Vertical Growth Pattern Research Articles

Morphometric analysis of the mandibular condyle of hyperdivergent individuals with class II and class III skeletal patterns / Análise morfométrica do côndilo mandibular de indivíduos hiperdivergentes com padrões esqueléticos de classe II e classe III

Introduction: to compare the condyle morphology of individuals with hyperdivergent skeletal patterns in class ii and class iii skeletal patterns. Methods: multislice computed tomography examinations of 41 individuals (82 temporomandibular joints), aged 18 to 42, with an accentuated vertical growth pattern, of whom 21 had a class ii skeletal pattern and 20, a class iii skeletal pattern were evaluated retrospectively. The following measurements were taken: width (d1), thickness (d2), horizontal angle (a1), and anterior angle (a2) of the condyle. The normality of data distribution was verified by means of descriptive statistics, graphical analysis, and the shapiro-wilk test. The student’s-t test was used to compare the measurements between the groups tested. The pearson correlation was used to identify correlations among quantitative measurements. A 5% level of significance was used for all tests. Results: there was statistically significant difference between groups for the four measurements analyzed (p 0.05). D1 and d2 values were lower for hyperdivergent individuals with a class ii skeletal pattern. A1 was higher for hyperdivergent individuals with a class ii skeletal pattern, and a2, higher for hyperdivergent individuals with a class iii skeletal pattern. Conclusions: hyperdivergent individuals with a class ii pattern have a condyle with a smaller thickness and width, than individuals with a class iii pattern, and these characteristics should be considered when planning the orthodontic and orthognathic treatments.

Relationship of maxillary and mandibular effective base length, arch length and dental crowding in different vertical growth pattern

Objectives: The objectives of the study were to assess, measure, and correlate the maxillary and mandibular effective base length, arch length to the amount of dental crowding in different vertical growth pattern patients. Materials and Methods: Sample comprising 100 pre-treatment lateral cephalograms and study models (age group – 16–25 years) was randomly selected. The sample was divided into two groups, that is, clockwise (50) and anticlockwise (50) rotation based on the measurement of the gonial angle. The gonial angle and maxillary and mandibular effective lengths were measured on pre-treatment lateral cephalograms. Dental crowding and arch length were measured on the pre-treatment dental casts. Intergroup comparisons of effective base length, arch length, and crowding were performed with unpaired t-tests. Correlations between effective base length, arch length, and dental crowding were examined by means of Pearson’s correlation coefficient (P < 0.05). Results: Subjects with clockwise rotation significantly had more mandibular dental crowding and significantly decreased mandibular arch length compared to the anticlockwise group. An inverse correlation was found between maxillary and mandibular effective base length, arch length, and dental crowding while a positive correlation was found between maxillary and mandibular base length and arch length in both the groups. Conclusion: Clockwise rotation of the mandible along with skeletal and dental factors such as decreased effective base lengths and arch length, respectively, constitutes an important factor leading to dental crowding.

Association of Gonial Angle with Hand Grip Strength in Vertical, Horizontal and Average Growers: A Cross-sectional Study

Introduction: The orthodontic treatment focuses on improving facial esthetics and functional occlusion by improving the masticatory function, including masticatory chewing pattern, masticatory muscle activity, maximum occlusal force, and occlusal contact area. In orthodontics, every decision is based on the patient’s growth pattern and muscle strength. Aim: To evaluate the gonial angle, hand grip strength and association of the gonial angle with Hand Grip Strength(HGS) in vertical, horizontal and average growers. Materials and Methods: This cross-sectional study was conducted from 24th June 2021 to 24th July 2022 in the Orthodontics Department at Sharad Pawar Dental College and Hospital in Sawangi, Wardha District, Maharashtra, India on a total of 196 patients. Data were categorized according to the growth pattern. For the vertical growth pattern, 49 patients were selected, 49 for the horizontal growth pattern, and 98 for the average growth pattern. A Jamar hand dynamometer was used to measure HGS and gonial angle using a lateral cephalogram. Study compared the results using inferential and descriptive statistics with a Analysis of Variance (ANOVA) (one-way) and multiple comparisons with the Tukey test. Also, p<0.05 was considered as a level of significance. Results: The data of total of 49 patients in vertical growth pattern, 49 for the horizontal growth pattern, and 98 for the average growth pattern was collected and analysed. Grip strength and Gonial angle were compared between horizontal, average, and vertical growers. The gonial angle ranged from 101°to 124° in the average growth pattern, 81° to 99° in the horizontal growth pattern and 121° to 156° in the vertical growth pattern. The HGS in the horizontal growth pattern patients ranged from 27.2 Kg to 57.5 Kg. The HGS in the vertical growth pattern ranged from 14.7 Kg to 37.7 Kg. In the vertical growth pattern, the HGS was decreased compared to the Horizontal growth pattern group. To determine the factor of HGS, Gonial angle is the most prominent one. The assessment of growth patterns is vital in diagnosis and treatment planning. Conclusion: The study concluded that due to weak muscle strength, vertical group cases should be treated more carefully

Vertical growth pattern as a determinant of mandibular asymmetry

Objectives:To determine normal mandibular linear values in three vertical groups, to compare right and left side to highlight a prevalent pattern towards mandibular asymettry.Methods:This is a descriptive cross sectional study in which pre-orthodontic treatment panoramic radiographs and lateral cephalograms of 224 patients (between 18 to 34 years) undergoing treatment in Orthodontic Department of Bahria University Medical and Dental College were used and traced on an acetate sheet. There were 74 patients in high angle,76 and 78 in low angle and normal angle group respectively based on their vertical growth pattern using SNMP angle. Condylar height (CH) and Ramal height (RH), and condylar plus ramal height (CH+RH) measurements were done as previously described by Habets.Results:There was no statistically significant difference between the three groups as determined by one way ANOVA. Condylar height and Gonial angle showed statistically significant difference when right and left side was compared, with increased values on the right side.Conclusion:There was no statistically significant difference in condylar, ramal, and total asymmetry index between different vertical groups. Between the right and left sides, condylar height and gonial angles were significantly increased on the right side. However, Ramal height showed no significant difference. Ramal index has a strong linear correlation with total asymmetry index.

Balance and thickness of soft tissue of the lower third of the face in different vertical patterns of growth

Introduction/Objective. Variations in thickness of soft tissues can influence the position of facial structures as well as facial aesthetics. The objective of the study was to determine whether the frequency of soft tissues imbalance depends on the vertical growth pattern of the face. Methods. The present study consisted of 90 pretreatment lateral cephalograms of adult Serbian Caucasian orthodontic patients (30 male and 60 female), between 18?27 years of age, average 23.6 years. Only the patients with the skeletal class I, based on the values of A-Nasion-point B angle and Wits appraisal, were chosen for the study. All patients were divided into three groups of 30 patients, those with hyperdivergent, hypodivergent and normal vertical growth patterns based on the values of Frankfort mandibular plane angle. Soft tissue of each patient was evaluated following the method given by Merrifield. Results. The obtained results showed that soft tissues of the chin and upper lip were thickest in hypodivergent and thinnest in patients with hyperdivergent growth type. The largest number of patients with soft tissue imbalance was observed in the normal and hyperdivergent vertical growth pattern groups, eight out of 30 patients. The number of patients with imbalance greater than 3 mm was largest in the group with hyperdivergent growth pattern. Conclusion. The pathological skeletal pattern of growth combined with the common occurrence of soft tissue imbalance makes orthodontic treatment in hyperdivergent group of patients more difficult in comparison to patients with normal or hypodivergent growth pattern.

Cephalometric evaluation of the main airway dimensions in subjects with different growth patterns and their relationship to patients' ages and genders

Background: Airway shape and dimensions have attracted attention during the past few decades; this can be attributed to the relationship between the upper airway configuration and sleep-disordered breathing and its relationship with craniofacial morphology in general. This study was conducted to 1. Compare the pharyngeal dimensions of subjects with different vertical growth patterns and 2. Assess the impact of modifying variables, like age and gender, on the airway dimensions. Methods: Data collection was based on both cephalometric radiographs and patients\' files analysis. Radiographs were grouped according to patients\' ages, genders, and vertical growth patterns. Lateral cephalometric radiographs were taken using a standardized technique. The simple network management angle was used to divide the sample into hypodivergent, noromodivergent, hyperdivergent growth patterns with 38°, respectively. The upper and lower pharyngeal airway widths were measured by using McNamara\'s airway analysis. Results: The widest upper and lower pharyngeal widths (LPWs) were found among hypodivergent subjects (20.1 ± 2.3 and 11.6 ± 4, respectively), and gender differences were found in the upper pharyngeal width (UPW) but in the lower (17.4 ± 3.4 and 18.1 ± 3.5, 10.1 ± 2.3 and 10.2 ± 3.1) for males and females in the upper and lower airways, respectively. Increasing the subject\'s ages significantly increased the UPW but did not affect the LPW. Conclusion: Hypodivergent patients had a higher UPW and LPW compared to the noromodivergent and hyperdivergent growth patterns. Also, the UPW and LPW were slightly higher in females than in males and increasing age had significantly increased UPW but did not affect LPW.

Evaluation of Relationship between Pharyngeal Airway Space and Varying Dimensions of Maxilla and Mandible

Aim: Craniofacial abnormalities such as maxillary retrusion, mandibular retrognathism, short mandibular body, and downward and backward rotation of the mandible in hyperdivergent patients are considered to be the most important risk factor for upper airway obstruction. The aim of the study is to analyze the influence of maxillary and mandibular morphology on pharyngeal length. Materials and Methods: The study sample includes 146 pretreatment lateral cephalographs of both male and female patients aged between 18 and 30 years. The study sample was divided into three groups: Group I – Class I skeletal relationship, Group II – Class II, and Group III – Class III. Each group is further divided into three subgroups according to the growth pattern (A – horizontal, B – average, and C – vertical). The lateral cephalograms were traced both manually and digitally using FACAD imaging software. Results: Comparison of mean maxillary, mandibular, and airway dimensions done using one-way analysis of variance proclaims that the means of all the parameters of the study are statistically significant with P < 0.05 except the upper pharyngeal space. Pearson correlation test reveals a statistically significant positive correlation between the height of the ramus and the lower pharyngeal space. Conclusion: The upper pharyngeal space is reduced in Class III, and the lower pharyngeal space is reduced in Class II and Class III malocclusions. The airway dimension decreased in vertical growth pattern in all the skeletal malocclusion groups. Upper and lower pharyngeal space has a negative correlation with ANS-PNS (maxillary length) and length of the body of the mandible, respectively.

Relationship of the maxillary posterior teeth and maxillary sinus floor in different skeletal growth patterns: A cone-beam computed tomographic study of 1600 roots.

PurposeThis study evaluated the distance from the posterior root apices to the maxillary sinus floor (MSF) and the frequency of roots touching or protruding through the MSF using cone-beam computed tomography (CBCT).Materials and MethodsThis study included 100 subjects divided into different vertical and anteroposterior skeletal growth patterns. On CBCT images, the distance from the posterior root apices to MSF was measured and the frequency of roots touching or protruding through the MSF was evaluated using NNT software (version 5.3.0.0; ImageWorks, Elmsford, NY, USA).ResultsNo statistically significant differences were found in the distance from the posterior root apices to the MSF among vertical skeletal groups (P>0.05). The palatal roots of the first molar and the palatal, mesio-buccal and disto-buccal roots of the second molars had significantly less distance from MSF in skeletal class II than in class III (P<0.05). The high-angle group had the highest frequencies of roots touching or protruding into the maxillary sinus (49.8%); the lowest proportion of these roots was found in skeletal class III (28.3%) and the highest proportion in class II (50.3%). Males had shorter distances from the posterior root apices to the MSF and higher frequencies of roots protruding through or touching the MSF than females.ConclusionAnteroposterior skeletal growth patterns and sex affected the distances from the maxillary posterior roots to the MSF. The frequency of roots protruding into or touching the sinus was affected by both vertical and anteroposterior skeletal groups and sex. These findings have implications for dental practice.

Palatal plane inclination on vertical growth pattern among Indians.

The skeletal discrepancies in the vertical dimensions can either lead to a long face or a short face. The palatal plane inclination is one such contributing factor. The study sample comprised of 15 lateral cephalograms collected between the time period of June 2019 - March 2020 with 5 cephalograms belonging to skeletal Class I, II and III respectively. The inclination angle and mandibular plane angle were measured using the FACAD software. The obtained results were tabulated and statistically analysed using Pearson's correlation test to determine the correlation between the two variables. There was a statistically significant negative correlation between the skeletal malocclusions with a p value of 0.011. Thus, palatal plane inclination is not a major contributing factor for vertical growth pattern and it is suggestive of a multifactorial influence.

Comparative Evaluation &amp; Correlation of Severity of Temporo-Mandibular Joint Disorders and Airway Difficulty in Class I and Class II Vertical Growth Pattern Cases

Introduction: There are contradictory opinions regarding the role of occlusal factors in the initiation of TMDs. These patients rarely visit or are referred to Orthodontists or dentists which also accounts for these TMDs being undiagnosed. There is conflicting evidence where most often TMDs are linked to occlusal prematurities. Undiagnosed. There is conflicting evidence where most often TMDs are linked to occlusal prematurities. There is a need to assess TMJ dysfunction before beginning of orthodontic treatment so that necessary precautions can be taken while ongoing orthodontic treatment. Also, between the stages of orthodontic treatment. TMJ evaluation will be helpful in monitoring any signs of TMJ dysfunction and TMD disorders so it can be identified and therapeutic measures can be taken. Many studies have been conducted to measure the pharyngeal airway difficulty; however, comparison with Class II individuals and the correlation between the variables involved in Class II malocclusion with airway measurements and TMD clinically has not been conducted, which encouraged the present study.&#x0D; Materials &amp; Methods: Total 50 patients in the age group of 18-30 years visiting the outpatient Department of Orthodontics will be selected after screening and divided into two groups as follows: Group A (Control Group) - 25 class I malocclusion patients. Group B (Experimental group) - 25 class II Division -1 malocclusion in patients having vertical growth pattern. For clinical evaluation of TMD The routine diagnostic pre-treatment records will be taken for each selected patient. For clinical evaluation of airway difficulty SUSMITA Airway Prediction Analysis will be used. The cases will then be subjected to MRI scan for 3Dimensional evaluation of TMJ and Airway. The results obtained will then be subjected to statistical analysis for evaluation, comparison &amp; co-relation.&#x0D; Expected Outcome: There exists a positive co-relation between severity of TMDs and airway difficulty in class II vertical growth pattern cases.

Correlation of Mandibular Angle and Malocclusion with Hand Grip Strength in Vertical, Horizontal and Average Grower

Background: An orthodontic treatment focuses on improving an individual's facial esthetics and functional occlusion via improved chewing patterns, muscular power, increased force, and occlusal contact area through a more efficient masticatory function. Every decision made during orthodontics treatment will be influenced by the patient’s growth pattern and /or muscle strength.&#x0D; Objectives: To evaluate the gonial Angle in vertical, horizontal and average grower, to evaluate the hand grip strength in vertical, horizontal and average grower and to correlate between gonial angle with hand grip strength in vertical, horizontal and average growth pattern.&#x0D; Methodology: We will study a patient group undergoing orthodontics treatment with vertical, horizontal, and average growth patterns in the Orthodontics Department at Sharad Pawar Dental College and Hospital in Sawangi (Meghe), Wardha District. The calculated sample size of the study will be 196, under criteria 49 for vertical, 49 for horizontal, and 98 for the average growth pattern. Both male and female norms for the value are to be evaluated based on the value.&#x0D; Expected Results: Hand grip strength is to be compared between average, horizontal and vertical growers. Hand grip strength would be inferior in the large gonial angle group compared to the small gonial angle group. Gonial angle is the most conspicuous determining factor of Hand grip strength. Assessment of growth pattern has a vital role in diagnosis and treatment planning.&#x0D; Conclusion: In the present study it will be an attempt to analyze effectiveness of gonial angle in vertical, horizontal and average growth pattern patients compared with hand grip strength. Subject with large and small gonial angle groups using cephalometric radiograph shall be assessed with hand grip strength. A major finding of this study is that gonial angle is one of the key factors for the strength of Hand grips.

Comparative Evaluation and Co-relation of Difficult Airway and Temporomandibular Joint Disorder in Skeletal Class II Vertical Growth Pattern and Class-I Malocclusion – An Observational Study

Introduction: In the recent years it is observed that there has been increase in the no. of cases of Temporomandibular joint disorder and TMJ pain related problem, many of patients go undiagnosed and may transform into irreversible severe cases if the predisposing factors are present. There are different clinical and radiographical methods of diagnosing TMD cases, and one of the simplest ways to diagnose and categorize a Temporomandibular disorder is Helkimo index. The present study is encouraged to measure difficult airway, in Class II malocclusion with TMD.&#x0D; Materials and Method: The observational study will be conducted in Orthodontics and Dentofacial Orthopaedics department, Sharad Pawar Dental College, Sawangi (M), Wardha in collaboration with department of Radiology, Acharya Vinoba Bhave Hospital. Sawangi (M), Wardha. Total 30 patient in age group of 20 to 50 years, will be selected from the patients coming to Out Patient Department (OPD) of Orthodontics and Dentofacial Orthopaedics, Wardha. MRI of patients with skeletal class II vertical growth pattern and class I malocclusion having temporomandibular joint disorder will be taken and then airway is to be evaluated.&#x0D; Expected Results: It is expected that individuals with skeletal class II vertical growth pattern and class I malocclusion with temporomandibular joint disorder may have a compromised airway.&#x0D; Conclusion: No such study has been carried out to evaluate co-relation of difficult airway and temporomandibular joint disorder. Thus, this study aims to evaluate it in skeletal class II vertical growth pattern and class I malocclusion.

Necessary diagnostic criteria of dental crowding in children during mixed dentition with different facial skeleton growth patterns

Annotation. Pathology of dental crowding during mixed dentition is one of the most common and difficult in the practice of dentist-orthodontist. Its prevalence, according to modern scientific data reaches 77% and occurs in all pathologies of occlusion (malocclusions). The aim of our study is to establish the relationship between the formation of dental crowding and the growth patterns of facial skeleton during mixed dentition in order to improve the effectiveness of orthodontic treatment. We used 42 pairs of plaster models and 42 slices of cone-beam computed tomography images (CBCT) for patients aged 7 to 11 years. Randomization of patients into study groups was performed according to the facial skeleton growth patterns and the Little index value. The analysis was performed by the method of variation statistics taking into account the mean values (mode, median, arithmetic mean) and mean error (M) with the assessment of reliable values by Student’s t-test, as well as determining the correlation coefficient using the Pearson pairwise method to detect connections between the obtained indicators at the minimum probability threshold p&lt;0.05 using the statistical package EZR v. 1.35. According to the results of the examined patients: 30 people (71.4%) had a severe degree of dental crowding on both maxilla and mandible (LII&gt; 8 mm.), more often it was associated with the neutral type of growth – 82% (with vertical – 60%). Statistically significant correlations were found between severe degree of dental crowding and vertical and neutral facial skeleton growth patterns (p&lt;0.05). The results of the CBCT study showed that narrowing of the upper pharyngeal airway (UP) according to McNamara was more common in patients with neutral (85%) and vertical (80%) growth patterns with skeletal II and I class malocclusions according to Engle, which were 55% and 35%, respectively. The study revealed that the vast majority of children with dental crowding with different facial skeleton growth patterns had clinically significant disorders of the development of both maxillary and mandibular apical bases and airways which required immediate interceptive orthodontic treatment.

Evaluation of pharyngeal airway width in relation to vertical facial types in children

The purpose of this retrospective study was to evaluate the pharyngeal airway width according to the vertical facial type in Korean children in the developmental stage. In total, 101 participants aged 7 - 11 years were selected and divided into three groups based on the mandibular plane angle. The size of pharyngeal airway width was assessed using lateral cephalograms. The data were statistically analyzed using one way ANOVA test and independent t-test.The vertical growth group showed significantly narrower nasopharyngeal and upper oropharyngeal airway width than that in the normal and horizontal growth groups. Lower nasopharyngeal airway width was the widest in the horizontal growth group and the difference was statistically significant. The vertical oropharyngeal airway space was significantly smaller in girls when compared to boys, and no distinct difference was observed between horizontal airway width of the sexes. The results from this study indicate that patients with vertical facial growth pattern had less pharyngeal airway width than the patients with normal and horizontal facial growth patterns.

Evaluation of Skeletal and Dental Maturity in Relation to Vertical Facial Types and the Sex of Growing Children

The purpose of this retrospective study was to evaluate the skeletal and dental maturity according to the vertical facial type and sex in Korean children in the developmental stage. In total, 184 participants aged 8 - 14 years were selected and divided into three groups based on the mandibular plane angle. For the comparison between the sexes, the three groups were each divided into male and female subgroups. The skeletal and dental maturity were assessed using lateral cephalograms, hand-wrist radiographs and panoramic radiographs. The vertical growth group showed significantly greater cervical vertebral and hand-wrist maturity than that in the horizontal growth group. Dental maturity was the highest in the vertical growth group. Girls showed greater skeletal maturity than boys, and no distinct difference was observed between the dental maturity of the sexes. Analysis of the vertical facial type in children can provide ancillary indicators that may help determine the optimal timing for orthodontic treatment initiation. Earlier initiation of orthodontic treatment may be considered for patients with vertical facial growth patterns.

Orthosurgical management of skeletal class-II malocclusion with vertical growth pattern- A case report

Edward H Angle first gave the classification for malocclusions into Classes I, II and III. Amongst these, Class II is the most prevalent and commonly treated at orthodontic clinics. Treatment of Class II malocclusion with mandibular deficiency in adult patients is usually managed with ortho-surgical treatment modality. In this article a case of Skeletal Class II malocclusion with vertical growth pattern is represented which was treated with BSSRO and mandibular advancement was carried out.

Influence of facial type on attractiveness of vertical canine position from the perspective of orthodontists and laypeople.

To evaluate the attractiveness of changes in vertical position of maxillary canines in frontal smiles of different facial types, and to evaluate the esthetic perceptions of orthodontists and laypeople, and the influence of facial type on these perceptions. Three adult female volunteers were selected as individuals with normal, vertical, and horizontal growth patterns. Frontal posed smile photographs were digitally altered by adjusting vertical positions of the maxillary canines above, below, or coincident with the incisal line in increments of 0.5 mm within a range of 1 mm of extrusion and intrusion. For assessment, a web-based survey was formed with 18 images (six images for each model). A scale was present underneath each image, graded from 0 to 10 (0: unattractive; 10: the most attractive). Images were rated by 233 participants (105 orthodontists; 128 laypeople). Orthodontists scored 0-mm images significantly as the highest in all groups. Laypeople scored significantly higher for -0.5 mm images regardless of facial type. The lowest scored images were -1 mm (except for horizontal pattern) and +1 mm images. Mean values of scores given by men were higher (P < .05). Orthodontists favored ideal dental alignment and preferred the incisal edges of central and canine teeth to be at the same level. Laypeople preferred a smoother smile arc than orthodontists and found harmony with the soft tissue more attractive. Facial type affected perceptions of the vertical changes of maxillary canines.

Different mitotic rates are associated with different prognostic factors, relapses, and survival rates in melanoma

Mitotic rate is one of the major prognostic factors in melanoma. To investigate the significance of mitotic rate and possible impacts of clinicopathological factors on the course of all staged melanoma patients. A total number of 970 melanoma patients were analyzed. Mitotic rates were grouped for analysis as follows: 0-1, 1.1-4.9, 5-9.9, and ≥10 mitoses/mm2 . Melanomas with higher mitotic rates were more likely to be associated with nodular histology (P = 0.0001), higher Clark level (P = 0.0001), thick Breslow depth (P = 0.0001), ulceration (P = 0.0001), vertical growth pattern (P = 0.0001), neurotropism (P = 0.04), lymphovascular invasion (P = 0.01), de novo melanoma (P = 0.0001), absence of tumor infiltrating lymphocytes (P = 0.02), advanced stage (P = 0.0001), and relapse (P = 0.0001). The 5-year overall survival (OS) rate of all patients was 68.7%, and it decreased significantly from 87% in melanomas with 0-1 mitoses/mm2 to 65.2%, 56.6%, and 50.4% in melanomas with 1.1-4.9, 5-9.9, and ≥10 mitoses/mm2 , respectively (P = 0.0001). Age (P = 0.04), gender (P = 0.03), histology (P = 0.0001), Clark level (P = 0.001), T-stage (P = 0.003), ulceration (0.006), node involvement (P = 0.0001), metastasis (P = 0.005), and relapse (P = 0.0001) were correlated with OS in 0-1 mitoses/mm2 melanomas, whereas lymphovascular invasion (P = 0.0001), BRAF mutation (P = 0.01), metastasis (P = 0.0001), relapse (P = 0.0001), and relapse pattern (P = 0.005) were found significant for ≥10 mitoses/mm2 melanomas. Higher tumor mitotic rates associated with known histopathological and clinical poor prognostic factors were found to be significantly independent predictors of early relapse and unfavorable survival for cutaneous melanoma patients. Moreover, different prognostic variables were found to be affecting survivals in melanoma patients with lower and higher mitosis.

Relation of Facial Growth Pattern with Molar’s Axial Inclination

OBJECTIVE: To investigate the relationship between mesiodistal angulation of maxillary and mandibular 1st molar to different facial growth patterns.METHODOLOGY: This cross-sectional study was conducted from January to February 2021 at theJinnah Sindh Medical University, Karachi, Sindh. According to the non-probability consecutive samplingtechnique, a lateral cephalogram of 90 individuals (55 female and 35 male) with mean age 19.7±4.38 wasanalyzed for the vertical growth pattern. Only those patients with age between 14 to 30, teeth inpermanent dentition, and presence of teeth posteriorly from 1st premolar to 2nd molar were included.Mesiodistal angle was measured of the maxillary and mandibular molar to the palatal plane (PP),mandibular plane(MP), and occlusal plane(OP). The findings were then related to the facial growthpattern. Data were analyzed utilizing SPSSversion 20. RESULTS: Molar’s angulation was significantly (P<0.001) related to the change in facial growth pattern.The mesiodistal angle of the molar increased with an increase in facial divergence and was relativelyupright in patients with low-angle individuals. However, there was a decrease in both maxillary andmandibular molar’s inclination on the occlusal plane with an increase in facial divergence.CONCLUSION: A strong relationship exists between the molar mesiodistal inclination and facial growthpattern. This research presents relative information that can help the clinician in better diagnosis andtreatment plan based on the pattern of individual’s vertical growth. KEYWORDS: Facial divergence, growth pattern, mandibular plane, masticatory force, molar inclination,occlusal plane, palatal plane

Morphometric analysis of the sella turcica in subjects with different vertical growth patterns - a cephalometric study.

The objective of this study is the comparison of the size and shape of the sella turcica in subjects with different vertical patterns in the skeletal class I in adults, as well as to determine sex differences within examined groups. Lateral cephalograms were used to examine parametars: shape of sella, angulation, length, diameter, index of the depth and cross-sectional area of the sella turcica in 155 adult Caucasian subjects (79 male and 76 female) from the central Balkan area. Subjects were divided into three groups according to the ANB angle, Wit's appraisal and SN/GoGn angle into normodivergent (angle value between 26° and 38° in 28 male, 27 female subjects), hypodivergent (angle value less than 26° in 26 male, 25 female subjects) and hyperdivergent (angle value higher than 38° in 25 male, 24 female subjects). A normal shape of the sella was established in 40% of the overall number of subjects. Significant sex differences were found for angulation angle and sella depth index (p < 0.05). Significant differences between groups were found only for sella depth (p < 0.02). The area of sella turcica appears to be saved from significant changes in morphology, as well as in measurable dimensions and the obtained results justify the use of sella turcica as an important landmark in different cephalometric analyses.