Cephalometric Parameters Research Articles

Clinical and Cephalometric Changes in Long-face Patients With Retrogenia Following the Novel B-genioplasty Technique.

The chin plays a fundamental role in facial attractiveness. Accordingly, several surgical procedures have been proposed for chin contouring. This study aimed to introduce "B-genioplasty" as a novel genioplasty technique and assess the clinical and cephalometric changes in long-face patients with retrognathia following the novel B-genioplasty. This is a cross-sectional study. Subjects with class I occlusion increased lower facial height and retrognathia underwent B-genioplasty in this prospective experimental study. Soft and hard tissue cephalometric measurements were made, and the depth of the notch in the lower border of the mandible was measured on lateral cephalograms at 6 months postoperatively and compared with baseline. Patient satisfaction with the outcome was also assessed. Seventeen subjects were studied. Ten (58%) patients underwent rhinoplasty plus genioplasty. All patients were satisfied with the outcome. The step/notch in the lower border of the mandible was not detected in clinical examination in any patient. The mean notch depth was 0.5±0.83 mm on lateral cephalograms. The change in all soft and hard tissue cephalometric parameters was significant at 6 months postoperatively compared with baseline ( P <0.001 for all). B-genioplasty caused satisfactory clinical and cephalometric changes in long-face patients with retrognathia, including prevention of step/notch in the inferior border of the mandible, significant reduction of gonial angle, correction of the mandibular plane, and reduction of lower facial height.

Novel prediction models for pharyngeal-airway volume based on the cranial-base and midsagittal cross-sectional area of the airway in the pharyngeal region: A cephalometric and magnetic resonance imaging study.

The objective of the study was to elucidate the association between cranial base (Bjork-Jarabak analysis), midsagittal cross-sectional area of the airway in the pharyngeal region (MCSA-PR) data and pharyngeal-airway volume (PAV) and develop a model that could help clinicians predict PAV using two-dimensional (2D) data (Bjork polygon and MCSA-PR). Pre-treatment lateral cephalometric radiographs and magnetic resonance imaging (MRI) scans of 82 women were categorized into three anteroposterior skeletal groups based on ANB angle: Class I (n = 29), 1.5° ≤ ANB≤5.1°; Class II (n = 26), ANB >5.1°; Class III (n = 27), ANB <1.5°. The Bjork polygon, MCSA-PR data from cephalograms and PAV data from MRI scans were examined. Intergroup comparisons were performed using the Kruskal-Wallis test and one-way analysis of variance (ANOVA), with pairwise comparisons conducted using the Bonferroni-corrected Mann-Whitney U-test for the Kruskal-Wallis test and Bonferroni-corrected multiple comparison test for one-way ANOVA. Forward multiple linear regression was used to create model equations for predicting PAV. MCSA-PR and anterior (N-S) and posterior (S-Ar) cranial-base lengths were positively correlated with the PAV. We developed four models; three operated at the group level, and one encompassed the entire sample. Notably, all models could effectively explain the variance in the PAV data. The model for the Class I group was the strongest (adjusted R2 = 0.77). Our findings indicate the remarkable potential of the MCSA-PR, N-S and Bjork sum angles (BSA) as predictors of the PAV and the relevance of 2D cephalometric and cranial-base parameters in predicting the three-dimensional (3D) pharyngeal-airway size.

The morphological peculiarities of the maxillo-facial region in children with cleft lips and palate

Considerable variation in malocclusion was found in children with cleft lip and palate. Class III malocclusionwere found more frequently due to congenital factors, such as maxillo-mandibular growth potential as well as the severity of the defect.Material and methods. In this study, 15 cephalometric x-rays were analyzed according to the methods proposed by McNamara, Tweed, Roth-Jarabak and Steiner, and 30 cephalometric parameters were calculated for each patient with complete unilateral cleft (so many on the left and so many on the right). The data obtained from the measurements are presented in the tables corresponding to each method. Results. Maxillary and mandibular length (Cond-A, Cond-Gn) statistically significantly reduced compared to normal mean values. The threshold of significance registered for these indices demonstrates significant deviations of the previous height of the face was statistically significantly reduced by the value p&lt;0.01 compared to the normal values (Sna-Me). The posterior vertical skeletal deficit is confirmed by the reduced value of the Hp parameter (posterior height, p&lt;0.01), which compared to Ha, reveals a type of posterior facial rotation. The enlarged lower anterior face is demonstrated by the increased value of the anterior height index, (Sna-Me) which registered an average deviation of 6.57 mm and an increased Ha/Hp ratio (p&lt;0.01). Conclusions. In the result of the analysis of the cephalometric analysis of the x-rays according to the McNamara, Roth-Jarabak, TweedMerriefield and Steiner methods, it was found that the cranio-facial morphology in children with unilateral cleft lips and palate was different from normal values due to the lack of growth of the facial part of the cranium both in sagittal and vertical planes.

Comparative Analysis of Cephalometric Parameters of Class II Malocclusion

Class II malocclusions are of immense interest to orthodontists as they constitute a significant percentage of the cases they treat. This study aimed to recognize the importance of the variations of Class II malocclusion and its implications in determining the best treatment approach. The sample of this study was collected from cases that had been reported to private clinics in Navi Mumbai and had not undergone any previous or ongoing orthodontic treatment. 58 lateral cephalograms were selected from patients having Class II malocclusion. Cephalometric tracing was performed manually. Steiner, Tweed and Jarabak analyses were done. It was seen that there is a significant difference in the maxillary and mandibular incisor angulation and position of the mandible between Class II Division 1 and 2 malocclusion cases; between cephalometric parameters of females and males in cases with Class II Division 1 and 2 cases with respect to the mandibular incisor angulation, mandibular corpus length, posterior cranial base, facial depth and posterior facial height; between the cephalometric parameters of cases with less than and more than 14 years of age in individuals with Class II Division 2 malocclusion with respect to the gonial angle, mandibular plane angle, the maxillary and mandibular incisor angulation and position, angle of convexity, ramus height, facial depth, posterior and anterior facial heights; upper and lower lip position. Thus, Class II malocclusions show a significantly diverse array of skeletal, dental and soft tissue cephalometric parameters; hence a customized orthodontic treatment plan for each case is imperative.

Effects of 3D Airway Geometry on the Airflow of Adults with Cleft Lip and Palate and Obstructive Sleep Apnea: A Functional Imaging Study.

Objective Individuals with cleft lip and palate (CLP) are at a high risk of developing obstructive sleep apnea (OSA). Hypothetically, the severity of OSA might be associated with the morphology of the upper airway (UAW) and the characteristics of the airflow. Thus, the present study aimed to assess and compare, in adults with CLP and skeletal class-III discrepancy, with or without OSA, simulations of airflow resistance and pressure according to the geometrical characteristics of the UAW and cephalometric parameters. Materials and Methods According to the results of type-I polysomnography tests, the sample ( n = 21) was allocated in 2 groups: 1) without OSA (N-OSA; n = 6); and 2) with OSA (OSA; n = 15). Cephalometric measurements were performed on the cone-beam computed tomography (CBCT) scans of the groups. After three-dimensional (3D) reconstructions, the volume (V) and minimal cross-sectional area (mCSA) of the UAW were generated. Computational fluid dynamics (CFD) simulations were used to assess key airflow characteristics. The results were presented at a significance level of 5%. Results The UAW pressure values and airway resistance did not differ between the groups, but there was a tendency for more negative pressures (26%) and greater resistance (19%) in the OSA group. Volume and mCSA showed a moderate negative correlation with resistance and pressure. The more inferior the hyoid bone, the more negative the pressures generated on the pharyngeal walls. Conclusion The position of the hyoid bone and the geometry of the UAW (V and mCSA) exerted effects on the airway-airflow resistance and pressure. However, key airflow characteristics did not differ among subjects with CLP, were they affected or not by OSA.

Is cutaneous profile perception an indicator of skeletal class III malformation treatment plan? A cross sectional Study

Background: The treatment choice in adults with skeletal class III malocclusion represents a challenging task for orthodontists, especially in borderline cases. With the growth spurt being surpassed, the clinician is left between two treatment options: orthodontic camouflage or orthognathic surgery. Around the years, many studies tried to uncover a guide model which enables practitioners to distinguish between skeletal class III that can be appropriately treated by orthodontics alone and those needing surgical intervention. Aim: The aim of this study is to demonstrate the importance of cutaneous profile perception as a subjective decisive parameter in the treatment of borderline skeletal class III adult patients and, as a secondary objective, to compare it with the most decisive cephalometric parameters found in previous studies. Material and methods: Among 28 skeletal class III patients found in the Saint Joseph university orthodontics department’s data base, 10 different adult patients: 4 males and 6 females have met the inclusion criteria. Three types of data have been gathered from each patient: lateral cephalograms, profile photographs and the treatment that the patient underwent. To understand the significance of profile perception in the treatment plan for these patients, all of the 10 patients profile photographs were put in a survey that was sent to 3 groups of people: orthodontists, dentists, and laypersons. Each participant should evaluate based only on his/her perception of the photo if the patient should be treated by orthodontic-surgical treatment or if an orthodontic camouflage alone is enough. In addition, the efficiency of profile perception will be compared with the efficiency of the most decisive cephalometric parameters found in literature: ANB angle=-4°, Witts appraisal =-5.8mm. Results: A total of 158 participants were included in this study. When we compare what participants chose based on profile perception with real treatment, 75% of orthodontists have correctly classified the patients. Lower rates were noted for dentists and laypeople, respectively 65% and 64.5%. If we also consider the cephalometric values found in literature (ANB=-4°, Witts appraisal=-5.8mm) as the correct treatment that should have been done, 70% of the patients were correctly treated in our faculty. Conclusion: There are no cephalometric or clinical golden standards to decide between surgical intervention or orthodontic camouflage in adult patients presenting skeletal class III malformation. Cephalometric values are very useful but insufficient tools even when many parameters are combined. Both objective and subjective criteria should be taken into consideration to individualize each treatment plan according to each patient.

Gender differences in the upper airway, craniofacial morphological and polysomnographic parameters in patients with obstructive sleep apnoea.

Obstructive sleep apnoea (OSA) is a common sleep disorder characterized by repetitive episodes of upper airway collapse during sleep associated with arousals with or without oxygen desaturation. This study aims to assess and analyse the morphological and neurological factors associated with obstructive sleep apnoea using polysomnography study data and two-dimensional cephalometric analysis of airway and skeletal parameters and their correlation in the patients with varying severities of obstructive sleep apnoea. This study included 892 patients who underwent a complete work up, including a thorough history, clinical examination, standard polysomnography study and 2D cephalometric analysis to diagnose obstructive sleep apnoea. This study divided the participants into two groups based on the AHI score from the PSG study: AHI < 15 and AHI > 15 groups. The groups were further divided into male and female groups to study the prevalence of OSA. The analysis involved 13 cephalometric parameters: Seven linear and six angular measurements. The airway parameters measured in this study were minimum posterior airway space (PAS_min), hyoid bone to the mandibular plane (H_MNP) and soft palate length (SPL). All the subjects in this study underwent a standard overnight polysomnography study at the sleep centre in Samsung Medical Center. A total of 892 adult participants (M: F = 727:165, mean age: 50.6 ± 13.2 years and age range: 18-85 years). AHI >15 group was significantly older with higher BMI, NC and WC compared to the AHI < 15 groups in both male and female groups. There was statistical significance observed in N1, N3, AI, ODI, lowest saturation (%) and apnoea max length between the groups (p < .001). The arousal index (AI), especially the respiratory arousal index was considerably higher in the male group. There were significantly higher values in all the PSG parameters in the male group. In the airway parameters, hyoid bone position and soft palate length showed significant differences (p < .001), whereas the PAS did not show any differences (p = .225) between the AHI <15 and AHI >15 groups. The overall skeletal cephalometric parameters showed no significant differences between the groups, whereas the gonial angle and AB to mandibular plane angle showed significant differences in the female group (p = .028, p = .041 respectively). The partial correlation of cephalometric parameters with AHI showed a stronger correlation between the H_MNP and AHI in both men and women. The position of the hyoid bone and the soft palate length influences the progression of OSA, especially in male patients. This study found no direct association between the minimum PAS and varying severities of OSA in men and women. We speculate that more than the craniofacial morphological factors such as the sagittal and vertical position of the maxilla and the mandible, the position of the hyoid bone might be more responsible for the severity of OSA.

Lower Incisor-Pg: A New Cephalometric Parameter to Evaluate the Anterior Limit of Dentition.

Background: This present retrospective study aimed to introduce Lower Incisor-Pg and to assess how this new parameter varies with the skeletal sagittal and vertical relationships. Methods: A total of 1256 cephalometric analyses were performed using lateral cephalometric radiographs of a sample of subjects divided according to SN^Go-Gn, ANPg^, and IMPA measurements. The differences in Lower Incisor-Pg between the groups were assessed through ANOVA tests and posthoc analyses, while Pearson's correlation analysis was used to assess the correlations between the measurements. Results: The mesofacial growth pattern (61.0%) was more common than dolichofacial (30.0%) and brachyfacial (8.6%) ones in the sampled population. Regarding skeletal sagittal relationships, Class I was more frequent (70.9%) than Class II (19.3%) and Class III (9.8%). The mean value of the Lower Incisor-Pg was 3.2 ± 4.0 mm. Linear regression showed that the β coefficient was 0.45 and 0.36 for ANPg^ and SnGoGn^, respectively. Conclusions: Lower Incisor-Pg is a linear cephalometric measurement to evaluate the lower incisor sagittal position. For each degree of increase in ANPg^ and SNGoGn^, the Lower Incisor-Pg increased 0.45 mm and 0.36 mm, respectively.

Effects of thalassaemia major on components of the craniofacial complex- a cephalometric study in Andhra Pradesh population

Introduction: The cephalometric study was conducted to evaluate the craniofacial effects of thalassaemia major on the Andhra Pradesh population. Methods: A total of 32 thalassaemic patients (23 male, 9 female) were selected from the Thalassaemia and Sickle Cell Society and 32 controls (19 male, 13 female) from schools of Hyderabad city to eliminate any bias on the ethnic background. All 64 lateral cephalograms were taken under standard conditions with teeth in occlusion and lips in a relaxed position. Forty - two linear and angular cephalometric parameters defining craniofacial morphology (22 skeletal, 13 dentoalveolarand 7 softtissue) were selected. Results: Everypatient with thalassaemia exhibited a skeletal base relationship of class II, accompanied by an average ANB angle of 4°. There was a significant increase in the length of the anterior cranial base. The length of the maxillary and mandibular base was significantly reduced, and the mandible appeared to be retruded in the face. Pronounced vertical growth was evident from linear and angular measurements. The dental deviations seen in thalassaemic patients were proclination, significant over-eruption of the maxillary anterior teeth and increased overjet. A marked increase in the convexity of the lower face, prominent upper lip, reduced nasolabial angle and increased inter-labial angle were evident from soft tissue measurements. Conclusions: The reduced length of the maxillary and mandibular base could be due to chronic anaemia which causes retardation of growth in thalassaemic patients. An increase in the anterior cranial base length resulted in the posterior positioning of the mandible and an increase in anterior facial height led to a skeletal class II pattern.Keywords: Anaemia; craniofacial growth; cephalometry; thalassaemia major.

Hypodontia and Skeletal Malocclusions Among Orthodontic Patients of Kathmandu, Nepal: A Radiographic Study

Objective To assess the association between hypodontia and skeletal malocclusions in orthodontic patients. Materials and Methods This cross-sectional study comprised of orthodontic records of 40 hypodontic patients (12 males and 28 females) and 120 non hypodontic patients (58 males and 62 females) as control group matched for gender and age with the study sample who came to the orthodontic department for their treatment were selected. Orthopantamograms were evaluated for hypodontia, whereas lateral cephalogram were traced to determine the cephalometric parameters. The association between different classes of skeletal malocclusion and hypodontia was determined using Pearson’s Chi-square test and the cephalometric parameters between patients with hypodontia and without hypodontia (controls) were assessed using Student’s t-test. Result In hypodontic group, 19 (47.5%) patients had skeletal class II, 18 (45%) patients had skeletal class I, and only 3 (7.5%) patients had skeletal class III malocclusions. Whereas in non-hypodontic group (control group), 86 (53.75%) patients had skeletal class II, 63 (39.38%) patients had skeletal class I, and 11 (6.87%) patients had skeletal class III malocclusions. There was no statistical difference between hypodontia and different skeletal classes of malocclusions ( p = .654). Cephalometric parameters between the control group and hypodontic group did not reveal any significant difference ( p &gt; .05). Conclusion This study did not find any association between different classes of skeletal malocclusions and hypodontia. The cephalometric skeletal parameters were not significantly different in hypodontic and control group. It is suggested that the patients having hypodontia will be evaluated on an individual basis for their treatment.

The Correlation between Mandibular Arch Shape and Vertical Skeletal Pattern.

Background and Objectives: The aim of this study was to evaluate the correlation between the mandibular arch shape and the vertical skeletal pattern in growing patients. Materials and Methods: A total of 73 Caucasian patients (33 males and 40 females; mean age 9.4) were retrospectively enrolled from a pool of patients treated in chronological order at the Department of Orthodontics, University of Foggia, Italy, from April 2018 to December 2021. Each patient received a laterolateral radiograph and a digital scan of the dental arch. Eight cephalometric parameters (lower gonial angle, intermaxillary angle, divergence angle, Wits index, Jarabak ratio, OP-MP angle, PP-OP angle, and ANB) and five dental measurements (posterior mandibular arch width, anterior mandibular arch width, mandibular occlusal angle, posterior width on distobuccal molar cusps, and molar angle) were analyzed and then compared. A Spearman's rho correlation test between the cephalometric measurements and the dental measurements was performed. Statistical significance was set at p < 0.05. Results: A negative statistically significant correlation was found between the Jarabak ratio and the intermolar angle; a statistically significant correlation was also observed between the Wits index, the posterior mandibular width, and the occlusal mandibular angle; the ANB angle and the occlusal mandibular angle; the intermaxillary angle (PP-PM) and the mandibular occlusal angle, posterior mandibular width on the disto-vestibular cusp, and the intermolar angle; and the OP-MP angle and mandibular occlusal angle and the posterior mandibular width on the disto-vestibular cusp. Conclusions: The mandibular arch form may be related to certain predisposing features in craniofacial morphology, such as jaw divergence, the Jarabak ratio, and the intermaxillary angle.

Association between the Obstructive Sleep Apnea and Cephalometric Parameters in Teenagers.

OSA is a common problem in children and adolescents. Angle class II malocclusion, a tendency toward the vertical type of growth, causes a decrease in the volume of the oral air space, increasing the risk of OSAS. The aim of this study was to evaluate the relationship between cephalometric and OSA parameters, to develop collaborative approaches between orthodontists and somnologists in the treatment of adolescents with OSA. We analyzed data from 41 adolescents with OSA. Their mean age was 15.8 ± 1.08 years. Orthodontic and polysomnographic examinations of patients were conducted. Statistical analysis was performed in SPSS 19.0.0. Most often in patients with distal occlusion, a violation of the harmony in the development of the dental system was observed. The sagittal incisive fissure, characteristic of a distal occlusion, was absent due to the palatal inclination of the upper incisors in 25 (60.98%) patients. The SNB was 79.4 ± 3.1°, indicating a distal position of the mandible relative to the anterior cranial base. The SNA exceeded the normal value, which is one of the prerequisites for mandibular retrognathia. The ANB angle was 4.3 ± 1.9°. Tonsillar hypertrophy affected 6 patients, 21 had adenoid hypertrophy, and 3 had both of them. Movements of the masticatory muscles during sleep were recorded in 22.0% of patients. To improve the quality of diagnosis and treatment of OSA, a multidisciplinary approach is needed that will correct the processes of child growth and development.

Cephalometric analysis performance discrepancy between orthodontists and an artificial intelligence model using lateral cephalometric radiographs.

The purpose of the present clinical study was to compare the Ricketts and Steiner cephalometric analysis obtained by two experienced orthodontists and artificial intelligence (AI)-based software program and measure the orthodontist variability. A total of 50 lateral cephalometric radiographs from 50 patients were obtained. Two groups were created depending on the operator performing the cephalometric analysis: orthodontists (Orthod group) and an AI software program (AI group). In the Orthod group, two independent experienced orthodontists performed the measurements by performing a manual identification of the cephalometric landmarks and a software program (NemoCeph; Nemotec) to calculate the measurements. In the AI group, an AI software program (CephX; ORCA Dental AI) was selected for both the automatic landmark identification and cephalometric measurements. The Ricketts and Steiner cephalometric analyses were assessed in both groups including a total of 24 measurements. The Shapiro-Wilk test showed that the data was normally distributed. The t-test was used to analyze the data (α = 0.05). The t-test analysis showed significant measurement discrepancies between the Orthod and AI group in seven of the 24 cephalometric parameters tested, namely the corpus length (p = 0.003), mandibular arc (p < 0.001), lower face height (p = 0.005), overjet (p = 0.019), and overbite (p = 0.022) in the Ricketts cephalometric analysis and occlusal to SN (p = 0.002) and GoGn-SN (p < 0.001) in the Steiner cephalometric analysis. The intraclass correlation coefficient (ICC) between both orthodontists of the Orthod group for each cephalometric measurement was calculated. Significant discrepancies were found in seven of the 24 cephalometric measurements tested between the orthodontists and the AI-based program assessed. The intra-operator reliability analysis showed reproducible measurements between both orthodontists, except for the corpus length measurement. The artificial intelligence software program tested has the potential to automatically obtain cephalometric analysis using lateral cephalometric radiographs; however, additional studies are needed to further evaluate the accuracy of this AI-based system.

Comparative Assessment of Sagittal Jaw Discrepancies by Various Cephalometric Parameters in Skeletal Class I and Class II Malocclusion among Bhopal Population: A Cephalometric Study

Comparative Assessment of Sagittal Jaw Discrepancies by Various Cephalometric Parameters in Skeletal Class I and Class II Malocclusion among Bhopal Population: A Cephalometric Study

Clear aligners for Class III malocclusion and severe open bite camouflage: A case report

Objective: The aim of the study was to describe a clinical case of a Class III malocclusion and severe open bite approached with clear aligners (CAs) and intermaxillary elastics. Case Presentation: A 21-year-old male patient showed to the dental clinic asking for orthodontic treatment. His chief complaint was an unpleasant smile esthetics. The patient showed an oval face with increased length of the lower third of the face, slight mandibular asymmetry, and concave profile. On intraoral evaluation, a bilateral canine and molar Class III with reduced overbite could be seen. Pre-treatment panoramic radiograph showed good root parallelism and presence of all dental elements. Cephalometric values confirmed skeletal Class III (Wits Appraisal = −6.5 mm), increased vertical dimension (FMA = 34.3°), correctly inclined upper incisors and retroclined lower incisors. After discussing the treatment options with the patient, CAs (F22, Sweden and Martina, Due Carrare, Padova, Italy) were chosen to approach this malocclusion together with intermaxillary elastics. After 9 months of active treatment involving 18 sets of aligners, the patient showed correct overbite, bilateral canine e molar Class I, leveled and aligned dental arches, and no signs of radicular or bone resorption. Cephalometric parameters show control of vertical dimension (FMA = 34.4°), upper incisor flaring and lower incisor retroclination, and signs of a dentoalveolar compensation. Conclusion: Careful diagnosis, treatment planning, and clinical management of CAs and intermaxillary elastics led to a successful dentoalveolar compensation featured by good occlusal results, bilateral Class I relationship, and normal overbite which remained stable after 1 year from the end of treatment.

Assessment of the quality of different commercial providers using artificial intelligence for automated cephalometric analysis compared to human orthodontic experts.

The aim of this investigation was to evaluate the accuracy of various skeletal and dental cephalometric parameters as produced by different commercial providers that make use of artificial intelligence (AI)-assisted automated cephalometric analysis and to compare their quality to agold standard established by orthodontic experts. Twelve experienced orthodontic examiners pinpointed 15radiographic landmarks on atotal of 50cephalometric X‑rays. The landmarks were used to generate 9parameters for orthodontic treatment planning. The "humans' gold standard" was defined by calculating the median value of all 12human assessments for each parameter, which in turn served as reference values for comparisons with results given by four different commercial providers of automated cephalometric analyses (DentaliQ.ortho [CellmatiQ GmbH, Hamburg, Germany], WebCeph [AssembleCircle Corp, Seongnam-si, Korea], AudaxCeph [Audax d.o.o., Ljubljana, Slovenia], CephX [Orca Dental AI, Herzliya, Israel]). Repeated measures analysis of variances (ANOVAs) were calculated and Bland-Altman plots were generated for comparisons. The results of the repeated measures ANOVAs indicated significant differences between the commercial providers' predictions and the humans' gold standard for all nine investigated parameters. However, the pairwise comparisons also demonstrate that there were major differences among the four commercial providers. While there were no significant mean differences between the values of DentaliQ.ortho and the humans' gold standard, the predictions of AudaxCeph showed significant deviations in seven out of nine parameters. Also, the Bland-Altman plots demonstrate that areduced precision of AI predictions must be expected especially for values attributed to the inclination of the incisors. Fully automated cephalometric analyses are promising in terms of timesaving and avoidance of individual human errors. At present, however, they should only be used under supervision of experienced clinicians.

Effects of mouth opening breathing for different reasons on maxillofacial development in children

Objective:To explore the effects of mouth opening breathing for different reasons on children's maxillofacial development. Methods:One hundred and fifty-one children were selected as the research objects of this experiment. They were divided into 49 cases of adenoid hypertrophy group（group A）, 52 cases of tonsillar hypertrophy group（group B） and 50 cases of adenoid with tonsillar hypertrophy group（Group C）. Healthy children in the same period were selected as the control group, a total of 45 cases. The reflex nasopharyngeal measurement parameters, facial development indexes and cephalometric parameters of group A, group B, group C and control group were analyzed, and the incidence of Angle ClassⅡand Angle Class Ⅲ in group A, group B and group C were studied. Results:Compared with the control group, the reflex nasopharyngeal measurement parameters in group A, group B and group C was significantly different（P<0.05）, and the cephalometric parameters changed with variation in groups（P<0.05）. The incidence of Angle Class Ⅱ facial pattern in group A and group C was higher, but the incidence of Angle Class Ⅲ facial pattern in group B and group C was higher（P<0.05）. Conclusion:Adenoid hypertrophy leads to mandibular retraction; tonsil hypertrophy leads to anterior mandibular arch; adenoid hypertrophy and tonsil hypertrophy are easy to lead to clockwise rotation of the mandible. In clinical practice, to avoid children's uncoordinated maxillofacial development, we should correct the maxillofacial situation of children as soon as possible.

Craniofacial Phenotype in Obstructive Sleep Apnea and Its Impact on Positive Airway Pressure (PAP) Adherence.

Positive airway pressure (PAP) is an important treatment tool for patients with moderate and severe obstructive sleep apnea (OSA), and adherence to PAP significantly affects treatment outcomes. Disease severity, adverse effects, and psychosocial factors are known to predict medication adherence. Cephalometric parameters have been reported to positively correlate with upper airway collapse. However, research on the correlation between these cephalometric parameters and PAP adherence remains insufficient. This study aimed to identify this relationship. This study included 185 patients with OSA who were prescribed PAP. Polysomnography (PSG) was performed to diagnose OSA, and paranasal sinus computed tomography (PNS CT) was performed to check for comorbidities of the upper airway. In addition, cephalometric parameters such as the hyoid-posterior nasal spine (H-PNS), posterior nasal spine-mandibular plane (PNS-MP), and hyoid-mandibular plane (H-MP) were measured in the midsagittal and axial CT views. Adherence was evaluated 3-12 months after the PAP prescription. A total of 136 patients were PAP-adherent, and 49 were nonadherent. There were more males in the adherent group and a higher average height in the adherent group. The PSG results showed that the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), oxygen desaturation index (ODI), arousal index (AI), rapid eye movement (REM) AHI, and supine AHI were significantly higher, and the lowest oxygen saturation was lower in the adherent group. In the analysis of covariance (ANCOVA) model adjusted for sex and height, among the cephalometric parameters, H-MP was significantly longer in the adherent group (p = 0.027), and H-PNS showed a longer tendency (p = 0.074). In the logistic regression analysis model, the odds ratio (OR) and 95% confidence intervals (95% CI) of adherence and severe OSA in the third tertile compared to the first tertile of H-MP were 2.93 (1.25-6.86) and 4.00 (1.87-8.56). In the case of H-PNS, they were 2.58 (1.14-5.81) and 4.86 (2.24-10.54), respectively. This study concluded that an inferiorly placed hyoid bone in adult patients is associated with PAP adherence and disease severity.

Comparative Analysis of Skeletal Changes, Occlusal Changes, and Palatal Morphology in Children with Mild Class III Malocclusion Treated with Elastodontic Appliances and Bimaxillary Plates.

The aim of the present study was to compare the changes observed in children after the early treatment of mild class III malocclusion using bimaxillary removable plates supported by class III elastics and elastodontic devices. Twenty children (mean age 7.6 ± 1.1 years) with signs of class III malocclusion were treated using by-maxillary plates (PG group) with class III elastics (10 subjects = mean age 7.9 ± 1.3 years) or using class III elastodontic devices (EG group) (10 subjects = mean age 7.4 ± 0.8 years). Digital models and lateral cephalograms were obtained before treatment (T0) and at the end of treatment (T1). The digital models were analyzed to assess occlusal changes and maxillary morphology using the surface-to-surface matching technique. Changes in cephalometric parameters were also analyzed. The data outcomes were statistically analyzed using the paired Student's t test for inter-timing assessments and the independent Student's t test for inter-group assessments. Both groups showed correction of class III malocclusions, with a significant increase in the ANB angle and the overjet (p < 0.05). Subjects in the PG group exhibited a greater reduction in the inter-incisal angle compared to the EG group (p < 0.05). The children in the EG group had a significantly lower percentage of palatal morphology matching between T0 and T1 compared to the PG group (p < 0.05), suggesting greater morphological changes in the palate. Elastodontic appliances (EAs) and bi-maxillary plates successfully correct class III malocclusions in children. However, elastodontic devices significantly improved the morphology of the palate, both in the transverse and anteroposterior directions.

Three-Dimensional Assessment of the Pharyngeal Airway in Growing versus Non-Growing Subjects with/without Cleft Lip and Palate

Clefts of the lip or palate (CLPs) are the most common craniofacial birth defect, with a worldwide incidence of ~1 in 700 live births. The objective of this study is to assess the characteristics of the nasopharyngeal airway in growing vs. non-growing cleft lip/palate subjects and compare them with normal subjects. This retrospective study analyzed eighty-seven scans of three groups from cone beam computed tomography (CBCT). The cone beam computed tomography (CBCT) scans were coded and landmarks were identified using a Dolphin three-dimensional (3D) imaging software server (version 11.7; Patterson Dental Supply, Chatsworth, Calif). All values showed strong measurement reliability (&gt;80), except for the nasopharynx measurement. Regarding gender difference, for the nasopharynx, female subjects (1261.32 ± 713.94) showed the lowest significant values in non-growing unilateral compared to males (6496.8 ± 2987) at p = 0.008. For oropharynx, in the growing bilateral cleft group, male subjects (13,046.79 ± 5521.89) showed a significant difference (p = 0.046) compared to females (8468.98 ± 4279.99). MP-SN, B, A, SNA., SN.B., and ANS-ME showed significant differences for cephalometric parameters (p &lt; 0.05). Despite significant differences in linear and angular measurements, volumetric airway measurements showed no significant differences in the growing groups. For non-growing cleft subjects, the cleft anomaly significantly affected the nasal cavity and left maxillary sinus volumes.