Sagittal Skeletal Relationships Research Articles

Evaluation of Mandibular Projection in Class II Division 2 Subjects Following Orthodontic Treatment Using Clear Aligners.

The purpose of this study was to evaluate the mandibular growth and/or projection following maxillary incisor proclination, overbite correction, and maxillary dentoalveolar expansion without the use of any class II mechanics, in growing class II division 2 patients treated with clear aligners. Before and after treatment cone-beam computed tomographic (CBCT) generated lateral and posteroanterior cephalograms of thirty-two patients with skeletal class II division 2, 16 in the treatment group and 16 in the untreated group, were reviewed to evaluate treatment-related changes. Upper incisors were proclined and protruded, as well as upper arch expansion and overbite correction were performed as part of their regular treatment. Cephalometric analysis was performed to evaluate skeletal and dental changes. Unpaired statistical t-tests were performed to determine if significant skeletal class II correction was achieved in the treatment group. In the treatment group, after treatment, the upper incisors became more proclined and protruded, and the inter-molar width increased while the overbite was reduced compared to the control group. An increase in skeletal mandibular growth and forward projection was also observed, thus contributing to an improvement of the sagittal skeletal relationship as evidenced by ANB and Wits values compared to the control group. A combination of upper incisor proclination, correction of deep overbite, and maxillary dentoalveolar expansion using clear aligners appears to contribute to an improvement of the skeletal class II relationship in growing patients with class II division 2. This study shows that unlocking the mandible by correcting a deep overbite, proclining upper incisors, and expanding the upper arch in growing class II division 2 patients can improve skeletal class II using clear aligners. How to cite this article: Mirzasoleiman P, El-Bialy T, Wiltshire WA, et al. Evaluation of Mandibular Projection in Class II Division 2 Subjects Following Orthodontic Treatment Using Clear Aligners. J Contemp Dent Pract 2024;25(4):295-302.

Airway Analysis in Different Malocclusions - A Cephalometric Study

Background: It was essential to evaluate respiratory function when diagnosing and planning orthodontic treatment. Based on the correlation between pharyngeal airway space and craniofacial structure, airway width was hypothesized to be an indicator of airway patency in different groups of skeletal malocclusion. Aim: The purpose of this study was to investigate age and gender related changes in pharyngeal airway dimensions in different sagittal skeletal relationships Materials and Method: Sixty lateral cephalograms of patients aged 10-30 years with no pharyngeal pathology or nasal obstruction were retrospectively selected and categorized into skeletal Class I (n = 20), Class II (n = 20), and Class III (n = 20) malocclusion based on ANB angle. McNamara's airway analysis was used to quantify upper- and lower-airway dimensions. The analyses of intergroup differences were performed using a one-way ANOVA, an independent t-test, and Tukey's test as a post-hoc test. Results: Participants in the study ranged in age from 20.57 ± 5.41 years (males) and 20.03 ± 4.58 years (females) were included in the study. The upper pharyngeal airway (UPA) dimensions demonstrated a positive correlation with age. In both genders, the mean upper pharyngeal airway (UPA) size exceeded the lower pharyngeal airway (LPA) size, but neither age nor gender was associated with statistically significant differences in skeletal malocclusion. Conclusion: It was shown that skeletal malocclusions of different types have no effect on the upper and lower pharyngeal airways and that the upper and lower pharyngeal airways are not influenced by age or gender.

Functional needs in orthognathic patients with different sagittal skeletal discrepancies

ObjectivesThis retrospective study aimed to evaluate the relationship between the Index of Orthognathic Functional Treatment Need (IOFTN) and sagittal skeletal discrepancy (ANB angle) among orthognathic patients. Study DesignRecords of 403 orthognathic patients (229 females/174 males, aged 16-50 years) were reviewed. Malocclusion type (incisor-based), sagittal skeletal relationship (ANB angle), and IOFTN scores were documented. Spearman correlation coefficient (r) and scatter plots were utilized to examine the relationship between functional need (IOFTN scores) and sagittal skeletal discrepancy (ANB angle). Regression analyses were conducted to determine the extent to which variations in IOFTN scores could be attributed to variations in ANB angles. ResultsClass III malocclusion/sagittal skeletal pattern were most prevalent (62.3%). The Spearman correlation coefficient (r) for the entire sample was -0.297 (P<0.001), indicating a weak negative correlation. Linear regression analysis demonstrated a coefficient of determination of 0.069, indicating that approximately 6.9% of the variance in IOFTN data could be accounted for by variations in ANB angles. Upon stratifying data by different malocclusions, coefficients of determination were 0.065, 0.034, and 0.089 for Class I, II, and Class III malocclusions, respectively. ConclusionThe observed linear relationships between sagittal skeletal discrepancy (ANB angle) and IOFTN score were weak and lacked clinical significance.

Relationship between Body Posture Assessed by Dynamic Baropodometry and Dental Occlusion in Patients with and without Dental Pathology.

Body biomechanics and dental occlusion are related, but this interaction is not fully elucidated. The aim of this study was to investigate the association between body posture and occlusion in patients with and without dental pathology. A cross-sectional study was carried out with 29 patients divided into a control group and a group with pathology (malocclusions). Body posture was evaluated by dynamic baropodometry, analyzing parameters such as the line of gait and the anteroposterior and lateral position of the center of pressure (CoP). Occlusion was classified radiographically according to the sagittal skeletal relationship. Results showed significant differences in mean position phase line between groups (p = 0.01-0.02), with means of 115.85 ± 16.98 mm vs. 95.74 ± 24.47 mm (left side) and 109.03 ± 18.03 mm vs. 91.23 ± 20.80 mm (right side) for controls and pathologies, respectively. The effect size was large (Cohen's d 0.97 and 0.92). There were no differences in the anteroposterior (p = 0.38) or lateral (p = 0.78) position of the CoP. In gait analysis, significant differences were observed in left (548.89 ± 127.50 N vs. 360.15 ± 125.78 N, p < 0.001) and right (535.71 ± 131.57 N vs. 342.70 ± 108.40 N, p < 0.001) maximum heel strength between groups. The results suggest an association between body posture and occlusion, although further studies are needed to confirm this relationship. An integrated postural and occlusal approach could optimize the diagnosis and treatment of dental patients.

Sagittal Position of the Upper Incisor in Relation to the Forehead in Peruvian Individuals with Different Skeletal Relationships.

The aim of this study was to determine the sagittal position of the upper incisor considering Andrews' analysis based on the position of the forehead in Peruvian individuals with different skeletal relationships. This retrospective, cross-sectional study included 212 lateral head radiographs of Peruvian individuals (males: 85, mean age 21.38 ± 6.88, and females: 127, mean age 21.18 ± 6.95), with different skeletal relationships (Class I group = 96, Class II group = 57, Class III group = 59). The values of the ANB, SNA, SNB angles as well as the forehead anterior limit line (FALL) and goal anterior limit line (GALL) points were identified in the radiographs, and then a vertical line was drawn in each point to determine if the upper incisor was positioned forward (protruded), backward (retruded) or within (adequate) these lines. Two trained and calibrated investigators performed all the measurements. The Chi-square test was used to evaluate associations. A p-value < 0.05 was considered statistically significant. Overall, the sagittal position of the upper incisor showed a significant association with the sagittal skeletal relationship (p = 0.001). The upper incisors showed an adequate position (41.7%), protruded position (56.10%), and retruded position (42.40%), for Class I, II, and III skeletal relationships, respectively, as highest percentages in each Class. Statistical significance was found for females only (p = 0.005). Skeletal Class I mainly showed an adequate position of the upper central incisor, whereas for Class II a protruded position was most frequently found, and Class III presented a retruded position. Andrews' analysis based on the position of the forehead in Peruvian individuals is a valuable tool for orthodontic diagnosis. How to cite this article: Bazán-Mendoza JR, Arias-Modesto PB, Ruíz-Mora GA, et al. Sagittal Position of the Upper Incisor in Relation to the Forehead in Peruvian Individuals with Different Skeletal Relationships. J Contemp Dent Pract 2023;24(11):821-825.

A retrospective investigation of orthognathic patients and functional needs

Abstract Purpose The present study aimed to explore the malocclusion trends, sagittal skeletal discrepancies, and the index of orthognathic functional treatment need (IOFTN) scores in a sample of Iranian and Turkish orthognathic patients. Methods Four hundred and three orthognathic patients were retrospectively examined (203 Iranian/200 Turkish, 229 females/174 males, aged between 16 and 50 years). The following variables were recorded: malocclusion type (incisor-based), overjet, sagittal skeletal relationship (ANB angle) and IOFTN scores. The sagittal skeletal relationships and malocclusion patterns of the orthognathic patients were statistically examined using Chi-square tests and further explored graphically. The relationship between the IOFTN scores and overjet, as well as the sagittal skeletal discrepancies (ANB angle) was evaluated using box plots and at the 95% confidence interval (CI) in different IOFTN treatment categories (1–3,4,5). The characteristics of a subgroup sample of orthognathic patients and previous studies that identified with low IOFTN scores (1–3) were also explored. Results Class III malocclusions and Class III skeletal patterns were the most prevalent (62.3%), forming 69% and 55.7% of the Turkish and Iranian samples, respectively. Turkish and Iranian samples had more Class III [Mean (SD) ANB angle = -1.24° (4.75°)] and Class II cases [Mean (SD) ANB angle=1.06° (5.63°)], respectively. The mean overjet and reverse overjet for Class II and III malocclusions were 6.96 mm (95% CI, 6.40–7.53 mm) and 3.26 mm (95% CI, 2.87–3.65 mm), respectively. The mean ANB angle for Class II and III malocclusions was 6.64° (95% CI, 6.15°–7.13°) and -3.57° (95% CI, -3.92° to -3.21°), respectively. IOFTN scores of 4 or 5 were identified in 93.8% of the sample. Patients with low IOFTN scores (&lt;4) presented with a nearly normal overjet (mean = 3.19 mm, 95% CI, 2.62-3.76 mm, range = 1–5 mm), accompanied by a wide range of ANB angles [mean (SD)=3.44° (3.86°), range = -4° to 9°] Conclusions The findings at the 95% CI for overjet and the ANB angle can be used as identifiers for patients who would benefit from orthognathic surgery. Analysing patients with a low IOFTN score, particularly with scores of 3.3, 3.10, 2.8, and 1.14, revealed that IOFTN could be used in conjunction with a clinical examination plus diagnostic imaging to facilitate the identification of orthognathic surgery patients.

Prevalence of impacted third molars among different sagittal skeletal relationships in Upper Egyptian patients

Prevalence of impacted third molars among different sagittal skeletal relationships in Upper Egyptian patients

Associations between the 3D position of the mental foramen with sagittal skeletal relationships (classes I, II, and III) and vertical facial growth patterns (normal, long, and short faces) in different ages and sexes: a retrospective cohort study of 360 CBCTs

BackgroundThe 3D position of the mental foramen (MF) is of significant clinical value in dental implantology and mandibular surgeries or in local anesthesia. Despite its importance, it is not clearly known how the position of MF can alter in different individuals, since the literature on the associations between the MF position with vertical growth patterns is non-existent and those on links between the MF position and skeletal malocclusions are scarce. Therefore, we aimed to investigate these, for the first time, on cone-beam computed tomographies (CBCTs).MethodsArchival CBCTs of 9 sub-groups (i.e., 3 skeletal Classes I, II, and III × 3 vertical growth patterns ‘long face, short face, normal face’) were collected by evaluating patients’ SNA, SNB, ANB, facial angle, lower facial height, and FMA (n = 9 × 40 = 360). Included cases were older than 17 years and without any history of orthodontic/orthognathic treatments (243 women, 117 men, mean age: 22.28 ± 2.80 years). Perpendicular distances between the MF and 3 fixed bony structures (the mandibular symphysis [S/width], the mandibular ramus [R/length], and the mandibular lower cortex [C/height]) were measured on different sectional planes on both hemimandibles. Left- and right-side measurements were combined. Data were analyzed using the 3-way ANCOVA, Bonferroni, one-way ANOVA, Tamhane, Pearson, and t-test (α = 0.05).ResultsWidth was the smallest in Class II and greatest in Class III cases (all P values < 0.000001, Bonferroni). It was the shortest in long faces and longest in short faces (all P values ≤ 0.00008). The inferior-superior height was larger in Class III than both Classes I and II (both P values ≤ 0.003); there was no significant difference between Classes I and II in terms of height (P = 0.684). Height was the largest in long faces and smallest in short faces (all P values < 0.000001). The anterior-posterior length was the largest in Class III and smallest in Class II (all P values < 0.000001). Length was larger in short-face people versus normal- or long-face individuals (P ≤ 0.00003); nevertheless, long and normal faces did not differ in terms of length (P = 0.448). Subjects’ age was not correlated with their MF positions (P ≥ 0.579, Pearson coefficient). Sex dimorphism existed only for height (P = 0.009, t-test) but not for length or width.ConclusionsThe MF position may considerably differ in various horizontal or vertical growth patterns and sexes. This should be noted in mandible surgeries.

Associations across 22 dental and craniovertebral anomalies or variations, sagittal skeletal relationships, and vertical growth patterns: a comprehensive epidemiological study of 43 dentoskeletal traits

IntroductionDespite researchers' recent interest in identifying links between some dental and craniovertebral abnormalities, there are many important, unassessed gaps in our knowledge of this matter. In addition, previous samples were small. This large study aimed to examine, for the first time, the occurrence/severity of numerous dental and skeletal anomalies or variations and their correlations with each other and with growth patterns.MethodsThis epidemiological study was conducted on pretreatment radiographs of 1194 patients from 3 cities (815 females). Skeletal sagittal skeletal relationships and vertical growth patterns were determined. The occurrence/severity were assessed for: cervical vertebral fusion (CVF), atlas posterior arch deficiency (APAD), ponticulus posticus (PP), sella turcica bridging (STB), hypodontia, oligodontia, hyperdontia, missing of maxillary laterals, microdontia, macrodontia, root dilaceration, odontoma, taurodontism, dental fusion, dental gemination, enamel pearl, permanent molar ankylosis, primary molar ankylosis, dens in dente, dens invaginatus, dental impaction, ectopic eruption, and dental transposition. Incidental findings were recorded as well. Concurrent anomalies, sex dimorphism, and correlations across variables were examined statistically, adjusting for the false discovery rate (α = 0.05).ResultsPrevalence was calculated for 43 dentoskeletal traits/anomalies (22 abnormalities/variations [plus their severities/types] as well as 21 incidentally found traits/anomalies). Dental impaction may be more common in hyperdivergent and severer cases of sella bridging; also, primary molar ankylosis was associated with missing teeth. Dental impaction was associated only with STB and not with PP, APAD, or vertebral fusion. The only association observed among the four skeletal anomalies was seen between APAD and CVF. Merely the variables ‘sagittal skeletal relationships, vertical growth patterns, PP, and APAD’ showed sexual dimorphism; of these, only vertical growth pattern and APAD remained sexually dimorphic after adjusting for the FDR; still, the other two remained marginally significant and worth further evaluations. Sex dimorphism did not exist in concurrent abnormalities. The skeletal Class III was associated with the concurrent occurrence of craniovertebral, dental, and dentoskeletal abnormalities. Skeletal Class I was associated with fewer occurrences of concurrent dental anomalies. Vertical growth patterns were not associated with concurrent dental or dentoskeletal anomalies. However, the hyperdivergent pattern was associated with fewer cases of concurrent craniovertebral abnormalities.ConclusionsSTB and hyperdivergent pattern were associated with dental impaction. However, APAD, CVF, or PP were not associated with dental impaction. APAD was associated with CVF. Sexual dimorphism existed conclusively in the case of vertical growth patterns and APAD. Concurrent abnormalities (dental, skeletal, and dentoskeletal) were associated with skeletal Class III.

The saddle angle and its relationship with different sagittal skeletal patterns for Iraqi population

Abstract Background: The cranial base has a substantial role in determining how the maxilla and mandible are related to each other and its growth influences the maxillo-mandibular growth. Aim: The main aim of this study was to evaluate and assess the relationship of the saddle angle (NSAr) with different patterns of the sagittal interarch skeletal relationship for the Iraqi population and detect the effect of gender on it. Materials and Methods: The samples included 125 true lateral cephalometric radiographs for Iraqi patients of both genders (male and female) between the age of 18–25 years obtained from the clinic’s archives of the Orthodontic Department at the Dentistry Teaching Hospital of the Faculty of Dentistry, Baghdad University, Iraq, who was looking for orthodontic therapy. The samples were divided according to the value of ANB angle into skeletal Cl I (33 females and 14 males), skeletal Cl II (27 females, 14 males), and skeletal Cl III (17 females and 20 males) groups, then the saddle angle were digitized and recorded using AutoCAD 2012 computer program, the data then analyzed by SPSS version 24 (2016) computerized statistical analysis. Results: The results clarified that the mean value of saddle angle was smaller in the skeletal Cl III group for both genders, with females showed the smallest value with no significant difference, and the larger value of saddle angle was in the skeletal Cl II group for both genders with females showed the largest value with no significant difference. Conclusion: The sagittal skeletal relationship tends to alter from skeletal Cl III to Cl II with progressive flattening of the cranial base and vice-versa. The effect of gender on saddle angle was more than that of sagittal skeletal classes.

Condylar Size and Position, Comparison among Different Sagittal Skeletal Relationships: A CBCT Study.

To compare the size and spatial position of mandibular condyles among different sagittal skeletal patterns using CBCT imaging. A cross-sectional study. Place and Duration of the Study: Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from 20th March 2021 to 4th January 2022. CBCT scans of 66 subjects (33 males, 33 females) were divided into three equal groups on basis of sagittal skeletal relationships (Class I, Class II, and Class III). Condylar size and position were determined using the method described by Hilgers et al. and Ricketts et al. respectively. Independent samples t-test was applied to compare condylar size and position variables between the right and left condyles and between male and female subjects. All study groups were compared using ANOVA and Post Hoc Tukey's test. In males, the condylar size was larger and condyles were slightly more anteriorly positioned. Condylar width and height were smallest in skeletal Class II relation and largest in skeletal Class III relation. Regarding the condylar position, the anterior distance was investigated to be the smallest in Class II. The posterior distance was lesser in skeletal Class I subjects whereas the superior distance was lesser in Class III subjects. Angle of articular eminence was greater in class I, intermediate in class II, and lower in class III. Height of articular eminence was the lowest in Class III subjects. Statistically significant differences existed for the size and position of mandibular condyles among different sagittal skeletal relationships. Temporomandibular joint, Condylar position, Condylar size, Sagittal skeletal relationships, CBCT.

Angular Relationship between the Palatal Plane and the Anterior Cranial Baseline in Different Sagittal Skeletal Relationships: A Cephalometric Study

Angular Relationship between the Palatal Plane and the Anterior Cranial Baseline in Different Sagittal Skeletal Relationships: A Cephalometric Study

Assessment of skeletal relationships in cleft palate with or without cleft lip: A cone-beam computed tomography study in a pakistani population.

Understanding the different skeletal relationships in orofacial clefts by using cone-beam computed tomography (CBCT) may eventually lead to developing better diagnosis and treatment protocols for facial deformities. The objective of this study was to investigate the different skeletal relationships in the cleft palate with or without cleft lip (CP ± L), using CBCT scans. This is a retrospective study conducted at the Orthodontics and Oral Radiology department, CMH-Lahore medical college and Institute of dentistry. In the current study, 4,152 CBCT scans (dcm format) were collected from a radiology center in Lahore, Pakistan between February 2015 and February 2018. All CBCT scans were imported to the Romexis Viewer, version 4.4.0 (Planmeca, Finland). Data sorting was performed to identify age, sex, cleft phenotype, unilateral cleft quadrant, sagittal skeletal relationship, and facial soft tissue involvement. Statistics were generated, using the Chi-square test. A P value <0.05 was considered statistically significant. We identified 73 cases of CP ± L in the sample. The male-to-female ratio was 1.21:1. Bilateral cleft lip and palate (BCLP) mostly affected males (60%), whereas unilateral cleft lip and palate (UCLP) mainly affected females (57.6%), with a left-side female predominance. The different cleft phenotypes do not show any statistically significant difference regarding skeletal relationships and sex (P > 0.05). Skeletal class III relationships were found to be predominant in both sexes, followed by class II, and class I skeletal relationships. Henceforth, such CP ± L patients should be pre-emptively screened in early life to avoid such skeletal complications.

Deep convolutional neural network-based skeletal classification of cephalometric image compared with automated-tracing software

This study aimed to investigate deep convolutional neural network- (DCNN-) based artificial intelligence (AI) model using cephalometric images for the classification of sagittal skeletal relationships and compare the performance of the newly developed DCNN-based AI model with that of the automated-tracing AI software. A total of 1574 cephalometric images were included and classified based on the A-point-Nasion- (N-) point-B-point (ANB) angle (Class I being 0–4°, Class II > 4°, and Class III < 0°). The DCNN-based AI model was developed using training (1334 images) and validation (120 images) sets with a standard classification label for the individual images. A test set of 120 images was used to compare the AI models. The agreement of the DCNN-based AI model or the automated-tracing AI software with a standard classification label was measured using Cohen’s kappa coefficient (0.913 for the DCNN-based AI model; 0.775 for the automated-tracing AI software). In terms of their performances, the micro-average values of the DCNN-based AI model (sensitivity, 0.94; specificity, 0.97; precision, 0.94; accuracy, 0.96) were higher than those of the automated-tracing AI software (sensitivity, 0.85; specificity, 0.93; precision, 0.85; accuracy, 0.90). With regard to the sagittal skeletal classification using cephalometric images, the DCNN-based AI model outperformed the automated-tracing AI software.

Morfología del ángulo mandibular en sujetos con mordida abierta de acuerdo a la relación esquelética: un informe breve en CBCT.

Aim: The purpose of this research was to three-dimensionally evaluate the mandibular angle morphology in open bite subjects with different sagittal skeletal relationships. Material and Methods: Cone beam computed tomography (CBCT) images of 26 subjects (12 men and 14 women) with anterior open bite were evaluated. The sample included 3 groups categorized by their sagittal skeletal relationship (based on ANB angle and anteroposterior dysplasia indicator (APDI)): Class I (n=9), Class II (n=6) and Class III (n=11). The total gonial angle, upper gonial angle, lower gonial angle, intergonial width, interantegonial width and antegonial notch depth were measured. ANOVA and Tukey tests were used for intergroup comparison. The Kruskal Wallis test was also used when necessary. In addition, the Pearson correlation coefficient was calculated to evaluate significant correlations between overbite and antegonial notch depth with gonial angle, Frankfurt mandibular plane angle (FMA) and the palatal plane-mandibular plane (PP-MP). Results: A significant difference was only found on the upper gonial angle between Class II and Class III (p=0.047). The upper gonial angle showed greater values (48°±3°) with the mandibular branch toward backward in Class III subjects and lower values (42.42°±4.39°) with the mandibular ramus leaning forward in subjects with Class II skeletal relationship. Besides, only a statistically significant correlation was found between overbite and the lower gonial angle (r=-0.418, p=0.034). Conclusion: Mandibular angle morphology is similar in anterior open bite subjects with different sagittal skeletal relationships, except for the upper gonial angle which is increased in Class III and decreased in Class II subjects with open bite. Lower gonial angle is negatively correlated with overbite. This difference should be considered by orthodontists when planning their treatments.

Predicting the sagittal skeletal pattern using dental cast and facial profile photographs in children aged 9 to 14 years.

To quantify prediction of sagittal skeletal pattern using anteroposterior dental relationships on dental casts and facial profile photograph. The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from December 2016 to July 2017, and comprised orthodontic patients of either gender aged 9-14 years who attended the outpatient dental clinic. The sagittal skeletal relationship assessed on cephalometric radiographs was compared with anteroposterior dental and facial measurements on their dental cast and facial profile photographs. A prediction model was developed using multiple linear regression. The applicability of the prediction model was checked on an independent sample. Data was analysed using STATA 12. Of the 76 patients, about two-third (n=47) were females. The overall median age was 12.3 years (inter-quartile range: 1.8), with majority (60.5%) aged 12-14 years. The proportion of Class I, II and III malocclusion was 25 (32.9%), 50 (65.8%) and 1 (1.3%) respectively. Highest percentage of variability 47.4% in ANB angle was determined by the soft tissue ANB angle. 54.9% of the variability in the ANB angle could be explained by overjet, soft tissue ANB' angle, lower lip to E-line distance, Class II incisor relationship, history of malocclusion and thumb sucking, interaction terms between Class II incisor relationship and history of malocclusion, and history of thumb sucking and soft tissue ANB' angle. Sagittal skeletal relationship in an individual can be predicted with moderate accuracy using the prediction equation incorporating dental and facial variables along with history of malocclusion and thumb-sucking without potentially harmful exposure to cephalometric radiographs.

Evaluation of Skeletal Jaw Relation by Different Cephalometric Angles for Sample of Kurdish Young Adults in Sulaimani City-A Cephalometric Study

Objective: An accurate evaluation of the skeletal sagittal jaw relationship is important in orthodontic diagnosis and treatment planning. This study was done to establish cephalometric norms of all types of malocclusions using ANB angle, Wit’s appraisal, and Beta angle and evaluate the significance of W angle compared to these parameters. &#x0D; Methods: Ninety pre-treatment lateral cephalograms of male and female patients aged 18-28 years from Sulaimani city that met the sample criteria were traced digitally by the Easy Dent 4 software program. The sample was divided into three groups of skeletal malocclusions, class I, II, and III, by the two-finger method of Foster initially. It was later confirmed cephalometrically by ANB angle, Beta angle, and Wit’s appraisal; each group consisted of 30 patients. Also, for each subject, the W angle was measured. &#x0D; Results: Significant differences were found in the ANB angle, Beta angle, Wit’s appraisal, and W-angle in all 90 patients. The coefficient of variability showed that Wit’s appraisal was the most variable parameter and W angle was the least variable parameter. &#x0D; Conclusions: ANB angle, Beta angle, Wit’s appraisal, and W-angle are significant parameters to assess the sagittal jaw relationship. The use of W angle and other parameters can provide a more accurate assessment of the sagittal skeletal jaw relationship as it has the least coefficient of variance; it should therefore enable better diagnosis and treatment planning for patients.

Correlation Between Degree of Mandibular Incisors Crowding, Lower Incisor Position and Vertical Craniofacial Configuration in Different Malocclusions

Objective: To evaluate the correlation between the degree of mandibular incisor crowding, lower incisor position and vertical craniofacial configuration in different malocclusions.&#x0D; Study Design: Cross-sectional analytical study.&#x0D; Place and Duration of Study: Orthodontics department, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jan to Dec 2018.&#x0D; Methodology: This study was conducted on 100 pre-treatment study casts and lateral cephalographs of orthodontic, aged 10 to 26 years. Patients who presented with complaints of lower incisors crowding were included in the study. The cephalogram tracings, calculations and lower incisor crowding measurements were taken. All the fifteen parameters of vertical craniofacial configuration, lower incisors position and sagittal skeletal base relationship were measured.&#x0D; Result: Out of 100 patients, 45 were males and 55 were females with a mean age of 16.11 ± 3.53 years. According to this study, there was no statistically significant correlation between the degree of lower incisor crowding and vertical facial proportions and incisor position in studied malocclusions.&#x0D; Conclusion: The lower incisor crowding was a local and independent discrepancy. It was a frequently encountered problem, successful therapy depends upon several contributing factors that must be identified for successful management.

Percentage of tonsil hypertrophy in orthodontic patients with different sagittal skeletal relationship

Objective: To investigate the prevalence of tonsil hypertrophy in patients with different sagittal skeletal craniofacial patterns, as well as the correlation between tonsil hypertrophy and the type of skeletal pattern. Methods: Lateral cephalograms of patients who visited the Department of Orthodontics Division 1, School of Stomatology, Wuhan University during January to August, 2019 were retrospectively collected. Patients (children: age≥6 and ≤12 year; adults: age≥18 year) were divided into three groups according to the ANB (subspinale-nasion-supramental) angle: the skeletal class Ⅰ group (0°≤ANB≤4°), skeletal class Ⅱ group (ANB>4°) and skeletal class Ⅲ group (ANB<0°). Tonsil hypertrophy was diagnosed with lateral cephalogram by two specifically trained orthodontists independently, according to the Baroni's method. The between-group differences in tonsil hypertrophy prevalence were analyzed using chi-square tests with Bonferroni correction (α=0.017). Results: A total of 1 776 patients (593 children and 1 183 adults) were included, among which 672 (37.8%) were with class Ⅰ, 849 (47.8%) with class Ⅱ, and 255 (14.4%) with class Ⅲ skeletal pattern. The prevalence of tonsil hypertrophy in children was 66.3% (393/593). The proportion of children with tonsil hypertrophy in class Ⅲ group [87.0% (60/69)] were significantly higher than that in class Ⅰ [65.6% (145/221), χ²=11.56, P<0.017] and class Ⅱ [62.0% (188/303), χ²=15.69, P<0.017] groups. The prevalence of tonsil hypertrophy in adults was 23.2% (275/1 183). The proportion of adults with tonsil hypertrophy in class Ⅲ group [42.5% (79/186)] was significantly higher than that in class Ⅰ [19.1% (86/451), χ²=36.50, P<0.017] and class Ⅱ [20.2% (110/546), χ²=35.00, P<0.017] groups. However, there was no significant difference in the prevalence of tonsil hypertrophy between class Ⅰ and class Ⅱ groups for both children (χ²=0.70, P>0.017) and adults (χ²=0.18, P>0.017). Conclusions: The prevalence of tonsil hypertrophy in skeletal class Ⅲ patients was significantly higher than that in patients with skeletal class Ⅰ and Ⅱmalocclusion. Tonsil hypertrophy could be an important risk factor for skeletal class Ⅲ patients.

Total maxillary arch distalization with modified C-palatal plates in adolescents: A long-term study using cone-beam computed tomography

The aims of this study were to evaluate the long-term skeletodental effects, the volume of maxillary tuberosity, and airway space changes after maxillary molar distalization using modified C-palatal plate (MCPP) in adolescents with Class II malocclusion. The sample consisted of 20 adolescent patients (MCPP group; mean age, 12.9±1.0year) who underwent bilateral distalization of their maxillary dentition and 20 subjects as a control group. In the MCPP group, cone-beam computed tomography images were taken before distalization, at the end of the treatment, and during retention with a minimum of a 3-year posttreatment follow up period. Repeated measures ANOVA followed by post-hoc analysis with the Bonferroni test were used to identify significant differences between time points. After the long-term observation period, sagittal skeletal and dental relationships were maintained (there were no significant changes in ANB, occlusal plane angle, and overjet postretention). The vertical skeletal dimension did not change during treatment and was stable at the long-term follow-up (the mandibular plane angle and ANS-Me were relatively well maintained). The volume of the maxillary tuberosity showed no significant change during long-term retention. However, the volume was significantly smaller in the treatment group than in the control group (P<0.0001). There were no significant airway space changes after distalization and the postretention period. In addition, there was no significant difference between the MCPP and control groups. Improved sagittal skeletal and dental relationships because of treatment were maintained in the long-term evaluation. There was no negative long-term effect on airway space associated with the maxillary arch distalization. Therefore, these findings might be beneficial for clinicians in diagnosis and treatment planning for Class II malocclusion in adolescents.