Lateral Cephalometric Radiographs Research Articles

Application of a Multi-Layer Perceptron in Preoperative Screening for Orthognathic Surgery.

Orthognathic surgery is used to treat moderate to severe occlusal discrepancies. Examinations and measurements for preoperative screening are essential procedures. A careful analysis is needed to decide whether cases require orthognathic surgery. This study developed screening software using a multi-layer perceptron to determine whether orthognathic surgery is required. In total, 538 digital lateral cephalometric radiographs were retrospectively collected from a hospital data system. The input data consisted of seven cephalometric variables. All cephalograms were analyzed by the Detectron2 detection and segmentation algorithms. A keypoint region-based convolutional neural network (R-CNN) was used for object detection, and an artificial neural network (ANN) was used for classification. This novel neural network decision support system was created and validated using Keras software. The output data are shown as a number from 0 to 1, with cases requiring orthognathic surgery being indicated by a number approaching 1. The screening software demonstrated a diagnostic agreement of 96.3% with specialists regarding the requirement for orthognathic surgery. A confusion matrix showed that only 2 out of 54 cases were misdiagnosed (accuracy = 0.963, sensitivity = 1, precision = 0.93, F-value = 0.963, area under the curve = 0.96). Orthognathic surgery screening with a keypoint R-CNN for object detection and an ANN for classification showed 96.3% diagnostic agreement in this study.

Relationship of Nasolabial Angle with Maxillary Incisor Proclination and Upper Lip Thickness in North Indian Population.

The aim of the study was to evaluate the relationship between nasolabial angle (NLA) with maxillary incisor proclination (U1-NA) and upper lip thickness (ULT). Pretreatment lateral cephalometric radiographs of 120 patients were taken, and NLA, U1-NA, and basic ULT measurements were obtained for each patient. Descriptive statistics were calculated for all the variables involved in the study. The correlation was found using the Pearson correlation coefficient (r) test. p < 0.01 was considered statistically significant. The mean values of NLA, upper incisor proclination, and ULT were found to be 91.38° ± 7.10°, 34.21° + 5.17°, and 15.38 ± 1.76 mm, respectively. r (r = -0.583) was found between NLA and upper incisor proclination and (r = -0.040) for NLA and ULT. There is a statistically significant relationship between NLA and U1-NA. Garg H, Khundrakpam D, Saini V, et al. Relationship of Nasolabial Angle with Maxillary Incisor Proclination and Upper Lip Thickness in North Indian Population. Int J Clin Pediatr Dent 2022;15(5):489-492.

Comparison of angular cephalometric measurements between CBCT mid-sagittal plane projections and conventional lateral cephalometric radiographs

The purpose of this study was to verify the angular measurement values of conventional Lateral Cephalometric Radiographs (LCRs) and Cone-Beam Computed Tomography (CBCT) Mid- Sagittal Plane (MSP) projections when using the same cephalometric analysis method.

Does surgically assisted maxillary protraction with skeletal anchorage and Class III elastics affect the pharyngeal airway? A retrospective, long-term study.

Surgically assisted maxillary protraction is an alternative protocol in severe Class III cases or after the adolescent growth spurt involving increased maxillary advancement. Correction of the maxillary deficiency has been suggested to improve pharyngeal airway dimensions. Therefore, this retrospective study aimed to analyze the airway changes cephalometrically following surgically assisted maxillary protraction with skeletal anchorage and Class III elastics. The study population consisted of 15 Class III patients treated with surgically assisted maxillary protraction combined with skeletal anchorage and Class III elastics (mean age: 12.9 ± 1.2 years). Growth changes were initially assessed for a mean of 5.5 ± 1.6 months prior to treatment. Airway and skeletal changes in the control (T0), pre-protraction (T1), post-protraction (T2), and follow-up (T3) periods were monitored and compared using lateral cephalometric radiographs. Statistical significance was set at p < 0.05. The skeletal or airway parameters showed no statistically significant changes during the control period. Sella to nasion angle, N perpendicular to A, Point A to Point B angle, and Frankfort plane to mandibular plane angle increased significantly during the maxillary protraction period (p < 0.05), but no significant changes were observed in airway parameters (p > 0.05). No statistically significant changes were observed in the airway parameters in the follow-up period either. However, Sella to Gonion distance increased significantly (p < 0.05) during the follow-up period. No significant changes in pharyngeal airway parameters were found during the control, maxillary protraction, and follow-up periods. Moreover, the significant increases in the skeletal parameters during maxillary protraction were maintained in the long-term.

Evaluation of the accuracy of fully automatic cephalometric analysis software with artificial intelligence algorithm.

The aim of this study is to evaluate whether fully automatic cephalometric analysis software with artificial intelligence algorithms is as accurate as non-automated cephalometric analysis software for clinical diagnosis and research. This is a retrospective archive study using lateral cephalometric radiographs taken from individuals aged 12-20 years. Cephalometric measurement data were obtained from these lateral cephalometric radiographs by manual landmark marking with non-automated computer software (Dolphin 11.8). Again, the same radiographs were made using fully automatic digital cephalometric analysis software OrthoDx™ (AI-Powered Orthodontic Imaging System, Phimentum) and WebCeph (Assemblecircle, Seoul, Korea) with artificial intelligence algorithm, without manual intervention of the researcher and fully automatic markings and measurements were made by the software. According to the consistency test, a statistically significant good level of consistency was found between Dolphin and OrthoDx™ measurements and Dolphin and WebCeph measurements in angular measurements (ICC > 0.75, P < .01, ICC > 0.75, P < 0, respectively. 01). A weak level of consistency was found in linear measurement and soft tissue parameters in both software (ICC < 0.50, P < .05, ICC < 0.50, P < .05), and the difference between measurements was statistically found to be different from "0." The results obtained from fully automatic cephalometric analysis software with artificial intelligence algorithms are similar to the results of non-automated cephalometric analysis software, although there are differences in some parameters. To minimize the margin of error in artificial intelligence-based fully automatic cephalometric software, the manual intervention of the observer is needed.

Craniofacial and dental features of Axenfeld-Rieger syndrome patients with PITX2 mutations.

We aimed to characterize the genetic basis and craniofacial and dental features of Finnish patients with Axenfeld-Rieger syndrome (ARS). Mutational analyses of seven patients in five families were performed by sequencing or comparative genomic hybridization. Phenotypic analysis was based on both clinical and radiographic examinations, as well as on medical data. Lateral cephalometric radiographs of five patients were analysed using Viewbox 3.1-Cephalometric Software. The cephalometric values were compared to Finnish population-standard values of the same age and gender. Two frameshift mutations and three whole gene deletions were detected in five families. Class III skeletal relationship with retrognathic maxilla and mildly retrognathic mandible were detected in all five patients studied. Significant differences compared with the control values were in SNA (P=.0014), ANB (P=.0043) and SNB angles (P=.013). Five patients had anterior crossbite. Six patients showed tooth agenesis. The average number of missing teeth (third molars excluded) was 9 (range 0-15). The tooth agenesis rate was 52% in maxilla and 26% in mandible. Maxillary central and lateral permanent incisors were most often missing (rate 71% equally) while no one lacked canines or first molars in mandible. Two patients had a supernumerary mandibular permanent incisor. Six patients had either taurodontic and/or single-rooted molars. Our results suggest that class III skeletal relationship with maxillary and mandibular retrognathism, anterior crossbite, maxillary incisor agenesis and taurodontic, even pyramidal, roots are common determinants of ARS caused by PITX2 mutations.

Comparison of the effects of removable functional appliance therapy applied in pubertal and postpubertal periods: A retrospective cephalometric and fractal analyses study

In this study, we compared the effects of functional treatment with Twin-block appliance on the bony architectures of the maxilla and mandible by fractal dimension (FD) analysis, and the skeletal and dentoalveolar effects by cephalometric analysis, in pubertal and postpubertal patients with Class II malocclusion. This study comprised 60 patients who underwent Twin-block treatment. Group 1 consisted of 30 patients in the pubertal period (6 boys and 24 girls; mean age 12.27 ± 1.35 years), whereas group 2 consisted of 30 patients in the postpubertal period (6 boys and 24 girls; mean age 13.73 ± 1.51 years). FD analysis was performed on the patients before and after Twin-block panoramic and lateral cephalometric radiographs. Cephalometric analysis was also conducted. Paired and Student t tests were used to compare the parametric data, and Wilcoxon signed rank and Mann-Whitney U tests were conducted to compare the nonparametric data. SNB, Pg-N, N-Me, ANS-Me, IMPA, L1/NB, Co-Gn, Go-Gn, S-Go, Co-Go, and Go-Me significantly increased in both groups after treatment. FD values of tuber, condyle, and molar regions significantly decreased in group 1, whereas no significant differences were observed in group 2 after treatment. In the pubertal period, the Twin-block appliance resulted in skeletal correction by causing bone remodeling and reshaping in both jaws along with the dentoalveolar correction. In the postpubertal period, Twin-block had no significant effect on the bone trabecular arrangement in the investigated areas but produced cephalometric improvement to a certain extent with lower skeletal and higher dental impact.

Comparison of velopharyngeal morphology of two palatoplasty techniques in patients with hard and soft cleft palate.

The study aims to compare the velopharyngeal morphology of hard and soft cleft palate (HSCP) patients after Furlow and Sommerlad palatoplasty. A total of 51 patients (20 cases in Furlow palatoplasty group, 16 cases in Sommerlad palatoplasty group and 15 normal children in the control group) were included in our study. Velopharyngeal function and speech outcomes of patients with HSCP who had either Furlow palatoplasty or Sommerlad palatoplasty for cleft palate repair were evaluated by perceptual speech assessment (PSA), lateral cephalometric radiographs and nasopharyngoscopy. To assess velopharyngeal morphology of patients treated with two techqiques, we analyzed measurements such as velar length, pharyngeal depth, and the Adequate ratio (the ratio of velar length to pharyngeal depth). Furthermore, skeletal landmarks including cranial base, cervical vertebrae, posterior nasal spine which were defined as the pharyngeal triangle were measured. Finally, the position of the point U relative to the pharyngeal triangle were compared. Velopharyngeal closure (VPC) rate in Furlow palatoplasty group accounted for 90%, while that in Sommerlad palatoplasty group was 81.3%. PSA of the former group was significantly better than that of the latter group (P < 0.05). Velar length, pharyngeal depth and the Adequate ratio (1.37 ± 0.14 vs. 1.41 ± 0.15) were comparable between the Furlow group and control group (P > 0.05), while Sommerlad group had a shorter velar length, deeper pharyngeal depth and a smaller Adequate ratio (1.20 ± 0.18) compared to the above two groups (P < 0.05). Furhermore, the point U of Sommerlad group in the pharyngeal triangle was higher than that of the other two groups. In the treatment modality of patients with HSCP, both Furlow palatoplasty and Sommerlad palatoplasty seem to be effective. Furlow palatoplasty appears to have velopharyngeal morphology similar to normal control group., while Sommerlad group shows a shorter velar length, deeper pharyngeal depth and a smaller Adequate ratio.

Cephalometric effects of Twin-block and van Beek Headgear-Activator in the correction of Class II malocclusion

The Twin-block (TB) and the van Beek Headgear-Activator (vBHGA) are indicated for patients with Class II malocclusion with a retrognathic mandible. Although the former is commonly prescribed for horizontally growing patients, the latter is often recommended for those growing vertically. This study aimed to compare the skeletal, dentoalveolar, and soft-tissue short-term effects of TB and vBHGA, taking growth patterns into account. Immediate prefunctional (T1) and postfunctional appliance (T2) lateral cephalometric radiographs were retrospectively obtained for vBHGA (n= 46), TB (n= 45), and untreated control (n=45) groups. The interaction of several variables at T1, T2, and T2 - T1, as well as the resultant treatment effect, were analyzed using the analysis of covariance regression models at the 5% significance level. Except for a greater reduction in Wits measurement (3.0 mm; P<0.0001) in the TB group, no anteroposterior (AP) skeletal difference was observed between the 2 appliances (ANB, 0.530; P= 0.07) (Harvold, 0.13 mm; P= 0.81). Both improved the AP skeletal relationship (ANB and Harvold) compared with the control (P<0.05). Although this mostly occurred because of the forward positioning of the mandible with the TB (SNB, 0.960; P= 0.01), the maxillary restriction was the main mechanism with the vBHGA (SNA, 1.590; P<0.01). Dentoalveolar compensations were more pronounced with the TB (IMPA, 1.92; P= 0.02), leading to greater overbite and overjet correction. Only the inclination of the maxillary incisors showed interaction with the growth pattern, with the TB horizontal growers experiencing more retroclination (U1-NA°. 3.620; P=0.0067). Both appliances produced similar modest AP skeletal changes that, together with dentoalveolar compensations, were able to correct the Class II malocclusion regardless of growth pattern.

GROWTH INDICATORS AND THEIR RELATION IN INDIVIDUALS WITH DIFFERENT SKELETAL MALOCCLUSIONS

Objectives: The purpose of our study is to assess the correlation between chronological age, cervical vertebral maturation index and Demirjian index of the lower second molars and analyze if the correlation affected by intermaxillary sagittal malocclusion. Material and methods: 150 subjects were evaluated, with age range from 6-19 years. Skeletal maturation stages according to Baccetti method were determined in lateral cephalometric radiographs. Demirjian index for lower second molars were evaluated in panoramic x-ray. Digital lateral cephalograms and panoramic radiographs were performed by Vatech and they were analyzed and saved in DICOM format using dedicated software (Easydent version 4.1). Statistical analysis with IBM SPSS version 26 for Windows, Chicago, Illinois to assess the correlation between cervical vertebral maturation index and Demirjian index for lower second molars and intergroup comparison. Results: There is a strong positive correlation between chronological age, cervical vertebral maturation index and Demirjian index for lower second molars, with p &lt; 0.000, Pearson correlation coefficient was from r = .847 to r = .883. The duration of prepubertal stage for class II subject was significantly longer. Whereas the actual peak of pubertal growth in class II subject was short, 3, 5 months. The overall period of growth modification raging from stage 2-4 of cervical vertebral maturation index was significantly longer in class III subjects. Conclusions: There is a strong correlation bewteen cervical vertebral maturation index and Demirjian index for lower second molars. The correlation is not affected by intermaxillary sagittal relationship, however in class II patients we have a shorter pubertal peak period and in class III there is a longer period of pubertal peak.

Maksiller Büyüme Yönü ile Sinonazal Bölgenin Anatomik Varyasyonları Arasındaki İlişkinin İncelenmesi Vaka-Kontrol Araştırması Maksiller Büyüme Yönü ve Sinonazal Varyasyonlar

Objective: This study investigated the frequency of anatomic variations in the sinonasal region with septal deviation and the relationship of these anatomic variations with the developmental direction of the maxilla in cone-beam computed tomography images. Material and Methods: Forty-eight patients who underwent orthognathic surgery were included in this study. These patients were divided into 3 groups: normal maxilla (n=16), prognathic maxilla (n=16), and retrognathic maxilla (n=16) by determining the position of the maxillae in relation to the skull base on lateral cephalometric radiographs. The anatomic variations of the sinonasal region and the presence of maxillary sinus ostium (MSO) obstruction were studied in all groups. The relationship between the anatomical variations and the different developmental aspects of the maxilla was analyzed. Results: The most common anatomical changes in all patients were: hypertrophy of the inferior turbinate (68.8%), deviation of the nasal septum (66.7%), and concha bullosa (62.5%). No statistically significant difference was found between the groups with different skeletal deformities based on the position of the maxilla in relation to the skull base (p>0.05). While there was a statistically significant difference between gender distribution and hypertrophy of the middle concha (p=0.016), no statistically significant difference was found between other anatomical variations and gender distribution (p>0.05). Conclusion: In conclusion, in this study, we investigated the relationship between the anatomical variations of the sinonasal region and the direction of maxillary growth. There was no significant relationship between the above anatomical variations and MSO obstruction between the groups.

Evaluation of Treatment Outcomes of Skeletal Class III Malocclusion Resulted from Dynaflex Appliance: A Clinical study

Purpose: This clinical study was carried out to assess skeletal and dentoalveolar changes introduced by Dynaflex appliance on skeletal class III malocclusion treatment. Materials and methods: 8 patients (4 males & 4 females) aged 10-13 years old with skeletal class III discrepancy (-3 < ANB < 0) and dental class III malocclusion were treated using Dynaflex. Following leveling and alignment the appliance was positioned mesial to maxillary first molars and distal to mandibular canines. After reaching normal overbite and overjet with Class I molar and canine relationship, Dynaflex was removed. Lateral cephalometric radiographs were taken before treatment and after Dynaflex removal. Tracing for the two radiographs were done digitally using Webceph software. Skeletal, dental, and soft tissue changes were calculated by subtracting measurements taken before treatment from measurements taken after Dynaflex removal. Results: Positive overjet with class I molar and canine relationship was accomplished. Significant skeletal, dental, and soft tissue changes between pre and post treatment radiographs were detected. Forward movement of maxillary base by 1.9 mm and backward movement of mandibular base by 1.3 mm were seen with ANB improvements. Forward movement of maxillary incisors by 2.1 mm was found. Upper and lower lip showed significant protrusion and retrusion, respectively. Conclusion: Dynaflex appliance can be used to correct mild to moderate skeletal class III malocclusion (-3 < ANB < 0) with minimal patient compliance. Factors that contributed to overjet correction were anterior movement of maxilla, posterior and downward movement of mandible together with maxillary incisors proclination.

Estudo dos padrões cefalométricos de indivíduos com oclusão normal e prevalência das maloclusões no município do Rio de Janeiro

ABSTRACT Objective: The accomplishment of this cephalometric objective to evaluate the face characteristics of this cefalometric work individuals had to the city of this cephalometric prevalence, as well as measure the objective of malocclusion. Methods: For this study, 531 sort of individuals of the masculine organizations of Rio de Janeiro had been submitted to the clinical chait of the course of Master in Orthodontics of the Center Research Leopold Mandic, of which if it got prevalence of malocclusion. Results: Of this sample, it was observed that 22 individuals with normal occlusion and that if they had never submitted the orthodontic treatment. In these patients they had been made taken from normal head in lateral cephalometric radiographs and evaluated the cephalometrics largeness: SNA, SNB, ANB, Axle “Y”, NS.Go-Me, FMA, FMIA, IMPA, 1.NA, 1- NA, 1.NB, 1-NB, 1.1, 1.SN, 1.Go-Gn, SN.PLO, AO-BO, Line H, Z angle, P-NB, AFA, AFP and IAF. The gotten date had been submitted to the analysis with a level of significance of 5% (p&lt; 0.05) and used descriptive statistics and the error of Dalbergh. The results showed that of the total of the evaluated sample, the malocclusion of 44.3% of Classroom I; 29.5% of Classroom II; 17.2% of Classroom III and 9.2% of normal occlusion. Conclusion: The individuals with normal occlusion of the city of Rio De Janeiro had presented equal cephalometric characteristics with many standard measures described in literature, except for the superior incisor that were presented vestibulate and the well inclined inferior incisor for vestibular contest.

Dentoalveolar effects of skeletally anchored extrusion arch in anterior open bite patients: A prospective clinical trial.

The purpose of this prospective clinical trial was to explore the dental and soft tissue changes accompanying the use of skeletally anchored nickel-titanium (NiTi) extrusion arch in the correction of anterior open bite (AOB). Twenty female patients with a mean age of 16.5 ± 1.5 years and a mean dentoalveolar AOB of 2.38±0.7 mm participated in this study. All patients were treated with an maxillary 0.017×0.025-in NiTi extrusion arch, with the aid of miniscrews inserted between the maxillary second premolars and first molars bilaterally, to act as indirect anchorage. Three-dimensional digital models and lateral cephalometric radiographs were taken just before the insertion of the extrusion arch (T0) and after 10 months (T1). Paired-sample t-tests were used in analyzing the data, to evaluate the changes after treatment (T1-T0). A significance level of p < 0.05 was used. AOB was successfully closed in all patients, with a 4.35 ± 0.61 mm increase in the overbite. Maxillary incisors significantly extruded (2.52 ± 1.02 mm) and significantly reclined (5.78 ± 0.77°), with a resultant decrease in the overjet of 1.58 ± 0.5mm. A significant intrusion of maxillary first molars with no change in their inclination was observed. The upper lip showed a significant retraction tendency to the E-plane, and a significant increase in the nasolabial angle was observed. The skeletally anchored NiTi extrusion arch was an effective technique in treating AOB, with no adverse effects on the molars.

Criteria for early diagnosis of third molar agenesis: a retrospective radiographic study.

To explore the association between chronological, dental and skeletal ages and early diagnosis of third molars agenesis. This retrospective radiographic study comprised a sample of 282 Portuguese patients (122 males and 160 females) who sought orthodontic treatment between 2007 and 2018. Each participant had panoramic and lateral cephalometric radiographs performed before and after the age of 14 years. The chronological age was categorized into three intervals between 11.0 and 13.11 years of age. The full eruption of the four-second molars was used as a criterion in determining dental age. Skeletal age was verified by the vertebral maturation method. The diagnosis of agenesis of third molars was initially performed by observation of the initial panoramic radiography undertaken before the age of 14 years. Subsequently, the diagnosis of agenesis of third molars was confirmed by visualizing the second panoramic radiography, obtained after the age of 14 years. The association between the accuracy of the diagnosis and the chronological, dental and skeletal ages was evaluated using the chi-square test, at a 5% significance level. No significant association between chronological age and alterations in the diagnosis of third molar agenesis was identified. However, there was a significant association between third molar agenesis and both dental age (p<0.001) and skeletal age (p=0.006). The eruption of the four-second molars and the peak of growth could be considered as criteria for early diagnosis of third molar agenesis, whereas chronological age is not a reliable diagnostic indicator.

Effective mandibular and maxillary base length in developing Class III malocclusions with high and low mandibular plane angles

Introduction Skeletal Class III is one of a complex sagittal interjaw relationship. It is the result of malrelation in sagittal position of one or both jaw bones or disproportionate ratio of their length. Objective This study was carried out to assess the effective mandibular and maxillary bases length in developing Class III malocclusion with high and low mandibular plane angles. Materials and methods Cross-sectional study was carried out on a selected sample of 75 lateral cephalometric radiographs of orthodontic patients of both sexes with age ranged from 6 to 12 years old. They were divided into three equal groups. Group 1: normal ANB and mandibular plane angles as a control group, group 2: skeletal Class III with low mandibular plane angles, and group 3: skeletal Class III with high mandibular plane angles. The sample was collected from patient record files at the clinic of the Orthodontic Department, Faculty of Dentistry, Tanta University, Egypt. Results A statistically significant difference was found in the effective maxillary length between group 1 and group 2 and 3. While effective mandibular length showed no statistically significant differences between the three groups. Conclusion Short maxillary base length is the main etiological factor for skeletal Class III malocclusion. While prominent mandibular base length has minimal effect in development of skeletal Class III malocclusion.

Influence of the Neck Posture on the Masticatory Apparatus in Children

Aim: The study aimed to determine the peculiarities of influence of the neck posture on masticatory apparatus in children. Materials and Methods: We reviewed lateral cephalometric radiographs of 22 children, 10 girls, and 12 boys (mean age 12 years). Steiner cephalometric analysis and analysis of the upper cervical spine, which was available on corresponding cephalometric radiographs, were performed. In addition to cephalometric analysis, the angle between the McGregor line and the base of C2 (Oc-C2), the angle between the base of C1 and C2, and the angle between C2 and C5 were determined. Spearman’s correlation was computed to assess the relationship between neck sagittal plane posture and cephalometry results. Results: The strong correlation between sagittal neck posture and positioning of the incisor teeth was determined. We found, that the more lordotic is the neck and kyphotic or frontal tilted is the occipital position, the more the position of the incisors is altered towards open bite. Oc-C2 angle had a negative correlation with the Max1-NA (1-NA) angle (r (20) = - 0.63, p = .002), and 1uNA (r(20) = -0.65, p = .001), and positive with interincisor (II) angle (r (20) = 0.55, p = .007). C1-C2 angle had a negative correlation with 1uNA (r(20) = -0.50, p = .017). C2-C5 angle was found to have an opposite relation with incisors: negative correlation with II (r(20) = -0.55, p = .006), positive with Max1-NA (r(20) = 0.44, p = .038), Max1-SN (r (20) = 0.45, p = .031) and Mand1-NB (r(20) = 0.42, p = .048). The upper cervical vertebrae positioning in the sagittal plane is in strong relation with incisors positioning and can be the cause of open bite or vice versa. Conclusions: Based on cephalometry radiographs analysis we can consider the relation between the neck vertebrae posture and masticatory apparatus to be significant. Neck sagittal alignment is strongly related to the occipital tilt and has a strong correlation with incisors proclining, meaning the increase in spinal lordosis angle is related to forward occipital tilt and an increase in interincisor angle, resulting in upper incisor proclination.

Morphological types of sella turcica bridging and sella turcica dimensions in relation to palatal canine impaction: a retrospective study.

The aim of this study was to determine the relationship between the presence of sella turcica bridging and palatal canine impaction (PCI) using several classification methods. In this retrospective study, lateral cephalometric radiographs of 120 subjects with PCI (43 males, 77 females; mean age 18.8 ± 7.8 years) and 120 controls (44 males, 76 females; mean age 18.1 ± 5.6 years) with complete permanent dentition were examined. The extent of sella turcica bridging was assessed using two different methods, and the types of complete sella turcica bridging were evaluated. The sella turcica dimensions were measured and analyzed using the t-test, and comparison of the presence of sella turcica bridging was performed using the two-tailed Fisher's exact test. The frequency of complete sella turcica bridging was significantly higher in subjects with PCI (18.3%) than in controls (8.3%, p = 0.023) but without significant differences in the occurrence of sella turcica bridging of Type A (ribbon-like fusion) and Type B (extension of clinoid processes). No significant differences in partial bridging were found between patients with PCI and controls according to both methods. The length and the anteroposterior diameter were significantly larger in subjects with PCI and no difference was observed between the groups in the sella turcica depth. Complete sella turcica bridging occurred significantly more frequently in subjects with PCI than in controls. However, the association between partial bridging and PCI was not confirmed, therefore, we do not recommend any classification of partial bridging for clinical practice.

Sella can tell your age and gender: Determination of age and gender by evaluating the linear dimension of the sella turcica on lateral cephalogram - Retrospective study

ABSTRACT Background: In the lateral cephalogram, the sella turcica, a saddle-shaped concavity in the middle cranial fossa on the intracranial surface of the sphenoid bone, is clearly visible. Since it is utilized for forensic analysis, gender determination, and age determination, it is an excellent source of further diagnostic data regarding the estimation of the average sella turcica dimension and morphological variance in various age groups and genders. Aim: This study aims to determine the average dimension and morphological variations of the sella turcica in different age and gender groups on lateral cephalogram. Materials and Methods: The study sample consisted of 100 lateral cephalometric radiographs from patients 18 years or older. Linear Measurements: The length, depth, and anteroposterior diameter of the Sella Turcica were measured using the Silverman and Kisling methods. Statistical analysis was performed using the one-way ANOVA test and unpaired sample t-test. Results: In the present study, age-wise comparison of the linear measurement of sella turcica was not statistically significant in accordance with age with parameter P ≤ 0.05. Among the linear measurement, the parameter depth and diameter had statistically significant differences using parameter P ≤ 0.05 and unpaired t-test with gender. In gender-wise comparison, females tend to have higher sella turcica measurements than males. Conclusion: There was a statistically nonsignificant relation between age, and length, depth, and A-P diameter. There were statistically significant differences between sella turcica depth and diameter with genders.

Efficiency of Skeletal Class II Malocclusion Treatment Using Herbst Appliance (Type II)

Purpose: The aim of this study was to assess the skeletal and dentoalveolar treatment outcomes using Herbst type II appliance with multibracket system in treatment of skeletal Class II malocclusion. Subject and Methods: The present study was applied on ten female patients with age ranges 12-13 years old, with skeletal Class II Division 1 malocclusion (deficient mandible). The line of treatment was to use nonextraction fixed functional appliance (Herbst) type II with multibracket system. Pre and post-treatment lateral cephalometric radiograph were obtained, cephalometric analysis and superimposition was performed to assess changes in skeletal and dentoalveolar structure. Results: Class II correction was obtained mainly by dentoalveolar effects, which include statistically significant lingual inclination of the upper incisors and labial inclination of the lower incisors with mesializiation of the lower molars. There was relative mandibular length increase with maxillary restriction. P ≤ 0.05. Conclusions: Skeletal Class II Divison 1 in adolescent patients can be effectively treated by Herbst type II with multibracket system. Both skeletal and soft tissue profile convexities are reduced as a result of dentoalveolar changes with mandible growth and forward movement.