Linear Cephalometric Measurements Research Articles

Cephalometric Evaluation of Children with Short Stature of Genetic Etiology: A Review.

Introduction: A plethora of biological molecules regulate chondrogenesis in the epiphyseal growth plate. Disruptions of the quantity and function of these molecules can manifest clinically as stature abnormalities of various etiologies. Traditionally, the growth hormone/insulin-like growth factor 1 (IGF1) axis represents the etiological centre of final stature attainment. Of note, little is known about the molecular events that dominate the growth of the craniofacial complex and its correlation with somatic stature. Aim: Given the paucity of relevant data, this review discusses available information regarding potential applications of lateral cephalometric radiography as a potential clinical indicator of genetic short stature in children. Materials and Methods: A literature search was conducted in the PubMed electronic database using the keywords: cephalometric analysis and short stature; cephalometric analysis and achondroplasia; cephalometric analysis and hypochondroplasia; cephalometric analysis and skeletal abnormalities; cephalometr* and SHOX; cephalometr* and CNP; cephalometr* and ACAN; cephalometr* and CNVs; cephalometr* and IHH; cephalometr* and FGFR3; cephalometr* and Noonan syndrome; cephalometr* and "Turner syndrome"; cephalometr* and achondroplasia. Results: In individuals with genetic syndromes causing short stature, linear growth of the craniofacial complex is confined, following the pattern of somatic short stature regardless of its aetiology. The angular and linear cephalometric measurements differ from the measurements of the average normal individuals and are suggestive of a posterior placement of the jaws and a vertical growth pattern of the face. Conclusions: The greater part of the existing literature regarding cephalometric measurements in short-statured children with genetic syndromes provides qualitative data. Furthermore, cephalometric data for individuals affected with specific rare genetic conditions causing short stature should be the focus of future studies. These quantitative data are required to potentially establish cut-off values for reference for genetic testing based on craniofacial phenotypes.

Nutritional programming of physical development and bone growth of offspring by a maternal high-fat diet

Objective: Investigate the influence of a maternal extended high-fat diet (HFD) consumption, an animal model for the human Western diet pattern, combined to preconceptional obesity on offspring development and growth. Methods: Female Wistar rats were subjected to HFD (52% energy from fat - primarily sourced from lard) or a control diet (12% energy from fat) from 37 days of life until the end of lactation. The dams in the HFD group were obese at the time of mating. Post-weaning, all offspring consumed a standardized diet. Somatic growth, physical maturation, neurobehavioral assessments, locomotor performance, and linear cephalometric measurements of the mandible (anteroposterior and alveolar lengths) and skull (diastema and alveolar lengths) were evaluated in both groups of offspring. Results: The offspring in the HFD group exhibited prolonged latency in the negative geotaxis reflex, lateness mandibular incisive eruption, and notable reductions in somatic growth and all linear cephalometric measurements when compared to the control group. Conclusion: The long-lasting maternal HFD exposition and preconceptional obesity leads to a delay in offspring physical development and bone growth.

Comparison of the skeletodental effects of miniscrew-anchored and tooth-anchored facemask treatment in growing patients with skeletal class III malocclusions.

This retrospective study aimed to evaluate the skeletal and dental effects of the miniscrew-anchored facemask in skeletal Class III growing patients and compare them with those of conventional tooth-anchored facemasks. Retrospectively a total of 50 patients with skeletal Class III (mean ANB: -1.12°) were investigated and divided into two groups according to the treatment modality. Twenty-five patients were treated using the conventional tooth-anchored facemask (T group: mean age 9.3 ± 1.1 years, mean ANB: -0.93°) whereas the other 25 were treated using a miniscrew-anchored facemask (M group: mean age 9.7 ± 1.3 years. mean ANB: -1.61°). Two miniscrews were placed on the palate for bone anchorage. In both T and M groups, facemasks applied a force of 20-30° down on the occlusal plane, and the force increased from 200 g to 300-350 g per side throughout the treatments. The patients were instructed to wear facemasks for at least 14 h per day. A total of 16 angular and 11 linear cephalometric measurements were analysed to determine the skeletal and dental changes before and after facemask treatment. A paired t-test was used to verify the effects before and after treatment in each group. All miniscrews were well maintained during treatment. The values of SNA, SN-ANS, ANB and A to N-Perp, which indicate anterior protraction of the maxilla, were significantly higher in the M group compared with the T group (P < .05). Proclination of the maxillary incisors, extrusion and mesialization of the maxillary molars were significantly greater in the T group (P < .05). Miniscrew-anchored facemask treatment increased the amount of maxillary protraction and reduced the dental side effects compared with conventional tooth-anchored facemask treatment in growing patients with skeletal Class III malocclusion.

Cephalometric comparison of mandibular growth in Brazilian children with Class II malocclusion and normal occlusion during the growth stages determined by the cervical vertebrae maturation.

This study compared mandibular growth in children, aged 7 to 12 years, with Class II malocclusion and normal occlusion, between the following stages of cervical vertebrae maturation: initiation (I), acceleration (A), transition (T). A total of 148 lateral cephalograms (78 males, 70 females) of Class II malocclusion patients, and 60 lateral cephalograms (30 males, 30 females) of normal occlusion patients were included. The following linear cephalometric measurements were performed: Co-Gn (effective mandibular length), Co-Go (ramus height), and Go-Gn (length of mandibular body). Mean values of increments between stages (I-A, A-T, I-T) were obtained for each group and gender. Results were compared using the Student t-test, and a significance level of 0.05% was adopted. Females group: A-T interval presented a greater increment in Co-Go in the Class II group, which was not significant for the I-T interval, with numerically smaller increments in Co-Gn and Go-Gn, without statistical significance. Males group: intervals I-A, A-T and I-T showed numerically smaller growth increments in the Class II group, with statistical significance for Co-Gn in I-A (p=0.001) and I-T (p=0.003). Comparing genders of the Class II group, Co-Go was higher in males (p=0.002) and I-T interval (p=0.031). In the Normal Occlusion group, the male gender had the greatest Co-Gn (p=0.038) for the I-A interval. In A-T and I-T, Co-Go in males was higher, with statistical significance (p=0.000 and p=0.002, respectively). Growth phenomenon affects the mandibular dimensions regardless of the character of the malocclusion, with a tendency to be smaller in the presence of Class II malocclusion.

Automated calibration system for length measurement of lateral cephalometry based on deep learning

Objective. Cephalometric analysis has been significantly facilitated by artificial intelligence (AI) in recent years. For digital cephalograms, linear measurements are conducted based on the length calibration process, which has not been automatized in current AI-based systems. Therefore, this study aimed to develop an automated calibration system for lateral cephalometry to conduct linear measurements more efficiently. Approach. This system was based on deep learning algorithms and medical priors of a stable structure, the anterior cranial base (Sella–Nasion). First, a two-stage cascade convolutional neural network was constructed based on 2860 cephalograms to locate sella, nasion, and 2 ruler points in regions of interest. Further, Sella–Nasion distance was applied to estimate the distance between ruler points, and then pixels size of cephalograms was attained for linear measurements. The accuracy of automated landmark localization, ruler length prediction, and linear measurement based on automated calibration was evaluated with statistical analysis. Main results. First, for AI-located points, 99.6% of S and 86% of N points deviated less than 2 mm from the ground truth, and 99% of ruler points deviated less than 0.3 mm from the ground truth. Also, this system correctly predicted the ruler length of 98.95% of samples. Based on automated calibration, 11 linear cephalometric measurements of the test set showed no difference from manual calibration (p > 0.05). Significance. This system was the first reported in the literature to conduct automated calibration with high accuracy and showed high potential for clinical application in cephalometric analysis.

Evaluation of fully automated cephalometric measurements obtained from web-based artificial intelligence driven platform

BackgroundArtificial Intelligence has created a huge impact in different areas of dentistry. Automated cephalometric analysis is one of the major applications of artificial intelligence in the field of orthodontics. Various automated cephalometric software have been developed which utilizes artificial intelligence and claim to be reliable. The purpose of this study was to compare the linear and angular cephalometric measurements obtained from web-based fully automated Artificial Intelligence (AI) driven platform “WebCeph”™ with that from manual tracing and evaluate the validity and reliability of automated cephalometric measurements obtained from “WebCeph”™.MethodsThirty pre-treatment lateral cephalograms of patients were randomly selected. For manual tracing, digital images of same cephalograms were printed using compatible X-ray printer. After calibration, a total of 18 landmarks was plotted and 12 measurements (8 angular and 4 linear) were obtained using standard protocols. The digital images of each cephalogram were uploaded to “WebCeph”™ server. After image calibration, the automated cephalometric measurements obtained through AI digitization were downloaded for each image. Intraclass correlation coefficient (ICC) was used to determine agreement between the measurements obtained from two methods. ICC value < 0.75 was considered as poor to moderate agreement while an ICC value between 0.75 and 0.90 was considered as good agreement. Agreement was rated as excellent when ICC value > 0.90 was obtained.ResultsAll the measurements had ICC value above 0.75. A higher ICC value > 0.9 was obtained for seven parameters i.e. ANB, FMA, IMPA/L1 to MP (°), LL to E-line, L1 to NB (mm), L1 to NB (°), S-N to Go-Gn whereas five parameters i.e. UL to E-line, U1 to NA (mm), SNA, SNB, U1 to NA (°) showed ICC value between 0.75 and 0.90.ConclusionA good agreement was found between the cephalometric measurements obtained from “WebCeph”™ and manual tracing.

Posterior fossa volume in idiopathic intracranial hypertension: a magnetic resonance imaging-based study.

The etiology of idiopathic intracranial hypertension (IIH) is uncertain. Studies suggest the fundamental cause of the Chiari 1 malformation, a congenitally hypoplastic posterior fossa, may explain the genesis of IIH in some patients. To assess the hypothesis that linear and volumetric measurements of the posterior fossa (PF) can be used as predictors of IIH. A retrospective analysis of magnetic resonance imaging (MRI) studies on 27 patients with IIH and 14 matched controls was performed. A volumetric sagittal magnetization prepared rapid acquisition gradient echo sequence was used to derive 10 linear cephalometric measurements. Total intracranial and bony posterior fossa volumes (PFVs) were derived by manual segmentation. The ratio of PFV to total intracranial volume was calculated. In total, 41 participants were included, all women. Participants with IIH had higher median body mass index (BMI). No significant differences in linear cephalometric measurements, total intracranial volumes, and PFVs between the groups were identified. Linear measurements were not predictive of volumetric measurements. However, on multivariate logistic regression analysis, the likelihood of IIH decreased significantly per unit increase in relative PFV (odds ratio [OR]=3.66 × 10-50; 95% confidence interval [CI]=1.39 × 10-108 to 1.22 × 10-5; P = 0.04). Conversely, the likelihood of IIH increased per unit BMI increase (OR=1.19; 95% CI=1.04-1.47; P = 0.02). MRI-based volumetric measurements imply that PF alterations may be partly responsible for the development of IIH and Chiari 1 malformations. Symptoms of IIH may arise due to an interplay between these and metabolic, hormonal, or other factors.

Dentoskeletal effects of Twin Block appliance in patients with Class II malocclusion.

Background and aimClass II malocclusions are most commonly seen in orthodontic practice and in the recent times Twin Block appliance has been the most popular and widely used among removable functional appliances for the correction of Class II malocclusion in growing patients. The aim of this retrospective study was to evaluate the dentoskeletal effects produced by the Twin Block appliance for the correction of Class II division 1 malocclusion with retrognathic mandible.MethodsPre-treatment (T1) and post-treatment (T2) lateral cephalograms of 30 patients treated with Twin Block appliance (mean age = 10.8 ± 1.2 years) for the correction of class II division 1 malocclusion were compared with the 30 untreated class II control patients (mean age 11.2 ± 0.8 years) who did not undergo any treatment during this period. Both the groups were evaluated for the dentoskeletal changes using 24 angular and linear cephalometric measurements. The differences between the pre and post-treatment were calculated using a paired t-test.ResultsThe cephalometric analysis revealed that the Twin Block appliance stimulated mandibular growth and statistically significant differences were found between the two groups. Twin Block patients showed a statistically very high significant (p<0.001) increase in mandibular length (6.02 mm) compared with the control group (0.3 mm). “Headgear effect” on the maxilla, increase in lower anterior facial height, significant reduction of overjet, overbite and Class I molar relationship were achieved in the Twin Block group. However, no significant changes appeared in the control group.ConclusionThe results of the present study conclude that the Twin Block appliance is effective in the treatment of Class II malocclusion and this is due to a combination of skeletal and dentoalveolar changes in both the arches.

GHR and IGF2R genes may contribute to normal variations in craniofacial dimensions: Insights from an admixed population

This study aimed to determine whether single nucleotide polymorphisms in the growth hormone receptor (GHR) and insulin-like growth factor 2 receptor (IGF2R) genes are associated with different craniofacial phenotypes. A total of 596 orthodontic and 98 orthognathic patients from 4 cities in Brazil were included for analyses. Angular and linear cephalometric measurements were obtained, and phenotype characterizations were performed. Genomic DNA was collected from buccal cells and single nucleotide polymorphisms in GHR (rs2910875, rs2973015, rs1509460) and IGF2R (rs2277071, rs6909681, rs6920141) were genotyped by polymerase chain reactions using TaqMan assay. Genotype-phenotype associations were assessed in the total sample (statistical significance was set at P<8.333×10-3) and by a meta-analytic approach implemented to calculate the single effect size measurement for the different cohorts. Rare homozygotes for the GHR rs2973015 showed increased measurements for the lower anterior facial height (ANS-Me) and mandibular sagittal lengths (Co-Gn and Go-Pg). In contrast, common homozygotes for the IGF2R rs6920141 presented reduced measurements for these dimensions (ANS-Me and Go-Pg). Furthermore, the less common homozygotes for IGF2R rs2277071 had reduced maxillary sagittal length (Ptm'-A'). The meta-analytical approach replicated the associations of rs2973015 with ANS-Me, rs2277071 with Ptm'-A', and rs6920141 with Go-Pg. Our results provide further evidence that GHR contributes to the determination of mandibular morphology. In addition, we report that IGF2R is a possible gene associated with variations in craniofacial dimensions. Applying meta-analytical approaches to genetic variation data originating from likely underpowered samples may provide additional insight regarding genotype and/or phenotype associations.

A Comparative Study on Use of Manual Versus Digital Method using Mobile Application for Cephalometric Measurements

Introduction: Various computer software and smartphone applications have been developed for digital cephalometric analysis with ease and in short time. The objective of this study was to compare linear and angular cephalometric measurements obtained, and cephalometric tracing duration between smartphone application tracing (app method) and conventional tracing (manual method) methods.&#x0D; Materials &amp; Method: 35 digital Lateral cephalometric radiographs of patient who came for orthodontic treatment were collected. Measurements of cephalometric parameters of composite analysis were obtained with manual and smartphone application (OneCeph) method and compared statistically. Cephalometric tracing duration was also compared between two methods.&#x0D; Result: Cephalometric tracing duration using manual method was found to be significantly higher (p&lt;.001) than that of the app method. There was no significant difference in values of SNA, SNB, ANB, Nasion perpendicular to point A, Nasion perpendicular to pogonion (pog), Angle of convexity, Go-GN/SN, FMA, U1–NA (degree), U1-NA (linear), L1–NB (degree), Cant of Occlusion, Interincisal angle, Nasolabial angle, Upper lip to Steiner’s S line, Lower lip to Steiner’s S line obtained with the manual and application method. The values of linear measurement between Lower incisor to NB line showed significant difference (p&lt;0.05).&#x0D; Conclusion: Although there was no significant difference in cephalometric measurement, cephalometric tracing duration of cephalometric analysis using Smartphone application was significantly faster than that of conventional method.

The effect of facemask in patients with unilateral cleft lip and palate: a systematic review and meta-analysis.

Patients with cleft lip and palate usually present a Class III skeletal pattern. Facemask (FM) is one of the conventional orthodontic treatment modalities used to address the skeletal discrepancy in cleft patients. To investigate the potential effectiveness of FM in unilateral cleft lip and palate (UCLP) patients. Search without restrictions except language in seven databases since inception and hand searching until January 2019 was conducted. Detailed search strategies were developed for each database which were based on the PubMed strategy and adapted accordingly. Controlled studies assessing the effect of FM in UCLP patients were to be included. After retrieval and selection of the studies, data extraction was performed. Both angular and linear cephalometric measurements were collected. Weighted mean differences (WMDs) and 95% confidence intervals (CΙs) between treated and untreated UCLP patients concerning the pre- and post-treatment angular measurements of each group were calculated using a random-effects meta-analysis model. The risk of bias in individual studies was assessed using the ROBINS-I tool. From nine eligible studies, five were included in the meta-analysis investigating the use of FM in patients and controls with UCLP (with and without maxillary expansion). Statistically significant differences were evident for SNA/S-N-ss, SNB/S-N-sm, ANB/ss-N-sm, and SN-MP. FM was found to induce an increase of SNA (WMD = 2.12 degrees, 95% CI: 1.58 to 2.66), ANB (WMD = 4.17 degrees, 95% CI: 3.60 to 4.74), and SN-MP angles (WMD = 2.60 degrees, 95% CI: 1.10 to 4.10) and a decrease of SNB angle (WMD = -1.94 degrees, 95% CI: -2.48 to -1.40) in UCLP patients. Low to moderate heterogeneity was observed. They emerge due to risk of bias, exclusion of non-English papers and methodological characteristics of the included papers. According to the available data, FM seems to improve the sagittal skeletal relationships in UCLP patients, increasing the SNA and ANB angles and decreasing the SNB angle. Moreover, in the vertical dimension, FM increases the SN-MP angle. Regarding dental measurements, there are controversial results. More high-quality studies need to be conducted in order to further clarify the impact of FM on UCLP patients. PROSPERO: CRD42019131619.

RELIABILITY OF 3-D-PRINTED MANDIBLES CONSTRUCTED FROM CONE BEAM CT VOLUMES OF DIFFERENT VOXEL SIZES

<h3>Background</h3> 3-D printing, also known as <i>additive manufacturing or rapid prototyping</i>, is a manufacturing process in which layers are sequentially added to create an object. 3-D printing is used in a wide variety of fields, ranging from dentistry and medicine to food manufacturing, toy manufacturing, house manufacturing, and automobile manufacturing and in the fashion industry. 3-D printed models can have a wide variety of uses in dentistry, ranging from anatomic models to surgical implants. <h3>Objective(s)</h3> The aim of the present study was to establish the reliability of linear cephalometric measurements made on mandibles and their respective 3-D printed models created from different voxel sizes in cone beam computed tomography (CBCT) scans. <h3>Study Design</h3> Ten dry mandibles were used for this study. All mandibles were scanned using the i-CAT FLX cone beam CT unit (Imaging Sciences International, LLC, Hatfield, PA) using voxel sizes of 0.30 mm, 0.25 mm, and 0.20 mm at 16 × 8 cm field of view and 360° rotation arc. The 3-D models were reconstructed and saved as STL files using 3-D Slicer software and sent to a 3-D printer for printing. Two observers measured the 10 mandibles and 30 3-D printed models. The measurements were repeated on 50% of the samples after at least 1 week. Cronbach's alpha and intraclass correlation coefficient were calculated to measure reliability. <h3>Results</h3> Good to excellent interobserver and intraobserver reliability were achieved across most of the measurements. There was no difference in reliability across models made from different voxel sizes. <h3>Discussion/Conclusions</h3> The present study successfully showed that the reliability of measurements made on 3-D printed models of dry skull mandibles created using the fused deposition modeling technique with images of different voxel sizes from an iCAT FLX CBCT machine are valid, reproducible, and reliable and can be used for diagnostic and clinical purposes.

Clinical Investigation of Congenital Factor Affecting Craniofacial Morphology of Unilateral Cleft Lip and Palate in Japanese Patients

Objective: To evaluate the craniofacial morphology of Japanese patients with unilateral cleft lip and palate and to evaluate the multiple congenital factors that affects craniofacial morphology in unilateral cleft lip and palate patients. Material and Methods: Lateral cephalograms of 140 subjects with unilateral cleft lip and palate were taken before any orthodontic treatment and alveolar bone graft. Subjects mean age was 6.85 ±1.56 years. Primary surgeries performed by surgeons from Hokkaido University Hospital. The craniofacial morphology of the 140 subjects was assessed by angular and linear cephalometric measurements. Gender, side of cleft, complete/incomplete type of cleft, presence/absence of lateral incisor in the affected side, family history of cleft and family history of skeletal Class III was chosen as congenital factors. To compare the assessments using congenital factors affecting craniofacial morphology in the unilateral cleft lip and palate subjects, angular and linear cephalometric measured values from each individual subject (control group) were converted into Z scores in relation to the means and standard deviation of the two parameters. Results: Twelve out of 13 craniofacial morphology outcomes were insignificant in 5 out of 6 dependent variables. Only 1 dependent variable showed 3/13 significant differences. Conclusion: Current study revealed the evidence that there were almost no significant differences in the craniofacial morphology outcome among various congenital factors. This will provide base line information and help determine the effectiveness of such factors.

Calibration Factor for Conventional Linear Cephalometric Measurements

Calibration Factor for Conventional Linear Cephalometric Measurements

Relationship between sella turcica bridging and cephalometric parameters in adolescents and young adults.

Sella turcica bridging occurs with fusion or calcification of the anterior and posterior clinoid processes in the middle cranial region. This study aimed to compare the cephalometric parameters among normal shape, partial bridge, and total bridge of the sella turcica in adolescent and young adult subjects. This retrospective study was performed on the lateral cephalometric radiographs of 410 Turkish adolescent and young adult subjects. The subjects were divided into three groups: normal sella turcica shape (128 females, 32 males; mean age: 17.7 ± 1.54years), partial sella turcica bridge (129 females, 32 males; mean age: 17.8 ± 2.15years), and total sella turcica bridge (66 females, 23 males; mean age: 18.2 ± 1.82years). Thirteen angular and eight linear cephalometric measurements were performed using a cephalometric software program. The data were analyzed by one-way analysis of variance, and the Kruskal-Wallis test with the Bonferroni correction. Significant differences were found for Nperp-A distance, Nperp-Pg distance, and palatal plane-to-anterior cranial base angle among the groups (p < 0.016). There were no significant differences in the cephalometric parameters between the partial and total sella turcica bridging groups (p > 0.05). This study evaluated a large amount of data for cephalometric measurements focusing on the degree of calcification of the sella turcica in adolescent and young adult subjects. The maxilla and mandible were located in a sagittally retrusive position in the partial and total sella turcica bridge subjects compared with the normal sella turcica shape subjects.

A Study on the Evaluation of Pharyngeal Size in Different Skeletal Patterns: A Radiographic Study

The aim of this study was to evaluate the upper and lower pharyngeal airway dimensions were affected by different skeletal malocclusions. Lateral cephalograms of 120 subjects were used to measure the pharyngeal airway and were divided into three groups (each group included 40 subjects) according to ANB angle: Class I (ANB angle 2° ≤ ANB ≤ 4°), Class II (ANB angle(ANB ≥ 6°), and Class III (ANB angle ≤ 0°). Various linear cephalometric airway measurements (14 measurements) were used to evaluate pharyngeal airway at various levels. Statistical analyses were performed Using the ANOVA and student t-test. PNS-ppwl (p < 0.001) and McNamara' lower pharynx dimension (p < 0.05) showed a statistically significant difference between the groups. Two out of 14 variables ie Ba-PNS and t-ppw showed a statistically significant difference between male and female. In both measurements, the difference is significant only in the Class II group with the level of significance being (p < 0.001) in Ba-PNS measurement, and (p < 0.05) in t-ppw measurement. In both measurements males have statistically significant higher mean values than the females. The dimensions of pharyngeal structures were not affected by the changes of the ANB angle. The sagittal skeletal pattern does not seem to influence the variations in the upper airway dimension. There was no significant difference in the dimensions of pharyngeal structures among males and females. The upper and lower pharyngeal airway dimensions are affected by different skeletal malocclusions can significantly aid in Orthodontic treatment planning.

Craniofacial cephalometric morphologies in different cleft types: a retrospective cross-sectional study of 212 patients.

The aim of this study was to evaluate and compare the craniofacial cephalometric morphologies among different cleft types in a Spanish population. A retrospective cross-sectional study was carried out on 212 patients. The patients were subdivided into four groups according to their cleft types: unilateral cleft lip and palate; bilateral cleft lip and palate; cleft lip; and cleft palate. Angular and linear cephalometric measurements were taken on lateral radiographs. Unilateral cleft lip and palate was associated with a dolichofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Bilateral cleft lip and palate was associated with a mesofacial growth pattern, skeletal Class I with protruded maxillary position, and lingual incisor inclination. Cleft palate was associated with a mesofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Cleft lip was associated with a brachyfacial growth pattern, skeletal Class I with protruded maxillary position, lingual upper incisor inclination, and corrects lower incisor inclination. Significant correlations were observed between cleft types and their craniofacial cephalometric measurements. The present information can be used for the determination of orthodontic treatment and even future orthognathic surgery planning, a requirement in most cleft patients.

Changes in the craniofacial complex and alveolar bone height of young adults: Applications to dental medicine.

The few studies on craniofacial complex changes in adults have reported contradictory findings. The aim of this study was to radiographically evaluate changes in the craniofacial complex and alveolar bone height of young adults over a 4-year period. This prospective study included 82 young adults (62 men; mean age, 19.0 ± 0.8 years; 20 women; mean age, 18.8 ± 0.9 years). Three radiographic examinations were performed longitudinally: the first (T0) was conducted at the start of the study, the second (T1) was conducted 2 years later, and the third (T2) was conducted at the end of the study period. As part of these examinations, lateral cephalograms, maxillary and mandibular anterior periapical radiographs, and bilateral posterior bitewing radiographs were obtained. During the 4-year follow-up period, all linear cephalometric measurements were significantly greater in men than in women. The amount of increase in the anterior facial height between T1 and T2 was lower in women than in men (P = 0.029). The rate of uprighting of the upper incisors was lower in men than in women over time (P = 0.020). The apex of the nose moved inferiorly between T0 and T2 (P = 0.006). The average overall change in the alveolar bone height was 0.27 mm and the yearly change was 0.07 mm over the 4-year period (P< 0.001). Significant changes in the skeletal, dental, and soft tissue, as well as, natural changes in alveolar bone, occur in young adults over time. Clin. Anat. 29:1011-1017, 2016. © 2016 Wiley Periodicals, Inc.

Sex determination using discriminant function analysis in Indigenous (Kurubas) children and adolescents of Coorg, Karnataka, India: A lateral cephalometric study.

Aim: To test the validity of sex discrimination using lateral cephalometric radiograph and discriminant function analysis in Indigenous (Kuruba) children and adolescents of Coorg, Karnataka, India. Methods and materials: Six hundred and sixteen lateral cephalograms of 380 male and 236 females of age ranging from 6.5 to 18 years of Indigenous population of Coorg, Karnataka, India called Kurubas having a normal occlusion were included in the study. Lateral cephalograms were obtained in a standard position with teeth in centric occlusion and lips relaxed. Each radiograph was traced and cephalometric landmarks were measured using digital calliper. Calculations of 24 cephalometric measurements were performed. Results: Males exhibited significantly greater mean angular and linear cephalometric measurements as compared to females (p < 0.05) (Table 5). Also, significant differences (p < 0.05) were observed in all the variables according to age (Table 6). Out of 24 variables, only ULTc predicts the gender. The reliability of the derived discriminant function was assessed among study subjects; 100% of males and females were recognized correctly. Conclusion: The final outcome of this study validates the existence of sexual dimorphism in the skeleton as early as 6.5 years of age. There is a need for further research to determine other landmarks that can help in sex determination and norms for Indigenous (Kuruba) population and also other Indigenous population of Coorg, Karnataka, India.

Skeletal Stability of Orthognathic Surgery: A Comparison of Patients Over and Under 40 Years of Age

Orthognathic surgery is the treatment of choice for correction of dentofacial deformities secondary to jaw size discrepancies and asymmetries. Although patients have been typically in the second or third decade of life, there has been a noted increase in patients$40 years of age undergoing orthognathic surgery. 2 In general, these older patients seek treatment to manage severe malocclusion or obstructive sleep apnea.Skeletal stability and other surgical outcomes are not well documented in this group. The purpose of this study is to compare skeletal stability following maxillary and mandibular advancement procedures in patients over and under 40 years of age. This was a retrospective cohort study of all patients who underwent maxillary or mandibular advancement procedures at Massachusetts General Hospital from 2004-2012. Subjects were included if preoperative, postoperative and 1 year (+/2 months) postoperative lateral cephalograms were available. Subjects were excluded if they underwent a setback or non-conventional orthognathic surgery procedures (eg, osteotomies for distraction osteogenesis, condylar reconstruction) or had a diagnosis of hemifacial microsomia, craniofacial microsomia, or other craniofacial syndromes or incomplete records. Demographic variables including age and gender, and type(s) of procedures performed were documented. The predictor variable was age over or under 40 years. The outcome variable was skeletal stability measured via standard linear and angular cephalometric measurements taken preoperatively (T0), immediately postoperatively (T1), and at 1 year follow-up (T2). Skeletal and dental movements were also quantified in the vertical and horizontal planes by assessing changes in position of A point, B point, U1 tip, and L1 tip. Statistical comparisons were performed using Student’s t-test. During the study period a total of 139 subjects (25 subjects $ 40) had adequate radiographic records and were included. Procedures included: One piece Le Fort 1 osteotomy (53 subjects, 7 subjects $40), bilateral sagittal