Lateral Cephalometric Radiographs Research Articles

Diagnostic evaluation of skeletal cephalometric parameters and photograph-Based soft tissue parameters in Malwa Population

The primary goal of orthodontic diagnostic and treatment planning is to create a balanced and aesthetically attractive face. During the decades-long period of cephalometric dominance, the "aesthetic" of the face was predominantly used to describe the profile as observed on a lateral cephalogram However, the paradigm has now shifted to soft tissue-based diagnosis and treatment planning. This creates the need for soft tissue-based analysis especially on photographs considering its evaluation of myriad populations. To evaluate the skeletal cephalometric parameters and photograph-based soft tissue parameters in the Malwa population. The study was conducted using 50 lateral cephalometric radiographs and 50 profile photographs. Data were analyzed for probability distribution using the Shapiro-Wilk test. Descriptive statistics were performed and data were presented as median and inter-quartile range. Correlation between the variables was assessed using Spearman’s correlation coefficient. P value < .05 was considered statistically significant. Our reported values of both photographic and lateral cephalogram parameters are different not only from the international population, but also different values are observed from the not only Indian population, but also from various subsets of the Indian population. Therefore, the average value of lateral profile photographic parameters as well as cephalometric parameters in my study can be used as floating norms for the Malwa population.

The relationship of medial sigmoid depression and sigmoid notch morphology with vertical and sagittal growth patterns in Turkish population

Medial sigmoid depression (MSD) is an anatomical variation located just below the deepest point of the sigmoid notch (SN). The etiology of MSD is unknown. It has been reported that increased maximum bite force affects the occurrence of MSD, and vertical growth pattern affects SN morphology. The aim of this study was to investigate the effects of these malocclusions on the presence and morphology of MSD and SN, since bite force can change with vertical and sagittal growth patterns. This is the first study to investigate the effects of vertical growth pattern on the presence and morphology of MSD, and the effects of sagittal growth pattern on SN morphology. Panoramic and lateral cephalometric radiographs of a total of 634 (427 female, 207 male) patients aged from 18 to 35 years (mean 19.58) were included in this retrospective study. MSD and SN shapes, SN depth and width were evaluated on panoramic radiographs. Mann Whitney-U, Kruskal-Wallis and Chi-square tests were used for data analysis. Sagittal and vertical growth patterns were not significantly associated with the presence and shape of MSD (p>0.05). SN depth was greater in individuals with class III malocclusion, and both SN depth and width were lower in hyperdivergent individuals. There was no significant relationship between SN shapes and vertical and sagittal growth patterns (p>0.05). SN depth is affected by both vertical and sagittal growth pattern, and SN width is affected only by vertical growth pattern. The presence of MSD was not associated with growth pattern.

Evaluation of The Relationship Between Dental and Cervical Vertebrae Maturation in Terms of Age Determination

Aim: Age determination is a very important issue in anthropology, forensic science, and dentistry. Today, the most commonly used methods for age determination are the methods in which tooth and bone development are evaluated. This study aims to evaluate the relationship between gender, chronological age, dental maturation, and cervical vertebral maturation in individuals aged 8-25 years. Material and Method: Digital panoramic, lateral cephalometric radiographs of 500 patients aged 8-25 years were used in this study. Cervical vertebra maturation was evaluated using the dental maturation-modified Demirjian classification system of Baccetti et al. Means, minimum, maximum, and standard deviations were calculated and analyzed as descriptive statistics. Kolmogorov-Smirnov, Kappa, Kruskal-Wallis, Chi-Square, Linear Regression, and Spearman Correlation tests were used for statistical analysis. Results: There was a statistically significant difference between chronological age and dental maturation and cervical vertebral maturation levels (p <0.01). While dental maturation levels did not differ significantly according to gender (p> 0.05), cervical vertebra maturation was statistically different (p <0.01). There was a positive correlation between chronological age and dental maturation, and cervical vertebral maturation levels (p <0.01). There was a strong correlation between dental maturation and cervical vertebral maturation levels (p <0.01). Conclusion: The findings of this study showed that skeletal maturity increased with the increase in chronological and dental age for both genders. The earlier formation was consistently observed for each stage of skeletal maturation in females. All correlations between skeletal and dental maturations were statistically significant.

Correlating Jaw Bone Growth and Nasal Morphology Among Adult Patients With Cleft Lip and Palate: A Retrospective Cephalometric Study.

This retrospective cross-sectional study reviewed adult patients with operated cleft lip and/or palate (CL/P) and normal control, and performed comprehensive craniofacial and nasal morphological analyses based on lateral cephalometric radiographs. Pearson or Spearman correlation coefficient assessed intraclass correlation. Seven hundred fifty-seven operated patients with CL/P, and 165 noncleft normal controls were enrolled. Among the normal and CL/P groups, S-N-A angle registered positive correlations with nasal base prominence (S-N'-Sn, degrees). Upper facial height (N-ANS, mm) had positive correlations with nasal dorsum length (N'-Prn, mm) and nasal bone length (N-Na, mm). Although in patients with bilateral cleft lip and palate, there were moderate negative correlations (r=-0.541, P<0.05) with soft tissue facial profile angle (FH-N'Pog', degree) and nasolabial angle (Cm-Sn-ULA, degree). Correlation exists between the morphology of jaw bones and external nose among patients with CL/P. Maxillary sagittal insufficiency is associated with concave nasal profile, and maxilla height is associated with nasal length.

Individualized management of chronic periodontitis in patients with orthodontic abnormalities: a clinical case report

Relevance. Chronic periodontitis is a multifactorial disease influenced by a variety of factors. Beyond periodontal pathogens and systemic conditions, important contributing factors include malocclusion, dental misalignment, and tooth loss. These conditions can compromise the tissue blood flow hemodynamics and precipitate occlusal trauma with signs of functional overload. Subsequently, this may intensify the inflammation and degradation of the alveolar bone, often leading to premature tooth loss.Correction of malocclusion is paramount in the effective management of periodontal diseases, requiring orthodontic treatment to resolve malocclusion and mitigate signs of functional overload. This treatment aims to redistribute occlusal forces uniformly, thus creating a conducive environment for successful prosthodontic rehabilitation and promoting optimal personal oral hygiene.Clinical case description. This article outlines a personalized approach to managing periodontal inflammation in individuals with orthodontic anomalies. Patient Z., born in 2002, was diagnosed with moderate severity chronic periodontitis (K05.31), presenting with a Class I molar and canine relationship on both sides, constricted dental arches, individual tooth macrodontia, and retrusion and torsiversion of the incisors. The assessment of the patient's periodontal status and overall health was conducted using standard clinical, radiographic, and laboratory diagnostics, whereas the orthodontic assessment involved anthropometric analysis of dental casts and lateral cephalometric radiographs. The periodontal intervention included foundational non-surgical treatments such as ultrasonic scaling both supra- and subgingivally, biofilm disruption using the Vector Paro system, and specific pharmacotherapy. The orthodontic treatment aimed to widen both dental arches and correct the inclination of the upper and lower incisors, achieving a normal occlusion with fixed orthodontic appliances (Damon Q brackets) in accordance with the treatment plan. The effectiveness of the treatment was measured by examining the improvement in gingival conditions, periodontal parameters, and radiographic evidence before and after the intervention.Conclusion. The research demonstrated that an individualized treatment protocol integrating periodontal and orthodontic care can substantially improve the overall health of the dentofacial complex, masticatory efficiency, and aesthetic aspects.

Factors influencing root resorption in retained mandibular second deciduous molars with congenital absence of second premolars: a cross-sectional study

BackgroundThere are currently no studies that quantitatively compare the relationship of root resorption to the patient’s systemic history or craniofacial and intraoral morphology, especially in relation to possible host factors. Thus, this study aimed to clarify the factors associated with root resorption in retained mandibular second deciduous molars with the congenital absence of second premolars and predict the prognosis of retained mandibular second deciduous molars.MethodsA cohort of 5547 patients who visited the orthodontic clinic at Tokyo Medical and Dental University Dental Hospital between 2013 and 2022 was screened. Lateral cephalometric radiographs, panoramic radiographs, upper and lower dental models, and orthodontic treatment questionnaires were used as reference materials to apply the inclusion and exclusion criteria. Ultimately, 111 patients were included in the analyses. The patients were divided into two groups based on the root resorption levels of the retained mandibular second deciduous molars. Those with less root resorption were classified under the good condition (GC) group, whereas those with more root resorption were classified under the poor condition (PC) group. Demographic, clinical, and cephalometric parameters were compared between the groups. A multivariate logistic regression model was used to predict the probability of root resorption.ResultsThe prevalence of congenitally missing mandibular second premolars with persistent mandibular second deciduous molars was 2.0%. In a total of 111 patients, eighty-three teeth (53.2%) were classified into the GC group, whereas 73 teeth (46.8%) were classified into the PC group. The Frankfort-mandibular plane angle (FMA) [odds ratio (OR): 0.87], Frankfort-mandibular incisor angle (FMIA) (OR: 0.93), overbite (OR: 1.38), adjacent interdental space (OR: 1.46), distance from occlusal plane (OR: 0.80), and caries treatment (OR: 7.05) were significantly associated with the root resorption of the retained mandibular second deciduous molars.ConclusionsOur findings suggest that skeletal morphology, oral morphological patterns, and history contribute to root resorption in retained mandibular second deciduous teeth with congenital absence of subsequent permanent teeth.

Cephalometric Assessment of Skeletal Class II Malocclusion in a Sample of Kurdish Population in Sulaimani City (Retrospective Study)

Objective: This retrospective comparative cephalometric study aims to identify the cephalometric features of skeletal class IImalocclusion in a sample of the Kurdish population, the result of this study willl be useful in diagnosing and treating orthodontic andjaw surgery.&#x0D; Methods: A total of 85 pre-treatment lateral cephalometric radiographs with skeletal class II malocclusion (ANB&gt;=4) and 81 withskeletal class I malocclusion (1=&lt;ANB&lt;4) were obtained from the pre-orthodontic patient records in a private orthodontic clinic inSulaimani city. The patients were between 18 and 35 years old. The lateral cephalometric radiographs were analyzed digitally usingFACAD cephalometric software. Twenty-two variables were measured from each cephalometric radiograph. The correlation betweenClass I and II was analyzed using the Mann-Whitney Test.&#x0D; Results: The result showed that the values of SNA, ANB, Y-axis, Convexity angle, Gonial angle, Intermaxillary angle, facial angleand FMA, posterior cranial base, effective maxillary length, LAFH were higher in skeletal Class II than in Class I cases, which indicatesthat skeletal class II Kurdish population have more vertical mandibular growth and prognathic maxilla, retrognathic mandible, andlonger face than class I. Meanwhile, SNB, Mandibular length, TFH, UAFH, Maxillary length, UI-Palatal plane angle, IMPA, andeffective mandibular length values were lower and the difference was statistically significant in the majority of cases.This illustratesthat the incisors are more proclined in class I than skeletal class II, whereas the mandible is shorter in skeletal class II patients. Theseresults summarize the characteristic features of skeletal class II patients in a sample of the Kurdish population in Sulaimani City, whichare caused by etiological factors (genetic, congenital). This information is useful for enabling orthodontists and maxillofacial surgeonsto attain a diagnosis and treatment plan for skeletal class II patients in a shorter period.&#x0D; Conclusions: Skeletal class II malocclusion in the Kurdish population is characterized by a prognathic but short maxilla, retrognathic,short, backward, and downward rotated mandible, and a prominent chin.

Examining Tongue Size in OSA Patients with Lateral Cephalometric Radiography

Aim: This article aims to investigate tongue dimensions in patients using lateral cephalometric radiography, examining the potential impact of differences in tongue size on Obstructive Sleep Apnea Syndrome (OSAS). The data obtained in this study may contribute to a better understanding of the risk factors involved in the development of OSAS.&#x0D; Methods: This study included 80 patients, with 34 females and 46 males. Among these patients, 48 were in the patient group with OSA, and 32 were in the control group AHI

Assessment of mandibular trabecular structure and cervical vertebral maturation using fractal analysis.

Changes in bone trabeculae occur during skeletal maturation. Fractal analysis is a technique for assessing changes in the internal structure of the bone. The aim of this study was to investigate correlation of bone trabeculation measured on panoramic and lateral cephalometric radiographs with cervical vertebral maturation stages (CVMS). CVMS was evaluated on lateral cephalometric radiographs of 120 individuals aged 6 to 18 years. The subjects were divided into 6 groups (n= 20 each) according to CVMS. On panoramic and lateral cephalometric radiographs, fractal dimension (FD) analyses were performed in mandibular corpus, gonial and condylar regions and cervical vertebral bodies (C2, C3, C4). FD measurements from the mandibular corpus region bilaterally and C2-C4 vertebral bodies showed significant positive correlations with CVMS (r= 0.418, r= 0.412, r= 0.324, r= 0.304, r= 0.263, respectively). Significant differences were found in the FD values of the right/left mandibular corpus and C2 and C3 vertebrae compared to CVMS (P< 0.001, P< 0.001, P= 0.005, P= 0.019, respectively). Significant positive moderate correlations between the FD values of the right and left mandibular corpus and CVMS suggest that fractal analysis may be useful in determining skeletal maturity stage. The significant FD values obtained from the right/left mandibular corpus, and C2 and C3 vertebra indicate that the complexity of the internal trabecular structure increases with maturation.

Skeletal Growth Status Agreement in a Group of Thai Children and Adolescents: A Comparative Analysis of Fishman's Skeletal Maturation and Baccetti's Cervical Vertebral Maturation Indices

This study aimed to determine the agreement of skeletal maturation (SM) assessed by hand-wrist radiographs and cervical vertebral maturation (CVM) assessed by lateral cephalometric radiographs. It also explored the feasibility of using CVM as an alternative to hand-wrist radiographs among Thai children and adolescents. The samples comprised 95 males and 67 females from Thailand, aged 7–17 years. A total of 162 hand-wrist radiographs and lateral cephalometric radiographs were included. Two experienced oral radiologists independently assessed SM (using Fishman’s method) and CVM (using Baccetti’s method); a third referee observer resolved any discrepancies. The correlation and agreement between the methods were evaluated. The results found a substantial agreement (weighted kappa = 0.594) between SM and CVM. The interobserver discrepancy in categorizing SM stages was mostly found at stage 5, while the most common discrepancy for CVM was at stage 6. A significant positive correlation (Spearman’s correlation coefficient = 0.677, P &lt; 0.001) indicated a moderate to strong association between SM and CVM. The substantial agreement and moderate to strong correlation between CVM and SM highlighted the feasibility of using CVM to assess skeletal growth. However, to ensure reliability, it was necessary to precisely evaluate the appearance of the capping of the epiphyseal plate for SM and the distinction between a rectangular and square cervical spine shape at C3 and C4 for CVM differentiation. Keywords: Cervical spine, Hand, Radiographic evaluation, Orthodontics

Radiological Measurement of Sella Turcica Dimensions in Different Skeletal Patterns in Romanian Patients

(1) Background: The purpose of this study was to evaluate the morphology and linear dimensions of sella turcica in Romanian participants from all three skeletal classes to see whether there were any differences. (2) Method: We examined 90 lateral cephalometric radiographs of patients aged 12 and older and divided them into skeletal classes I, II, and III (30 participants in each). Sella turcica linear measurements such as length, depth, and anteroposterior diameter were measured and studied. To see the nature of our data, Q–Q plots tests were performed. By examining these tests performed for each variable belonging to a particular class, it can be noted that the points are fairly well distributed along some lines, meaning that the data are normally distributed. An Anova test with Bonferroni correction was used to compare the mean values of the examined parameters between the classes. Also, to observe the correlation between our experimental data, the Pearson correlation coefficient was calculated. (3) Results: In all three skeletal classes, the average length of the sella was 8.98 mm ± 1.470, the average depth was 7.99 mm ± 1.081, and the average diameter was 10.29 mm ± 1.267. For all examined linear dimensions, there was a statistically significant difference between class I and class III subjects and between class II and class III subjects (p &lt; 0.001). The morphology of sella turcica was found to be normal in 51.1% of instances, representing the majority across all skeletal classes. In the Romanian population, sella turcica has shown a significant amount of variation. Class III subjects had larger sella dimensions, whereas class II subjects had smaller values. (4) Conclusions: The measurements and morphology of the sella analysed in the present research can serve as standards for subsequent research concerning the sella turcica region in individuals from Romania.

Determination of the pubertal growth spurt by artificial intelligence analysis of cervical vertebrae maturation in lateral cephalometric radiographs

ObjectiveThis study aimed to assess the performance of a convolutional neural network (CNN) model in detecting the pubertal growth spurt by analyzing cervical vertebrae maturation (CVM) in lateral cephalometric radiographs (LCRs). Study designIn total, LCRs of patients from 6 to 17 years old were selected. Three radiologists independently and blindly classified the maturation stages on the LCRs and defined the difficulty of each classification. Subsequently, the stage and level of difficulty were determined by consensus. LCRs were distributed between training, validation, and test sets across four CNN-based models. The models’ responses were compared with the radiologists’ reference standard, and the architecture with the highest success rate was selected for evaluation. Models were developed using full and cropped LCRs with original and simplified maturation classifications. ResultsIn the simplified classification, the Inception-v3 CNN yielded accuracy of 74% and 75%, with recall and precision values of 61% and 62%, for full and cropped LCRs, respectively. It achieved 61% and 62% success rates with full and cropped LCRs, respectively, reaching 72.7% for easy-to-classify cropped cases. ConclusionOverall, the CNN model demonstrated potential for determining whether the patient's maturation status regarding the pubertal growth spurt through images of the cervical vertebrae. It may be useful as an initial assessment tool or as an aid for optimizing the assessment and treatment decisions of the clinician.

3D evaluation of cranial and dentofacial morphological differences between individuals with mouth breathing and nasal breathing

IntroductionThe present study aimed to identify the morphological differences in cranial and dentofacial structures between individuals with mouth-breathing and nasal-breathing. Materials and MethodsThe study included 120 individuals, 60 each in the nasal breathing (NB) and mouth breathing (MB) groups. 3D stereophotogrammetry, lateral cephalometric radiographs, and intraoral examination results were recorded by the researchers to determine the morphological differences between the MB group and the NB group. The study utilized cephalometric radiographs for 2D hard tissue measurements and 3D stereophotogrammetric records for linear and angular measurements. ResultsStatistically significant differences were found between the NB and MB groups’ SNB angles (respectively, 79.3 ± 3.04, 76.6 ± 4.24, and p=0.002). Also, the NB group's SN-GoGn angle was lower than the MB group's (respectively, 31.5 ± 5.12, 36.0 ± 5.55, and p=0.002). Considering the Jarabak ratio, the NB group's Jarabak ratio was higher than the MB group (respectively,65.7 ± 4.16, 62.6 ± 4.10, and p=0.014). In 3D stereophotogrammetry measurements, increased Li-Me’ was detected in the MB group than in NB group. ConclusionMouth breathing results in significant morphological differences that affect the development of both soft tissues and skeletal structures. Orthodontists utilize these characteristic features observed in mouth-breathing anomalies for early diagnosis and consider referring their patients for medical treatment of mouth breathing.

Retrospective comparison of two different miniscrew-supported molar distalization methods applied in the buccal and palatal regions

BackgroundTo compare dentofacial effects of distalization with miniscrew-supported pendulum and infrazygomatic crest miniscrews. MethodsThe study included 36 patients whose lateral cephalometric radiographs were obtained before (T0) and after (T1) distalization. Patients were divided into two groups according to the treatment methods: 1) distalization with miniscrew-supported pendulum (MSP) (n = 19; 14 girls and 5 boys; mean age 16.9 ± 1.46 years) and 2) distalization with infrazygomatic crest (IZC) miniscrews (n = 17; 8 girls and 9 boys; mean age 17.0 ± 1.68 years). Dental, skeletal and soft tissue measurements were performed on lateral cephalograms taken from individuals. ResultsA significant molar distalization was achieved both in the MSP group (3.52 ± 0.76 mm at 8.71 ± 2.02 months) and the IZC group (3.5 ± 0.74 mm at 9.7 ± 2.5 months) (P < 0.001 for both). Premolar distalization was significantly lower in the MSP group (1.73 ± 1.09 mm) than in the IZC group (2.81 ± 0.79 mm) (P < 0.01). Significant molar tipping was observed in both groups (P < 0.001), while no significant difference was found between the groups (P > 0.05). Retrusion of maxillary incisors were significantly higher in the IZC group (2.75 mm) than in the MSP group (0.98 mm) (P < 0.01). A significant difference was found between the two groups with regard to the changes in overjet and overbite (P < 0.05). ConclusionsBoth distalization methods were found to be effective in achieving a Class I molar relationship in patients with Class II malocclusion.

Position of the mandibular foramen in relation to the occlusal plane in children with skeletal class malocclusion

Frequently, practitioners use the inferior alveolar nerve block in the procedures desired on the teeth in the mandible and the surrounding tissues. This study aimed to reveal the position of the mandibular foramen (MF) according to the malocclusion types on panoramic radiographs of children aged 9-18 years living with malocclusion in Turkey. Panoramic and cephalometric radiographs of 330 patients between 9 and 18 years old were analyzed retrospectively. We grouped the skeletal malocclusion types as Class 1, 2, and Class 3 based on lateral cephalometric radiographs and evaluated the location of MF in malocclusion types according to age and gender. We observed that the distances to the occlusal plane, posterior edge, and gonion point increased with age while the distance to the anterior edge decreased. There was a significant difference according to age and gender in all malocclusion types (p&lt;0.05). We determined that the MF was positioned upward parallel to the increase in age and approached the midpoint of the ramus of the mandible from the posterior. The fact that MF is placed higher than the occlusal plane in Class 3 malocclusions compared to other types and differs by gender will guide clinicians in providing effective and safe inferior alveolar nerve block in pediatric malocclusions.

Effects of eruption guidance appliance in the early treatment of Class III malocclusion.

To evaluate the dentoskeletal effects and effectiveness of the eruption guidance appliance in Class III patients in the mixed dentition. The experimental group comprised 22 patients with Class III malocclusion and anterior cross-bite (12 males, 10 females, mean age 7.63 ± 0.96 years) treated with the eruption guidance appliance over a mean period of 1.72 ± 0.48 years. The control group comprised 22 untreated subjects (12 males, 10 females, mean age 7.21 ± 0.60 years) with Class III malocclusion. Lateral cephalometric radiographs were obtained at pretreatment (T1) and posttreatment (T2). Intergroup comparisons were performed with Mann-Whitney and t-tests (P < .05). In the experimental and control groups, the anteroposterior relationship between the maxilla and mandible (ANB angle) remained stable during the treatment period (T1 to T2). The mandibular plane angle decreased in the experimental group and increased in the control group. In the experimental group, the lower anterior face height increase and maxillary molar vertical development were significantly smaller compared to controls. Positive overjet was achieved in 54% of the experimental group. The eruption guidance appliance produced no change in the skeletal anteroposterior relationship. The anterior cross-bite/edge-to-edge relationship was corrected in only about half of the treated subjects.

Exploring the association between PITX2, third molars agenesis and sella turcica morphology

ObjectivesPITX2 is required for mammalian development and single nucleotide polymorphisms (SNPs) in this gene could be involved in dental agenesis and sella turcica patterns. Thus, the present study evaluated the association between SNPs in PITX2, third molars agenesis and sella turcica phenotypes.Materials and methodsThe sample consisted of healthy orthodontic German patients with lateral cephalometric radiographs with clearly visualization of the sella turcica, and dental orthopantomograms. The morphological variations of the sella turcica were evaluated using the lateral cephalograms, while third molar agenesis was evaluated using orthopantomograms. DNA isolated from buccal cells was used for genotyping three SNPs in PITX2 (rs3796902, rs1947187, and rs2595110). The analyzes were performed using a significance of 5%. There was no association between third molar agenesis and sella turcica phenotypes (p > 0.05). SNPs in PITX2 were also not associated with third molars agenesis (p > 0.05).ResultsSNPs in PITX2 were associated with sella turcica phenotypes. The rs3796902 was associated with hypertrophic posterior clinoid process (p = 0.013). The rs1947187 and rs2595110 were associated with sella turcica bridge type A (p = 0.013 and p = 0.011, respectively for genotype distribution). Patients that carry the genotypes GG-CC-AG (rs3796902- rs1947187- rs2595110) had 7.2 higher chance to present sella turcica bridge type A (p = 0.002; Odds ratio = 7.2, Confidence interval 95% 2.04–27.04).ConclusionsThird molar agenesis was not associated with SNPs in PITX2 and sella turcica phenotypes. SNPs in PITX2 may have an important role in sella turcica pattern.

Deep learning for automatic detection of cephalometric landmarks on lateral cephalometric radiographs using the Mask Region-based Convolutional Neural Network: a pilot study

ObjectiveWe examined the effectiveness and feasibility of the Mask Region-based Convolutional Neural Network (Mask R-CNN) for automatic detection of cephalometric landmarks on lateral cephalometric radiographs (LCRs). Study DesignIn total, 400 LCRs, each with 19 manually identified landmarks, were collected. Of this total, 320 images were randomly selected as the training dataset for Mask R-CNN, and the remaining 80 images were used for testing the automatic detection of the 19 cephalometric landmarks, for a total of 1520 landmarks. Detection rate, average error, and detection accuracy rate were calculated to assess Mask R-CNN performance. ResultsOf the 1520 landmarks, 1494 were detected, for a detection rate of 98.29%. The average error, or linear deviation distance between the detected points and the originally marked points of each detected landmark, ranged from 0.56 to 9.51 mm, with an average of 2.19 mm. For detection accuracy rate, 649 landmarks (43.44%) had a linear deviation distance less than 1mm, 1020 (68.27%) less than 2mm, and 1281 (85.74%) less than 4mm in deviation from the manually marked point. The average detection time was 1.48 seconds per image. ConclusionsDeep learning Mask R-CNN shows promise in enhancing cephalometric analysis by automating landmark detection on LCRs, addressing the limitations of manual analysis and demonstrating effectiveness and feasibility.

Laryngeal cartilage calcifications on lateral cephalometric radiographs

The aim of this study was to determine the influence of age and gender on the incidence of calcification in laryngeal cartilage diagnosed on lateral cephalometric radiographs routinely taken for orthodontic diagnosis. The lateral cephalometric radiographs of 957 patients who met the study criteria were analyzed from among the 1000 lateral radiographs originally collected. The images were evaluated independently by two investigators. Given the dichotomous dependent variable (calcification or no calcification), a mixed logistic regression model was used to test how age and gender affected calcification. The effect of age and gender reliably determined the likelihood of laryngeal cartilage calcification. The greatest differences in the degree of calcification by gender were found at ages 20–25 years. The degree of calcification increased with age, reaching 100% in women at age 30 and in men at age 50. In women, the degree of calcification was higher than in men from the age of 13 years and levelled off at the age of 50 years. The interrater agreement was strong k = 0.97, z = 30.0, p < .001. Calcification can be detected by orthodontists trained in lateral cephalogram analysis and can be used as a screening or diagnostic tool to detect calcified areas in the larynx.

Evaluation the Actual and Effective Symphysis to Detect the Direction of Mandibular Rotation in Iraqi Sample (Cephalometric Study)

This study is attempted to find out if the actual and effective symphysis are correlated with the measurements of mandibular rotation and can be used to detect the direction of mandibular growth. Ninety five Iraqi adult patients (54 females and 41 males)with an age ranged between 18-31 years collected among patients having Cl I skeletal and occlusal relations and full permanent dentition regardless the third molars were chosen for this study. Each person was subjected to clinical examination and digital true lateral cephalometric radiograph. The radiographs were analyzed by using AutoCAD 2007 computer program to measure the two symphyseal measurements with eleven measurements for mandibular rotation. Descriptive statistics were obtained from the measurements of both genders; independent samples t-test was performed to evaluate the gender differences, while Pearson’s correlation coefficient test was used to find the correlation of actual and effective symphysis with the mandibular rotation measurements. Actual and effective symphysis were not significantly differing between genders, while facial heights were significantly higher in males. Regarding the mandibular rotation angles, only SN-MP, saddle (N-S-Ar), and the sum of the posterior angles (Sum PA)were significantly higher in females, while PP-MP, FMA, articular (S-Ar-Go), and gonial (Ar-Go-Me) angles showed non-significant higher mean values in males. For both genders and the total sample, the actual symphysis didn’t show any significant correlation with the facial heights and the mandibular rotation angles, on the contrary the effective symphysis showed in both genders and the total sample significant positive correlations with Jarabak ratio, and significant negative correlations with SN-MP, PP-MP, FMA, and the sum of the posterior angles. In males and the total samples, the saddle angle (N-S-Ar) significantly positively correlated with the effective symphysis, while gonial angle (Ar-Go-Me) was significantly negatively correlated with it. Articular angle (S-Ar-Go) only significantly negatively correlated with the effective symphysis in the total sample. Effective symphysis is a good predictor of the direction of mandibular rotation, while actual symphysis is a poor predictor.