Facial Biotype Research Articles

Correlation Between Maxillary Canine Impaction and Facial Biotype.

The etiology of teeth impaction is still not fully understood, despite that cofactors have been considered important to develop such a clinical picture. The aim of the authors' paper was to investigate about facial biotype, about the values of inclination of the upper cuspid axis to the perpendicular to Frankfort-horizontal plane and about the distance "d" of the canine cuspid to occlusal plane: each factor was statistically compared. The authors also performed a comparative analysis on the radicular length of the left and right lateral incisors of subjects with impacted maxillary canine. The authors recruited with "cluster sampling" randomization more than 30 patients, then refined to 25 after the application of exclusion criteria. Specific values were carried out by x-rays: the authors calculated both the α and β angles, the intermaxillary angle, the distance "d" and the inclination of upper cuspid axis to the perpendicular-to-Frankfort-horizontal plane. Spearman rank correlation coefficient or Spearman rho (ρ) was used as statistical methods. The authors' results assessed that the inclination of the upper cuspid axis to the perpendicular-to-Frankfort-horizontal plane showed a statistically significant inverse correlation with the intermaxillary angle. The authors' data clearly indicate that hyperdivergence is a key-factor that will certainly support the eruption path of canine cuspid: in this light, the treatment of tooth impaction in hyperdivergent subjects can be considered as predictive for a good prognosis.

Proximity of the roots of posterior teeth to the maxillary sinus in different facial biotypes.

Orthodontists consider facial growth pattern and oral function when developing a treatment plan. Less attention is given to the relationship between the maxillary posterior teeth and the maxillary sinus. We aimed to evaluate the relationship between the roots of the maxillary posterior teeth and the floor of the maxillary sinus. Proximity of the roots to the maxillary sinus was scored for the left and right first and second premolars and molars (scores, 0-3). Mean scores per patient and per tooth type were calculated. The influences of age, sex, and facial biotype on mean scores per patient and tooth were analyzed. The mean scores per patient and the secondmolar scores were significantly lower in the normodivergent subjects compared with the hypodivergent subjects, and in the hypodivergent vs the hyperdivergent groups, indicating that the hypodivergent biotype had significantly fewer secondmolar roots into the sinus than the normodivergent and hyperdivergent biotypes. Age had no effect on mean score per patient, but in the hyperdivergent group, the secondmolar score increased with age, meaning that secondmolar roots tend to be closer to the sinus floor. In a young population (7-24years), the positions of the apices of the maxillary secondmolar roots in relation to the maxillary sinus floor are associated with the facial biotype. In a hypodivergent biotype, the roots of the secondmolars are located farther from the sinus floor compared with the normodivergent and hyperdivergent facial patterns.

Efficiency of the Ocluch©MAD in the treatment of patients with OSAS and its association with craniofacial morphology.

ObjectiveThis study uses polysomnography and the Epworth sleepiness scale to assess the efficiency of the Ocluch©MAD in patients with Obstructive sleep apnea-hypopnea syndrome (OSAS), on overall respiratory disturbance indices (RDI), supine respiratory disturbance index (SRDI), minimum oxygen saturation, microarousals, CT90 (or ID90), sleep efficacy and snoring. These data are associated with skeletal class and facial biotype in order to establish predictive parameters for its effectiveness according to craniofacial morphology.Methods22 adult patients (between 38 and 60 years of age) of both sexes (7 women, 15 men) diagnosed with OSAS in the Hospital de Carabineros de Chile (HOSCAR) Neurology Unit were recruited and given the Ocluch© MAD in the hospital’s dental clinic, for its use during a three-month period. Patients were assess at the beginning and in the end of this period.Results87.5% of patients with mild OSAS achieved the success criterion and normalization; 71.5% of patients with moderate OSAS achieved the success criterion and 33.3% achieved normalization; 85.7% of patients with severe OSAS achieved the success criterion and 57.1% achieved normalization. All class I and mesofacial patients achieved normalization, but class II patients had the greatest proportional improvement.ConclusionsThe Ocluch MAD is an efficient low-cost alternative that should be considered among the therapeutic arsenal for a multidisciplinary approach to treating this disease.

Predicting Facial Biotypes Using Continuous Bayesian Network Classifiers

Bayesian networks are useful machine learning techniques that are able to combine quantitative modeling, through probability theory, with qualitative modeling, through graph theory for visualization. We apply Bayesian network classifiers to the facial biotype classification problem, an important stage during orthodontic treatment planning. For this, we present adaptations of classical Bayesian networks classifiers to handle continuous attributes; also, we propose an incremental tree construction procedure for tree like Bayesian network classifiers. We evaluate the performance of the proposed adaptations and compare them with other continuous Bayesian network classifiers approaches as well as support vector machines. The results under the classification performance measures, accuracy and kappa, showed the effectiveness of the continuous Bayesian network classifiers, especially for the case when a reduced number of attributes were used. Additionally, the resulting networks allowed visualizing the probability relations amongst the attributes under this classification problem, a useful tool for decision‐making for orthodontists.

Relationship between facial morphology and the level of sleepiness in patients with obstructive sleep apnea syndrome

Obstructive sleep apnea syndrome (OSAS) is a chronic respiratory disorder characterized by upper airway obstruction. It is believed that facial biotype and skeletal pattern may be related to OSAS. The objective of this research was to measure the relationship between facial morphology and the level of sleepiness in patients diagnosed with OSAS. 28 records were used of patients diagnosed with OSAS who sought treatment in a private dental office in the city of Belem, Para, Brazil. Photographs of the documentation were used to perform the morphological analysis, and the patients were classified according to facial biotype, profile and shape of the palate. Patients also completed a survey about Epworth Sleepiness Scale (ESS). The average of male and female patients was 48 and 58 years, respectively. From the medical records analyzed, 35.7% of men and 50% of women were classified as brachycephalic. Regarding the sleep scale, women had a higher percentage of moderate sleepiness (35,7%) than men (28,6%). When the Chi-square test, Spearman’s correlation index and multiple linear regression analysis were applied, the results were not statiscally significant (p>0,05) for all variables. The data from this research were not able to confirm the relationship between facial morphology and the ESS. However, the analysis of facial morphology and the sleepiness scale can be used to assist in the diagnosis of OSAS.

Facial growth pattern: Association between lower incisor position and symphyseal morphology

BackgroundA key factor in planning orthodontic treatment is the position of the lower incisor, which must keep a correct relationship with its underlying bony support, the mandibular symphysis. ObjectivesTo determine whether there is a statistically significant relationship among the position of the lower incisor, Holdaway ratio, symphyseal morphology, and facial pattern. MethodsA total of 100 patients were randomly selected from the records of the Master in Orthodontics and Dentofacial Orthopedics (University of Seville, Spain). Measurements were made manually on pretreatment cephalograms by two operators using Aki analysis to assess the height/width ratio (H/A), mandibular plane with point B–Menton, and the retro-occlusion of the Jarabak/MSE analysis to determine the facial biotype. A descriptive analysis of the data was made evaluating the possible correlations between the Holdaway ratio and H/A, and the Holdaway ratio and mandibular angle. ResultsThe correlation among facial pattern, H/A, and the Holdaway ratio proved significant (P < 0.05). ConclusionsSymphyseal morphology is correlated to facial growth pattern and lower incisal inclination. There are biological limits to inclination movements of the lower incisor in narrow symphysis, which are usually found in vertical growth patterns.

Barrel-shape upper lateral incisor. A case report

A case of barrel-shape incisors is reported in a male individual, belonging to mixed population ethnicity with predominantly mongoloid facial biotype. This morphologic trait is observed bilaterally in upper central incisors.

Applicability of the Moyers' Probability Tables in Adolescents with Different Facial Biotypes.

Introduction:The Moyers’ probability tables are used in mixed dentition analysis to estimate the extent of space required for the alignment of canines and premolars, by correlating the mesiodistal size of lower incisors with the size of permanent canines and premolars.Objective:This study intended to evaluate the applicability of the Moyer's probability tables for predicting the mesiodistal space needed for the correct location of premolars and permanent canines non-erupted, in adolescents of the city of Cordoba, Argentina, who show different facial biotypes.Materials and Methods:Models and tele-radiographies of 478 adolescents of both genders from 10 to 15 years of age were analyzed. The tele-radiographies were measured manually in order to determine the facial biotype. The models were scanned with a gauged scanner (HP 3670) and measured by using Image Pro Plus 4.5 software.Results:According to this study, the comparison between the Moyer´s probability table, and the table created at the National University of Córdoba (UNC) (at 95%, 75%, and 50%) shows that, in both tables, a higher value of mesiodistal width of lower incisors corresponds to a bigger difference in the space needed for permanent canines and premolars; being the need for space for permanents canines and premolars bigger in the UNC´s table. On the other hand, when contrasting the values of mesiodistal space for permanent canines and premolars associated with each facial biotype, the discrepancies between groups were not statistically significant (P >0.05). However, we found differences in the size of the space required according to the mesiodistal width range of the lower incisors for each biotype:a) The comparison of lower-range values, with a mesialdistal width of lower incisors less than 22 mm, the space required for permanent canines and premolars resulted smaller in patients with dolichofacial biotype than in patients with mesofacial and braquifacial biotypes. The latter biotypes have meager differences between them.b) The comparison of mid-range values, with a mesialdistal width of lower incisors from 22 to 25 millimeters, shows that the values of required alignment space are similar in the three facial biotypes.c) Finally, the comparison of upper range values, with a mesialdistal width of lower incisors greater than 25 millimeters, indicates that the space required for dolichofacial biotypes tends to be higher than in mesofacial and brachyfacial biotypes.Conclusion:The Moyer´s probability tables should be created to meet the needs of the population under study, with no consideration of patients’ facial biotypes.

Characterization of the pharyngeal airway in skeletal class II patients in relation to the skeletal facial pattern

The aim of this study was to determine the relationship between different facial biotypes of a skeletal class II population with the area and volume of the pharyngeal airway. Material and methods: The sample was composed by 111 cone-beam CT scans of class II individuals, (women 15 to 40 years and men 18 to 40 years of age). The sample was divided into three groups according to facial biotype: 43 for the brachifacial group, 43 for the dolichofacial groupand 25 for the mesofacial group. In order to determine the airway dimensions the volume and the area were considered. The pharynx was divided in two areas: oropharynx and hypopharynx. Asection was performed through the center of the axial view. This slice was transformed into a sagittal view, where the area was obtained. In this view, the narrowest area was also identified and in the axial view it was contoured to determine the area. To determine the volume the same planeswere obtained. Results: Both the areas as well as the volumes of the pharyngeal airway of individuals class II showed no significant differences in relation to facial biotype. The narrowest area, which was more frequently found in the oropharynx, did not show signifi cant differences either.

Lower incisor inclination in relation to facial biotype in skeletal Class I patients

The lower incisor and its position in the arch are considered of vital importance when planning orthodontic treatment due to its effects on aesthetics and treatment stability. Facial biotype plays an important role in diagnosis and orthodontic treatment planning. Objective: of this study was to compare the lower incisor inclination of each facial biotype in patients whose maxillomandibular sagital relationship was class I as assessed by Ricketts lateral cephalometry. Material and methods: 100 lateral headfilms of class I skeletal patients were selected and classified according to VERT’s facial biotype and the lower incisor inclination to the A-Pog plane was measured. Results: showed that incisor inclination between dolichofacial and mesofacial patients is not different, but among brachyfacial and dolichofacial there were statistically significant differences, as it happens between mesofacial and brachyfacial. In dolichofacial patients, there is more incisor inclination than in brachyfacial patients. Conclusion: that dental inclinations vary according to facial biotype, so diagnosis is essential in order to make the correct choice of appliances. When treating brachyfacial patients a reduced lower incisor inclination should be considered compared to dolichofacial patients.

Correlation of facial profile and dental arches in a population of Yucatan

Soft tissue facial profile is one of the most important elements for orthodontic diagnosis and treatment. It is influenced by genetic factors, heritage, race, ethnicity, environmental factors (mouth breathing, atypical swallowing habits) sagittal maxillo-mandibular position, facial biotype, type of muscles among others. Objective: To correlate facial profi le with dimensions and shape of the dental arches in a school population of Yucatan. Material and methods: An observational, prospective, analytical, cross-sectional study of models and photographs from 6-8 year-old scholars enrolled as regular students in two schools of southern Yucatan. Results: The study group consisted of 88 models and photographs: 52.27% were from male subjects and 47.72% from females. The predominant facial profile was convex for both genders. OrthoForm III arch shape was the most observed. The association between facial profi le and upper and lower arch shape was determined by χ2 test, showing a statistically significant relationship (p < 0.05). Conclusions: It would be convenient to establish specific normal values for each geographic region, taking into consideration environmental, genetic and nutritional factors as well as race, ethnicity, gender and age.

Relationship between the S-N plane and the Frankfort plane depending on the facial biotype

The purpose of this study was to verify if the angle formed by the SN plane with the Frankfort plane (Bimler factor 7) tends to open in long-faced facial patterns (dolichofacial) and to close in shortfaced facial patterns (brachifacial). Material and methods: This was a comparative, retrospective, cross-sectional study. The study universe was initial digital lateral headfi lms of patients who attended the clinic of the Department of Orthodontics at the Division of Postgraduate Studies and Research of the UNAM. The lateral headfilms were taken randomly from the period between August 2010 and August 2012. The sample consisted of 100 radiographs of patients between 18 and 30 years of age, 50 brachifacial and 50 dolichofacial; previously classified using Bimler facial index and confirmed with Ricketts facial taper. Results: From the 100 measured radiographs, 58 belonged to female patients and 42 to male patients. The average age was 27 years, with an age range from 18 to 30 years. In the 50 radiographs of dolichofacial patients, there was a range of 7 to 14o and in brachifacial patients, a range of 3 to 8o of the SN-FK angle or Bimler factor 7. In the 50 X-rays of dolichofacial patients an average of 11o was found and in the 50 X-rays of brachifacial patients an average of 5o was found. Conclusions: On the basis of the results hereby obtained it may be observed that the angle formed by SN-Frankfort planes increases in patients with a vertical growth pattern (dolichofacial) and decreases in patients with a horizontal growth pattern (brachifacial). Key words: Facial biotype, SN plane, Frankfort plane, Bimler factor 7.

Retrospective Analysis of the Correlation Between the Facial Biotype and the Inclination of the Upper Canine Cusp Axis to the Occlusal Plane.

Permanent maxillary canines are the second most frequently impacted teeth and the prevalence of this clinical condition is estimated to be 1-2% in the general population. The diagnosis of maxillary canine impaction should be based on both clinical and radiographic examinations. The aim of this study was to evaluate the presence of a correlation between the facial biotype and the inclination of the upper cusp axis. A correlation between the total radicular length of the lateral incisors was also evaluated, by comparing the side of impaction with the healthy side. Twenty three patients with a diagnosis of unilateral upper cusp impaction were recruited. For each patient, dental casts and radiographic material (panoramic radiographs and lateral cephalograms) were examined. Statistical analyses were done with Spearman's rank correlation coefficient or Spearman's rho (ρ). X-ray examinations demonstrated that canine impaction was associated to other dental anomalies (32% of the sample). The mean α angle measurements were 22.9° ± 4.1°, and mean values of the β angle were 34.7°± 4.0°. The mean distance "d" value was 14.6 mm ± 1.2 mm. The mean values of the angle between the upper cusp axis and the perpendicular-to-Fh plane were 20.8° ± 2.6°. Among the 23 subjects recruited, 5 showed values included in the range 25°-45° and 1 an inclination > 45°. The results obtained in the present study demonstrate a significant inverse correlation between the MM angle and the inclination of the upper cusp axis to the perpendicular-to-Fh plane.

Prevalence of palatally impacted canines

BackgroundPalatally impacted canines (PICs) are among dental anomalies with different prevalence in each region. This study was designed to investigate the prevalence of palatally impacted cuspids in Portuguese population, and to evaluate the possible relationships between PIC, gender, malocclusions, facial biotype, and morphological and occlusion features. MethodsA descriptive, retrospective, and cross-sectional study was conducted. The sample consisted of 1333 patients (581 males and 752 females), 12–63 years old evaluated in a period between September 2003 and December 2010. The clinical records were studied for evidence of one or both canines palatally impacted. Collected data were analyzed using chi-square tests (decision rule was α=0.05). ResultsThe most frequent PIC was right cuspid. Females showed higher number of PIC. The prevalence of PICs in females was found approximately 5.2%. ConclusionsThe prevalence of PICs in Portuguese population was 4.5% (with 95% confidence interval: [3.5%, 5.8%]). The frequency is greater of impacted cuspids in females than in males.

Fatores preditores da inclusão do canino maxilar permanente

ObjectiveThe main objective of this study was to evaluate whether impaction of the maxillary permanent canine (IMPC) can be predicted by factors such as sex, class of malocclusion, facial biotype, microdontia/peg‐shaped maxillary permanent lateral incisor or congenital missing maxillary permanent lateral incisor. MethodsThe initial study sample consisted of 95 children with 9 years old, which were selected from the clinic of the Faculty of Dental Medicine, University of Porto in the period between 2008 and 2010. In April 2014, all participants were asked to return for clinical examination. Agreed to participate in the study 51 children, now with the chronological age of 13‐14 years. In the intraoral exam at 2014, the eruption of 13 and 23 was checked. Statistical analyses were performed with the IBM SPSS Statistics 22.0 statistical package. The statistical methods for the associations between each variable and IMPC included chi‐square tests.P values less than 0.05 were considered significant. ResultsThere was no statistically significant differences (p<0.05) between the studied predictive factors and the eruption of the maxillary permanent canine. Further investigations with large samples should be performed in order to increase our knowledge in this field. ConclusionNo statistically significant differences were found between the predictive variables analyzed and the impaction of the maxillary permanent canine.

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Los objetivos han sido restituir la guia anterior de la denticion primaria, mediante el uso de la matriz de acetato; alinear los dientes de acuerdo al biotipo facial, logrando una estetica apropiada y permitir tambien una correcta fonacion; devolver una de las funciones de los dientes anteriores que es la de corte y asi favorecer la correcta masticacion; lograr recuperar la autoestima, pues el nino era objeto de burlas por parte de sus companeros de clases y amigos del vecindario. El paciente fue de sexo masculino, de 5 anos y 3 meses de edad que acudio a la Clinica de la Segunda Especialidad de Odontopediatria de la Universidad Continental en Huancayo, este presentaba lesiones cariosas amplias en el sector anterosuperior; al elaborar la Historia Clinica, la madre informa que el paciente padece de Asma desde la edad de 12 meses. En la anamnesis relato que la alimentacion fue lactancia mixta y amamantamiento nocturno con ausencia de limpieza bucal; el estudio radiografico confirmo lo observado clinicamente: caries amplias mesiales y distales a nivel de la corona. Al finalizar la intervencion se puede mencionar que los resultados fueron optimos en la parte clinica, estetica y funcional. La matriz de acetato es una alternativa optima para la confeccion de las coronas de resina y asi se reestablecio la guia anterior, masticacion, fonacion, estetica, logrando recuperar la autoestima y la confianza perdida en si mismo debido a las burlas en su entorno escolar, consiguiendo un cambio positivo en su personalidad.

Relationship between the shape of the upper central incisors and the facial contour in dental students. Lima. Peru.

Objective: To determine if there is a relationship between the shape of the face and the shape of the right upper central incisor in accordance with law of harmony proposed by Williams. Materials and methods: this study was observational analytical cross-type, we selected a sample of 124 students of both sexes between 17 and 28 years of age, which was determined facial biotype and the shape of the right upper central incisor, by means of a direct method and other photographic. By the direct method was clinically evaluated the height and the facial width as well as also the proximal contours of the incisor using a Vernier digital and by the photographic method were strokes the images taken using the software of Adobe Photoshop 5.0. Results: For the direct method the relationship, or correlation between the shape of the face and the shape of the incisor was a 43.5% sample (n=124) (p=0.006<0.05 IC 95%). By the photographic method concordance between the shape of the face and the shape of the incisor or the relationship was in a 41.1% sample (n=124) (p=0.037<0.05 IC 95%). Facial biotype more frequently with the direct and photographic method was the dolichofacial in a 61.3% and 71% respectively. The shape of the tooth more frequently with the direct and photographic method was the ovoid on a 55.6% and 51.6% respectively. Conclusion: The results do not confirm law of harmony proposed by Williams, therefore when choosing the most suitable anterior tooth, should be considered experience and the critical sense of professional as well as the wishes of the patient in order to achieve a good aesthetic result.

Dental Arch Size, Biting Force, Bizygomatic Width and Face Height in Three Colombian Ethnic Groups

El objetivo fue describir las dimensiones transversales de los arcos dentales, la fuerza de mordida y el indice facial en tres grupos etnicos de Colombia. El tamano de la muestra fue de 197 adolescentes, de 12 a 14 anos; 33% mestizos, 35% de ascendencia africana y 32% indio amazonico; 50,3% hombres y 49,7% mujeres. El analisis comparativo para determinar las diferencias entre los grupos etnicos se hizo mediante la prueba de Kruskal Wallis y luego el Componente Principal de Analisis se utilizo para establecer el patron de las mediciones para identificar las caracteristicas etnicas. Todas las mediciones mostraron diferencias estadisticamente significativas entre los grupos etnicos, excepto la altura facial (p=0,157). Se evidencia que el indio amazonico tiene una mayor fuerza de mordida (p<0,05) que los otros dos grupos etnicos. En cuanto a las dimensiones transversales del arco dental, el indio amazonico se caracterizo por tener un mayor ancho, con una longitud media de 44,1 mm. Esta longitud es mayor que en los adolescentes mestizos (M=36,7 mm) y afroamericanos (M=38,3 mm). En conclusion, la etnia india amazonica Ticuna tiene una fuerza de mordida significativamente mayor, asi como mayor ancho del arco dental transversal y ancho bicigomatico que los otros dos grupos etnicos considerados.

Association between the smile arc and buccal corridors with the facial biotype in subjects with normocclusion

Introduction: The correlation between the aesthetic characteristics of the smile and the facial biotype, could be useful in the design of the treatment plan. Objectives: To assess the relationship between Facial Biotype and the smile aesthetics evaluating the smile arc and the presence or absence of buccal corridors in subjects with normocclusion. Methods: From a sample of 100 subjects with normocclusion, 40 of them were randomly selected, 22 women and 18 men between 18 to 25 years, without temporomandibular joint or periodontal problems and without prior orthodontic treatment. Fontal photographs of social or posed smiles were used to determine the smile arc (consonant or not consonant) and the presence or absence of buccal corridors. Results: 82.5% of the subjects showed a brachifacial biotype, with presence of buccal corridors and a consonant smile arc. No statistically signifi cant relation was found between the facial biotype and the smile arc or with the presence or absence of buccal corridors. Conclusions: Aesthetic characteristics of the smile such as the smile arc and buccal corridors are present in subjects with normocclusion and are not affected by the facial biotype. Key words: Smile aesthetics, facial biotype.

Changes in the Inclination of the Palatal Plane using short Elastics On SN1 Functional Appliance with Decreased Overbite

Background: The use of short elastics in the SN1 functional appliance for the correction of palatal plane has not been reported. Objective: To evaluate changes in the inclination of the palatal plane with the use of short elastics in the SN1 functional appliance at the Dentofacial Orthopedic clinic of the Fundación Universitaria CIEO in Bogotá, between 2004 and 2012. Methods: A retrospective observational analytical study was carried out. The sample consisted of 21 4-to-12-year-old patients who presented overbite &lt; 2 mm, palatal plane –0.1 mm, and used the functional orthopedic appliance SN1 with short elastics located in the last molar present for an 8-15 month period. Initial and control radiographs were taken. Cephalometric measurements included: factor 4 (palatal plane inclination), factor 3 (mandibular plane inclination), angle B (maxillary-mandibular angle), facial biotype according to Bimler, Frankfurt plane-anterior nasal spine (ENA) distance, Frankfurt plane-posterior nasal spine (ENP) distance, and overbite. Results: Statistically significant increase in factor 4 (p = 0.000), factor 3 (p = 0.04), ENP-ENA to Frankfurt plane distance (p = 0.00), and overbite (p = 0.61) were observed after the use of the short elastics in the SN1 functional appliance. Conclusion: The use of short elastics produced a parallelization of the palatal plane over Frankfurt, after 8-15 months of use. Likewise, it caused a change in the mandibular plane by increasing their height and improving the overbite.KEYWORDSmalocclusion; overbite; palatal plane; functional appliance; SN1; short elastics