Mandibular Dimensions Research Articles

Comparative Evaluation of Adenoids, Upper Airway, and Tongue Using “Predictors of Difficult Airways” in Class II Division 1 and Division 2 Cases with Class I Cases: Prospective In Vivo Observational Study

Introduction: Altered nasorespiratory function leads to altered craniofacial growth. Thus, airway evaluation is important for preventive, interceptive, and corrective orthodontic treatment. The aim of this study was to evaluate and compare adenoids, the upper airway, the tongue, and mandibular dimensions using “predictors of difficult airways” in class II division 1 and class II division 2 cases with class I cases. Method: Sixty subjects of age 15 to 18 years were divided into 3 groups (group 1: class I cases; group 2: class II division 1 cases; and group 3: class II division 2 cases) based on cephalometric parameters, with 20 cases in each group. Cephalometric evaluation of adenoids and the nasopharyngeal airway was done using the Handelman–Osborne area method. Upper and lower airway evaluation was done using McNamara’s linear method. “Predictors of difficult airways” were used for evaluation of the airway, which included nasal competency, the Mallampati scale, mandibular length, mandibular protrusion, and the thyromental distance. Results: The present study found a significant positive correlation between the grades of nasal competency and percentage adenoid wall area, and a significant negative correlation between the grades of nasal competency and the upper airway. There was a significant positive correlation between the grades of nasal competency and mandibular length, and a significant positive correlation between the grades of mandibular protrusion and mandibular length. There was a significant positive correlation between the grades of the thyromental distance and mandibular length. Conclusion: It was concluded that the “predictors of difficult airways” would be helpful in early diagnosis and identification of potential risk factors that may cause “breathing disorders”–related malocclusions and later on increase the risk of developing OSA.

Mandibular advancement with clear aligners in the treatment of skeletal Class II. A retrospective controlled study.

The current study aimed to analyse the dentoskeletal effects of the Invisalign mandibular advancement (MA) device in the treatment of skeletal Class II malocclusions. Pre-treatment and post-treatment lateral skull radiographs from patients treated with MA versus TB (Twin-Block Appliance) at the Department of Orthodontics of the University of L'Aquila, Italy, were traced. Eligibility criteria included SNB<78; ANB>4; no previous orthodontic treatments; and vertebral maturation stage (CVM) CS3. Radiographs from patients with craniofacial anomalies, or who underwent extraction treatments, were excluded. Totally, 20 patients were examined, 10 of whom treated with MA and 10 treated with TB. All the radiographs were traced by one expert operator, blind to the groups. A preliminary method error study was performed to exclude intra-operator differences. Baseline characteristics of the participants were similar between the groups. Both appliances demonstrated a reduction of SNB and ANB angle, and a decrease in overjet. TB demonstrated a higher efficacy in increasing mandibular dimensions. A significant retroinclination of the upper incisive was observed in the TB group, where a decrease of SNA angles was additionally observed. The resulting differences between the two groups could be attributed to the different design of the appliances. The present data show the effectiveness of both TB and MA in the management of skeletal Class II malocclusions due to mandibular retrusion. But some differences exist in the dentoalveolar effect of the two appliances. MA seems indicated in Class II cases where a control of the upper frontal teeth position is needed.

COMPREHENSIVE EVALUATION OF FACTORS LEADING TO CLASS III SUBDIVISION MALOCCLUSION USING 3-D CBCT

Introduction:Several studies have been conducted to assess skeletal and dental asymmetry on Class II subdivision cases but no studies have yet been published to assess such asymmetries for patients with Class III subdivision malocclusion. The purpose of the study was to assess the maxilla-mandibular dimensional and positional asymmetry along with asymmetry at glenoid fossa level and to find out true dental asymmetry at molar and canine level in class III subdivision malocclusion. Materials and Methods: A split mouth prospective study was conducted on Angles Class III subdivision malocclusions (n=15) and CBCT scans were analyzed with 3-D Dolphin software. 3-D and 2-D measurements were recorded to assess asymmetry between class I and class III sides. 2-D measurements were recorded to assess the position of glenoid fossa, joint spaces and condyle dimension, position and their angulation. Results: Statistically significant differences were found in glenoid fossa depth, position of the maxilla, mandible, as well as in gonial angle. Statistically significant dental differences were also found for the position of the mandibular first molars and canines along with total asymmetry (combined skeletal and dental) in maxilla and mandible. Conclusions: The components contributing to Class III subdivision malocclusion were multifactorial involving glenoid fossa asymmetry, positional asymmetry in maxilla and mandible. Mandibular dimensions were more on class III side but it was not statistically significant. True dental asymmetry was also foundin mandible along with total asymmetry in maxilla and mandible.

The Hypoplasic Mandible: What Makes it Different From the Healthy Child?

This study aimed to analyze the morphology of the hypoplasic mandible and its evolution during the growth period to better understand how it differs from the pediatric healthy mandible. Three-dimensional mandibular models of hypoplasic and healthy children aged from 39 gestational weeks to 7 years old were analyzed with a morphometric method including data clustering. Morphological distinctions between pathological and healthy mandibles were highlighted. Bilateral and unilateral mandibular hypoplasia were distinguished. The study sample was composed of 31 hypoplasic children and as many sex- and age-matched healthy children. Morphological distinctions between pathological and healthy mandibles were highlighted only from the first year of life. In bilateral hypoplasia, the overall mandibular dimensions were reduced while there was only a ramus asymmetry in unilateral mandibular hypoplasia (mean ± SD of the difference between the Grp03c and Grp03b subgroups: 6.80 ± 6.37 - P value = 1.64e-3 for the height of the left ramus versus 0.18 ± 4.18 - P value = .82 for the height of the right ramus). Supervised classification trees were built to identify the pathology and discriminate unilateral from bilateral mandibular hypoplasia (prediction rates = 81% and 84%, respectively). Based on a morphometric analysis, we demonstrated that mandibular hypoplasia significantly impacts the mandibular morphology only from the first year of life, with a distinction between bilateral and unilateral hypoplasia.

Estimation of the mandibular dimensions from linear cranial measurements for use in craniofacial reconstruction: A preliminary study.

A missing mandible is a common problem in facial identification cases requiring forensic facial approximation or reconstruction. The Sassouni and Sassouni-Plus methods which are currently used to predict the missing mandible from the cranium produce low levels of accuracy. This study proposes a new method for the estimation of the overall dimensions of the mandible based upon linear cranial measurements, the proposed method has the potential to be utilised in the facial reconstruction of a range of adult skulls with dentition. 21 measurements were taken from a sample of 90 skulls, 44 male, 43 female and three juvenile, originating from 9 different geographical areas. Ordinary least-squares regression, hierarchical cluster analysis and analysis of variance (ANOVA) were used to investigate trends in the data and to produce equations for the estimation of condylar height, corpus length and anterior height. When tested the equations produced an overall mean error of 0.09mm with a standard deviation of ±4.84. The proposed method offers an improvement upon the currently used methods. It can be used to estimate the overall mandibular dimensions with a good level of accuracy.

The Middle Pleistocene hominin mandible from Payre (Ardèche, France)

Although Neandertals are the best-known fossil hominins, the tempo and evolutionary processes in their lineage are strongly debated. This is in part due to the scarcity of the fossil record, in particular before the marine isotopic stage (MIS) 5. In 2010, a partial hominin mandible was discovered at the Middle Paleolithic site of Payre (France) in a layer that is dated to the end of MIS 8/beginning of MIS 7, a time period for which very few fossils are known in Europe. The Payre 15 mandible retains the complete symphyseal region and right lateral corpus with heavily worn P4, M1, and M2 in situ. Taphonomic modifications in the form of three notches suggest that this individual was chewed by a carnivore. We provide here the first detailed description of this specimen and a comparative analysis that includes morphological features, linear mandibular dimensions, an elliptic Fourier analysis of the symphysis, and a morphometric analysis of the M1 roots (based on segmented CT scan data). Our comparative sample encompasses European Middle and Upper Pleistocene specimens attributed to Homo heidelbergensis and Homo neanderthalensis, Upper Pleistocene Homo sapiens, and Holocene Homo sapiens. The Payre 15 mandible shows a combination of primitive and Neandertal-like features, with a receding symphyseal profile without any element of the mentum osseum, a posterior location of the mental foramen and lateral prominence. Its mandibular body is tall and thick anteriorly. Payre 15 has mesotaurodont M1 roots and a three-rooted M2. By its dimensions and combination of features, Payre 15 aligns better with Middle Pleistocene European hominins than with MIS 6–3 Neandertals. Noteworthy, it falls well within the range of variation of the Sima de los Huesos sample. Our results underscore that the total pattern of Neandertal-derived morphology was not achieved at the beginning of the MIS 7 and suggest a low level of mandibular diachronic changes for the period MIS 11–7.

Primary Retention of Molars and RANKL Signaling Alteration during Craniofacial Growth.

The primary retention of molars observed in clinic corresponds to a still-unexplained absence of molar eruption despite the presence of an eruption pathway, resembling the experimental transient inhibition of RANKL signaling in mice. The aim of the present study was to confront the hypothesis according to which the primary retention of molars is associated with transitory perturbations to RANKL signaling during growth as part of a wider craniofacial skeleton pattern. The experimental strategy was based on combining a clinical study and an animal study corresponding to the characterization of the craniofacial phenotypes of patients with primary retention of molars and analyses in mice of the consequences of transient inhibition of RANKL signaling on molar eruption and craniofacial growth. The clinical study validated the existence of a particular craniofacial phenotype in patients with primary retention of molars: a retromandibular skeletal class II typology with reduced mandibular dimensions which manifests itself at the dental level by a class II/2 with palatoversion of the upper incisors and anterior overbite. The animal study demonstrated that transient invalidation of RANKL signaling had an impact on the molar eruption process, the severity of which was dependent on the period of inhibition and was associated with a reduction in two craniofacial morphometric parameters: total skull length and craniofacial vault length. In conclusion, primary retention of molars may be proposed as part of the craniofacial skeleton phenotype associated with a transitory alteration in RANKL signaling during growth.

Sexual Dimorphism in Mandibular Canine Crown Dimensions in Early Adolescents: A Hospital based Study

Sexual Dimorphism in Mandibular Canine Crown Dimensions in Early Adolescents: A Hospital based Study

Patient-Specific Mandibular Reconstruction Plates Increase Accuracy and Long-Term Stability in Immediate Alloplastic Reconstruction of Segmental Mandibular Defects

ObjectivesThe aim of the current study was to evaluate potential differences in the accuracy of mandibular reconstruction and long-term stability, with respect to different reconstructive procedures.MethodsIn total, 42 patients who had undergone primary segmental mandibular resection with immediate alloplastic reconstruction, with either manually pre-bent or patient-specific mandibular reconstruction plates (PSMRP), were included in this study. Mandibular dimensions, in terms of six clinically relevant distances (capitulum [most lateral points], capitulum [most medial points], incisura [most caudal points], mandibular foramina, coronoid process [most cranial points], dorsal tip of the mandible closest to the gonion point) determined from tomographic images, were compared prior to, and after surgery.ResultsDimensional alterations were significantly more often found when conventionally bent titanium reconstruction plates were used. These occurred in the area of the coronoid process (p = 0.014). Plate fractures were significantly (p = 0.022) more often found within the manually pre-bent group than within the PSMRP group (17%/0%).ConclusionThe results suggest that the use of PSMRP may prevent rotation of the proximal mandibular segment, thus avoiding functional impairment. In addition, the use of PSMRP may potentially enhance the long-term stability of alloplastic reconstructions.

Comparison of cephalometric measurements of living subjects and ancient skulls in Anatolia

Aim: This study aims to provide insights into the evolutionary adaptation of human, via comparing the craniofacial characteristics of living subjects and ancient skulls from Anatolia. Material and Methods: Cone-beam computed tomography (CBCT) generated 2D cephalometric projections of 32 ancient skulls and well matched lateral cephalometric images of 32 patients were evaluated. Sixteen widely used cephalometric measurements were performed. Intra-class correlation coefficients were used to examine intra-observer reliability. Mann–Whitney tests and chi-square tests were used to compare cephalometric measurements of the groups.Results: The linear measurements of living subjects were smaller than the linear measurements of ancient skulls (p0.05). Significant differences were found between the groups in the cranial base lengths, maxillary and mandibular dimensions (p0.05). The maxilla and mandible were found more prognathic in ancient men and women (p0.001).Conclusion: Environmental factors and genetic changes lead to a reduction in the sagittal and vertical dimensions of the human craniofacial complex. Dental practitioners should consider these evolutionary changes during the treatment planning process.

The correlation between cervical vertebral maturation and mandibular dimensions in children aged 8-16 years: study on children’s population in Jakarta, Indonesia

The correlation between cervical vertebral maturation and mandibular dimensions in children aged 8-16 years: study on children’s population in Jakarta, Indonesia

Three-dimensional assessment of transverse dentoskeletal mandibular dimensions after utilizing two designs of fixed mandibular expansion appliance: A prospective clinical investigation.

The aim of this clinical study was to evaluate and compare the dentoskeletal transverse mandibular arch dimensions following the use of two designs of fixed mandibular expanders using cone beam computed tomography (CBCT). Twenty orthodontic patients, 12 females and 8 males, with mean age of 13.4 ± 0.5 years were selected and randomly divided into two equivalent groups; group A consisted of 10 patients (4 boys, 6 girls) who were treated with modified Williams expander and group B consisted of 10 patients (4 boys, 6 girls) who were treated with a two-arm fixed expander. Consistent expansion instructions were given to all patients according to a standardized slow protocol of one quarter turn twice/week for both expanders. Routine orthodontic records as well as mandibular CBCTs were obtained before (T1) and immediately after expansion (T2) to estimate changes in dentoskeletal mandibular transverse dimensions. The data was statistically analyzed and the significance level was set at p ≤ 0.05. Mandibular intercanine, inter-premolar, intermolar widths; and arch perimeter were significantly increased (p ≤ 0.05) following expansion with both fixed expanders. However, the changes in inter-premolar width, intercanine width, and arch perimeter were significantly augmented in two-arm fixed expander group than modified Williams’s group. In contrast, their effects on the skeletal mandibular body width were non-significant (p > 0.05). Both expanders yielded significant and equivalent dentoalveolar effects that were more evident with two-arm fixed expander than the William one. Both fixed designs enhanced mandibular transverse dental dimensions; however, they were unsuccessful to create any considerable skeletal effects.

Comparative morphology and trophic ecology in a population of the polymorphic lizard Sceloporus minor (Squamata: Phrynosomatidae) from central Mexico.

Polymorphism among individuals of the same population has generally been linked to alternative reproductive tactics, where different morphs can exhibit differences in their morphological, ecological, and behavioral attributes. These differences may result in a divergence in diet between morphs due to differential exploitation of habitat, morphological differences that influence prey selection, or differential energy expenditure that results in different nutritional needs. The present study analyzes the morphology (morphometry and body mass) and diet of red and yellow male morphs in a population (El Enzuelado) of the lizard Sceloporus minor from central Mexico. No differences between morphs were found for any of the morphometric variables analyzed (snout-vent length, tail length, jaw length, jaw width, head length, head width, head height, tibia length, femur length, forearm length and ventral patch length). In both morphs, allometric growth was observed in all body features analyzed, as well as in morphometric features of the head across seasons. Analysis of stomach contents showed that the diet of red males was composed of 12 categories of prey, while that of yellow males was composed of 10 categories; those categories of diet not shared between morphs (e.g., Isoptera, Psocoptera) were consumed by their respective morph in very low proportions. Categories of diet with the highest values of food importance for both groups were Coleoptera, Orthoptera, and leaves; a similar pattern was seen across seasons. This, in turn, is reflected in low niche breadth values for each morph and a very high niche overlap. There were no significant differences between morphs overall, or between morphs per season, in the weight and volume of stomach contents or in the number of prey items found in stomachs; however, differences in these variables across all males (independent of morph) were recorded between seasons. Likewise, no significant correlations were found between body size (snout-vent length) and the volume of stomach contents for either morph or between lizard mandibular dimensions and the volume of stomach contents for red morph males. For the yellow morph, prey volume unexpectedly decreased significantly with jaw size rather than increasing as expected. Overall, this study adds new information about the morphology and feeding of males in this species, and suggests that in this population, color morphs lack the morphological and ecological differences found in some other species of polymorphic lizard.

Does Gender Have an Effect on Craniofacial Measurements?

The aim of this cross-sectional study was to evaluate craniofacial structures in terms of different sagittal relations and gender in adolescent individuals. Pre-treatment dental models, lateral cephalometric, and hand-wrist radiographs of 223 adolescent subjects (102 male, 121 female) were evaluated. Subjects were divided into the Angle Class I, II, and III (skeletally) subgroups according to the ANB angle. Four angular and 33 linear measurements were used to evaluate the lateral cephalometric radiographs relative to the R1 and R2 coordinate system. The Kolmogorov-Smirnov test was performed to assess the normal distribution of the data. The independent samples t-test and Mann-Whitney U test were used for the comparison of male and female subjects in each group. The values were considered statistically significant at p<0.05. The vertical facial dimension was found to be significantly greater in Class I male subjects than in female subjects (SGo, p=0.023; ANS-M, p=0.036), and there was a protrusive maxilla (R2ANS, p=0.038; R2A, p=0.016), while the mandibular sagittal position and the mandibular dimension were similar. The maxilla was placed protrusively (R2ANS, p=0.001; R2A, p=0.002), while the mandible was found to be larger both in the position and dimension (CoGn, p=0.003; R2M, p=0.014) in Class II male subjects. Class III male and female subjects were found to have similar maxillary and mandibular vertical and sagittal location and dimensions. Class I and II subjects showed more gender variation than Class III subjects. The gender-related results of this study declare that treatment planning of malocclusions should be based on gender differences rather than general treatment procedures, which will be useful in achieving successful orthodontic treatment results.

Analysing Cheiloscopic Pattern and Mandibular Canine Index for Gender Determination

Aim: To analyse the cheiloscopic pattern and mandibular canine index and assess their benefits for gender determination. Materials and methods: The study population comprised 100 subjects inclusive of 50 males and 50 females with an age range of 18-25 from Saveetha Dental College and Hospital. Lip print of each subject was obtained on a bond paper and analysed by Tsuchihashiclassification. Measurements made with a verniercalliperin mm at the contact point of mesiodistal width of the right and left canines and intercanine distance intraorally, and the mandibular canine index (MCI) was calculated. The results were subjected to statistical analysis. Results: The most predominant pattern in the entire study population was found to be Type I in females and Type IV in males with significant statistical values. It was also demonstrated that no two lip prints were found to match each other which proves that every individual has unique lip prints.Theintercanine distance, canine width, and canine index were greater in males compared to females indicating significant sexual dimorphism of mandibular canines. Conclusion: Significant sexual dimorphism occursin the pattern of mandibular canine among the males and females thereforecan be used to identify the gender of an individual.Among plethora methods of forensic identification, place for cheiloscopy is recommended within the scope of forensic odontology. Nevertheless, bigger representative sample with sturdy analytical tools can provide a necessary blueprint of human identification. The data of this study proves the occurrence of significant sexual dimorphism in mandibular canines. We can therefore, recommend the use of mandibular canine dimensions as an applicable and additional method for gender determination in human identification.

ANALISIS PENGGUNAAN TWIN BLOCK PADA PERAWATAN MALOKLUSI DENTOSKELETAL KELAS II DIVISI 1 DISERTAI RETROGNATI MANDIBULA BERDASARKAN CERVICAL VERTEBRAL MATURATION STAGE

Background:Class II division 1 dentoskeletal malocclusion with mandibularretrognatic can be treated with twin block appliance. The objectives of this studyare to analyse twin block appliance based on mandibular dimension and anteriorfacial height changes, and to determined the most effective time base on CVMSto begin the treatment.Method: The type of research was a retrospective analysis study usingsecondary data. The sample was 14 lateral cephalometric radiographs beforeand after treatment with twin block appliance. It was taken in IKGA RSGM FKGUNPAD 2010 to 2016. Statistic analysis used paired t-test.Results: Study shows that there is a significant change (p&lt;0.05) in mandibulardimension and anterior facial height after treatment with twin block appliance.Changes in mandibular dimension including total mandibular length, mandibularbody length, ramus height, and gonial angle. Changes in anterior facial heightincluding lower anterior facial height and total anterior facial height. The CVMSIII group showed statistically significant result with the biggest improvement.Conclusion: The use of twin block appliance in Class II division 1 dentoskeletalmalocclusion with mandibular retrognatic could change mandibular dimensionand anterior facial height. Apart from that, CVMS III was found to be the mosteffective time to start the treatment with twin block appliance

Volume Analysis a Novel Tool to Determine Mandibular Cyst Dimensions Using CBCT Technique

To evaluate a method of creating three-dimensional representations of mandibular cysts on the cone beam computed tomography (CBCT) data and the data obtained following the evaluation according to Archimede�s principle. A total of 10 mandible with different bone defects miming cysts took part in this study. CBCT scans were obtained from all mandibles and saved in the Digital Imaging and Communications in Medicine (DICOM) format. Data were analysed by two observers: a general dentist and a maxillofacial surgeon. The accuracy of the two methods in assessing cyst volume was compared. There are no major differences between the analysis performed on CBCT data and the real volume of the simulated cystic lesions. Also, there were found differences between the observers. Our results demonstrated the rehabilitee of CBCT scans and volume evaluation of the bone defects. In addition, this study may improve surgical planning and outcomes by knowing the exact volume of grafting material needed prior to the surgical intervention.

Comparison of Permanent Mandibular Molar Crown Dimensions between Mongolians and Caucasians

The aims of this study were to comparecrown dimensions of mandibular first molars (M1) andsecond molars (M2) between Mongolians (belonging tothe Khalkha-Mogol grouping) and Caucasians (NorthernEuropean ancestry) and to attempt to explain anyobserved differences in phylogenetic and ontogeneticterms. Materials in this study comprised dental casts of48 Mongolian female subjects with a mean age of 20.5years and 50 Caucasian female subjects with a mean ageof 21.5 years. For M1, the buccolingual diameters of bothmesial and distal crown components in Mongolianswere significantly larger than in Caucasians. For M2,the mesiodistal and buccolingual diameters of the distal crown components in the Mongolian samplewere significantly larger and the mesiodistal andbuccolingual diameters of mesial components weresignificantly smaller compared with those of Caucasians.Common environmental effects, possibly related to theprenatal environment, as well as genetic influences,may be contributing to the differences in buccolingualdimensions of M1 between Mongolians and Caucasians.Given that the M2 develops later and over a longerperiod of time than the M1, it is reasonable to assumethat this tooth may be subject to greater environmentalpressures than applied to the M1.

Contribution of the periosteum to mandibular distraction.

Mandibular distraction is a surgical process that progressively lengthens bone. To improve the distraction procedure and devices, the load of distraction and the mechanical strain of soft tissues during the process must be determined. We tested the assumption that it could be the periosteum primarily opposing distraction. Therefore we assessed the mechanical properties of the human mandibular periosteum and compared the stress-strain data with the torque measured on the activator during a cadaveric mandibular distraction. A 20 mm horizontal mandibular distraction was performed in 7 cadavers using standard distractors. Torque was measured with a torquemeter placed on the activation rods of the devices, providing a load (Lt) for each millimeter of distraction. In parallel, 18 periosteum samples were harvested from 9 cadaver mandibles. Uniaxial tensile tests were performed on the specimens and an estimated load (Lc) was calculated using periosteal stress-strain data and mandibular dimensions. During the distraction process, we observed an increase of the load Lt from 11.6 to 50.6 N. The periosteum exhibited a nonlinear viscoelastic stress-strain relationship, typical of biological tissues composed of collagen and elastin. The median Lc and Lt were not significantly different for the first millimeter of distraction. We demonstrated the periosteum is primarily responsible for opposing the distraction load.

Genetic polymorphism in RANK is associated with mandibular size.

The aim of this study was to evaluate the association between genetic polymorphisms in RANK, RANKL and OPG with maxillary and mandibular dimensions in humans. DNA extracted from saliva and the rs3826620, rs9594738 and rs2073618 polymorphisms in RANK, RANKL and OPG, respectively, were analysed by real-time PCR. Four linear measurements (Co-Gn, GoPg, Co-Go and PTM-A) from lateral cephalograms were examined for the evaluation of craniofacial measurements. ANOVA testing and a multivariate linear regression analysis, adjusted for age and gender, were used for statistical analysis, with an alpha of 5%. Hardy-Weinberg equilibrium was also evaluated using the chi-square test within each polymorphism. School of Dentistry of Ribeirão Preto, University of São Paulo. A total of 100 unrelated non-syndromic Brazilian Caucasian subjects were included in this study. The polymorphism in RANK was associated with a higher Go-Pg measurement (p = .039). In the multivariate analysis, adjusted for age and gender, the polymorphism in RANK was associated with Go-Pg (p = .017) and Co-Gn (p = .043). The polymorphism rs3826620 in RANK is associated with the mandibular size.