Sagittal Skeletal Malocclusions Research Articles

Pharyngeal width comparison in different skeletal malocclusions and growth patterns of Nepalese population

Context: Regarding the relationship between the size of the pharynx and several sagittal skeletal malocclusions and patterns of growth, contradictory findings have been documented. Aims: The intent of this research was to analyze the size of the pharynx in various sagittal malocclusions and growth patterns in the Nepalese population. Settings and Design: An analytic cross-sectional research was undertaken on patients who attended the Orthodontics Division of BPKIHS. Materials and Methods: A total of 135 patients’ lateral cephalometric radiographs were gathered. Medians and interquartile ranges of pharyngeal widths according to McNamara airway analysis and Arnett/Gunson FAB airway analysis adapted by Santiago et al. in different skeletal malocclusions and growth patterns were compared. Results: There was not any discernible statistically noteworthy variation within the upper pharynx size, lower pharyngeal width, nasopharyngeal width (WNP), oropharyngeal width, hypopharyngeal width (WHP), and deep pharyngeal width (WDP) in different skeletal malocclusions. A statistically significant variation was discovered in nasopharyngeal size (P = 0.010), hypopharyngeal size (P = 0.027), and deep pharyngeal size (P < 0.001) in various patterns of growth, i.e. hypodivergent versus normodivergent, and in hypodivergent versus hyperdivergent, not in normodivergent versus hyperdivergent group of patients. Conclusion: There was not anything statistically noteworthy variation in the pharyngeal widths of the participants with respect to the various skeletal malocclusions. WNP, WHP, and WDP showed a statistically significant variation between hypodivergent versus normodivergent and hypodivergent versus hyperdivergent growth patterns.

Craniocervical posture in patients with skeletal malocclusion and its correlation with craniofacial morphology during different growth periods

The association between craniocervical posture and craniofacial structures in the various sagittal skeletal malocclusion during different growth stages has been the focus of intense interest in fields of orthodontics, but it has not been conclusively demonstrated. Thus, this study aimed to investigate the association between craniofacial morphology and craniocervical posture in patients with sagittal skeletal malocclusion during different growth periods. A total of 150 from a large pool of cephalograms qualified for the inclusion and exclusion were evaluated and classified into three groups according to the Cervical Vertebral Maturation (CVM) by examining the morphological modifications of the second through fourth cervical vertebrae, each group consisted of 50 cephalograms. In each growth period, for the comparison of head and cervical posture differences among various skeletal classes, the radiographs were further subdivided into skeletal Class I (0° < ANB < 5°, n = 16), skeletal Class II (ANB ≥ 5°, n = 18), and skeletal Class III (0° ≤ ANB, n = 16) on the basis of their ANB angle. There was no significant difference in gender (P > 0.05). Some variables were found to be significant during pubertal growth and later in patients with sagittal skeletal malocclusion (P < 0.05). Most indicators describing craniocervical posture were largest in skeletal Class II and smallest in skeletal Class III during the peak growth periods and later. Cervical inclination variables were greater in skeletal Class III than in skeletal Class II. Variables of craniofacial morphology and craniocervical posture are more correlated during the pubertal growth period and later in patients with sagittal skeletal malocclusion. A tendency is an indication of the close interrelationship that a more extended head was in skeletal Class II while a flexed head was in skeletal Class III. Nevertheless, with the considerations of some limitations involved in this study, further longitudinal studies with large samples are required to elucidate the relationship clearly.

An evaluation of inter-relationship between cervical posture and skeletal malocclusions

Introduction: The growth pattern of the cervical spine and the craniocervical structure are interconnected, inflencing one another both morphologically and functionally. As a result, stretching the head in relation to the cervical spine leads to notable changes, including greater anterior facial height, a shorter sagittal dimension, and a posterior rotation of the jaw. This study was conducted to determine the correlation between cervical curvature in different sagittal skeletal malocclusions and association between cervical lordosis and maxillary and mandibular base. Materials and Method: One hundred fity adults presenting with skeletal Class I, II, and III malocclusion were investigated, irrespective of growth pattern. Three groups were delineated based on the lateral cephalograms of the selected participants: Group 1 (50 skeletal Class I), Group 2 (50 skeletal Class II), and Group 3 (50 skeletal Class III). A comprehensive assessment of cervical posture was conducted through the measurement of manually traced 15 specifi angles, which were carefully chosen to provide a detailed characterization of cervical variations across all three groups. Validity was assessed using Wilk and Kolmogorov-Smirnov tests, and analysis was done using One way Analysis of variance and Post hoc Turkey’s test. Result: Statistically signifiant correlations (P&lt;.05) were found between angles OPT/HOR and CVT/HOR (representing cervical inclination with reference to the true horizontal plane),NSL/CVT, and FH/CVT (indicating middle craniocervical posture), NSL/RL, FH/RL, and NL/RL(reflcting rotation of mandibular ramus). Conclusion: It was proven that changes in head posture and craniofacial development are strongly correlated. The rotation of the mandibular ramus in relation to the cranium was compared between groups, and was found that skeletal Class II malocclusion subjects had more posterior rotation of the ramus in relation to the cranium and extended head compared to those with skeletal Class III and skeletal Class I malocclusion subjects.

Evaluation of safe areas for miniscrew use according to various skeletal anomalies with CBCT.

We aimed to determine safe areas to apply miniscrews in the interradicular region of the maxilla and mandible in individuals with various sagittal skeletal malocclusions. Cone beam-computed tomography images of 159 individuals were used. Individuals were divided into three groups: Class I, Class II, and Class III. In the sagittal plane, 3-6-9-mm apical sections were determined from the alveolar crest apex. The buccal cortical bone thickness, interradicular distance, and buccolingual bone distances were measured. In the buccal cortical bone thickness, we observed statistically significant differences between the classes except for the 1-1 region in the maxilla and all regions and sections in the mandible (p < 0.05). The differences in the buccolingual bone distance between classes were statistically significant, except for the 3-mm and 6-mm sections in the 3-4 and 4-5 regions of the maxilla, the 9-mm sections in the 1-2 and 2-3 regions, the 6-mm and 9-mm sections in the 3-4 region, and the 6-mm section in the 4-5 regions of the mandible (p < 0.05). The differences in the interradicular bone distance were statistically significant between the classes in all regions and sections of the mandible except the 6-mm sections in the 1-2 region and in all sections of the maxilla except the 6-mm sections in the 3-4 region (p < 0.05). We observed significant differences in the buccal cortical bone thickness, interradicular bone distance, and buccolingual bone distance among individuals. Understanding the anatomy of interradicular regions and preventing complications.

Correlation of Sagittal Skeletal malocclusion and Growth patterns between Digital and Conventional Dermatoglyphics

Background: The craniofacial morphology and its growth pattern are determined by the influence of various environmental factors depending on the genetic background. Due to the close association of MSX 1 and SMARCAD gene on the same chromosome, it can be hypothesized that malocclusion and fingerprint pattern are related. Furthermore, it is observed that the orofacial structures originate from the same embryonic tissue as the epidermal ridges, which are the ectoderm. Thus, the simultaneous development of the epidermal ridges and the orofacial structure during this time is deciphered and reflected in the fingerprint patterns.&#x0D; Aim: This study aimed to analyse, compare, and correlate the fingerprint patterns of individuals with different skeletal malocclusions and growth patterns using manual and digital methods.&#x0D; Materials and Methods: Patients (a random sample of 544) who were undergoing orthodontic treatment and were able to give informed consent were included in the study. Informed consent was obtained prior to the start of the procedure, with due regard to ethical issues and the confidentiality of fingerprint records. The anteroposterior jaw relation was determined from the patient's lateral cephalogram with evaluation of the parameters: SNA, ANB, SNB and growth patterns are determined using the mandibular plane angle according to Steiners analysis, the nature of the growth patterns, i.e., horizontal (HGP), Average (AGP) and vertical (VGP) growth pattern.&#x0D; Results: Individuals with loop patterns had a frequency of skeletal class I malocclusion, Whorl patterns with skeletal class II malocclusion, and Arch patterns with skeletal class III malocclusion. Consistent with the growth patterns, the whorl pattern was seen more prominently in the horizontal growth pattern, Arch pattern in the average growth pattern, and the loop pattern in the vertical growth pattern.&#x0D; Conclusion: Thus, the dermatoglyphics can be used as a screening tool for early prediction of skeletal malocclusion in a younger age group.

THREE-DIMENSIONAL EVALUATION AND COMPARISON OF CONDYLE-FOSSA RELATIONSHIP, THEIR POSITION AND SYMMETRY USING CBCT IN VARIOUS SAGITTAL SKELETAL MALOCCLUSIONS

Introduction: Three-dimensional evaluation and comparison of condyle-fossa relationship, their position and symmetry using CBCT in various sagittal skeletal malocclusions. Aims and Objectives: To evaluate and compare the size and morphology of right and left fossa and condyle, condyle-fossa relationship, position and symmetry in various malocclusions. Materials and Methods: Sixty eight subjects with a mean age of 18.2±3.5 years, were divided into three sagittal Skeletal malocclusion (Class I,Class II. Class III) groups. 15 Linear and 2 Angular variables were evaluated from the CBCT images obtained from Carestream CS 9300C 3D system. The digitization and measurements were carried out using Trophy Dicom CS 3D software. Statistical Analysis: Independent t test and Karl Pearsons coefficient of correlation. Results: On comparison between the Right and Left sides, Angle Md.Co.Pro-MS Plane in Group I (p=0.007**)and C.Co-MS Planein Group II (p=0.047*)was significant. On Comparison of Concentric positioning of condyles, the mean differences in Group II on the Right side (p =0.039 *) and on the Left side (p =0.004**) were significant. Conclusion: In Skeletal Class I malocclusion, width and height of condyle was increased on the left side. Anterior joint space was decreased significantly in Skeletal Class II malocclusion. Superior joint space was significantly decreased and width of mandibular fossa was increased on both the sides in Skeletal Class III malocclusion. The condyles were anteriorly placed in all skeletal malocclusions but greatest difference was present in Class II.

INCISIVE CANAL AND ITS PROPINQUITY TO MAXILLARY CENTRAL INCISORS IN VARIOUS SAGITTAL GROWTH PATTERNS: A CBCT STUDY

Aim: To evaluate and compare the position of the incisive canal to maxillary central incisors root using CBCT among subjects with different sagittal growth patterns. Materials and Method: Seventy subjects with ages ranging from 18 to 45 years were divided into three sagittal Skeletal malocclusion groups. 6 linear variables were measured from the CBCT images obtained from the Carestream CS 9300C 3D system which included 3 transverse and 3 anteroposterior measurements. All measurements were carried out at three different vertical levels, the palatal opening of the incisive canal (L1), mid-level (L2), and root apex of the maxillary central incisors (L3). The digitization and measurements were carried out using Trophy Dicom CS 3D software. Results: Greatest incisive canal width (Cl-Cl) was seen in Skeletal Class III malocclusion and smallest in Class II malocclusion. Skeletal Class III malocclusion showed significantly smaller inter-root distance than Class I and Class II. In Class I malocclusion, the average anteroposterior distance between incisive canal and maxillary central incisor roots was approximately 4-5mm, 2-4mm in Class II, and 3-4mm in Class III malocclusion. Conclusion: The incisive canal and its association to the roots of the maxillary incisors are affected by the various sagittal skeletal malocclusions. In order to minimise difficulties while contemplating a substantial amount of retraction, 3D assessment may be helpful.

Investigation of the Relationship between Sagittal Skeletal Nasal Profile Morphology and Malocclusions: A Lateral Cephalometric Film Study.

The aim of this study was to evaluate the relationship between skeletal sagittal nasal profile morphology and sagittal skeletal malocclusions. Regarding lateral cephalometric films, the study was conducted in a total of 135 individuals without any prior orthodontic treatment (mean age of 17.91 ± 1.91), including 49 males (mean age 17.91 ± 1.16) and 86 females (mean age 17.78 ± 1.91 years). The groups were divided into two groups as male and female according to gender, and three groups as skeletal Class 1, Class 2, and Class 3 according to the Steiner's ANB angle. In addition, skeletal groups were compared within groups by dividing into two groups of male and female. A total of eight parameters, three skeletal sagittal angular (SNA, SNB, and ANB angles), four nasal linear (R-A, N-A, N-ANS, and N-R distances) and one nasal angular (N1-N2/N2-R angle), were measured on each cephalometric film. The arithmetic mean and standard deviation of all measured nasal parameters were calculated. For statistical analysis, independent sample t-test and one-way analysis of variance (One-Way ANOVA) were used for normally distributed data, and Mann Whitney U and Kruskal Wallis tests were used for data that did not show normal distribution. For statistical analysis, p < 0.05 was considered significant. R-A, N-A, and N-ANS linear nasal parameters differed significantly between the male and female groups, which were evaluated regardless of the skeletal groups, with a higher rate in males (p < 0.05). N-R linear nasal parameter showed a statistically significant difference between skeletal malocclusion groups, which were evaluated regardless of gender. N-R distance was found to be significantly longer in skeletal Class 3 individuals than in Class 1 and 2 individuals (p < 0.05). There was no statistically significant difference in nasal bone concavity angle in all groups (p > 0.05). R-A and N-A linear nasal parameters showed statistically significant differences between male and female sex groups in all skeletal malocclusion classes (p < 0.05). At first, results showed that males had longer measurements than females in all linear nasal parameters. Second, longer measurements were found in all linear nasal parameters in skeletal Class 3 individuals than those in skeletal Class 1 and Class 2 individuals. Third, the nasal bone concavity angle was greater in skeletal Class 2 individuals than the others.

Türk Ortodonti Hastalarında Sagital Yönde İskeletsel ve Dental Maloklüzyonların İlişkisi: Retrospektif Bir Çalışma

Objective: This study aims to evaluate the compatibility between skeletal and dental malocclusions in the sagittal direction.&#x0D; Material and Methods: 230 patients (male, female) aged 11-18 years, who applied to Van Yüzüncü Yıl University Faculty of Dentistry Orthodontic Clinic, had no craniofacial anomaly, had not received orthodontic treatment and had no history of trauma, were included in the study. Individuals were divided into groups according to their ANB angles. The molar relationships in different sagittal skeletal malocclusions were examined. Descriptive analysis and the Pearson chi-square test were used to evaluate the information. The obtained data were statistically analyzed at the 5% significance level.&#x0D; Results: 230 individuals between the ages of 12-30 were divided into groups according to their ANB angles. In individuals with skeletal Class 1 malocclusion, the molar relationship was Angle Class II at most and Angle Class IV at most negligible. In individuals with skeletal Class 2 malocclusion, the molar relationship was determined as Angle Class II at most, while Angle Class III subdivision and no molar relationship were observed at least. In individuals with skeletal Class 3 malocclusion, the molar relation was Angle Class III at most, Angle Class IV at least, and no molar relation.&#x0D; Conclusion: In this study, it was observed that there was a significant relationship between skeletal malocclusions and molar relationships. However, it is thought that the molar relationship may vary due to different factors other than skeletal malocclusion.

PHARYNGEAL AIRWAY SPACE IN DIFFERENT SKELETAL MALOCCLUSION AND FACIAL FORMS

Background: Evaluation of the upper and lower airway space should be an integral part of diagnosis and treatment planning to achieve the functional balance and stability of the result after orthodontic or orthognathic treatment. This study aimed to analyze the pharyngeal airway space in different skeletal malocclusion and facial forms. Methods: Study was carried out in lateral cephalometric radiographs of 210 patients. Data was collected from March 2021 to December 2021. Pharyngeal airway spaces were analyzed according to McNamara Analysis. Upper and lower pharyngeal airway in different skeletal malocclusion and facial form was determined. Data was analyzed in SPSS version 20. Independent samples-t test was applied for gender distribution and Pearson correlation test was applied for upper and lower pharyngeal space. Results: The mean value of upper pharyngeal airway width in Class I, II and III were 12.07 mm, 11.57 mm and 12.34 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 12.35 mm, 11.83 mm and 11.81 mm respectively. Similarly, the mean value for lower pharyngeal airway width in Class I, II and III were 9.51 mm, 9.13 mm and 10.03 mm respectively and for Mesofacial, Dolichofacial and Brachyfacial facial form were 9.62 mm, 9.34 mm and 9.61mm respectively. Male had higher value of mean lower pharyngeal width than female. Conclusions: There was no impact of sagittal skeletal malocclusion on the upper and lower airways width. Also, there was no impact of different vertical skeletal types or facial forms on the upper and lower airways width.

Comparison between cephalometric measurements using digital manual and web-based artificial intelligence cephalometric tracing software.

ABSTRACTObjective: The aim of this study was to compare the measurements performed with digital manual (DM) cephalometric analysis and automatic cephalometric analysis obtained from an online artificial intelligence (AI) platform, according to different sagittal skeletal malocclusions.Methods: Cephalometric radiographs of 105 randomly selected individuals (mean age: 17.25 ± 1.87 years) were included in this study. Dolphin Imaging software was used for DM cephalometric analysis, and the WebCeph platform was used for AI-based cephalometric analysis. In total, 10 linear and 12 angular measurements were evaluated. The paired t-test, one-way ANOVA test, and intraclass correlation coefficient tests were used to evaluate the differences between the two methods. The level of statistical significance was set at p< 0.05.Results: Except for SNB, NPog, U1.SN, U1.NA, L1-APog, I/I, and LLE parameters, all other parameters presented significant differences between the two methods (p< 0.05). While there was no difference (p> 0.05) in both SNA and SNB measurements between the two methods in the Class I malocclusion group, there was a difference between both methods in the Class II malocclusion group. Meanwhile, only the SNA in the Class III malocclusion group was different (p< 0.05). The ANB angle differed significantly in all three malocclusion groups. For both methods, all parameters except CoA and CoGn were found to have good correlation.Conclusion: Although significant differences were detected in some measurements between the two cephalometric analysis methods, not all differences were clinically significant. The AI-based cephalometric analysis method needs to be developed for more specific malocclusions.

Gender differences in lower facial soft tissue thickness among different skeletal patterns, based on soft tissue cephalometric analysis.

Lower face soft tissue thickness and dentoskeletal features form the lower facial profile. Sagittal skeletal malocclusions with varying degrees of soft tissue thickness in males and females were herein examined using soft tissue cephalometric radiography. Based on their dentoskeletal correlations, a total of 160 lateral cephalometric radiographs of adult males and females (n = 80) seeking orthodontic treatment were classified as class I (n = 40), class II division 1 (n = 40), class II division 2 (n = 40), or class III (n = 40). Holdaway analysis was used to assess soft tissue thickness in seven linear parameters. In class I, class II division 1, class II division 2, and class III dentoskeletal connections, males exhibited larger soft tissue thickness. They have an average lower lip thickness, chin depth H, and depth V for class I males. Males and females differed from one another when it came to the thicknesses of the upper and the lower lips. These lip thicknesses as well as the chin's width differed more between men and women in class II division 1. Except for upper lip strain, all measures in the class II division 2 sample males demonstrated a greater significance. In the class III sample, males also demonstrated more significance than females. Males with various sagittal skeletal malocclusions demonstrated a significant difference in lower soft tissue thickness (characterized as thicker lower facial soft tissue) compared to female patients in class I, class II division 1, class II division 2, and class III malocclusions.

A heuristic model for cephalometric diagnosis of sagittal dysplasia.

To identify the best-suited cephalometric parameter for assessing the sagittal skeletal discrepancy in the Indian population. An in vitro, observational, single-blinded, retrospective study. Department of Orthodontics and Dentofacial Orthopaedics. A total of 94 lateral cephalograms were used in this study. The study involved one key person and two examiners. The key person collected the radiographs, coded, analysed and classified them into three groups (skeletal classes I, II and III). Subsequently, the coded radiographs were independently analysed by the two examiners. They classified the cases by matching a minimum of 6 out of 11 parameters. On completion of diagnosis by the examiners, the samples were decoded and matched with the original diagnosis given by the key person. The samples in which identification of a particular cephalometric parameter matched the original evaluation as given by the key person was regarded as correctly diagnosed. The number of correctly assessed cases was used to judge the diagnostic performance of all the parameters in all the cases. Cross-validation of the method was performed, and a diagnostic algorithm was developed for diagnosis. β angle and Pi angle showed a positive predictive value of 1 in both skeletal class I and II cases. ANB angle, W angle and HBN angle showed a positive predictive value of 1 in skeletal class III cases. No single cephalometric parameter can independently be used to diagnose sagittal skeletal discrepancy in all cases. However, a conclusive diagnosis on the type of sagittal skeletal malocclusion can be made by using a simple and easy to use diagnostic algorithmic process having a combination of cephalometric parameters.

The Assessment of Maturation Indicators in Individuals with Different Skeletal Pattern

Objective: The aim of this study is to evaluate the relationships among dental age, chronological age, hand-wrist maturation and cervical vertebral maturation in Class I, Class II and Class III individuals.Method: Panoramic, cephalometric and hand-wrist radiographs of 289 individuals (151 girls, 138 boys) aged between 8 and 18 were evaluated in this study. Subjects divided into three main groups as Class I, Class II and Class III according to their sagittal skeletal malocclusion. The dental ages of the individuals were defined according to the Demirjian’s method. The Fishman maturation indicators were used for evaluating the hand-wrist radiographs and the method improved by Bacetti et al. were used for evaluating the maturation stages of the cervical vertebrae. The Spearman correlation analysis was used to evaluate the relationships between the variables separately for males and females.Results: The Spearman correlation coefficient indicated a significant positive correlation at different levels between all variables evaluated for both female and male individuals in all groups (P&amp;lt; 0.01). The lowest correlation was found between chronological age and dental age skeletal in Class II group (r: 0.413). The correlation between cervical vertebra maturation and hand-wrist maturation were highly positive for both sexes in all groups (P&amp;lt; 0.01).Conclusion: According to the results of our study, to define the growth spurt and developmental stages, cervical vertebrae maturation could be used as an alternative to hand-wrist maturation assessment. However, additional studies with a larger sample size may be helpful in proving the reliability of the dental age.

Potential impact of pediatric obstructive sleep apnea on mandibular cortical width dimensions.

To analyze differences in mandibular cortical width (MCW) among children diagnosed with obstructive sleep apnea (OSA) or at high- or low-risk for OSA. A total of 161 children were assessed: 60 children with polysomnographically diagnosed OSA, 56 children presenting symptoms suggestive of high-risk for OSA, and 45 children at low risk for OSA. Children at high- and low-risk for OSA were evaluated through the Pediatric Sleep Questionnaire. MCW was calculated using ImageJ software from panoramic radiograph images available from all participants. Differences between MCW measurements in the 3 groups were evaluated using analysis of covariance and Bonferroni post-hoc tests, with age as a covariate. The association between MCW and specific cephalometric variables was assessed through regression analysis. The participants' mean age was 9.6 ± 3.1 years (59% male and 41% female). The mean body mass index z-score was 0.62 ± 1.3. The polysomnographically diagnosed OSA group presented smaller MCW than the group at low-risk for OSA (mean difference = -0.385 mm, P = .001), but no difference with the group at high-risk for OSA (polysomnographically diagnosed OSA vs high-risk OSA: P = .085). In addition, the MCW in the group at high-risk for the OSA was significantly smaller than the group at low-risk for the OSA (mean difference = -0.301 mm, P = .014). The cephalometric variables (Sella-Nasion-A point angle (SNA) and Frankfort - Mandibular Plane angle (FMA)) explained only 8% of the variance in MCW. Reductions in MCW appear to be present among children with OSA or those at high-risk for OSA, suggesting potential interactions between mandibular bone development and/or homeostasis and pediatric OSA. Fernandes Fagundes NC, d'Apuzzo F, Perillo L, et al. Potential impact of pediatric obstructive sleep apnea on mandibular cortical width dimensions. J Clin Sleep Med. 2021;17(8):1627-1634.

Correlation Between Pharyngeal Airway Space and Sagittal Skeletal Malocclusions

OBJECTIVE: To determine correlation between pharyngeal airway space and sagittal skeletal malocclusions. METHODOLOGY: Data was collected using pre-treatment records including pre-treatment lateral cephalograms of 54 orthodontic patients. Patients from both gender were included. The age group of selected patients was 15-25 years, Patients belonging to Pakistani ethnicity were included to avoid selection bias. Sagittal skeletal malocclusion was measured by ANB angle to group the skeletal Class I, II and III subjects (ANB=0-4°, ANB &gt; 4° and ANB &lt;0 respectively). Upper pharyngeal space and Lower Pharyngeal space was measured. This cross sectional study was conducted in Orthodontic OPD at Karachi Medical and Dental College, from August 2019 to March 2020. RESULTS: The obtained data showed strong negative correlation between ANB angle and upper pharyngeal space whereas moderately negative correlation between ANB angle and lower pharyngeal space. CONCLUSION: Upper and lower pharyngeal widths were influenced by Sagittal malocclusion. KEYWORDS: Pharyngeal airway space, Sagittal skeletal malocclusion, Obstructive sleep apnea, Sleep disordered breathing, ANB. HOW TO CITE: Siddiqui H, Rizwan S, Faisal SS, Hussain SS. Correlation between pharyngeal airway space and sagittal skeletal malocclusions. J Pak Dent Assoc 2020;29(4):217-222.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p&lt;0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p&lt;0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Morphology of Palatal Rugae in Various Sagittal Skeletal Malocclusions in Kerala Population- A Retrospective Study

The present study was designed evaluate the structural morphology of palatal rugae in Kerala orthodonticsubjects with varying Sagittal Skeletal Malocclusions. Pretreatment maxillary casts of 105 patients wereanalyzed for rugae patterns qualitatively and quantitatively using modified Thomas and Kotze classification.The data were statistically analyzed. According to the Fishers exact test, the most common type of rugaepattern in all the groups (Class I, Class II, and Class III) were observed to be wavy followed by curved.Skeletal Class III had the highest number of straight rugae 71.4% among the three groups which wasstatistically significant. Direction of rugal alignment was horizontal and droplet-shaped incisive papillawas identified among different skeletal dysplasia groups.Palatal ruage may serve as valuable indicators forpopulation identification and help in facial reconstructions through their association with varying skeletalmalocclusions.

Posterior dental compensation and occlusal function in adults with different sagittal skeletal malocclusions

ObjectiveThe aim of this study was to compare posterior tooth inclinations, occlusal force, and contact area of adults with different sagittal malocclusions.MethodsTransverse skeletal parameters and posterior tooth inclinations were evaluated using cone beam computed tomography images, and occlusal force as well as contact area were assessed using pressure-sensitive films in 124 normodivergent adults. A linear mixed model was used to cluster posterior teeth into maxillary premolar, maxillary molar, mandibular premolar, and mandibular molar groups. Differences among Class I, II, and III groups were compared using an analysis of variance test and least significant difference post-hoc test. Correlations of posterior dental inclinations to occlusal function were analyzed using Pearson's correlation analysis.ResultsIn male subjects, maxillary premolars and molars had the smallest inclinations in the Class II group while maxillary molars had the greatest inclinations in the Class III group. In female subjects, maxillary molars had the smallest inclinations in the Class II group, while maxillary premolars and molars had the greatest inclinations in the Class III group. Occlusal force and contact area were not significantly different among Class I, II, and III groups.ConclusionsPremolar and molar inclinations showed compensatory inclinations to overcome anteroposterior skeletal discrepancy in the Class II and III groups; however, their occlusal force and contact area were similar to those of Class I group. In subjects with normodivergent facial patterns, although posterior tooth inclinations may vary, difference in occlusal function may be clinically insignificant in adults with Class I, II, and III malocclusions.

A study of cervical vertebra anomalies among individuals with different sagittal and vertical facial growth patterns.

Objective:The objective was to evaluate the prevalence of cervical vertebra anomalies (CVA) in individuals with different sagittal and vertical skeletal growth patterns of jaws and also to establish the associations of anomalies with the type of growth, if any.Materials and Methods:A total of 293 lateral cephalograms were evaluated for CVA. Based on the Frankfort mandibular plane angle, cephalograms were categorized into three groups: Group I, II, and III. Based on the ANB angle, cephalograms were classified into three classes, Class 1, 2, and 3. Six types of CVA such as partial cleft (PC), block fusion (BF), dehiscence (D), fusion between C2 and C3 (F23), occipitalization (OC), and spina bifida (SB) were identified on lateral cephalograms. Descriptive statistics were applied along with multinomial logistic regression analysis. P = 0.05 was considered as the level of statistical significance.Results:PC was most common in the overall samples (36%). BF was the least common (3.2%) CVA. The frequency of various CVA was comparable between males and females in all the three classes of individuals. The association of vertical growth patterns with CVA was found to be statistically nonsignificant (P > 0.05). Class 2 malocclusion was found to be statistically significantly associated with the D (P = 0.043).Conclusions:PC, fusion, and D were the most frequently found CVA, and SB was found only among the hypodivergent growth pattern individuals. The association of CVA with vertical facial growth patterns was not significant, somewhat influenced by age, sex, and sagittal skeletal malocclusions.