Lateral Cephalometric Radiographs Research Articles

Evaluation of the posterior reference point of ala tragus line in relation to occlusal plane and Frankfort horizontal plane through cephalometry in Sangareddy (Telangana) population

The Occlusal plane (OP) inclination is determined by paralleling the ala- tragus line to the occlusal plane. The location of the ala-tragus line is unclear because the exact location of the posterior reference tragal point is controversial. Additionally, morphological variations are observed between different ethnic groups. Therefore, evaluation of the exact reference point on the tragus is important. The study aimed to determine the most reliable posterior reference point on the ala‑tragus line that forms the most parallel line with the natural OP among the dentate Sangareddy volunteers from Telangana. Prosthodontically related craniofacial reference lines and angles of lateral cephalometric radiographs were analyzed for 25 dentate volunteers. Stainless steel balls were attached to the ala of the nose (A) and three points corresponding to the inferior (I), middle (M), and superior (S) points on the tragus. The angle formed by each line (IA, MA, and SA planes) with the OP and Frankfort horizontal (FH) plane were measured on cephalometric tracings.

Skeleto-dental features among a sample of Saudi female children compared to British standards: A cephalometric study.

This cross-sectional observational retrospective study aimed at assessing the cephalometric skeleto-dental features of class I, II, and III skeletal relationship of Saudi female school children sample and comparing the results to the established British Caucasian cephalometric standards. The sample consisted of 205 retrospective lateral cephalometric radiographs of female school children. The age range of the subjects were between 10 and 13 years old with a mean age of 11 ± 1 years. Several cephalometric and constructed points were identified. Angular, linear, and proportional measurements were obtained and analyzed. The skeleto-dental features of class II and class III were compared to class I of this sample and then compared with the established British Caucasian population. Different angular, linear, and proportional variables were investigated. Descriptive statistics and Student's t-test were used for data analysis. The distribution of the skeletal relationship revealed that 68.3% of the sample showed class I relationship, 16.1% class II, and 15.6% class III. The result indicates significant differences among the different classes. A greater tendency towards class II facial pattern and more convex profile among Saudis were detected in the present study compared to Caucasians. Furthermore, The dento-alveolar relationship results showed more bi-maxillary protrusion among Saudi females compared to the British Caucasians. The results of the study can serve as a base-line for future investigations in Saudi Arabia. Furthermore, the results obtained can also be of great value in distinguishing the various skeleto-dental features in the different skeletal classes among the Saudi females, and in the clinical diagnosis and treatment planning.

Evaluation of the Effects of Distal Malocclusion Activators on the Craniofacial Complex

Introduction: Class II malocclusions are the most commonly seen, and therefore, the most commonly treated type of anomalies. Dental and skeletal factors are involved in the development of Class II malocclusions. The purpose of this study was to investigate whether or not there were any changes in the increased cranial base angle and cranial base dimensions, which have been reported to be among the morphological characteristics of Class II malocclusions, with functional orthopedic treatment and to evaluate effects of these changes on facial structures. Materials and Methods: The study was conducted on hand-wrist radiographs and lateral cephalometric radiographs of 50 patients taken at the beginning and at the end of treatment. The control group comprised 17 patients and the treatment group comprised 17 patients who were treated with a Class II division 1 activator and 16 patients who were treated with a combination of Class II division 1 activator and an Occipital Headgear (Hg). Results: Among the measurements for cranial base dimensions, only the increase in S-N in the treatment group was smaller than that in the control group. No significant differences were found among groups regarding the values of NSBa and NSAr angles, which are known to be cranial base angles. Conclusion: The increase in the S-N dimension being smaller in the treatment group brings about the idea that the activator treatment may influence maxillary development and consequently the nasomaxillary complex.

ASSOCIATION BETWEEN ANGULATION OF MANDIBULAR THIRD MOLAR IMPACTIONS WITH FACIAL SKELETAL TYPES AND CEPHALOMETRIC LANDMARKS

OBJECTIVE: To determine the association of impacted mandibular third molar with skeletal facial types and different anatomical and cephalometric landmarks. METHODS: This cross-sectional study was conducted at Rehman College of Dentistry and Khyber College of Dentistry, Peshawar, Pakistan from October to December 2020. Panoramic and lateral cephalometric radiographs of 800 patients (aged 22-35 years) were retrieved from the records. Third molar impaction was classified by Winter’s classification using IC Measure software. The skeletal facial type was determined by measuring Point A Nasion Point B angle using Viewbox software. An association of third molar impaction with skeletal facial types, cephalometric and anatomical variables was evaluated. RESULTS: The most common mandibular tooth impactions type was Mesioangular impaction (81.3%) and skeletal facial type was skeletal class-I (47.5%). Comparative analysis among different impaction types using One-way ANOVA showed that although these impaction types did not differ significantly in terms of skeletal facies (p=0.07), significant difference in terms of age (p=0.028), Maxillary Mandibular Plane Angle (MMPA) (p=0.007), depth (p=0.000), ramus relation (p=0.000) and inferior dental nerve (ID) canal (p=0.001) were observed. ID canal was found to be positively but weakly correlated (r=0.2) with impaction types. Contrariwise, depth and ramus relation showed moderately negative correlation (r=-0.40 and r=-0.30, respectively) with impacted tooth angulations. CONCLUSION: Although it is difficult to predict the impaction type in patient based on their skeletal facies, associations between other anatomical and cephalometric variables were observed which may help in predicting the degree of difficulty that may be encountered during the surgical procedures.

Effects of reverse headgear therapy on mandibular trabecular structure: A fractal analysis study.

The aim of this study was to assess the effects of reverse headgear (RHG) treatment combined with rapid maxillary expansion (RME) on the trabecular structure of the mandibula using fractal dimension (FD) analysis. Forty-four individuals with skeletal Class III malocclusion were selected from the archives and divided into two groups as patients who underwent treatment with RME+RHG (RHG-G, 22 patients) and untreated control group (C-G, 22 patients). The before (T0) and after (T1) treatment lateral cephalometric and panoramic radiographs were collected in the RHG-G and in the control group, radiographs obtained with similar time intervals were grouped as T0 and T1. Cephalometric and FD analysis was conducted on T0 and T1 lateral cephalometric and panoramic radiographs. The intragroup comparison of cephalometric and FD data was performed using paired t test and Wilcoxon Signed Ranks test, while independent t test and Mann-Whitney U test were used for intergroup comparison. C-G had higher FD values in the right mandibular corpus and left mandibular ramus values at T0 (P<.05). The only significant difference in the intragroup comparisons was detected in the FD values of the right mandibular corpus in the C-G (P<.05). No significant differences were found in the FD between the groups in any of the areas measured (P>.05). RME+RHG therapy did not cause any significant trabecular changes in the mandibula when compared to the control group.

Does Maxillary Protraction with Alt-RAMEC Protocol Affect Inferior Sclera Exposure? A Controlled 3dMD Study.

The purpose of this controlled retrospective study was to measure and evaluate the inferior sclera exposure changes using 3dMD stereophotogrammetric images in a prepubertal Class III patient sample that underwent maxillary protraction with alternate rapid maxillary expansions and constrictions protocol followed by facemask. The study group included 15 prepubertal patients (mean age: 9.85 ± 1.44 years) with Class III malocclusion due to maxillary retrognathism. Nine weeks of alternate rapid maxillary expansions and constrictions protocol was followed prior to 7 months of face mask treatment and 3 months of retention with Bionator. Pretreatment (T0) and post-retention (T1) lateral cephalometric radiographs and 3dMD images were retrieved from clinical archive. The same records were used for a control group of 15 well-matched, untreated patients (mean age: 9.4 ± 0.79 years). The distance between the upper eyelid margin and the lower eyelid margin was recorded as the overall eye height (E), and the distance between inferior limbus and the lower eyelid margin was recorded as inferior sclera exposure (S). The S : E ratio in percentage was calculated. Sella-nasion-A point angle (SNA) was used as the skeletal variable. SNA angle, right S : E, and left S : E changed significantly in both groups at T1-T0. The intergroup comparison was highly significant for SNA angle but was not significant for right and left S : E variables. The S : E ratio decreased significantly in both alternate rapid maxillary expansions and constrictions/facemask and the control groups. However, the change in S : E ratio between groups was not significant.

Comparison of Gonial Angle and Alveolar Bone Height Changes in Panoramic and Lateral Cephalometry Radiography in Growing Patients

Background: This study aimed to compare the gonial angle and alveolar bone height changes between panoramic and lateral cephalometry radiographic images in class II malocclusion patients before and after orthodontic treatment. Methods: The obtained radiographic images were selected from among 120 class 2 malocclusion cases. The gonial angle and alveolar bone height were measured in the midline and molar regions of panoramic and lateral cephalometric radiographs using the software tools before and after the treatment of patients. Study data were analyzed by SPSS statistical software (version 21.0), and a significance level was set to 0.05 for all statistical tests. Results: Based on the results, no significant difference was found regarding the gonial angle before and after treatment on the right and left sides in panoramic radiography and the gonial angle changes before and after treatment in cephalometric radiography (P&gt;0.05). However, the obtained results for posterior and anterior alveolar ridge height were significant in panoramic and cephalometric radiographs (P&lt;0.05). Moreover, the comparison of the measured gonial angle values before treatment in panoramic and cephalometric radiography represented a significant level (P&lt;0.05). Eventually, the statistical results suggested that the alveolar bone height differences between panoramic and cephalometry radiography were significantly different in both anterior and posterior regions after treatment (P&lt;0.05). Conclusions: The findings indicated that only measurements obtained from the panoramic radiography were valid for the gonial angle. However, panoramic and cephalometry radiography procedures cannot be replaced for assessing the anterior and posterior alveolar bone height.

Dental and Skeletal Age in Patients with Palatally Displaced Canines.

ObjectiveTo determine potential associations between dental and skeletal maturation and palatally displaced canines (PDC) considering gender and chronological age.Material and methodsThis study included pretreatment panoramic and lateral cephalometric radiographs of 43 subjects with PDCs and 203 randomly selected orthodontic subjects with normally erupted canines. Both groups were non syndromic patients. Chronological age of subjects was rounded and noted in years with decimal points and compared with chronological age according to Demirjian's dental age assessment. Skeletal maturation was determined by cervical vertebrae changes on cephalometric radiographs.ResultsFemale subjects with PDC were more affected by left side canine displacement than males (p=0.027) with five times higher odds ratio (OR = 4.9; 95% CIL=1.2-19.7). A comparison of chronologic and skeletal age indicated that PDC subjects were skeletally younger than unaffected groups with statistically significant differences at the age of 10, 12 and 13. (p=0.05).ConclusionYoung subjects with PDCs showed skeletal maturation delay compared to control group, indicating that skeletal maturation assessment could be one of unexplored predicting factors of a PDC, especially at the age between 10 and 13 years in both genders. Subjects with PDC showed intensive growth spurt after the age of 12 years in females, and after the age of 13 in males. Dental maturation delay showed no statistical significance in PDC prediction.

PHARYNGEAL AIRWAY SPACE IN DIFFERENT SKELETAL MALOCCLUSION AND FACIAL FORMS

Background: Evaluation of the upper and lower airway space should be an integral part of diagnosis and treatment planning to achieve the functional balance and stability of the result after orthodontic or orthognathic treatment. This study aimed to analyze the pharyngeal airway space in different skeletal malocclusion and facial forms. Methods: Study was carried out in lateral cephalometric radiographs of 210 patients. Data was collected from March 2021 to December 2021. Pharyngeal airway spaces were analyzed according to McNamara Analysis. Upper and lower pharyngeal airway in different skeletal malocclusion and facial form was determined. Data was analyzed in SPSS version 20. Independent samples-t test was applied for gender distribution and Pearson correlation test was applied for upper and lower pharyngeal space. Results: The mean value of upper pharyngeal airway width in Class I, II and III were 12.07 mm, 11.57 mm and 12.34 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 12.35 mm, 11.83 mm and 11.81 mm respectively. Similarly, the mean value for lower pharyngeal airway width in Class I, II and III were 9.51 mm, 9.13 mm and 10.03 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 9.62 mm, 9.34 mm and 9.61mm respectively. Male had higher value of mean lower pharyngeal width than female. Conclusions: There was no impact of sagittal skeletal malocclusion on the upper and lower airways width. Also, there was no impact of different vertical skeletal types or facial forms on the upper and lower airways width.

Nasoalveolar molding and skeletal development in patients with bilateral cleft lip and palate: A retrospective cephalometric study at the completion of growth

The aim of this retrospective long-term study was to assess the influence of primary columella lengthening and presurgical nasoalveolar molding (NAM) on the skeletal development at the completion of growth in patients with bilateral cleft lip and palate (BCLP).Lateral cephalometric radiographs at the completion of growth of consecutively treated patients BCLP patients, operated by the same surgeon, who had undergone NAM were compared with a second group of BCLP patients who were not treated with NAM. The groups were matched for sex and age. Independent samples t tests were carried out.23 Lateral cephalometric radiographs of BCLP patients (mean age 18.2 ± 1.3 years) who had undergone NAM were compared with a second group of 23 BCLP patients (mean age 18.4 ± 1.3 years) who were not treated with NAM. The only two significant differences were observed in Ans-Me/N–Me (control group = 0.6 ± 0.02; sample group = 0.57 ± 0.05; p = 0.019) and ILs^AnsPns (control group = 105.5 ± 7.9; sample group = 112.4 ± 8.6; p = 0.007). No other significant differences were observed in terms of facial skeletal development between the two groups.Presurgical NAM performed during infancy in BCLP patients does not seem to have negative effects on the skeletal development at the completion of craniofacial growth compared to the group of patients treated without NAM.

Comparative Validation of the Mixed and Permanent Dentition at Web-Based Artificial Intelligence Cephalometric Analysis

This retrospective study aimed to evaluate the difference in measurement between conventional orthodontic analysis and artificial intelligence orthodontic analysis in pediatric and adolescent patients aged 7 - 15 with the mixed and permanent dentition. A total of 60 pediatric and adolescent patients (30 mixed dentition, 30 permanent dentition) who underwent lateral cephalometric radiograph for orthodontic diagnosis were randomly selected. Seventeen cephalometric landmarks were identified, and 22 measurements were calculated by 1 examiner, using both conventional analysis method and deep learning-based analysis method. Errors due to repeated measurements were assessed by Pearson’s correlation coefficient. For the mixed dentition group and the permanent dentition group, respectively, a paired t-test was used to evaluate the difference between the 2 methods. The difference between the 2 methods for 8 measurements were statistically significant in mixed dentition group: APDI, SNA, SNB, Mandibular plane angle, LAFH (p &lt; 0.001), Facial ratio (p = 0.001), U1 to SN (p = 0.012), and U1 to A-Pg (p = 0.021). In the permanent dentition group, 4 measurements showed a statistically significant difference between the 2 methods: ODI (p = 0.020), Wits appraisal (p = 0.025), Facial ratio (p = 0.026), and U1 to A-Pg (p = 0.001). Compared with the time-consuming conventional orthodontic analysis, the deep learning-based cephalometric system can be clinically acceptable in terms of reliability and validity. However, it is essential to understand the limitations of the deep learning-based programs for orthodontic analysis of pediatric and adolescent patients and use these programs with the proper assessment.

Early Secondary Alveolar Bone Grafting and Facial Growth of Patients with Complete Unilateral Cleft Lip and Palate.

To investigate the craniofacial growth outcomes of early secondary alveolar bone grafting(ABG) around 6 years of age. Retrospective cohort study. 1 North-American and 5 Northern-European cleft centers. 33 subjects with CUCLP consecutively treated with secondary ABG around 6 years of age were compared to 105 subjects from 4 centers treated with late secondary ABG and 19 subjects from 1 center with primary ABG. Preorthodontic standardized lateral cephalometric radiographs taken after 12 years of age were traced and analyzed according to the Eurocleft Study protocol. Fourteen angular and two proportional measurements were performed. Measurement means from the Study Center(SC) were compared to 5 Northern-European centers using analysis of variance and Welch's modified t-tests, and P < .05 was considered statistically significant. For the SC, the mean age ± SD at the time of bone graft was 5.85 ± 0.71 years and the mean age at the time of the lateral cephalogram was 13.4 ± 1.8 years. The sagittal maxillary prominence of the SC was favorably comparable to the 5 Northern-European centers. The mean SNA (78.1 ± 4.3) for the SC was significantly higher compared to 4 of the 5 Northern-European centers(all P < .05), and the mean ANB angle was comparable to 4 of the 5 centers. Similarly, the mean soft tissue ANB angle was not significantly different to the 5 centers. The soft tissue vertical proportions compared favorably to all 5 Northern-European centers(all P < .01). Craniofacial growth outcomes of early secondary ABG around 6 years compare favorably to the outcomes of late secondary ABG.

Analysis of factors affecting postoperative relapse after bilateral saggital split osteotomy for mandibuler set back

ObjectivePostoperative orthodontic treatment after orthognathic surgery is particularly affected by relapse of ≥2 mm. Patients who had undergone surgery were retrospectively reviewed, and factors contributing to relapse were investigated. MethodsThe study subjects were 130 patients who underwent bilateral sagittal split ramus osteotomy between January 2016 and December 2017 in our hospital. Lateral cephalometric radiographs were taken preoperatively (T1), immediately postoperatively (T2), and 1 year postoperatively (T3), and the positions of the maxilla and mandible (SNA, SNB), mandibular changes due to surgery [Point B (X, Y), Argo-FH, mandibular plane], hyoid position (MP-H), head position (NSL/CVT, SN-C2C4), and airway space (SPAS, MAS, IAS) were measured. Postoperative changes (T2–T1) and postoperative stability (T3–T2) were assessed, the change in Point B (X) between T3 and T2 was calculated, and those patients in whom this change was <2 mm (Group S) were compared with those in whom it was ≥2 mm (Group R). An unpaired t-test (p < 0.05) was used for statistical analysis. ResultsComplete sets of radiographs were obtained for 42 patients. A comparison of T2–T1 between Group S (n = 33) and Group R (n = 9) found no significant difference in either SNB or Point B (X), but significant differences in MP-H, NSL/CVT, and SN-C2C4 (p < 0.05). ConclusionsThese results showed that postoperative mandibular relapse of ≥2 mm occurred irrespective of the degree of mandibular setback, and it was more likely to occur when surgery had resulted in a greater change in hyoid position.

Le Fort I osteotomy with segmentation for the treatment of maxillary dentoalveolar protrusion: a single-centre, 10-year outcome study

A retrospective study was conducted to evaluate the stability and complications of Le Fort I osteotomy with segmentation for the treatment of bimaxillary dentoalveolar protrusion. A total of 120 consecutive patients who had undergone orthognathic surgery between 2008 and 2017 at a single centre were recruited. Lateral cephalometric radiographs were taken before surgery, within 6 weeks after surgery, and at 2 years after surgery. U1–SN and U1–PP underwent mean uprighting of 8.7° and 9.6°, respectively, and mean relapse of 2.1° and 2.6°, respectively (both P < 0.05). The only significant risk factor for relapse was the use of intermaxillary fixation (risk ratio (RR) 1.2, P = 0.01). The most common complication was wound dehiscence (41.7%), which was a significant risk factor for wound infection (RR 3.3, P < 0.01) and fixation hardware exposure (RR 3.7, P < 0.01). Other common complications were gingival recession (40.8%), periodontal bone loss (40%), and blood loss requiring transfusion (26.7%), the latter of which was associated with the preoperative diagnosis of vertical maxillary excess (RR 2.4, P = 0.01). Some degree of relapse occurred in more than 90% of the patients by 2 years after surgery. The procedure is not without risks and complications but may be useful in severe cases.

Cephalometric Analysis for Gender Determination Using Maxillary Sinus Index in Population of Gujrat, India

Introduction: Humans are sexually dimorphic. Identification of remnants of skeletal and decomposing parts of humans is one of the most difficult skills in forensic medicine. Forensic anthropologists can receive whole or fragmented skeletal remains. But the unique thing is that the maxillary sinus is intact within the skull, so maxillary sinus radiography is being used to identify remains and determine gender. Materials and Method: A total of 51 adult digital lateral cephalometric radiographs (20 males and 31 females) were included in the study. The maxillary sinus analysis was performed by measuring the height and width of these digital lateral cephalometric radiographs using measurement tools of Sidexis4 software. Maxillary sinus index was calculated, discriminant function analysis performed, and discriminant equation derived for determination of gender. Results: Comparison of maxillary sinus parameters (height and width) between male and female groups showed statistically insignificant differences in this study. Regression analysis is done and an equation is derived, which will aid in the prediction of gender by substituting the values of specific measurements in the equation.

The Role of Maxillofacial Structure on Condylar Displacement in Maximum Intercuspation and Centric Relation.

Purpose This study is aimed at evaluating the impact of the craniofacial structure and occlusal conditions on the position of the articular heads of the mandibular condyles in the maximum intercuspal position (MIP) and comparing the centric relation (CR) and MIP of the mandibular condyles prior to orthodontic treatment. Methods The studied group consisted of 33 women and 15 men (median age of 17.75 years). Contact points of opposing teeth in the MIP were assessed by hand-held casts. Condylar displacement (CD) in three spatial planes on both sides was measured on models mounted in an articulator using a mandibular position indicator (MPI). Patients were divided into groups according to craniofacial structures (vertical and horizontal growth directions). The Mann-Whitney, Kruskal-Wallis, post hoc Dwass-Steel-Critchlow-Fligner, and Pearson's χ2 independence tests as well as Spearman's nonparametric correlations were used in the statistical analyses. Results Within the limitations of this study, no statistically significant correlation of CD with certain cephalometric measurements from a lateral cephalometric radiograph (ANB, SN-ML, and SGo/NMe) was observed. Correlation, however, was found between condylar displacement in the transverse axis and the mandibular plane angle SN-ML (p = 0.033) and also between condylar displacement in the anteroposterior axis and a midline shift of the mandible (p = 0.041). The results revealed a relationship between Angle's classification of molar position on the right side and anteroposterior CD values (p = 0.006). Conclusions Cephalometric measurements cannot be used to predict CD at the level of the condyles. Analysis of occlusal conditions of models mounted in an articulator is desirable for patients with Angle's class I and lower jaw asymmetry.

Comparison of the reproducibility of two cervical vertebrae maturation methods

Aim: Facial orthopaedic treatments based on the stimulation or restrictions of craniofacial bone growth are more effective when carried out during the pubertal growth spurt. The aim of this cross-sectional study was to evaluate the reproducibility of two cervical vertebrae methods (CVM) with manual tracing and direct visual inspection. Methods: A sample of 60 lateral cephalometric radiographs (10 of each of the 6 CVM stages) was randomly selected from 171 records. 5 orthodontists classified these radiographs according to the skeletal maturation stage in 2002 and 2005, and the application of both methods was conducted by direct visual inspection and evaluation through manual tracing. Results: The average reliability of the two methods determination and the two forms of evaluation was substantial. The direct visual inspection evaluation showed the highest reliability and agreement interexaminer values for both methods, as well as the intraexaminers evaluation. Conclusion: The reproducibility of CVM method was substantial, indicating its clinical use to determine the skeletal maturity and the ideal moment for treatment execution.

Cervical vertebrae maturation assessment as a predictive method for midpalatal suture maturation stages in 11- to 14-year-olds: retrospective study

ABSTRACT Introduction The treatment of transverse maxillary deficiency must be performed with the patient inside the growth phase, then, it is necessary to evaluate the patient’s skeletal maturation. There are two common methods: cervical vertebrae maturation (CVM) and midpalatal suture maturation (MSM). Objective to evaluate and correlate the methods in patients aged from 11 to 14 years old, to investigate if CVM method can be predictive of the midpalatal suture maturation stage. Methods Forty-two CBCT scans and lateral cephalometric radiographs of children, aged between 11 and 14 were analysed. The images were evaluated by two investigators. Kappa coefficient was calculated to estimate intra and inter-examiner agreement. Spearman correlation test was performed to evaluate the correlation between methods, age and gender. To evaluate the diagnostic performance of the CVM and MSM methods, the likelihood ratio (LHR positive) was applied. Results MSM evaluation showed a strong correlation with the CVM evaluation (rs = 0.6916). A high correlation between the methods were found for the male gender (rs = 0.7809). There was no correlation between age and the maturation methods, considering both genders. The CVM method presented a strong positive LHR with the MSM method (2.250), in the early stages; nonetheless, in the more advanced stages there was a lower ratio (1.500). Conclusions The CVM method can be used as a predictor of the maturation stages of the midpalatal suture in the early stages of maturity. In more advanced stages, the evaluation of the palatal suture by tomography is suggested.

Sex determination from lateral cephalometric radiographs using an automated deep learning convolutional neural network.

PurposeDespite the proliferation of numerous morphometric and anthropometric methods for sex identification based on linear, angular, and regional measurements of various parts of the body, these methods are subject to error due to the observer’s knowledge and expertise. This study aimed to explore the possibility of automated sex determination using convolutional neural networks (CNNs) based on lateral cephalometric radiographs.Materials and MethodsLateral cephalometric radiographs of 1,476 Iranian subjects (794 women and 682 men) from 18 to 49 years of age were included. Lateral cephalometric radiographs were considered as a network input and output layer including 2 classes (male and female). Eighty percent of the data was used as a training set and the rest as a test set. Hyperparameter tuning of each network was done after preprocessing and data augmentation steps. The predictive performance of different architectures (DenseNet, ResNet, and VGG) was evaluated based on their accuracy in test sets.ResultsThe CNN based on the DenseNet121 architecture, with an overall accuracy of 90%, had the best predictive power in sex determination. The prediction accuracy of this model was almost equal for men and women. Furthermore, with all architectures, the use of transfer learning improved predictive performance.ConclusionThe results confirmed that a CNN could predict a person’s sex with high accuracy. This prediction was independent of human bias because feature extraction was done automatically. However, for more accurate sex determination on a wider scale, further studies with larger sample sizes are desirable.

The relationship of maxillary arch dimension with vertical facial morphology in proto-malay race.

OBJECTIVE:To determine the relationship between the dimensions of the maxillary arch and vertical facial morphology within the Proto-Malay race.DESIGN:A cross-sectional study.SETTING:Orthodontics Department, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia.PARTICIPANTS:Proto-Malay individuals aged ≥18 years without orthodontic treatment history (n = 104).METHODS:Lateral cephalometric radiographs and maxillary study model were obtained from 104 subjects who had never received orthodontic treatment (45 males and 59 females), aged 18 years, belonging to the Proto-Malay race, with skeletal class I malocclusion, normal overjet and overbite, and complete dentition (except the third molar). The vertical facial morphology was obtained by measuring the Jarabak's ratio on lateral cephalometric radiographs by using CorelDRAW. The study model was used to measure the dimensions of the maxillary arch, which are intercanine width, intermolar width, arch length, and palatal height, by using the Korkhaus modification device.RESULTS:The results showed a significant positive correlation between intercanine and intermolar width and a negative correlation between arch length and palate height with vertical facial morphology in the male and female groups within the Proto-Malay race.CONCLUSION:There is a relationship between the maxillary arch dimension with vertical facial morphology in the male and female groups in the Proto-Malay race.