Maxillary Length Research Articles

Predicting the Risk of Maxillary Canine Impaction Based on Maxillary Measurements Using Supervised Machine Learning.

To predict palatally impacted maxillary canines based on maxilla measurements through supervised machine learning techniques. The maxilla images from 138 patients were analysed to investigate intermolar width, interpremolar width, interpterygoid width, maxillary length, maxillary width, nasal cavity width and nostril width, obtained through cone beam computed tomography scans. The predictive models were built using the following machine learning algorithms: Adaboost Classifier, Decision Tree, Gradient Boosting Classifier, K-Nearest Neighbours (KNN), Logistic Regression, Multilayer Perceptron Classifier (MLP), Random Forest Classifier and Support Vector Machine (SVM). A 5-fold cross-validation approach was employed to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision and F1 Score were calculated for each model, and ROC curves were constructed. The predictive model included four variables (two dental and two skeletal measurements). The interpterygoid width and nostril width showed the largest effect sizes. The Gradient Boosting Classifier algorithm exhibited the best metrics, with AUC values ranging from 0.91 [CI95% = 0.74-0.98] for test data to 0.89 [CI95% = 0.86-0.94] for crossvalidation. The nostril width variable demonstrated the highest importance across all tested algorithms. The use of maxillary measurements, through supervised machine learning techniques, is a promising method for predicting palatally impacted maxillary canines. Among the models evaluated, both the Gradient Boosting Classifier and the Random Forest Classifier demonstrated the best performance metrics, with accuracy and AUC values exceeding 0.8, indicating strong predictive capability.

Craniofacial features and incisor position design of esthetics population after orthodontic treatment.

This study aims to provide craniofacial features and incisor position prediction models among esthetics population after orthodontic treatment. A total of 338 patients with esthetic profiles were selected from 1 055 post-orthodontic adults based on inclusion and exclusion criteria and scored by five dental students. Mean values of cephalometric measurement were demonstrated with gender and sagittal skeletal pattern (ANB) differences assessed by generalized estimating equation. Correlations among age, skeletal, and soft tissue variables in different genders were determined. Multivariate analysis was used to assess the influence of skeletal and soft tissue variables on orthodontic incisor position. Within the esthetic cohort after orthodontic treatment, gender differences existed in cranial and mandibular length, mandibular rotation, protrusion of pogonion, inclination of maxillary incisors, upper lip thickness, lower 1/3 face height, and nose protrusion. However, in class Ⅰ malocclusion, the development of the chin showed no significance, whereas the protrusion of the lower lip significantly differed between genders, with less protrusion in males. In males, the protrusion of lip and chin varied among groups, with thinner basic upper lip thickness of class Ⅱ than class Ⅰ and greater lower lip height of class Ⅲ than class Ⅰ. In females, the protrusion and height of the upper lip and chin varied in groups, with thicker basic upper lip thickness of class Ⅲ than class Ⅰ. Upper lip thickness, female basic upper lip thickness, and female lower lip height were correlated with age. The protrusion of the upper lip was mainly correlated with posterior cranial base, mandibular body length, ANB in male and SNA, ANB, sagittal maxillary length, mandibular rotation, and protrusion of pogonion in female. The protrusion of the lower lip in males was mainly correlated with ramus height, mandibular rotation, protrusion of pogonion in male and ANB, mandibular rotation, and protrusion of pogonion in females. After employing skeletal variables to fit dental parameters, optimal results were achieved in male IMPA (adjusted R2=0.712) and female G Vert-U1 (adjusted R2=0.795). After employing skeletal and soft tissue variables simultaneously, optimal results were achieved in male and female G Vert-U1, which was mainly influenced by the protrusion of the chin and nasal base in males (adjusted R2=0.836) and the protrusion of the nasal base as well as ANB in females (adjusted R2=0.842). This study demonstrated the craniofacial features of esthetics population after orthodontic treatment and revealed the correlation of gender, age, skeleton, and soft tissues to provide reliable prediction models for aesthetic orthodontic incisor position.

Evaluation of Maxillary Protraction Using a Mini Screw-Retained Palatal C-Shaped Plate and Face Mask.

To evaluate a newly designed minimally invasive palatal-plate face mask combination for the management of developing Class III malocclusion due to maxillary deficiency. A sample of 16 Class III patients due to maxillary deficiency in the early mixed dentition (8 boys and 8 girls) aged between 7 and 9 years participated in this study and were treated with a combination of palatal plate face masks. Extra-oral elastics were attached between the intra-oral and extra-oral appliances; the elastics were set at 30° to the occlusal plane. The force magnitude was 250-300 g per quadrant. Cephalometric radiographs were taken before and immediately after maxillary protraction. In addition, skeletal measurements were measured, tabulated, and statistically analyzed. The pre- and post-protraction measurements were compared using the Student's t-test, and the significance level was set at a p-value <0.05. A statistically significant increase in SNA angle and maxillary length was observed by 3.13±1.52 degrees and 2.60±0.75 mm (p<0.05), respectively, indicating forward maxillary growth. The skeletal and soft tissue patterns were also improved, as evidenced by the statistically significant increase in the ANB angle, Wits appraisal, and H angle by 4.50±1.28 degrees, 5.30±1.86 mm, and 5.02±3.24 degrees (p<0.05), respectively. A favorable clockwise mandibular rotation was observed as evidenced by the increase in the SN/MP angle and the decrease in the SNB angle by 1.46±1.96 degrees and -1.38±1.86 degrees (p<0.05), respectively. The palatal-plate facemask combination is an effective treatment alternative for Class III malocclusion due to maxillary deficiency with minimal pain and discomfort.

A comparative study of the efficacy of customized titanium plates versus conventional maxillary protraction in the treatment of skeletal class Ⅲ patients

Objective: To compare the clinical efficacy of customized titanium plate and conventional maxillary protraction treatment in patients with skeletal class Ⅲ malocclusion during growth spurt. Methods: During growth spurt, skeletal class Ⅲ patients with maxillary hypoplasia who were treated in the Department of Orthodontics, Capital Medical University School of Stomatology from August 2018 to July 2021 were prospectively enrolled. They were treated with maxillary protraction using customized titanium plates (customized titanium plate group) and conventional methods (conventional protraction group), respectively. Lateral cephalometric radiographs were collected before and after treatment for conventional cephalometric analysis, including SNA angle (angle between Sella, Nasion and A point), ANB angle (angle between A point, Nasion, and B point), FH-MP angle (mandibular plane angle), Y-axis angle, U1-L1 angle (upper to lower central incisor angle), U1-SN angle (upper incisor to SN plane angle), anterior and lower height, maxillary length, etc. The stable basicranial line (SBL) was used as the reference line to measure the distance from each reference point (ANS point, A point, Prn point, Sn point, UL point etc.) to the stable basicranial vertical line (VerT, the perpendicular line of the skull base line at the intersection point of the anterior wall of the sella image and the inferior edge of the anterior bed process). Paired t-tests were performed on the cephalometric data before and after maxillary protraction treatment in the two groups, and two independent samples t-tests were performed to compare the differences in the efficacy of the two maxillary protraction methods. Results: A total of 20 patients (9 males and 11 females), aged (10.8±1.3) years, were included in the personalized titanium plate group. A total of 20 patients (8 males and 12 females), aged (10.5±1.1) years, were included in the conventional protraction group. The SNA angle, ANB angle, FH-MP angle, Y-axis angle, anterior lower height, maxillary length, ANS-VerT distance, A-VerT distance, Prn-VerT distance, Sn-VerT distance, and UL-VerT distance were significantly higher than those before treatment in the two groups (P<0.05). The changes of SNA angle, ANB angle and A-VerT before and after treatment in the personalized titanium plate group [3.15°±2.28°, 4.64°±1.40°, (4.41±3.43) mm, respectively] were significantly higher than those in the traditional group [2.13°±2.69°, 2.81°±1.10°, (3.13±4.76) mm, respectively](P<0.05), and the changes of U1-L1 angle and U1-SN angle before and after treatment (-0.76°±7.42° and 1.74°±6.38°, respectively) was significantly lower than that of the control group (-5.14°±6.62° and 4.57°±5.24°, respectively, P<0.05). Conclusions: Maxillary protraction can effectively improve skeletal class Ⅲ relationships in growing patients. The linear measurements using the SBL line as a reference plane visualize the sagittal improvement in sagittal relationship after maxillary protraction. The customized titanium plate maxillary protraction treatment has a clear therapeutic effect on patients with skeletal class Ⅲ deformities, and its dental effect is relatively small.

Sex determination through maxillary dental arch and skeletal base measurements using machine learning

BackgroundCranial, facial, nasal, and maxillary widths have been shown to be significantly affected by the individual’s sex. The present study aims to use measurements of dental arch and maxillary skeletal base to determine sex, employing supervised machine learning.Materials and methodsMaxillary and mandibular tomographic examinations from 100 patients were analyzed to investigate the inter-premolar width, inter-molar width, maxillary width, inter-pterygoid width, nasal cavity width, nostril width, and maxillary length, obtained through Cone Beam Computed Tomography scans. The following machine learning algorithms were used to build the predictive models: Logistic Regression, Gradient Boosting Classifier, K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Multi-Layer Perceptron Classifier (MLP), Decision Tree, and Random Forest Classifier. A 10-fold cross-validation approach was adopted to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision, and F1 Score were calculated for each model, and Receiver Operating Characteristic (ROC) curves were constructed.ResultsUnivariate analysis showed statistical significance (p < 0.10) for all skeletal and dental variables. Nostril width showed greater importance in two models, while Inter-molar width stood out among dental measurements. The models achieved accuracy values ranging from 0.75 to 0.85 on the test data. Logistic Regression, Random Forest, Decision Tree, and SVM models had the highest AUC values, with SVM showing the smallest disparity between cross-validation and test data for accuracy metrics.ConclusionTransverse dental arch and maxillary skeletal base measurements exhibited strong predictive capability, achieving high accuracy with machine learning methods. Among the evaluated models, the SVM algorithm exhibited the best performance. This indicates potential usefulness in forensic sex determination.

Automated Craniofacial Biometry with 3D T2w Fetal MRI.

Evaluating craniofacial phenotype-genotype correlations prenatally is increasingly important; however, it is subjective and challenging with 3D ultrasound. We developed an automated landmark propagation pipeline using 3D motion-corrected, slice-to-volume reconstructed (SVR) fetal MRI for craniofacial measurements. A literature review and expert consensus identified 31 craniofacial biometrics for fetal MRI. An MRI atlas with defined anatomical landmarks served as a template for subject registration, auto-labelling, and biometric calculation. We assessed 108 healthy controls and 24 fetuses with Down syndrome (T21) in the third trimester (29-36 weeks gestational age, GA) to identify meaningful biometrics in T21. Reliability and reproducibility were evaluated in 10 random datasets by four observers. Automated labels were produced for all 132 subjects with a 0.03% placement error rate. Seven measurements, including anterior base of skull length and maxillary length, showed significant differences with large effect sizes between T21 and control groups (ANOVA, p<0.001). Manual measurements took 25-35 minutes per case, while automated extraction took approximately 5 minutes. Bland-Altman plots showed agreement within manual observer ranges except for mandibular width, which had higher variability. Extended GA growth charts (19-39 weeks), based on 280 control fetuses, were produced for future research. This is the first automated atlas-based protocol using 3D SVR MRI for fetal craniofacial biometrics, accurately revealing morphological craniofacial differences in a T21 cohort. Future work should focus on improving measurement reliability, larger clinical cohorts, and technical advancements, to enhance prenatal care and phenotypic characterisation.

Phenotypic covariation predicts diversification in an adaptive radiation of pupfishes.

Phenotypic covariation among suites of traits may constrain or promote diversification both within and between species, yet few studies have empirically tested this relationship. In this study, we investigate whether phenotypic covariation of craniofacial traits is associated with diversification in an adaptive radiation of pupfishes found only on San Salvador Island, Bahamas (SSI). The radiation includes generalist, durophagous, and lepidophagous species. We compared phenotypic variation and covariation (i.e., the P matrix) between (1) allopatric populations of generalist pupfish from neighboring islands and estuaries in the Caribbean, (2) SSI pupfish allopatric lake populations with only generalist pupfish, and (3) SSI lake populations containing the full radiation in sympatry. Additionally, we examine patterns observed in the P matrices of two independent lab-reared F2 hybrid crosses of the two most morphologically distinct members of the radiation to make inferences about the underlying mechanisms contributing to the variation in craniofacial traits in SSI pupfishes. We found that the P matrix of SSI allopatric generalist populations exhibited higher levels of mean trait correlation, constraints, and integration with simultaneously lower levels of flexibility compared to allopatric generalist populations on other Caribbean islands and sympatric populations of all three species on SSI. We also document that while many craniofacial traits appear to result from additive genetic effects, variation in key traits such as head depth, maxilla length, and lower jaw length may be produced via non-additive genetic mechanisms. Ultimately, this study suggests that differences in phenotypic covariation significantly contribute to producing and maintaining organismal diversity.

Morphometric comparison of linear body size of IPB D1 chickens and native chickens through discriminant analysis

Animal protein production from chickens predominantly comes from purebred chicken farms rather than local ones. Improving the genetic quality of local chickens in Indonesia can be achieved through developing IPB D1 chickens. This study aims to identify distinguishing variables between IPB D1 chickens and native chickens using linear body measurements through discriminant analysis. The research involved IPB D1 chickens and native chickens in the layer phase, employing descriptive statistical analysis, T2-Hotelling, Fisher linear discriminant analysis, and Wald-Anderson classification. Results showed that IPB D1 roosters and native roosters differ in femur length (X1), tarsometatarsus circumference (X4), maxilla length (X7), and comb height (X8) with a morphometric dissimilarity of 2.06. IPB D1 hens and native hens differ in tarsometatarsus circumference (X4) and wing length (X6), with a morphometric dissimilarity of 1.41. The Wald-Anderson classification, based on natural selection, suggests removing particular chickens that are not classified as IPB D1 and native chickens from their respective groups to produce chickens that match their characteristics.

Assessment of Sexual Dimorphism Through Lateral Cephalogram in Children Aged 10-12 Years.

Forensic dentistry integrates interdisciplinary scientific knowledge to produce accurate and reliable forensic statements. Anthropometry, essential since its introduction by Alphonse Bertillon in 1882, describes human body shapes and has significant forensic applications. This study focuses on sexual dimorphism, phenotypic differences between males and females, using lateral cephalometric measurements to determine sex in children aged 10-12 years from the Chengalpattu population. The cross-sectional study included 80 participants (40 boys and 40 girls). Lateral cephalograms were analyzed using Ceph Ninja Pro software to obtain 15 cephalometric measurements. Statistical analysis using SPSS Software (Version 22.0) involved t-tests to identify significant differences (P<0.05). Discriminant function analysis assessed the predictive power of these variables. Seven variables showed significant differences between sexes. Discriminant models based on these variables determined sex with varying reliability. Ramus length was the most reliable predictor (81%), while maxillary length had the lowest reliability (62%). The study's findings align with existing literature, indicating the robustness of ramus length for sex determination. However, the low reliability of maxillary length contrasts with studies that found it useful for sex differentiation, suggesting variability across populations and age groups. Combining multiple cephalometric variables improved accuracy, consistent with previous research. Lateral cephalograms are effective for assessing sexual dimorphism in children. The study supports the forensic and clinical utility of cephalometric measurements and calls for further research with diverse populations and advanced imaging techniques to enhance method reliability and applicability.

Comparison of craniomaxillofacial morphology in children with unilateral cleft lip and palate treated with/without presurgical nasoalveolar molding - a retrospective study with a mean age of 5 years.

To three-dimensionally assess differences in craniomaxillofacial skeletal development in patients with operated unilateral cleft lip and palate (UCLP) treated with/without presurgical nasoalveolar molding (PNAM) with a mean age of 5 years. Cone-beam CT radiographs of 30 patients with UCLP who had undergone PNAM and 34 patients with UCLP who did not receive PNAM were analyzed. The data were stored in DICOM file format and were imported into the Dolphin Imaging program for 3D image reconstruction and landmark identification. 33 landmarks, 17 linear and three angular variables representing craniofacial morphology were analyzed and compared by using the Mann-Whitney U tests. The vast majority of linear variables and 3D coordinates of landmark points reflecting craniofacial skeletal symmetry were not significantly different between the two groups. In terms of craniofacial skeletal development, the PNAM group had a significantly smaller anterior nasal spine offset in the midsagittal plane and a greater maxillary length compared to the non-PNAM group. Evaluations performed in early childhood showed that treatment with/without PNAM in the neonatal period was not a major factor influencing craniomaxillofacial hard tissue development in patients with UCLP; moreover, PNAM treatment showed significant correction of skeletal deviation at the base of the nose. Follow-up in early childhood has shown that PNAM treatment administered during the neonatal stage does not impede maxillary development and has benefits in correcting nasal floor deviation. It is a viable option for improving nasal deformity in children with unilateral cleft lip and palate.

An integrative taxonomic study on needlefishes (Belonidae) unveils two new species within the genus Ablennes from the Indian Ocean

The needlefish genus Ablennes remains monotypic, characterized by the globally distributed flat needlefish known as Ablennes hians. Their taxonomy has been mired with ambiguities due to the greater-than-average morphological variations observed in samples from different regions. Utilizing integrated taxonomic methods relying on mitochondrial molecular markers, it was revealed that the species initially perceived as a single entity is, in fact, a complex comprising at least three different species. In this context, we introduce two new species: Ablennes joseberchmansis sp. nov. and Ablennes gracalii sp. nov., They are morphologically distinct: in view of the morphometry and meristic characteristics. A. joseberchmansis sp. nov. and A. gracalii sp. nov. display distinct differentiation characteristics from A. hians in terms of dorsal fin, nostril position, dorsal fin origin, vertebrae count, scale counts, head length, eye diameter, interorbital width, maxilla length, dorsal ray height, depth at pelvic origin, lower lobe of the caudal fin, and caudal peduncle depthcaudal peduncle depth. These variations highlight their unique morphological traits and aid in their differentiation within the genus Ablennes. We assessed genetic relationships using a Maximum likelihood (ML) phylogenetic tree, revealing three distinct clades of morphological differences in Ablennes specimens from different morphological groups. The genetic variation, as represented by Kimura 2 parameter (K2P) distances, within the three Ablennes species spans from 6.5% to 9.4%. More specifically, we observed a 7.5% genetic difference between A. hians and A. joseberchmansis sp. nov., and a 6.5% distinction between A. hians and A. gracalii sp. nov. The interspecies divergence between the two newly identified species measured at 9.4%. These findings, which showcase the genetic distinctions among the three morphologically distinct Ablennes specimens, provide strong confirmation for the existence of three separate species within the Ablennes genus of needlefish in the Indian Ocean.

Neomerinthe ornithoptera, a new species of scorpionfish (Teleostei: Scorpaenidae) from the southwestern Pacific Ocean, with a reassessment of the diagnosis for N. pallidimacula (Fowler 1938)

Neomerinthe ornithoptera n. sp., described on the basis of three specimens from Fiji and the Wallis and Futuna Islands, southwestern Pacific Ocean, was previously reported as Neomerinthe pallidimacula (Fowler 1938), due to its characteristic lack of both lateral lacrimal and second preopercular spines. The new species is clearly distinguished from Indo-Pacific congeners, including N. pallidimacula, by the following combination of characters: pectoral-fin rays 18; scale rows in longitudinal series 44 or 45; pored lateral-line scales 23; scale rows above lateral line 6 or 7, below lateral line 12, between sixth dorsal-fin spine base and lateral line 5, between last dorsal-fin spine base and lateral line 5; upper gill rakers 6, lower gill rakers 13, total gill rakers 19; longitudinal ridge on lateral surface of maxilla absent; many small cycloid scales on base of pectoral fin and ventral surface of body between isthmus and posterior to pelvic fin; pectoral-fin ray length 37.6–40.0% of SL; first anal-fin spine length 6.9–8.5% of SL; second anal-fin spine length 23.3–25.5% of SL; third anal-fin spine length 22.7–23.1% of SL; pelvic-fin spine length 17.9–18.1% of SL; longest pelvic-fin soft ray length 26.6–29.2% of SL; and several lower pectoral-fin rays markedly elongated. In addition, the diagnosis of N. pallidimacula shows the species to be similar to Neomerinthe bucephalus (Alcock 1896), although distinguished from the latter by the following features: upper-jaw length 25.0% of SL; maxilla depth 8.2% of SL; eleventh dorsal-fin spine length 5.7% of SL; and 22 pored lateral-line scales.

Evaluation of the infrazygomatic crest and mandibular buccal shelf in different sagittal skeletal patterns: a cone-beam computed tomography study

Abstract Objectives To compare bone thickness, bone height, and density in the infrazygomatic crest (IZC) and the mandibular buccal shelf (MBS) associated with different sagittal skeletal patterns. Material and Methods This retrospective study included three groups of which a Class I group consisted of 28 patients (24 female, 4 male, mean age: 26.46 ± 6.1), a Class II group comprised 31 patients (28 female, 3 male, mean age: 30.08 ± 5.9), and a Class III group included 26 patients (22 female, 4 male, mean age: 26.21 ± 5.3). Evaluations of bone characteristics were performed for both the IZC and MBS using cone-beam computed tomography (CBCT). Maxillary length and mandibular body length were also measured on lateral cephalograms. One-way ANOVA, chi-squared, and Spearman’s correlation tests were applied for statistical analysis. Results The Class II group showed significantly greater bone thickness at the distal root level of the maxillary second molar in IZC (p &lt; 0.05). While bone thickness showed no statistically significant difference in the MBS between the groups (p &gt; 0.05), the Class II group showed significantly higher bone height values at the distal root level of the mandibular second molar in the MBS (p &lt; 0.05). A statistically significant increase from the mesial aspect to the distal aspect was observed in total bone thickness in the Class I group and total bone thickness and height in the Class II and III groups in the MBS. The mandibular body length and SNB values were positively correlated with the total bone thickness and bone height of the MBS. Conclusions Bone thickness in the IZC and bone density in both the IZC and MBS were similar in the different sagittal skeletal patterns. Total bone thickness in the Class I and III groups and the total bone height in the Class II group showed a gradual increase from the mesial to the distal in the MBS. The length of the mandibular body may be a clinical clue to assist in the selection of the appropriate implantation area.

Is maxillary protraction the earlier the better? A retrospective study on early orthodontic treatment of Class III malocclusion with maxillary deficiency.

To investigate the optimal timing of maxillary protraction in children with Class III malocclusion to aid comprehension of this still non-consensual topic. In all, the data of 97 children with Class III malocclusion treated by using the Delaire facemask with maxillary expansion were collected retrospectively and divided into three groups according to their dentition stages; those subjects in the mixed dentition group were further divided into three subgroups. All patients were regrouped by the cervical vertebral maturation index (CVMI) and observed closely by cephalograms at the beginning of treatment (T0) and after facemask removal (T1). Comparisons between subgroups, within groups, and the final evaluation of the increment of maxillary length were performed by different statistical methods. Similar favorable maxillary traction effects were achieved in all stages. Intragroup comparisons showed changes without significance in aspect ratio during the mixed dentition stage, while there was a significant decrease during the deciduous and permanent dentition stages. The largest increment of maxillary length was obtained when the maxillary protraction began at Cervical Stage (CS)2. However, no significant difference was found in all skeletal measurements among the three groups (deciduous, mixed and permanent dentition stages) and the three subgroups with mixed dentition. The univariable linear regression analysis also showed that CVMI and dentition stage at T1 did not have a significant impact on the increment of maxillary length. In our center, Class III malocclusion patients treated with the Delaire facemask achieved similar skeletal changes in short term, when they began the treatment at different dentition stages or CVMI stages. Starting the maxillary protraction at CS2 was likely a reliable choice for those who desired more maxillary advancement.

The relationship between third molar agenesis and craniofacial morphology: a systematic review and meta-analysis.

Agenesis of third molar agenesis has a higher incidence than other tooth development anomalies. Previous research identified a potential correlation between third molar agenesis and specific craniofacial morphology; however, no systematic review and meta-analysis on this topic currently exists. The objective of this systematic review and meta-analysis was to evaluate the association between third molar agenesis and craniofacial sagittal and vertical morphology. An electronic search was conducted on PubMed, Embase, Web of Science, and the Cochrane Library without restrictions on publication year or language; this was supplemented by the manual retrieval of relevant literature. Cross-sectional studies that compared craniofacial morphology using angular and linear measurements obtained from lateral cephalography between patients with third molar agenesis and those without were included. The quality assessment of the enrolled articles was evaluated by the Joanna Briggs Institute critical appraisal tool. Meta-analysis and sensitivity analysis were performed by Review Manager software (The Cochrane Collaborative, version 5.4, Cochrane IMS). A total of seven studies were included. Meta-analysis demonstrated that the ANB (mean differences (MD) = -0.75, 95% CI: -1.31 to -0.19, P < 0.01), palate length (ANS-PNS, MD = -1.68, 95% CI: -2.24 to -1.11, P < 0.01), and mandibular length (Go-Pog, MD = -0.36, 95% CI: -0.59 to -0.13, P < 0.01) were smaller in patients with third molar agenesis. With regard to vertical craniofacial morphology, the mandibular plane angle (MP-FH; MD = -1.88, 95% CI: -3.45 to -0.31, P = 0.02), gonial angle (gonial angle; MD = -1.73, 95% CI: -2.69 to -0.77, P < 0.01) and lower face height (lower face heigh angle; MD = -1.36, 95% CI: -1.94 to -0.77, P < 0.01) were smaller in patients with third molar agenesis, indicating a flatter or brachyfacial skeletal pattern. The results of this study suggest that third molar agenesis maybe associated with a reduced maxillary length and a flatter mandible. However, these findings need to be interpreted with caution due to inconsistencies in the certainty of evidence. PROSPERO (CRD42023448226).

Role of Growth Hormone Therapy in Craniofacial Development of Children with or without Growth Hormone Deficiency—A Systematic Review

Objective To evaluate effect of growth hormone (GH) therapy in craniofacial development in children with or without growth hormone deficiency. Method The systematic review was conducted by searching the electronic databases—PubMed, Cochrane clinical trials register, Google scholar, and EBSCO host. Randomized controlled trials and observational studies published till January 2022 were included. The risk of bias was assessed by Risk-Of-Bias VISualization (ROBVIS) tool. The risk of bias of the included studies was presented as a “traffic light” plot of individual studies and a summary diagram. Data was studied by two authors and any dispute was resolved by another reviewer. Result A total of 964 articles were obtained through electronic database search. After eliminating the duplicates, 13 articles met inclusion criteria. Of the 13 studies, 8 studies had moderate risk of bias, 2 had serious risk of bias, and 1 had critical risk of bias as per the ROBINS-I assessment. According to the RoB 2, two studies were having high risk of bias. Conclusion The maxillary length, the mandibular length, and the cranial base length increased post-GH therapy, causing an overall increase in the facial height. The limitation of GH therapy was in the transverse direction as maxillary and mandibular arch dimensions remained almost equal to those in the untreated subjects. Dentition had minimal influence of GH therapy. Registration The systematic review was registered in the International Prospective Register of Systematic Reviews database under CRD42021257044.

Effect of SEC III protocol on upper airway dimensions in growing class III patients: a retrospective study

BackgroundThe primary objective of the study was to evaluate the effects of SEC III (Splints, Class III Elastics, and Chin cup) protocol on the upper airway dimensions using lateral cephalometric radiographs. The secondary objectives were to evaluate the skeletal and dental effects of the SEC III protocol using lateral cephalometric radiographs.MethodsThe pre- and post-treatment lateral cephalometric radiographs of 24 patients treated using the SEC III protocol were used to address the aim of the study. Children in the pre-pubertal (CS-1 or CS-2) or circumpubertal (CS-3 or CS-4) skeletal maturation stage and having class III dentoskeletal malocclusion were included in the study. Patients with a history of previous orthodontic treatment, maxillofacial surgery or trauma, tonsillectomy, adenoidectomy, or craniofacial malformations were excluded. The pre-treatment and post-treatment lateral cephalometric radiographs were traced, then airway measurements, skeletal measurements, and dental measurements were performed. The results were analysed using paired samples t-test or Wilcoxon signed rank test according to the data normality.ResultsData of 6 males and 18 females were analysed (Mean age = 11.21 ± 1.02 years). Duration of active treatment was 5.75 ± 1.03 months. Treatment using SEC III protocol resulted in a significant increase in ANB angle (2.92 ± 1.50 degrees, p < 0.001) and Wits appraisal (3.31 ± 1.99 mm) (p < 0.001). The increase in the mandibular plane angle (0.75 ± 1.42 degrees, p = 0.02) and the maxillary length (2.29 ± 2.69 mm, p < 0.001) was statistically significant. Contrarily, the mandibular length did not change significantly (p = 0.10). The maxillary incisors were significantly proclined (4.38 ± 4.28 degrees; p < 0.001), while the mandibular incisors were significantly retroclined (-5.79 ± 6.21 degrees; p < 0.001) following treatment. The change in the nasopharyngeal airway and the retropalatal airway was not statistically significant. The middle and inferior pharyngeal space (retroglossal airway) significantly decreased by 1.33 ± 1.97 mm (p = 0.003) and 1.96 ± 2.48 mm (p = 0.001), respectively.ConclusionsEarly class III correction using SEC III protocol reduced the retroglossal airway dimensions but did not affect the nasopharyngeal and retropalatal airway dimensions. Correction of the class III dentoskeletal relationship was obtained through both skeletal and dental changes.

Influence of BMI percentile on craniofacial morphology and development in adolescents,Part II: elevated BMI is associated with larger final facial dimensions.

Prevalence of adolescent obesity has markedly increased from 5.2% in 1974 to 19.7% in 2021. Understanding the impacts of obesity is important to orthodontists, as growth acceleration and greater pre-pubertal facial dimensions are seen in children with elevated body mass index (BMI). To identify whether adolescent obesity shifts the timing and rate of craniofacial growth resulting in larger post-treatment dimensions, we evaluated cephalometric outcomes in overweight/obese (BMI > 85%, n = 168) and normal weight (n = 158) adolescents (N = 326 total). Cephalometric measurements were obtained from pre- and post-treatment records to measure growth rates and final dimensions and were statistically evaluated with repeated measures analysis of variance and linear regression models. Overweight and obese adolescents began and finished treatment with significantly larger, bimaxillary prognathic craniofacial dimensions, with elevated mandibular length [articulare-gnathion (Ar-Gn)], maxillary length [condylion-anterior nasal spine (Co-ANS), posterior nasal spine-ANS (PNS-ANS)], and anterior lower face height (ANS-Me), suggesting overweight children grow more overall. However, there was no difference between weight cohorts in the amount of cephalometric change during treatment, and regression analyses demonstrated no correlation between change in growth during treatment and BMI. BMI percentile was a significant linear predictor (P < 0.05) for cephalometric post-treatment outcomes, including Ar-Gn, Co-ANS, ANS-Me, upper face height percentage (UFH:total FH, inverse relationship), lower face height percentage (LFH:total FH), sella-nasion-A-point (SNA), and SN-B-point (SNB). The study is retrospective. Growth begins earlier in overweight and obese adolescents and continues at a rate similar to normal-weight children during orthodontic treatment, resulting in larger final skeletal dimensions. Orthodontics could begin earlier in overweight patients to time care with growth, and clinicians can anticipate that overweight/obese patients will finish treatment with proportionally larger, bimaxillary-prognathic craniofacial dimensions.

Phenotypic variation of protandrous hermaphrodite fish Eleutheronema tetradactylum (Shaw, 1804) from Thailand coastal waters

This study was conducted to investigate the intraspecific variation of Eleutheronema tetradactylum (Shaw, 1804) using traditional morphometric measurements. In total, 136 samples were collected from four fishing areas across Thailand coastal waters. Raw data were standardized and then evaluated with univariate analysis of variance, canonical discriminant function analysis, and dendrogram of cluster analysis regarding to site, size, and sex. Result from ANOVA test exhibited that all morphological characters were significantly different among sites (P < 0.05). Nevertheless, forty-one morphometric characters were significantly different among size of male and female fish (P < 0.05) except for pre-orbital length, pupil diameter, eye diameter, and depth of maxilla for male fish. Forty-four morphometric characters were significantly different (P < 0.05) except of fork length among sex. From CDFA, E. tetradactylum showed phenotypic heterogeneity and two distinct stocks in the four selected fishing areas. Phenotypic variation on sites was determined by six morphological characters (MnFL, DFAF, DOM, HW, PeBFL and ED) for males, while eight characters for females (PrOL, AFSL, PeBFL, DOM, UJL, PD, AFRL and ED) in decreasing order. Differentiations between fish size classes, relied on PrDFL2, BD and UCFL in males and PrOL, PrePeFL and DFAF in females. Among sexes, PeFAF, PrDFL2, MxFL, MnFL, PrePeFL, HSDF and PrePFL were highly influential. Discriminate functions (DF1) clarified that 83.60% and 94.10% of the total variance were found among the sites of males and females, and 99.20% and 93.20% of the total variance were found among the sizes of males and females, respectively. and 73% of the total variance were found among the sexes. In the confusion matrix of CDFA, the overall assignments of individuals into their correctly classified original population were 98.68% and 100% for males and females based on site and size, and 75.74% of sex groups, respectively. Our study highlighted that the hermaphroditism of E. tetradactylum showed that three distinct stocks of males and two stocks of females inhabited Thai coastal waters.

Genetic Subtypes of Apert Syndrome Are Associated With Differences in Airway Morphology and Early Upper Airway Obstruction.

Apert syndrome is predominantly caused by 2 paternally inherited gain-of-function mutations in the FGFR2 gene, Pro253Arg, and Ser252Trp. Studies comparing phenotypic features between these 2 mutations have established differences in syndactyly severity and incidence of cleft palate. Obstructive sleep apnea can be debilitating in a subset of patients with Apert syndrome, yet is not well understood. This study aims to determine whether FGFR2 mutations impart differential effects on airway physiology and morphology. Patients with Apert syndrome and confirmatory molecular testing were reviewed for polysomnography, nasal endoscopy, microlaryngoscopy and bronchoscopy, and computed tomography imaging. Obstructive apnea-hypopnea index and oxygen saturation nadir, nasal airway volumes, choanal cross-sectional area, and midfacial cephalometric dimensions were compared across mutation types. Twenty-four patients (13 Ser252Trp, 11 Pro253Arg) were included. Severe obstructive sleep apnea (obstructive apnea-hypopnea index>10) occurred in 8 (62%) patients with Ser252Trp mutations compared with 1 (9%) patient with Pro253Arg mutations ( P =0.009). Computed tomography imaging at 1 year of age demonstrated that nasopharyngeal airway volumes were 5302±1076mm 3 in the Ser252Trp group and 6832±1414mm 3 in the Pro253Arg group ( P =0.041). Maxillary length (anterior nasal spine-posterior nasal spine, P =0.026) and basion-anterior nasal spine ( P =0.007) were shorter in patients with Ser252Trp mutations. The findings suggest that the Ser252Trp mutation in Apert syndrome is associated with higher severity obstructive sleep apnea and decreased nasopharyngeal airway volume. Heightened clinical awareness of these associations may inform treatment planning and family counseling.