Cephalometric Pattern Research Articles

Is the growth pattern in mouth breathers comparable with the counterclockwise mandibular rotation of nasal breathers?

The aim of this longitudinal study was to investigate mandibular rotation and angular remodeling in mouth-breathing children compared with nasal-breathing children. The sample included 55 severely obstructed mouth-breathing children (mean age, 6.1 years) and 55 nasal-breathing children (mean age, 7.3 years). The cephalograms at baseline and after 1 year were traced and measured, and superimpositions were made to determine true mandibular rotation, apparent rotation, and angular remodeling. The significance level was set at 5%. The mouth-breathing children had a longer face cephalometric pattern compared with nasal-breathing children. No cranial deflection differences were observed. No changes in the vertical growth pattern were observed during the 1-year period in either group. There were no statistically significant differences between the groups regarding apparent rotation (mouth breathing, -0.54°, vs nasal breathing, -0.41°). In comparison with the nasal breathers, the mouth breathers showed statistically significant lower yearly rates of counterclockwise true rotation (mouth breathing, -0.60°, vs nasal breathing, -1.31°) and angular remodeling (mouth breathing, 0.06°, vs nasal breathing, 0.87°). Mouth-breathing children had a hyperdivergent cephalometric pattern, but against all expectations, counterclockwise true mandibular and apparent rotations were the average observations. Mouth-breathing children showed less true rotation and angular remodeling than did nasal breathers; however, apparent rotations were similar.

Comparative evaluation of cephalometric and occlusal characteristics between the Long Face pattern and Pattern I

To compare the cephalometric and intraoral characteristics between Long Face pattern and Pattern I patients, besides evaluating associations between subjective facial patterns, cephalometric facial patterns and the intraoral characteristics. Through evaluation of frontal and right side extraoral photographs, three previously calibrated and experienced examiners selected 30 Long Face patients (Group 1) and 30 Pattern I patients (Group 2), aged between 9 and 19 years, of both genders. The cephalometric characteristics were assessed by the following variables: SN.GoGn, NS.Gn, AIFH, SNA, SNB, ANB, 1.1, 1.NA,1-NA, 1.NB, 1-NB, NA.Po, nasolabial angle and H-Nose. Clinical evaluations were also performed to determine the presence of posterior crossbite, anterior open bite and type of Angle's malocclusion. The cephalometric data were compared by independent t test. The chi-square test was used to evaluate the association between qualitative variables. Significant differences were observed between groups regarding the variables SN.GoGn, NS.Gn, AIFH, ANB, NA.Pog, 1-NA, 1.NB and 1-NB, with an increase of these measures in Group 1. There were also significant differences between groups on variable 1.1, being lower in Group 1 than in Group 2. The Long Face was associated to Angle Class II malocclusion, to the presence of posterior crossbite and to anterior open bite. The Long Face subjective facial pattern was associated to dolichofacial cephalometric pattern.

Obstructive sleep apnea prevents the expected difference in craniofacial growth of boys and girls

It was to compare cephalometric measures of mouth-breather boys and girls and with the cephalometric pattern observed in obstructive sleep apnea syndrome (OSAS) patients. Craniofacial measurements of lateral cephalometric radiographs obtained from 144 children aged 7-14 years were compared between boys and girls, and both were compared to cephalometric pattern of OSAS patients. Mouth-breather boys and girls had no gender differences regarding to craniofacial morphology while nose-breather boys and girls showed those expected differences. Nose-breather boys presented a more retruded mandible and proinclined upper incisor when compared to nose-breather girls, but mouth-breather boys and girls had no differences. The measure NS.GoGn was the only variable with an interaction with gender and breathing. There were no cephalometric difference in mouth breather-boys and girls related to normal growth, suggesting that oral breathing make the same craniofacial morphology and both have craniofacial morphology close to that of OSAS patients.

Analysis of the cephalometric pattern of Brazilian achondroplastic adult subjects

OBJECTIVE: The aim of this study was to assess the position of the cranial base, maxilla, and mandible of Brazilian achondroplastic adult subjects through cephalometric measurements of the cranio-dento-facial complex, and to compare the results to normal patterns established in literature. METHODS: Fourteen achondroplastic adult subjects were evaluated based on their radiographic cephalometric measurements, which were obtained using the tracings proposed by Downs, Steinner, Bjork, Ricketts and McNamara. Statistical comparison of the means was performed with Student's t test. RESULTS: When compared to normal patterns, the cranial base presented a smaller size in both its anterior and posterior portions, the cranial base angle was acute and there was an anterior projection of the porion; the maxilla was found to be smaller in size in both the anteroposterior and transversal directions, it was inclined anteriorly with anterior vertical excess, and retropositioned in relation to the cranial base and to the mandible; the mandible presented a normal-sized ramus, a decreased body and transverse dimension, a tendency towards vertical growth and clockwise rotation, and it was slightly protruded in relation to the cranial base and maxilla. CONCLUSION: Although we observed wide individual variation in some parameters, it was possible to identify significant differences responsible for the phenotypical characteristics of achondroplastic patients.

Orthopedic treatment of Class III malocclusion with rapid maxillary expansion combined with a face mask: a cephalometric assessment of craniofacial growth patterns

Objective: The aim of this prospective study was to assess potential changes in the cephalometric craniofacial growth pattern of 17 children presenting Angle Class III malocclusion treated with a Haas-type expander com- bined with a face mask. Methods: Lateral cephalometric radiographs were taken at beginning (T 1 ) and immediately after removal of the ap- pliances (T 2 ), average of 11 months of treatment. Linear and angular measurements were used to evaluate the cranial base, dentoskeletal changes and facial growth pattern. Results: The length of the anterior cranial base experienced a reduction while the posterior cranial base assumed a more vertical position at T 1 . Some maxillary movement occurred, there was no rotation of the palatal plane, there was a slight clockwise rotation of the mandible, although not significant. The ANB angle increased, thereby im- proving the relationship between the jaws; dentoalveolar compensation was more evident in the lower incisors. Five out of 12 cases (29.41%) showed the following changes: In one case the pattern became more horizontal and in four cases more vertical. Conclusions: It was concluded after a short-term assessment that treatment with rapid maxillary expansion (RME) associated with a face mask was effective in the correction of Class III malocclusion despite the changes in facial growth pattern observed in a few cases.

Mouth breathing children and cephalometric pattern: Does the stage of dental development matter?

ObjectiveTo test the hypothesis that there is no difference in the cephalometric pattern between mouth breathing children with primary dentition and mixed dentition. MethodsCephalometric measurements of 126 mouth breathing children (MB) were compared to 126 nasal breathing controls (NB). Both groups were divided into deciduous dentition (mean age 4 years, 8 months) and mixed dentition (mean age 7 years, 9 months) groups. ResultsA statistically significant difference was observed in the dentofacial patterns of MB children compared to NB children. The total length of the mandible was smaller in MB compared to NB children. However, this difference was found only in subjects with mixed dentition. The length of the mandibular corpus is similar in MB and NB children, although older MB children with mixed dentition had significantly smaller measurements. The lower anterior facial height was higher in MB compared to NB children, but this difference was evident only in younger children with primary dentition. Mandibular plane angle, Y-axis angle and lower anterior facial height to total anterior facial height ratio were greater, and posterior facial height to total anterior facial height ratio was smaller in MB than NB children, indicating that mouth breathers had a more vertical facial growth pattern. However, no differences were found in the vertical growth pattern associated with the stage of dental development. The ANB angle was not associated with the maturational status of occlusion. Linear measurements and the gonial angle were significantly different between children with primary and mixed dentition, but such differences were associated with normal vertical growth. ConclusionsThe present investigation rejected the null hypothesis and showed significant cephalometric differences between primary and mixed dentition MB children. Mouth breathing children in the mixed dentition have a smaller mandible (in terms of total length and corpus length) than nasal breathers. In children with primary dentition, the lower anterior facial height is higher in MB than in NB children. There was no significant association between the stage of dental development of mouth breathing children (either in the primary or mixed dentition) and the other cephalometric patterns.

Cephalometric characterization of an adult Emirati sample with Class I malocclusion.

Background:A review of literature indicates the Arab cephalometric pattern compared to the Caucasian cephalometric pattern is skeletally bimaxillary retrusive, dentally bimaxillary protrusive, and more divergent palatal and mandibular planes.Objective:The aim of this study was to clarify the cephalometric features of Emirates adults with Class I malocclusion and pleasing soft tissue profile and to evaluate for gender differences. The null hypothesis tested was no differences in lateral cephalometric measurements as a function of gender.Materials and Methods:The lateral cephalometric radiographs of adult Emirati nationals with Class I malocclusion were analyzed in order to characterize an indigenous Class I malocclusion population in the United Arab Emirates. Lateral cephalometric radiographs of 30 males with average age of 24.52±6.09 years and 31 females averaging 23.57±5.52 years were analyzed using Dolphin Imaging software. Twenty-two hard and soft tissue measurements comprised the cephalometric analysis.Results:Only one gender difference was demonstrated out of the 22 cephalometric analysis measurements used in the study; SN-PP mean for females (10.74±3.44 degrees) subjects averaged a 2.3 degree higher mean value than the males (8.43±3.95 degrees, P=0.018). The cephalometric study results were compared to published norms from Steiner and Eastman.Conclusions:Based upon the conditions of the present study, it may be concluded that adult Emirati males and females seeking orthodontic treatment with Class I malocclusion present similar cephalometric profiles with the exception that measurement SN-PP may be steeper in females than males. Moreover, Emiratis are likely to present greater incisor proclination and protrusion than Caucasians and may be generally considered as more bimaxillary protrusive.

Correlations between dentoskeletal variables and deep bite in Class II Division 1 individuals

This study aimed to evaluate the cephalometric pattern of Class II Division 1 individuals with deep bite, and to determine possible correlations between dentoskeletal variables and deep bite. Comparisons were also made between genders and cases that were to be treated both with and without premolar extraction. A total of 70 lateral cephalograms were used, from both male (n = 35) and female (n = 35) individuals with an average age of 11.6 years, who simultaneously presented with ANB ≥ 5º and overbite ≥ 4 mm. Statistical analysis involved parametric (t-test) and non-parametric (Mann-Whitney) tests for independent samples, as well as the Spearman correlation test (p ≤ 0.05). The values of Go-Me, Ar-Pog, PM-1 and PM-CMI were higher in males (p < 0.05). However, no significant differences were found among the averages of the cephalometric measurements when the sample was divided by treatment with and without extraction. Deep bite was positively correlated to the PM-1 and SNA measurements, and negatively correlated to the Go-Me, Ar-Pog, SNB and SNGoMe measurements. The main factors associated with the determination of deep bite in Angle's Class II Division 1 cases were: greater lower anterior dentoalveolar growth and/or lower incisor extrusion, horizontal growth pattern, maxillary protrusion and mandibular retrusion.

Correlações dentárias, esqueléticas e do perfil mole em amazonenses com oclusão dentária normal

A partir de uma amostra de jovens amazonenses com oclusão normal, determinou-se o valor médio das características do perfil mole por meio de telerradiografias cefalométricas em norma lateral. A amostra deste estudo constou de 30 jovens, sendo 15 do sexo feminino, e 15, do masculino, sem ter sido submetida a tratamento ortodôntico. Os integrantes possuíam todos os dentes permanentes em oclusão, com exceção dos terceiros molares, tendo uma idade média de 21,6 anos, filhos de amazonenses. Os resultados da pesquisa denotam a necessidade de utilizar um padrão cefalométrico específico para amazonenses. Após a coleta de dados estatísticos estabelecemos parâmetros embasados nas normas cefalométricas pertinentes à literatura especializada em que todas as variáveis dessas análises seguiram um padrão de distribuição normal. Houve dimorfismo sexual para a grandeza ANB. Determinaram-se padrões de normalidade em todas as grandezas avaliadas, constataram-se algumas diferenças estatísticas entre os padrões determinados e aqueles preconizados pela literatura especializada.

Mouth breathing children have cephalometric patterns similar to those of adult patients with obstructive sleep apnea syndrome

To determine whether mouth breathing children present the same cephalometric patterns as patients with obstructive sleep apnea syndrome (OSAS). Cephalometric variables were traced and measured on vertical lateral cephalometric radiographs. The cephalometric measurements of 52 mouth and 90 nose breathing children were compared with apneic patients. The children had not undergone adenoidectomy or tonsillectomy and had not had or were not receiving orthodontic or orthopedic treatment. Mouth breathing children showed same cephalometric pattern observed in patients with OSAS: a tendency to have a retruded mandible (p=0.05), along with greater inclination of the mandibular and occlusal planes (p<0.01) and a tendency to have greater inclination of the upper incisors (p=0.08). The nasopharyngeal and posterior airway spaces were greatly reduced in mouth breathing children, as observed in patients with apnea (p<0.01). Mouth breathing children present abnormal cephalometric parameters and their craniofacial morphology resembles that of patients with OSAS.

Determinação dos valores cefalométricos em amazonenses com oclusão dentária normal – parte 2

Em uma amostra de jovens brasileiros, amazonenses, filhos e netos de amazonenses, portadores de oclusão normal, determinaram-se os valores médios cefalométricos, preconizados na Análise de Ricketts, por meio de telerradiografias em norma lateral. Fizeram parte dessa amostra 30 jovens, sendo 15 do sexo feminino, e 15, do masculino, com idade média de 21,6 anos, sem tratamento ortodôntico prévio, todos com oclusão normal, com exceção dos terceiros molares e perfil harmônico. Depois de o estudo ter determinado os valores médios de normalidade para as grandezas cefalométricas de Ricketts e não haver encontrado dimorfismo sexual, o resultado da investigação evidenciou a necessidade de um padrão específico cefalométrico a ser utilizado em amazonenses brasileiros.

Determinação dos valores cefalométricos de Wits em jovens amazonenses, com oclusão normal

OBJETIVO: determinar os valores da medida de Wits para jovens amazonenses portadores de oclusão normal. METODOLOGIA: por meio de telerradiografias em norma lateral, determinou-se a medida Wits em uma amostra de 30 jovens, sendo 15 do gênero feminino e 15 do gênero masculino. Todos eram brasileiros, amazonenses, filhos e netos de amazonenses, sem tratamento ortodôntico prévio, com perfil harmonioso, oclusão normal e ausência dos terceiros molares. Nesses indivíduos, foi determinada a medida Wits e essa foi comparada entre os gêneros, por meio de um teste t. RESULTADOS E CONCLUSÕES: não houve dimorfismo sexual nas grandezas cefalométricas de Wits. Evidenciou-se a necessidade de um padrão cefalométrico específico a ser utilizado em amazonenses brasileiros.

Estudo cefalométrico do posicionamento dentário em jovens brasileiros feodermas com "oclusão normal"

OBJETIVO: com o propósito de apresentar um padrão cefalométrico específico para os jovens brasileiros feodermas, este estudo se propôs a obter os valores médios para algumas das variáveis cefalométricas dentárias e verificar a presença de dimorfismo entre os sexos. MÉTODOS: 40 telerradiografias, em norma lateral - de 20 indivíduos do sexo masculino, com idade média de 13,25 anos (idade mínima de 12,20 anos e máxima de 14,30 anos), e 20 do sexo feminino, com idade média de 13,10 anos (idade mínima de 12,00 anos e máxima de 14,21 anos) - foram obtidas de jovens brasileiros, feodermas (mulatos ou pardos), não submetidos a tratamento ortodôntico e que apresentavam Padrão I e "oclusão normal". As variáveis cefalométricas dentárias foram determinadas de acordo com as análises de Downs, Steiner, Riedel, Tweed, McNamara, Ricketts, e Interlandi. Os valores foram submetidos à análise estatística, pelo teste t independente, para comparar as variáveis entre os sexos. RESULTADOS: os incisivos superiores e inferiores apresentaram-se protruídos e inclinados para a vestibular. Não ocorreu diferença estatística significativa entre os sexos para as 13 variáveis dentárias avaliadas. CONCLUSÕES: observou-se que os jovens feodermas sem alterações esqueléticas (Padrão I) apresentam características faciais e posicionamento dentário específicos em relação aos demais grupos étnicos brasileiros.

Patients with multiple congenitally missing teeth have altered craniofacial morphologies

Ben-Bassat Y, I Brin. Skeletodental patterns in patients with multiple congenitally missing teeth. Am J Orthod Dentofacial Orthop 2003;124(5):521-5. 3b The authors examined the relationship between cases of multiple missing teeth and skeletodental pattern by comparing cephalometric data from patients with 3 or more congenitally missing teeth in at least 2 different tooth groups with published cephalometric norms and Israeli cephalometric norms. Secondary aims were to determine the impact of the number of missing teeth and their locations (anterior versus posterior) on the cephalometric patterns. Educational institution and professional organization Case-control (historical)

Cephalometric pattern of Jewish East European adolescents with clinically acceptable occlusion

Knowledge of the normal dentofacial patterns of various ethnic groups is important for clinical and research purposes. The objective of this study was to describe the dentofacial pattern of one Jewish ethnic group and to compare it with accepted standards for other white populations. Lateral cephalometric radiographs of 18 children of Jewish East European origin with clinically acceptable permanent occlusion, ages 11 to 13 years, were used. A computer-aided cephalometric analysis was performed, and the mean values and standard deviations for the various cephalometric variables were obtained. When compared with some classical standards, it was found that this ethnic group tended toward a mild skeletal Class II, a convex profile, and a more vertical direction of growth. These features appeared in persons selected on the basis of a clinically acceptable occlusion, suggesting the existence of dental compensations. Understanding these natural accommodations of the dentition to skeletal variations can be clinically useful when establishing treatment goals.

Evaluation of the cephalometric pattern in nonoperated patients with isolated cleft palate

Evaluation of the cephalometric pattern in nonoperated patients with isolated cleft palate

Effects of activator treatment--evidence for the occurrence of two different types of reaction.

A longitudinal cephalometric study was made of 12 boys and 13 girls with Class 11, Division 1 malocclusion treated with activators. The findings were compared with an untreated control group of 24 boys and 15 girls. The children were aged about 9 years at the start of the investigation and they were treated, or observed, for about two years. Possible alterations of mandibular condylar growth were investigated and the results were compared with previously published hypotheses on the mode of action of the activator. Since there were significant differences in the growth increments of control boys and control girls, the sexes were treated statistically as separate groups. Mandibular growth was found to be altered by activator therapy; in the boys growth was increased and redirected posteriorly while in the girls growth was only redirected. The maxilla and the dental arches were differently affected by the treatment. The differences in the observed results are probably explained by variation in the amount of vertical activation of the appliance but the possibility that boys and girls generally react differently could not be excluded. It is also possible that at least some of the differences were due to special growth patterns associated with certain features in the initial cephalometric pattern. There was no indication that modes of appliance action led to the different reactions. The results as a whole support the concept of the activator as an appliance which transduces elastic soft tissue forces to the skeletal and dental units.

Teratological and radiocephalometric analysis of craniofacial malformations induced with retinoic acid in rhesus monkeys (Macaca mulatta).

Fifteen pregnant Macaca mulatta were treated with doses of 20 or 40 mg of retinoic acid between 19--45 or 17--45 days of gestation, respectively, for 4--8 consecutive days. Based on gross examination, ten malformed infants, including one stillbirth and one abortus, four normal infants, and one resorption were produced. The most critical sensitive period was between days 24--35 of gestation, and the malformations primarily involved the craniofacial skeleton. Ten treated infants and eight age-matched controls were cephalometrically analyzed using craniometric points as closely correlated as possible with those in humans in order to define the craniofacial malformations induced prenatally by retinoic acid. Although all ten animals had detectable linear and angular deviations from the controls, four had cephalometric patterns which appeared to be of similar developmental origin.

Cephalometric patterns of adults with normal occlusion.

1. People with normal occlusion tend to have more brachyfacial than dolicofacial patterns. 2. Many of the norms vary significantly with the different facial patterns. When treating a patient, the norms used should reflect differences associated with the various facial patterns and sex. This will enable us to treat with fewer extractions with the confidence that the teeth and bony structure will remain stable. 3. Our findings re-establish and re-confirm our cephalometric standards for adults based on the individual's facial type as described by his or her vertical description of growth and ethnic type. We can be accurate in treating the patient to the clinical normal for that individual and not to an overall composite of the average.

Cephalometric roentgenographic patterns associated with malocclusion: Sex and age differences: By Irwin Steurer, D.D.S., Lawrence Hermann, D.D.S., and Robert H. Thompson, Jr., Columbia University, New York, New York

Cephalometric roentgenographic patterns associated with malocclusion: Sex and age differences: By Irwin Steurer, D.D.S., Lawrence Hermann, D.D.S., and Robert H. Thompson, Jr., Columbia University, New York, New York