Steiner Analysis Research Articles

Comparative Evaluation of Digital Cephalometric Tracing Applications on Mobile Devices and Manual Tracing.

BACKGROUND Cephalometric radiography evaluates facial skeleton development and aids in diagnosis and treatment phases (pre and post) in orthodontics. This study aimed to compare digital cephalometric tracing using a smartphone application (App), a tablet-based platform, and manual tracing in 30 orthodontic patients. MATERIAL AND METHODS Thirty orthodontic pretreatment, criteria based, lateral cephalometric radiographs were analyzed/grouped for Steiner analysis parameters (5 skeletal, 3 dentals, 1 soft tissue) by 3 tracing methods [manual - group (Gp M), smartphone (Android - OS9) - Gp S, tablet (Apple - IOS13) - Gp T) after mandatory standardization/calibration. Measurements include 5 angular (SNA, SNB, ANB, SNMPA, SNOP), 3 linear U1NA, L1NB, U1L1, and 1 soft tissue (S line) (millimeters and degrees). Inter-examiner rating was determined using Dahlberg's test. After normality distribution testing (Shapiro-Wilk), data were analyzed using one-way analysis of variance (ANOVA) for group differences. Homogeneity of variance was verified using the Levene test. Differences were determined on probability value of (p≤0.05). RESULTS The results showed that Steiner's analysis parameters were similar in all groups with homogenous variances. Highest differences in mean values were found for L1NB, U1L1, and S line measurement, with higher values being observed in Gp S tracings. However, these differences were not statistically significant (p≤0.05). All parameters, irrespective of being measured in either degrees or millimeters, had means comparable to each other. CONCLUSIONS Smartphone and tablet-based applications produced tracings that were comparable and reliable when compared to conventional manual tracings. Standardization of images, processing, printing, and calibration of devices is important to achieve good results.

Steiner cephalometric analysis in orthognathic surgery patients treated at Department of Oral and Maxillofacial Surgery, Hasan Sadikin General Hospital, Bandung

Objective: Orthognathic surgery is surgery on abnormalities of dentofacial that occur in the maxilla, mandible, or both. Determine measurement of the type of dentoskeletal abnormality in malocclusion using cephalometric analysis. Steiner analysis is used because it is considered that the Sela tursica-nasion-point A (SNA) angle, Sela tursica-nasion-point B (SNB) used to describe the relationship between the maxilla and the mandible. Material and Methods: The study involved 30 patients who underwent orthognathic surgery between April 2017 and April 2022 at Hasan Sadikin Hospital Bandung. Cephalometric radiography was utilized for assessment, employing the Steiner method to analyze various angles. Patient characteristics, including gender and age, were also observed. Parameters such as the average angle of SNA, SNB, and ANB were examined, alongside diagnoses, the number of corrected jaws, and the type of orthognathic surgery. Results: The findings indicated a predominance of male orthognathic surgery patients (63.3%), with the majority falling within the age range of 19 to 20 years (40%). Grade III malocclusion was the most prevalent diagnosis (96.7%), with double jaw correction being the most common procedure performed (90%). Bilateral sagittal split osteotomy was utilized in 93% of cases, followed by Le Fort I osteotomy in 96.7% of cases and chinplasty in 16.7% of patients. The average SNA, SNB and ANB was 83.8o, 90.6o, and -6.8o, respectively. Conclusion: The findings indicated a higher frequency of orthognathic surgery among patients diagnosed with class III malocclusion. Additionally, a notable proportion of patients underwent simultaneous orthognathic surgery on both the maxilla and mandible.

Comparison study of chewing efficiency in patients with different vertical skeletal patterns of Angle Class I and Angle Class II malocclusions.

The purpose of this study was to analyze and compare the differences in chewing efficiency among patients with different vertical skeletal types of Angle Class I and Angle Class II malocclusions, to provide reference for orthodontic clinical practice. Sample size estimation revealed a minimum of 53 for each class. Thus, a total of 108 patients with Angle Class I and Angle Class II malocclusions were selected. Lateral skull radiographs were taken, and head measurements were analyzed via geometric tracing software. Chewing efficiency was measured using the gravimetric method to compare between the two groups. The vertical skeletal pattern was classified via Steiner analysis. Significant statistical differences in chewing efficiency were observed between patients presenting with Angle Class I and Angle Class II malocclusions (P < .05). Additionally, significant differences in chewing efficiency were observed among patients with different vertical skeletal patterns (P < .05). Furthermore, a statistically significant difference in chewing efficiency was found between men and women (P < .05). Patients with Angle Class I malocclusions exhibited significantly higher chewing efficiency compared to those with Angle Class II malocclusions. Among patients with different vertical facial types, the chewing efficiency followed the order of low angle > normal angle > high angle. Moreover, men demonstrated a higher chewing efficiency than women.

COMPARISON OF THE ACCURACY OF MANUAL CEPHALOMETRY RADIOGRAPHIC MEASUREMENTS AND WEB-BASED DIGITAL SOFTWARE

Background: Determining anatomical landmarks - in the cranium, maxilla and mandible - as well as measuring skeletal and dental angles on cephalometric radiographs are supporting examinations that determine important diagnoses in orthodontic treatment. Traditionally, cephalometric analysis has been performed by tracing radiographic landmarks on acetate overlays and measuring linear and angular variables using protractor. However, despite its widespread use in orthodontics, the technique is time consuming and has several drawbacks, including a high risk of error in tracing, landmark identification, and measurement. Objective: to evaluate the difference of cephalometric measurements using manual and digital technique. Method: pre-treatment cephalometric digital radiographs of 40 patients were traced manually and digitally using WebCeph Ver. 1.0.0 computer software program by the same investigator. A total of 8 anatomical landmarks were located and five angular measurements based on Steiner Analysis were measured. Independent t-tests and Mann-Whitney tests were used to compare the difference of manual and digital measurements. Result: the p-values for SNA, SNB, ANB, I-NA, I-NB were greater than 0.05 (p&gt;0.05). Conclusion: There were no significant difference between manual and digital tracing cephalometric technique using WebCeph for SNA, SNB, ANB, I-NA and I-NB Keywords: Cephalometric measurement, Digital cephalometric analysis, Steiner Analysis, Tracing cephalometry, WebCeph

Steiner Analysis of Cephalometric in Orthognathic Surgery Patients of Department Oral and Maxillofacial Surgery Hasan Sadikin General Hospital Bandung of Period April 2017 – April 2022

Objective: Orthognathic surgery is surgery on abnormalities of dentofacial that occur in the maxilla, mandible, or both. Determine measurement of the type of dentoskeletal abnormality in malocclusion using cephalometric analysis. Steiner analysis is used because it is considered that the Sela tursica-nasion-point A (SNA) angle, Sela tursica-nasion-point B (SNB) used to describe the relationship between the maxilla and the mandible Material and Methods: The study involved 30 patients who underwent orthognathic surgery between April 2017 and April 2022 at Hasan Sadikin Hospital Bandung. Attention was carried out using cephalometric radiography and analyzed using the stainer method by observing angles also observing patient characteristics such as gender and age, average angle of SNA, SNB, ANB, diagnosis, number of corrected jaws and type of orthognathic surgery. Results: The results of this study showed that orthognathic surgery patients were more male (63.3%), most aged between 19 - 20 years (40%), diagnosis of grade III malocclusion (96.7%), double jaw correction action (90%), bilateral sagittal split osteotomy (93%), osteotomy le fort I (96.7%), chinplasty (16.7%), mean angle SNA (83.8), angle SNB (90.6), angle ANB (-6.8). Conclusion: The results showed that more patients underwent orthognathic surgery with class III malocclusion and underwent orthognathic surgery on the maxilla and mandible simultaneously Keywords: Orthognathic surgery, cephalometry, Steiner analysis, malocclusion

Association between Bolton Analysis and Dentoskeletal Parameters of Patients with Malocclusion

The mesiodistal diameter of the teeth must be considered during orthodontic diagnosis; the implementation of measurement tools has made it possible to classify each patient into parameters that determine their treatment needs. The aim of this study is to analyze the association between the Bolton Index and dentoskeletal parameters in patients who come to receive orthodontic treatment at the University Polyclinic of the Mexicali Faculty of Dentistry of the Autonomous University of Baja California. A cross-sectional analytical observational study was carried out. The sample consisted of 45 initial plaster models that met the inclusion criteria. The models were measured to obtain the Bolton Index. Lateral skull radiographs were plotted to determine skeletal class according to Steiner's cephalometric analysis. The data were collected and tabulated in Microsoft Excel 365. A two-factor analysis of variance was performed with several samples per group to determine the association between the Bolton Index with dentoskeletal parameters and sex. To compare the mesiodistal measurements of the teeth, a test was performed. hypothesis for a two-tailed mean difference where the normal distribution was used in both with a significance level of α=0.05. No statistically significant results were found between the values of the analysis of variance and the normal distribution value with a confidence interval of α=0.05. In conclusion no statistically significant difference was found between the results of the dentoskeletal parameters between men and women that determine an association with Bolton index discrepancies.

Facial Soft Tissue Characteristics Among Sagittal and Vertical Skeletal Patterns: A Cone-Beam Computed Tomography Study.

Background Facial esthetics depend on the skeletal and dental structures underlying variable facial soft tissue thickness. In this social context, determining the relationship between external soft tissue and underlying skeletal and dental hard tissue is essential for detailed orthodontic diagnosis and treatment planning. Objective This study aims to measure facial soft tissue thickness in different sagittal and vertical skeletal patterns. Methodology This is an observational study utilizing pre-existing cone-beam computed tomography (CBCT) images of 170 subjects (110 females and 60 males) with a mean age group of 37.45 ± 13.83 years. CBCT images were then classified sagittally based on the point A-Nasion-point B (ANB) angle from Steiner's analysis into skeletal Class I, Class II, and Class III. Furthermore, vertical patterns were grouped based on the Frankfort-mandibular plane angle (FMA) from Tweed's analysis into hyperdivergent, hypodivergent, and normodivergent facial types. One-way ANOVA was used to compare the means of facial soft tissue thickness between the skeletal groups, followed by Tukey's post-hoc test for individual comparison. Multinomial logistic regression analysis was used to test the association between gender, age, and skeletal groups. The significance level was 0.05. Results One-way ANOVA revealed statistically significant differences in both sagittal and vertical groups (p≤0.05).Tukey's post hoc analysis showed that the skeletal Class III group has increased soft tissue thickness in the subnasale, upper lip, and mention compared to Class I and Class II subjects. Moreover, the hypodivergent group demonstrated increased soft tissue thickness in gnathion and mentioned landmarks in relation to the other groups. Multinomial logistic regression analysis showed significant differences between groups according to both gender and sagittal skeleton patterns (p≤0.05), with males less likely to be in Class II. Conclusions Skeletal Class III and hypodivergent groups have thicker soft tissue in specific facial landmarks. Sexual dimorphism was marked in soft tissue measurements.

Comparative analysis for variation of skeletal and dental parameters in bilateral cleft palate in central India population – A Nemoceph study

Introduction: An area of dentistry called orthodontics focuses on repositioning crooked teeth and regulating facial development. Orthodontists and oral surgeons use cephalometric analysis as a planning tool for their patient care. Conventional film-based radiography equipment has been replaced with direct digital devices, which have advantages such as reduced patient radiation exposure, immediate radiographic image generation, the removal of the need for darkrooms, and simple image sharing. The second-most typical craniofacial abnormality that results in birth abnormalities is cleft lip and palate. Such patients frequently do not receive cephalometric testing because of their hypoplastic growth and limited development. Research is needed to help plan a standard treatment regimen, perform orthognathic operations, and use a low-radiation analysis technique. Objectives: To evaluate skeletal and dental parameters for cleft lip and palate using Down analysis, Steiner's analysis, and Tweed's analysis using Nemoceph. Methods: Around 50 cases from cleft lip and palate and non-cleft lip and palate will be selected from the orthodontics department of Sharad Pawar Dental College and Hospital. Steiner's, Down's, and Tweed's analyses will be evaluated using Nemoceph. Further analysis will be conducted using the observational data from the readings. There will be millimetre-based measurements made. Comparative analysis will be done with one-way ANOVA and post hoc statistics and regression analysis will be done for association of demographic variables. Expected outcomes: This study will use the nasion as a stable landmark to evaluate point A in cleft lip and palate patients, making it easier to perform normal cephalometric analysis. This will enable the evaluation of the probable position of point A for performing cephalometric analysis in orthodontics.

On the role of isospin violation in the pion–nucleon σ-term

In recent years, a persistent tension between phenomenological and lattice QCD determinations of the pion–nucleon σ-term σπN has developed. In particular, lattice-QCD calculations have matured to the point that isospin-violating effects need to be included. Here, we point out that the standard conventions adopted in both fields are incompatible, with the data-driven extraction based on the charged-pion mass, but lattice-QCD conventions relying on the mass of the neutral pion to define the isospin limit. The corresponding correction amounts to ΔσπN=3.1(5)MeV when evaluated in chiral perturbation theory with low-energy constants determined from a Roy–Steiner analysis of pion–nucleon scattering as well as σπN itself. It reduces the tension with lattice QCD, and should be included in the comparison to phenomenological determinations. We also update the extraction from pionic atoms accounting for the latest measurement of the width of pionic hydrogen, σπN=59.0(3.5)MeV, and provide the corresponding set of scalar couplings of the nucleon.

Comparison of Steiner Cephalometric analysis of lateral skull X-ray images with CBCT in a group of students of the dental school of the University of Cuenca

The Steiner analysis from images obtained from cone beam computed tomography is one of the essential tools today for diagnosis in the area of orthodontics, within this aspect its high value for the study of points, angles and cephalometric planes allows the prediction of the possible treatment plan for each patient according to the specific characteristics resulting in each patient. Objective: To compare the results in Steiner cephalometric measurements obtained in 2D lateral skull radiographs and in 3D cephalograms generated from Cone Beam Computed Tomography (CBCT). Methodology: Type of comparative analytical study. A non-probabilistic sample was established by convenience consisting of 29 diagnostic studies divided into: 29 lateral skull X-rays and 29 standardized CBCT. Subsequent localization, tracing and measurement of skeletal and dental angles were performed according to Steiner's cephalometric analysis using Nemostudio 2022 software. The study and analysis was performed using the Intraclass Correlation Coefficient. Results: The mean difference between the skeletal angles SNA, SNB, ANB, SND and Occlusal Plane Angle showed that there is no significant discrepancy when performing a cephalometric analysis in three-dimensional images compared to two-dimensional images. Conclusion: There is a high degree of reliability and accuracy of cephalometric measurements for obtaining skeletal and dental angles in two-dimensional images obtained from a CBCT with respect to a lateral radiograph.

Photographic Frankfort plane subnasale pogonion (FSA) angle for assessment of anteroposterior discrepancies in malocclusion subjects: A prospective study.

Anterior-posterior discrepancy assessment is a crucial component of orthodontic diagnosis and is often carried out using hard tissue cephalometric analysis. The purpose of this study was to compare the photographic Frankfort plane subnasale pogonion (FSA) angle with established cephalometric parameters to determine the accuracy of the angle in determining maxillomandibular anteroposterior discrepancies. In this prospective study, a total of 60 subjects, 20 in each skeletal sagittal malocclusion, were included in the final sample based on the selection criteria. Both photographic and cephalometric records were taken, and the parameters assessed were the beta angle, Steiner's analysis, the ANB (A point- Nasion- B point) angle in the cephalograms, and the FSA angle in the profile photographs. Statistical analysis was done with SPSS software. The correlation between the measured parameters was assessed using Pearson's correlation test. A high positive and significant correlation between the FSA angle and beta angle (r = 0.793) was noted, and a high negative and significant correlation between the FSA angle and ANB angle (r = -0.848) was noted. The photographic FSA angle can be used as a reliable parameter to diagnose anteroposterior discrepancies.

Correlation between Chronological Age and Cervical Vertebrae Morphology in Adolescents with Class I, II and III Malocclusions

Background: Predicting the best treatment time is an important factor for treating different malocclusions and growth modification treatments. The aim of this study is to compare the mean age of adolescent growth spurt and duration of pubertal growth peak in Class I, Class II and Class III patients according to Baccetti's cervical vertebral analysis. Material &amp; Methods: In this retrospective cross-sectional study, 310 lateral cephalograms (198 girls and 112 boys) aged between 7 and 17 years were examined. The evaluation of skeletal maturation stage was performed by visual analysis of morphological features of the cervical vertebrae (C2, C3, and C4). The skeletal malocclusion was determined by Steiner analysis performed and calibrated independently by two orthodontists. The Kappa coefficient was done to calculate the intra and inter-observer error. Results: This study showed high correlation coefficient between chronological age and skeletal age with class I and II malocclusion, in girls were 0.78 and 0.74 and in boys 0.78 and 0.70 respectively. The results of the study showed a higher correlation coefficient in class III malocclusion, both in girls and boys, (0.83 and 0.82, respectively). In girls the average duration of growth spurt was 1.5 years in class I patients, 0.9 years in class II and 3.5 years in class III patients. In boys the average duration of growth spurt was 1.4 years in class I patients, 1.1 years in class II and 2.9 years in class III patients. Pubertal growth peak occurs earlier in girls with class III malocclusion than in girls with class I and class II malocclusions. Conclusion: The results of this study showed a high correlation coefficient between chronological age and the stages of cervical vertebrae maturation in all three malocclusions. Therefore, it is possible to use CVM to measure skeletal maturity in all three malocclusions. Girls experience adolescent growth spurt 1.3 years earlier than boys on average. Girls with class III malocclusion experience the adolescent growth spurt earlier in comparison to other malocclusions, while class II boys mature later than the others.

Lateral cephalometric values of FKG ULM students Banjar ethnic according to Steiner analysis

Objectives: This study aimed to determine the value of dentocraniofacial measurements of FKG ULM students from Banjar ethnic in terms of lateral cephalometric radiography using Steiner analysis.&#x0D; Materials and Methods: Cephalometric measurements were performed using the Steiner analysis method on skeletal landmarks: SNA, SNB and ANB; dental: UI-NA, LI-NB, and interincisal angle. Data analysis was performed by descriptive statistical method.&#x0D; Results: The average skeletal and dental value of the FKG ULM students from Banjar ethnic at the SNA angle is 86.31°± 4.49°, the SNB is 81.33°± 4.39°, the ANB is 4.98°± 2.05°, the UI-NA angle is 19.69°± 8.22°, the LI-NB angle is 28.65°± 6.76°, the UI-NA distance is 4.45± 2.86 mm, the LI-NB distance is 8.58± 3.19 mm and the interincisal angle is 126.43°± 10.51°.&#x0D; Conclusion: The dental and skeletal averages showed that the FKG ULM students from Banjar ethnic had more prognathic maxillary and mandibular positions and more protrusive maxillary and mandibular incisor positions than the normal standard of Steiner's analysis.

Evaluation and Comparisons of Steiner's Analyses in Class I, Class II, and Class III Patients of Central India as an Aid in Orthodontic Treatment Plan

Background: Cephalometric values particular to one ethnic group may not be applicable to others. Purpose: The purpose of the study was to evaluate and compare Steiner's analyses in Class I, Class II, and Class III patients of Central India in two different age groups. Materials and Methods: Sample size comprised 240 patients belonged to Central India. Patients were divided into two main groups: Group I comprised 120 young children in age of 12–16 years and Group II comprised 120 young adults in age of 18–22 years. Steiner's analysis was done from the data collected to assess skeletal and dental parameters. Results: Central Indian patients had bimaxillary dentoalveolar protrusion, particularly predominant in Class I and Class II males and Class III females. Central Indian patients had predominant retrognathic jaws in comparison to Caucasian norms. Conclusions: The differences of skeletal and dental parameters indicate that Caucasian norms cannot be truly adhered to Central India patients during orthodontic treatment. Incisors were normally more proclined in Central Indian patients and their overretraction during orthodontic treatment would cause flattening of facial profile and therefore should be avoided.

An Establishment of Various Cephalometric Parameters in an Urban Setup in Odisha and Linking it with the Discernment of Pleasant Profiles by Lay Persons.

Aim:To evaluate cephalometric parameters of orthodontic population in an urban setup in Odisha using Steiner's, Tweed's and Rakosi's analysis and compare it with the established Caucasian norms.Methodology:Pre-treatment patient records from a dental hospital were collected. Lateral cephalograms of the normal and supernormal sample were traced. Cephalometric features relating to various facial hard tissue that determine balance and harmony were measured using Steiner's, Tweed's and Rakosi's analysis. The values obtained were compared with the established Caucasian norms. Comparison of mean values were done via independent sample t test and ANOVA. Subsequently post hoc Tukey's was used to establish the significance of the mean difference of all the variables used.Results:Significant differences were obtained for lower incisor to NB, mandibular plane angle, FMA, FMIA, articular angle, basal plane angle, inclination angle, Rakosi Jarabak ratio and interincisal angle.Conclusion:Fundamental variations were seen in various parameters. Perception of lay persons can be of aid to the clinician in assembling commendations for alternative treatment plans.

The perception of attractiveness of the facial profile among people of Telangana ethnicity

Background: The success of orthodontic treatment to a significant extent is largely dependent on the patient's and lay peoples' perception. Treatment can influence the soft tissue profile of the face, which is why, it is important for orthodontists to perceive what is considered attractive and unattractive amongst locals, and further, incorporate this knowledge in their diagnosis and treatment planning for population-specific groups.Aim: To evaluate differences in perception of attractiveness of the human face (in profile view) among ethnic Telangana subjects when compared to ideal Caucasian facial profile attractiveness standards.Methods: Profile silhouettes of ethnic Telangana subjects with straight, convex and concave facial profiles were rated by 10 adult laypersons (ethnic Telangana origin) and scored from least to most attractive. Fifteen relevant soft-tissue parameters from the Ricketts, Legan-Burstone, Steiner's and Z-Merrifield analysis were then evaluated on lateral cephalometric radiographs of the highest scoring subjects (considered most attractive) and sample t test statistical analysis was done in order to investigate differences between obtained values of the 'attractive' group as compared to standard values given in these analyses.Results: Of 15 parameters compared, significant differences from standard cephalometric values were evident for- vertical lip-chin ratio, lower lip protrusion, mento-labial sulcus and Z- angle. These measurements were smaller in the evaluated population group as compared to orthodontic norms.Conclusion: People of ethnic Telangana origin considered a shorter and less prominent lower lip and chin and a shallower mento-labial sulcus to be more attractive, as compared to standard orthodontic cephalometric norms of Caucasian populations.

Maxillomandibular Development after Mandibular Distraction Osteogenesis in Isolated Pierre Robin Sequence Patients

Mandibular distraction osteogenesis (MDO) is a favored surgical technique for addressing the airway difficulties that result in patients with Pierre Robin sequence. Devices are placed to distract the micrognathic mandible forward and generate bone at bilateral mandibular osteotomies.1 Though it is generally accepted that these patients will continue to develop with disproportionate maxillomandibular growth after distraction2, the timeline for relapse back to a skeletal class II relationship, as well as differences between male and female development post-distraction, is not well-described.The purpose of this study is to characterize a timeline of maxillomandibular growth for patients with isolated Pierre Robin sequence (iPRS) after MDO during infancy based on Steiner's analysis and clinical impressions, as well as to identify differences in post-distraction growth between males and females. The researchers hypothesized that these patients would demonstrate disproportionate growth after distraction and that females would relapse at a faster rate than males. By improved understanding of this timeline, clinicians may better educate parents with expectations for their child's craniofacial development after distraction.Department records were retrospectively reviewed to identify patients with iPRS who underwent MDO during infancy from 2004 through 2016. Patients with post-distraction imaging from which cephalometric data could be traced (i.e., lateral cephalograms or cone beam computerized tomography [CBCT] scans) were included. These were traced by 2 independent reviewers for SNA, SNB, and ANB angles, according to Steiner's analysis to determine skeletal classification. Patients with pre- and post-distraction lateral profile photos were assessed by 1 reviewer for skeletal classification based on clinical appearance. Patient age at distraction, sex, time from initial distraction to imaging study, and prior maxillomandibular surgeries were abstracted. Descriptive statistics and significance testing were performed; 38 patients with iPRS who underwent MDO were identified. Of these, 15 (39.5%) had at least 1 postoperative lateral cephalogram. Average time from surgery to initial lateral cephalogram (TAS) was 67.81 months for all patients (range 25.53 to 129.93 months). The majority of patients (n = 12) had an ANB > 2° at the time of lateral cephalogram. One patient (TAS 25.53 months) had an ANB of 1.3°, whereas 2 patients (both with prior cleft palate repair) had an ANB < 0° (TAS 32.67 and 97.17 months). Nine (60%) of all patients with lateral cephalogram data fell within 1 standard deviation of average TAS (39.52 to 96.1 months), with corresponding average SNA, SNB, and ANB angles of 80.97, 73.99, and 7.03, respectively; 33% of these patients (n = 3) had prior palatal surgery. Of the 38 patients, 37 had pre- and post-distraction lateral photographs; 13 of 15 (86.7%) females, and 12 of 22 (54.5%) males relapsed to a skeletal class II relationship by the last follow-up appointment (P = .04). The mean postoperative follow-up months for females (69.3 months) and males (79.9 months) was similar (P = .50). Based on post-distraction cephalometric tracing, 80% of patients reverted back to a skeletal class II relationship by an average of 68 months. Based on post-distraction clinical appearance, 68% of patients reverted to a class II relationship by an average of 76 months. Furthermore, a more significant percentage of females relapsed to a skeletal class II relationship compared to males at similar follow-up points. These findings may help clinicians and parents better understand and prepare for the maxillomandibular developmental timeline of these patients post-distraction.

Maxillomandibular Development after Mandibular Distraction Osteogenesis in Isolated Pierre Robin Sequence Patients

Mandibular distraction osteogenesis (MDO) is a favored surgical technique for addressing the airway difficulties that result in patients with Pierre Robin sequence. Devices are placed to distract the micrognathic mandible forward and generate bone at bilateral mandibular osteotomies.1 Though it is generally accepted that these patients will continue to develop with disproportionate maxillomandibular growth after distraction2, the timeline for relapse back to a skeletal class II relationship, as well as differences between male and female development post-distraction, is not well-described.The purpose of this study is to characterize a timeline of maxillomandibular growth for patients with isolated Pierre Robin sequence (iPRS) after MDO during infancy based on Steiner's analysis and clinical impressions, as well as to identify differences in post-distraction growth between males and females. The researchers hypothesized that these patients would demonstrate disproportionate growth after distraction and that females would relapse at a faster rate than males. By improved understanding of this timeline, clinicians may better educate parents with expectations for their child's craniofacial development after distraction.Department records were retrospectively reviewed to identify patients with iPRS who underwent MDO during infancy from 2004 through 2016. Patients with post-distraction imaging from which cephalometric data could be traced (i.e., lateral cephalograms or cone beam computerized tomography [CBCT] scans) were included. These were traced by 2 independent reviewers for SNA, SNB, and ANB angles, according to Steiner's analysis to determine skeletal classification. Patients with pre- and post-distraction lateral profile photos were assessed by 1 reviewer for skeletal classification based on clinical appearance. Patient age at distraction, sex, time from initial distraction to imaging study, and prior maxillomandibular surgeries were abstracted. Descriptive statistics and significance testing were performed; 38 patients with iPRS who underwent MDO were identified. Of these, 15 (39.5%) had at least 1 postoperative lateral cephalogram. Average time from surgery to initial lateral cephalogram (TAS) was 67.81 months for all patients (range 25.53 to 129.93 months). The majority of patients (n = 12) had an ANB > 2° at the time of lateral cephalogram. One patient (TAS 25.53 months) had an ANB of 1.3°, whereas 2 patients (both with prior cleft palate repair) had an ANB < 0° (TAS 32.67 and 97.17 months). Nine (60%) of all patients with lateral cephalogram data fell within 1 standard deviation of average TAS (39.52 to 96.1 months), with corresponding average SNA, SNB, and ANB angles of 80.97, 73.99, and 7.03, respectively; 33% of these patients (n = 3) had prior palatal surgery. Of the 38 patients, 37 had pre- and post-distraction lateral photographs; 13 of 15 (86.7%) females, and 12 of 22 (54.5%) males relapsed to a skeletal class II relationship by the last follow-up appointment (P = .04). The mean postoperative follow-up months for females (69.3 months) and males (79.9 months) was similar (P = .50). Based on post-distraction cephalometric tracing, 80% of patients reverted back to a skeletal class II relationship by an average of 68 months. Based on post-distraction clinical appearance, 68% of patients reverted to a class II relationship by an average of 76 months. Furthermore, a more significant percentage of females relapsed to a skeletal class II relationship compared to males at similar follow-up points. These findings may help clinicians and parents better understand and prepare for the maxillomandibular developmental timeline of these patients post-distraction.

Duration of the pubertal growth spurt in patients with increased craniofacial growth component in sagittal and vertical planes\u2014retrospective and cross-sectional study

ObjectivesThe aim of the study is to assess the skeletal age at the onset and end of the pubertal growth spurt and determine its duration in four growth type groups: (1) normodivergent skeletal Class I (I N), (2) normodivergent skeletal Class III (III N), (3) high-angle skeletal Class III (III H) and (4) high-angle skeletal Class I (I H).Materials and methodsTwo hundred thirteen subjects were selected from 2163 examined files. The cervical vertebral maturation stage was recorded by means of Baccetti’s method. The sagittal and vertical skeletal relations were evaluated according to Steiner analysis with Kaminek’s modification. The duration of the pubertal growth spurt was calculated from the difference between the means of the chronological age related to CS3 and CS4 maturation stages.ResultsThe shortest lasting pubertal growth spurt was observed in group I N (1.1), followed by group III N (1.6). Major differences between arithmetic means CS4-CS3 were seen in groups I H and III H (2.3 and 2.7, respectively).ConclusionsThe following tendency was observed in the duration of the pubertal growth spurt: I N < III N < I H < III H. This tendency has statistical significance only in high-angle patients in comparison with normodivergent skeletal Class I.Clinical relevanceKnowledge on the longer pubertal growth spurt in high-angle patients compared to patients with normal anteroposterior and vertical relationships can be useful in the selection of an appropriate therapeutic method and a treatment time.

Cephalometric Evaluation Based on Steiner's Analysis on Adults of Bihar.

Aim:To evaluate the mean cephalometric values for Steiner Analysis in bihar population.Objectives:To evaluate the cephalometric features of a bihar population and to present_an organized, comprehensive cephalometric norms for Steiner cephalometric analysis.. To introduce mean values to assess skeletal, dental and soft tissue relationship using Steiner analysis for orthodontic diagnosis.. To compare standards that will be derived with the earlier established norms for other population.Materials and Methods:The study was conducted in the Department of orthodontics and dentofacial orthopedics,Buddha Institute of Dental Sciences And Hospital,Patna(Bihar). The sample was collected from the out patient department of the same college.Source of the Data:The present analysis was made on lateral cephalograms of 60 subjects with well balanced and acceptable facial profile of Bihar population. The subjects were informed about the purpose of the study.Methods of Collection of Data:Subjects with age group of 18-26 years with dento-alveolar class I malocclusion and acceptable facial profile were selected by trained orthodontists, who belonged to the department of orthodontics and dentofacial orthopedics,Buddha Institute of Dental Sciences And Hospital.Results and Conclusion:There was increase in SNA angle, SNB angle, SND angle,in Bihar population than Caucasians. Bihar population has proclined and forwardly placed upper and lower incisors, which was indicative of bimaxillary protrusion as compared to Caucasians. Bihar population had protrusive upper and lower lips as compared to Caucasians. Bihar population males had tendency towards horizontal growth pattern of the mandible than females. Bihar females had more proclined lower incisors than males