Hyperdivergent Facial Pattern Research Articles

Treatment of Vertical Maxillary Excess in Skeletal Class II Hyperdivergent Face Using Skeletal Anchorage—An IBO Case Report

This case report was presented at the Indian Board of Orthodontics (IBO) examination under category III in September 2022. It describes the case of 13-year-old female with hyperdivergent facial pattern and class II skeletal base, treated using microimplant anchorage. Patient presented with vertical maxillary excess, increased lower facial height, gummy smile, and incompetent lips. All four first premolar extraction treatments were planned with simultaneous retraction and intrusion of maxillary and mandibular dentition. The case was treated using 022 slot MBT prescription appliance. Lip exercises were prescribed to increase the tone of lips, which would aid in attainment of lip seal. Case was completed with class I molars, normal overjet–overbite, and improved smile aesthetics. The patient exhibited competent lips and reduced anterior–posterior gingival show.

Correlation Between Cephalometric Values and Soft Tissue Profile in Class I and Class II Adult Patients based on Vertical Patterns.

To compare soft tissue profile variations between Class I and Class II adult patients due to three vertical skeletal facial patterns (normodivergent, hypodivergent and hyperdivergent) and determine which skeletal variation has the most significant impact on soft tissue profile. Retrospective soft tissue profile analysis was performed on lateral cephalograms of 131 adult patients. The analysis was divided into two categories correlated with subnasal and general soft tissue profiles. The sample was divided based on two sagittal skeletal patterns (Class I and II) and three vertical groups. In addition, comparisons were made between males and females. Viewbox 4 was used for the analysis. Descriptive, comparative, and correlation statistics were performed using SPSS software. Statistically significant inter-gender differences were found at the subnasal profile level, but not at the general profile level. No significant differences were observed when comparing subnasal profiles for the sagittal groups. However, significant differences were observed at the level of the general profile, especially at the level of Z-angle, lower lip, and chin prominence. In the vertical groups, hyperdivergent facial patterns had significant differences at the level of subnasal and general profiles compared with other vertical facial patterns. Females had more convex subnasal profiles than males. Hyperdivergent facial patterns had an impact on both general and subnasal soft tissue profiles. The sagittal dimension affected only the general soft tissue profile. Therefore, changes in the vertical dimension had the greatest impact on facial esthetics.

Digital lingual appliance combined with micro-screws for the treatment of a skeletal bimaxillary protrusion and ‘gummy’ smile

Abstract This case report describes the lingual orthodontic treatment of a 28-year-old female patient who presented with a bimaxillary protrusion malocclusion, a hyperdivergent facial pattern, mentalis strain, and a ‘gummy’ smile. To achieve favourable occlusal and facial results, the four first premolars were extracted, and micro-screws utilised to provide maximum anchorage. With the widespread application of three-dimensional technology, a digital goal-oriented treatment plan was applied for its predictability and precision. A fully customised lingual appliance system with preset torque in the anterior teeth combined with ribbon-wise arch wires was placed to prevent excessive lingual inclination of the incisors during retraction. As a result, an attractive facial profile and a well-aligned dentition with ideal intercuspation was obtained.

Treatment of severe Class II skeletal malocclusion in a hyperdivergent adult patient via hybrid clear aligner approach: A case report.

This case report describes the camouflage treatment of an adult patient with hyperdivergent facial pattern presenting with severe Class II skeletal malocclusion, through the use of a hybrid clear aligner approach, that relies on both a partial lingual fixed appliance and the continuous use of Class II elastics throughout therapy. After 11 months of treatment, the goals had been achieved, highlighting that the correct diagnostic framework, proper patient selection and careful digital planning of a compromise treatment can provide satisfactory aesthetic and functional outcomes.

Excessive overjet, steep mandibular plane, and posterior buccal crossbite treated with aligners, infrazygomatic crest bone screws, and Class II elastics

A 23-year-old male with dysfunctional incisors due to a large overjet preferred clear aligner therapy. Facial profile was convex with a skeletal Class II relationship (ANB, 8.4°). Overjet of 8.0 mm was associated with a hyperdivergent facial pattern and recessive chin. The UL7 was in buccal scissors bite, which contributed to a 2.0 mm functional shift to the right. Buccal relationships were Class I molar and Class II canines bilaterally. Other dental and facial structures were within normal limits. Aligners alone corrected the buccal scissors bite in 6 months and provided intrusive force in maxillary and mandibular buccal segments. Infrazygomatic crest bone screws served as anchorage for intra-arch elastics to retract the maxillary anterior segment. Class II intermaxillary elastics were added for the last stages of aligner treatment to help retract the upper incisors. After 12 months of treatment, the 8.0 mm overjet was resolved. Alignment with the initial set of aligners was completed in 15 months. A 5-month refinement phase with a second set of aligners was initiated to finish the occlusion. Total treatment time was 20 months. Overall, a malocclusion with a Discrepancy Index of 41 was treated to a Cast-Radiograph Evaluation score of 16 and a Pink and White esthetic score of 4.

Segmental Maxillomandibular Rotational Advancement (SMMRA) in the Treatment of Adult Patients with Severe Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) occurs as an increased collapsibility of the upper airway during sleep, which threatens health and quality of life. Asian men with greater severity of OSA presents less obese and are connected with craniofacial abnormalities. Although the traditional maxillomandibular advancement (MMA) had the comparable effectiveness to the continuous positive airway pressure therapy, the midfacial esthetics might be compromised in Asian individuals. The modified MMA procedure was proposed to balance the esthetic demands and improvement of OSA symptoms. The case report showed a 25-year-old man presented with a diagnosis of severe OSA. The pretreatment Apnea Hypopnea Index (AHI) score was 100 events/h. He exhibited skeletal Class II hyperdivergent facial pattern with mandibular retrognathism. To correct dentofacial deformities and improve sleep function, the modified surgical-orthodontic procedure was undertaken. The surgery-first approach was adopted for early improvement of OSA. The surgical procedures of SMMRA comprise the maxillary LeFort I segmental osteotomy, bilateral sagittal split osteotomy and genioglossus-genioplasty osteotomy. The counterclockwise rotation of maxillomandibular complex was further done to maximize mandibular advancement. The total treatment duration was 13 months. The well-aligned dentitions and solid dental occlusion were achieved. The subjective perception of sleep quality was improved. The patient was satisfied with the post-treatment facial appearance. Following the skeletal movement, the dimension of pharyngeal airway space was increased. The post-treatment AHI score was reduced to 12.1 events/h; the nadir oxygen saturation increased from 74% to 86%. The case report demonstrated the SMMRA procedure effectively improved adult Asian patients with severe OSA without deterioration of facial attractiveness and dental occlusion.

Obstructive Sleep Apnea Treated with Maxillomandibular Advancement Surgery by Computer-Assisted Simulation

This 23-year-old female patient was diagnosed as a severe type of obstructive sleep apnea (OSA), skeletal Class II jaw relation with mandibular deficiency, hyper divergent facial pattern, dental Class II malocclusion, midline deviation and occlusal plane canting. By the assistance of virtual surgical simulation and maxillomandibular advancement (MMA) approaching, patient was satisfied the improvement of functional and esthetic changes after the 18-months treatment.

Craniofacial characteristics of Syrian adolescents with Class II division 1 malocclusion: a retrospective study

BackgroundMalocclusion characteristics vary across different ethnic groups and populations. Limited data are available regarding the characteristics of Syrian adolescents with Class II division 1 (Class II-1) malocclusion, and the recent inflow of Syrian refugees and immigrants into Europe and many areas worldwide demonstrate the need for updated studies to discover the craniofacial characteristics of these new immigrants.ObjectivesThe present compound cephalometric and tooth-size study sought to assess the dentofacial morphology, upper-airway dimensions, and tooth-size characteristics of Syrian adolescents with Class II-1 malocclusion and compare the results with established Syrian population norms.Materials and MethodsThe study sample consisted of 43 Syrian patients including 24 females and 19 males with Class II-1 malocclusion (age: 14.3 (±1.5) years, mean (±SD)). Cephalometric radiographs and orthodontic casts were analyzed using special orthodontic software (OnyxCeph3™) and a universal digital caliper, respectively. Statistics were calculated using the SPSS software.ResultsIn Syrian adolescents with Class II-1 malocclusion, the position of the mandible relative to the nasion perpendicular (mean (95% confidence interval)) was −11.01 (−12.45, −9.57) mm. Facial axis angle showed a negative value: −6.25 (−7.65, −4.85) degrees. An obtuse nasolabial angle was observed: 104.05 (101.77, 106.33) degrees. The average width of the upper pharynx was 11.50 (10.53, 12.47) mm; however, there was no prevalence of an upper-pharyngeal width of 5 mm or less. The average value of the anterior tooth-size ratio was 80.69 (79.85, 81.53) percent. In total, 39.5% of the investigated subjects had anterior ratios outside two standard deviations from Bolton’s norm, while 25.6% of the investigated subjects had anterior ratios outside two standard deviations from Syrian population norm.ConclusionsIn this study, the inter-maxillary discrepancy of Class II-1 Syrian adolescents was a consequence of their hyperdivergent facial pattern. The observed small pharyngeal widths were not clinically significant, while the anterior tooth-size discrepancy might be clinically relevant.

The study of facial morphology in patients with vertical growth pattern (hyperdivergent) lacking or showing temporomandibular disorders symptoms

AimAccording to the large number of studies, there seems to be a significant relation between hyperdivergence growth pattern and temporomandibular disorders. However, it is not clearly scrutinized which morphological factors can contribute to the development of temporomandibular disorders. The aim of this study was to investigate the relation between some skeletal and facial morphologic features of hyperdivergent facial growth pattern patients and temporomandibular disorders. Materials and MethodsThis case-control study was performed on a population of 50 patients including 25 patients with temporomandibular disorder and 25 non- temporomandibular disorder individuals aged between 15–30 years with hyperdivergent growth pattern (Frankfurt Mandibualr plane angle between 28 and 35 degree). Two groups of symptomatic and asymptomatic patients (case and control) were matched for age and gender. In order to evaluate the skeletal and dental variables, lateral cephalometries was taken and traced after obtaining written consent from the patients. The measured variables were A point to Nasion to B point, Frankfurt plane to Nasion to Pogonion, Nasion to A point to Pogonion, Sella to Gnathion to Frankfurt plan, Articular point to Gonion-Menton, Sella to Articular point to Gonion, Palatal plane to Mandibular plane, and Articular point to Gonion angles. The intervals of Basion to Nasion, Sella to Basion, Gonion to Menton, and amounts of Anterior facial height meas, Upper Anterior facial height ratio to Lower Anterior facial height, posterior facial height, overjet, and overbite Data were analyzed by Chi2 test, t-test, and multivariate test. ResultsAccording to the descriptive statistics, the age of the control and case groups averaged 21.12±1.99 and 21.63±1.58 years respectively. Among the people referred to the dental school, the frequency of males and females in the control and case groups were 6, 7 and 19, 18 respectively. The results of t-test and multivariate tests indicated significant differences between the two variables of overbite and mandibular length. ConclusionThe present study revealed increased overbite (dental feature) and mandibular length (skeletal feature) is more likely to be associated with a higher risk of temporomandibular disorders joint disease in patients with hyperdivergent facial growth pattern. Clinical significanceTreatment of the deep bite condition can be helpful in improving temporomandibular disorder.

Bone regeneration after alveolar dehiscence due to orthodontic tooth movement – A case report

This article presents the orthodontic treatment of a 15 year old male patient with an Angle class I malocclusion with a class II skeletal base, lower incisor proclination along with a hyperdivergent facial pattern. Such situations that involve camouflage treatment, usually results in further lower incisor proclination which can be reduced to an extent by adding buccal root torque. Placement of additional torque in this case however, resulted in positioning of the root apex of the lower right lateral incisor outside the alveolar housing, although no gingival signs were present. The mechanics were then reversed and at the end of 21 months of treatment, the apices were back within the alveolar housing. A 4-year post-treatment cone-beam computed tomography showed normal bone coverage of the affected tooth; and no clinical signs of gingival pathology were present. Orthodontists should be aware of possible complications of excessively torqueing lower incisors in order to prevent proclination. If root apices are inadvertently moved through the cortex, a good long-term prognosis is possible using orthodontics alone by reversing the mechanics, if no gingival complications are present.

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.

Three-dimensional evaluation of dentofacial transverse widths of adults with various vertical facial patterns.

The purpose of this study was to investigate maxillomandibular transverse widths and molar inclinations of adults with hypodivergent, normodivergent, and hyperdivergent facial patterns using cone-beam computed tomography. We evaluated Class I subjects (55 men, 66 women) who were divided into hypodivergent (<27°), normodivergent (28°-37°), and hyperdivergent (>38°) groups by their mandibular plane angles. Frontal and coronal views of the images were analyzed. Sex differences, vertical facial pattern differences, and related factors were assessed with independent 2-sample t tests, 1-way analysis of variance followed by post hoc Tukey tests, and Pearson correlation analysis. The hypodivergent group had greater maxillary alveolar widths 7mm apically from the alveolar crest. The intermolar widths and molar inclinations showed no significant differences among the groups. As the mandibular plane angles increased, interjugular widths, transverse mandibular widths, and buccolingual maxillary alveolar widths at the midroot level decreased, whereas the maxillomandibular width differences and palatal heights increased im both sexes. An increase in the mandibular plane angle is associated with tendencies of narrow mandibular arches, thinner maxillary alveolar bones at the midroot level, and higher palatal arches in both sexes. Intermolar widths and molar inclinations were not significantly affected by vertical facial patterns.

Differences in distances between maxillary posterior root apices and the sinus floor according to skeletal pattern.

The aim of this study was to evaluate the distances from the maxillary posterior root apices to the inferior wall of the maxillary sinus using cone-beam computed tomography images and the relationships between roots and maxillary sinus according to age, sex, and skeletal pattern. Three-dimensional images of each root were checked, and the distances were measured along the true vertical axis from the apex of the root to the sinus floor in 118 patients (63 male, 55 female) aged 10 to 28years. Compare-means statistic tests were done to assess the differences between groups classified according to age, sex, and skeletal pattern. The frequency of root contact with the sinus floor increased from 70% at the second premolar to more than 80% at the buccal roots of the first and secondmolars. Male and older age (20-28years) groups had significantly smaller distances or more protrusion of the root into the sinus than female and younger age (10-20years) groups. The distances were shorter, or there was more protrusion of the root into the sinus in the hyperdivergent, down-canted palatal plane, and large gonial angle groups. Male, older age, hyperdivergent skeletal pattern, and large gonial angle groups had significantly closer distances between maxillary root tips and the sinus floor or more protrusion of the roots into the sinus. The intrusion of the maxillary molars in those situations may be difficult and slow because of the pneumatized maxillary sinus.

Dentoalveolar Heights in Vertical and Sagittal Facial Patterns.

To determine and compare the mean dentoalveolar heights (mm) in different vertical and sagittal facial patterns. Cross-sectional study. Orthodontics Clinic, The Aga Khan University Hospital, Karachi, from September to November 2013. Subjects, aged 15 - 20 years, having fully erupted first permanent molars and central incisors were included in the study from orthodontic records. The pretreatment cephalographs of subjects were traced manually over an illuminator. The various parameters like angles and dentoalveolar heights were measured and recorded on data collection form. Mean value ± SD for the variables were generated. ANOVAwas used to compare the means of dentoalveolar heights among the vertical and sagittal facial patterns. Post Hoc Bonferroni test was applied to show difference among the three vertical and three sagittal facial patterns. P-value equal to or less than 0.05 was taken as statistically significant. The mean age of subjects was 15.8 ±3.2 years in vertical group and 16.3 ±2.9 years in sagittal group. There was statistically significant difference (p=0.008) for the upper anterior dentoalveolar height (UADH) among vertical groups, with statistically significant difference for UADH between hyperdivergent and normodivergent (p=0.04) and hyperdivergent and hypodivergent (p=0.01) facial patterns. The UADH were significantly greater in the hyperdivergent group as compared to both the normodivergent and hypodivergent groups. The sagittal groups showed no statistically significant difference for dentoalveolar heights.

Short-term treatment effects of the quad-helix appliance on dentofacial morphology of hyperdivergent patients

Abstract Objectives The purpose of this study was to evaluate the effects of short-term expansion treatment using the quad-helix appliance on dentofacial morphology in orthodontic patients presenting with a hyperdivergent facial pattern. Methods The treatment group consisted of 40 patients with a hyperdivergent facial pattern, who were treated for maxillary incisor crowding with a quad-helix appliance during the mixed dentition period. Lateral cephalograms taken at the start (T0) and end (T1) of the treatment were obtained as a course of care. A similar number of patients, who possessed the same type of facial pattern and who remained untreated, were assigned to a control group. Two consecutive lateral cephalograms of each untreated patient were taken at the same time points as T0 and T1. All cephalograms were traced, analysed and compared between the two groups. Results The treatment changes as a result of the quad-helix appliance were expressed in an upward rotation of the mandible (2.34°) and distal tipping and impeded mesial movement of the maxillary first molars. Significant differences were evident between the treatment and control groups. Conclusion Quad-helix appliance treatment can be appropriate for significantly decreasing the mandibular plane angle in hyperdivergent patients presenting with moderate maxillary incisor crowding and a positive overjet and overbite.

Pharyngeal dimensions in skeletal class I, II, and III orthodontic patients in a Nigerian population

Background: Routine lateral cephalometric radiographs can determine upper and lower pharyngeal airway constriction or patency depending on the dentofacial skeletal discrepancy. Appropriate orthodontic treatment that would maintain or improve the airway patency can be considered if the width of the airway in the various skeletal classes is determined. Aim: The aim of this study was to evaluate the upper and lower pharyngeal widths in skeletal Class I, II, and III untreated orthodontic patients in Benin City, Nigeria. Materials and Methods: In this study, 188 lateral cephalometric radiographs comprising three groups based on the ANB angle: Class I (ANB 2-4°), Class II (ANB >4), and Class III (ANB < 2) were analyzed using the method described by McNamara. The vertical facial pattern (the Sella-Nasion-GoGn angle) and palatal length were also determined. The differences between groups and correlations between variables were determined with the Students t-test and the Spearman correlation coefficient, respectively. Results: The mean upper and lower pharyngeal width for skeletal Classes I were 10.56 ± 3.67 mm and 11.14 ± 3.79 mm, respectively. Skeletal Class II had the narrowest upper airway width, whereas skeletal Class III had the narrowest lower airway widths, respectively. The palatal length was 9.04 mm in males and 8.6 mm in females, and there was a highly statistically significant difference P < 0.05 between hyperdivergent facial pattern and the upper pharyngeal width. There was a significant difference between skeletal pattern II and the upper pharyngeal width. Conclusion: Pharyngeal dimensions should be taken into consideration when managing patients with skeletal patterns II and III and the hyperdivergent facial patterns.

Upper and lower pharyngeal airway space in West-Tamil Nadu population.

Aim:To compare the upper and lower pharyngeal airway (LPA) width in Class II malocclusion patients with low, average, and high vertical growth patterns.Study Design:Cross-sectional analytical study.Materials and Methods:Pretreatment lateral cephalometric films of 90 Class II subjects were used to measure the upper and LPAs. The inclusion criteria were subjects of West-Tamil Nadu, aged between 14 and 25 years, only skeletal Class II subjects of either gender and no pharyngeal pathology at initial visit. The sample comprised a total of 90 Class II subjects divided into three groups according to the vertical facial pattern: Normodivergent (n = 30), hypodivergent (n = 30), and hyperdivergent (n = 30). The assessment of upper and LPAs was done according to McNamara's airway analysis.Statistical Analysis:The intergroup comparison of the upper and LPAs was performed with one-way analysis of variance and the Tukey test was used to compare among the various vertical patterns.Results:Skeletal Class II subjects with hyperdivergent facial pattern showed statistically significant narrow upper pharyngeal width when compared to normodivergent and hypodivergent facial patterns. No statistically significant difference was found in the lower pharyngeal width in all three vertical facial growth patterns.Conclusion:Subjects with Class II malocclusions and hyperdivergent growth pattern have significantly narrow upper pharyngeal airway space when compared to other two vertical patterns. Narrow pharyngeal airway space is one of the predisposing factors for mouth breathing and obstructive sleep apnea.

Impact of orthodontic decompensation on bone insertion.

There has always been concern in determining the relationship between orthodontic tooth movement and the consequent biological costs to the periodontium and tooth root. The possibility of evaluating the tooth and bone morphology by CBCT allows more accurate analysis of qualitative and quantitative aspects of these processes. This paper presents a case report of a 20-year-old male patient with Class III malocclusion and hyperdivergent facial pattern, who was surgically treated. A significant amount of labial movement of mandibular incisors was performed during orthodontic treatment before surgery. CBCT was used for evaluation of buccal and lingual bone plates before and after tooth decompensation. The changes in the bone insertion level of maxillary and mandibular incisors in the present case encourage a reflection on the treatment protocol in individuals with dentoskeletal discrepancies.

Comparisons of soft tissue chin thickness in adult patients with various mandibular divergence patterns

To evaluate the association between soft tissue at the chin (STC) thickness and mandibular divergence. Nongrowing patients seeking orthodontic treatment (n = 190; 113 women and 77 men), who had an average age of 26.94 years (range = 18.10-53.50 years), were stratified in four subgroups based on cephalometric mandibular plane inclination to anterior cranial base (MP/SN): low = MP/SN ≤ 27° (n = 48); medium-low = 27° < MP/SN ≤ 32° (n = 60); medium-high = 32° < MP/SN < 37° (n = 37); and high = MP/SN ≥ 37° (n = 45). The STC thicknesses were measured at pogonion (Pog), gnathion (Gn), and menton (Me). Group differences were evaluated with two-way analysis of variance and Student's t-test. The Pearson product moment correlation gauged associations between parameters. The STC values were greater in men than women (P < .02) and were smaller in the high group (7.47 ± 2.42 mm) than in all other groups at Gn (mean values = 9.00 mm < STC < 9.58 mm; P < .001) and at Me (high group = 6.30 ± 1.89 mm; other groups = 7.15 mm < STC< 7.57 mm; P = .011). The STC is thinner at Gn and Me in hyperdivergent facial patterns, apparently in contrast to Pog. This differential thickness warrants focused research as it implies that it is possible (1) to vertically grow hard tissues impinging on the inferior soft tissue envelope in patients with severe hyperdivergence and (2) to plan for genioplasty in such patients when more advancement of the chin might be needed to compensate for the increased vertical height.

Cephalometric deviations present in children and adolescents with temporomandibular joint disorders

INTRODUCTION: Temporomandibular disorders (TMD) have proved to be a risk factor for developing hyperdivergent facial growth patterns. OBJECTIVE: The aims of this study were: (1) Assess differences between the cephalometric measurements in children with articular TMD and a control group, before and after mandibular growth peak according to cervical vertebral maturation; and (2) Identify a predictive model capable of differentiating patients with TMD and control group patients based on early cephalometric characteristics. METHOD: The study included children and adolescents with maximum age of 17 years, divided into experimental group (n=30) diagnosed with articular TMD-according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for children and adolescents-subdivided according to growth stage, called pre-peak (n=17) and post-peak (n=13) and control group (n = 30), matched by gender, skeletal maturity stage of the cervical vertebrae and classification of malocclusion. Lateral cephalometric and craniofacial structures were traced and their relations divided into: Cranial base, maxilla, mandible, intermaxillary relations, vertical skeletal relations and dental relations. Differences between the means for each variable were evaluated by applying the statistical Student t test for independent samples. RESULTS: The means of the variables analyzed in the pre-peak showed no statistically significant differences. However, analysis of post-peak showed that the experimental group displayed decreased SNA and SNB and increased SN.Gn and 1.NB (p<0.05). CONCLUSION: It was possible to identify a predictive model able to differentiate patients with TMD and asymptomatic controls from early cephalometric characteristics.