M. O., 2016, 2017): the first group – basic metric characteristics of the skull; the second group – teleroentgenometric indicators by which it is possible to change the parameters of the upper and lower jaws with the help of orthognathic surgery; the third group – indicators that characterize the position of each tooth relative to each other, cranial structures and the profile of the soft tissues of the face. Construction of regression models was carried out in the license package "Statistica 6.0". Only reliable models with a coefficient of determination R2 of at least 0.60 were subject to further analysis. It was found that in young women with a wide face, using the COGS method, 6 models of teleroentgenometric indicators were built out of 33 possible, which were included in the second and third groups depending on the indicators of the first group (R²= from 0.601 to 0.705, p&lt;0.01-0.001); out of 19 possible, 16 indicator models were built, which were included in the third group depending on the indicators of the first and second groups (R²= from 0.614 to 0.983, p&lt;0.01-0.001). The analysis of the models showed that most often the regression equations of the indicators included in the second and third groups, depending on the indicators of the first group, include the distance P-PTV and N-СС according to Ricketts, N-Se according to Schwarz, N-S and S-Ar according to Roth-Jarabak, Ar-Pt and Pt-N according to the COGS method (7.69 % each), as well as the value of the H angles according to Schwarz and N-S-Ba according to Bjork; and to the indicator models that were included in the third group depending on the indicators of the first and second groups – the value of the distances ANS-Me, N-B, N-A, N-Pog, B-Pog, N-CC according to Ricketts, PNS-N, Ar-Go and ANS-PNS, as well as the magnitude of the angles N-A-Pog, N-S-Ba according to Bjork, MP-HP, as well as Por-NBa according to Ricketts.

“The impact of orthognathic surgery on articulation proficiency and speech intelligibility in skeletal Class III malocclusion: 18 months follow up”

IntroductionOrthognathic surgery results in the positional change of the maxilla and mandible that may affect speech. The present study evaluated the effect of combined maxillary advancement and mandibular setback surgery on articulation proficiency and speech intelligibility in patients with non-syndromic skeletal Class III malocclusion. MethodsIn this prospective study, twenty-five patients with skeletal class III malocclusion and consecutively treated with Lefort-1 maxillary advancement and mandibular setback (BSSO) orthognathic surgery were included in this study. The speech sample was recorded with a digital audio tape recorder one day before surgery and at 3, 6, 9, 12 and 18 months after surgery. Three qualified and experienced speech and language pathologists evaluated articulation errors and intelligibility of speech samples. Repeated One-way analysis of variance was used to compare articulation proficiency and speech intelligibility at different time intervals. ResultsThe substitution, omission, distortion and addition errors showed no significant changes at 3 months and 6 months. The total articulation errors decreased to zero at 9 months and no significant increase was observed till 18 months (P < 0.05). Speech intelligibility showed statistically non-significant improvement at any time interval. Cephalometric skeletal parameters SNA and N ḻ A°. were significantly correlated with addition and total articulation errors at 18 months follow up. ConclusionsThe ortho-surgical treatment improves speech (decreases. articulation errors) in most of the patients usually 6–9 months post-surgery. Speech intelligibility is not affected by bimaxillary orthognathic surgery in skeletal class III patients. The articulation errors were correlated to changes in position of maxilla.

Digital versus Manual Tracing in Cephalometric Analysis: A Systematic Review and Meta-Analysis.

Background: Over the years, various researchers have attempted to compare digital cephalometry with the conventional manual approach. There is a need to comprehensively analyze the findings from the earlier studies and determine the potential advantages and limitations of each method. The present systematic review aimed to compare the accuracy of digital and manual tracing in cephalometric analysis for the identification of skeletal and dental landmarks. Methods: A systematic search was performed using the keywords "Digital" AND "Manual" AND "Cephalometry" to identify relevant studies published in the English language in the past decade. The electronic data resources consulted for the elaborate search included the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, PsycINFO, Scopus, ERIC, and ScienceDirect with controlled vocabulary and free text terms. Results: A total of n = 20 studies were identified that fulfilled the inclusion and exclusion criteria within the timeframe of 2013 to 2023. The data extracted from the included articles and corresponding meta-analyses are presented in the text. Conclusions: The findings of the present systematic review and meta-analysis revealed trends suggesting that digital tracing may offer reliable measurements for specific cephalometric parameters efficiently and accurately. Orthodontists must consider the potential benefits of digital cephalometry, including time-saving and user-friendliness.

Diagnostic evaluation of skeletal cephalometric parameters and photograph-Based soft tissue parameters in Malwa Population

The primary goal of orthodontic diagnostic and treatment planning is to create a balanced and aesthetically attractive face. During the decades-long period of cephalometric dominance, the "aesthetic" of the face was predominantly used to describe the profile as observed on a lateral cephalogram However, the paradigm has now shifted to soft tissue-based diagnosis and treatment planning. This creates the need for soft tissue-based analysis especially on photographs considering its evaluation of myriad populations. To evaluate the skeletal cephalometric parameters and photograph-based soft tissue parameters in the Malwa population. The study was conducted using 50 lateral cephalometric radiographs and 50 profile photographs. Data were analyzed for probability distribution using the Shapiro-Wilk test. Descriptive statistics were performed and data were presented as median and inter-quartile range. Correlation between the variables was assessed using Spearman’s correlation coefficient. P value &amp;#60; .05 was considered statistically significant. Our reported values of both photographic and lateral cephalogram parameters are different not only from the international population, but also different values are observed from the not only Indian population, but also from various subsets of the Indian population. Therefore, the average value of lateral profile photographic parameters as well as cephalometric parameters in my study can be used as floating norms for the Malwa population.