Vertical Skeletal Growth Pattern Research Articles

Reliability of Dhaval–Rohan angle for assessment of vertical dysplasia

Objectives Assessment of Dhaval–Rohan (DR) angle as a vertical dysplasia indicator. Materials and methods One hundred and forty lateral cephalometric radiographs of Egyptian orthodontic patients of both sexes with age ranging from 16 to 28 years old, collected from the record files of patients admitted for treatment of various malocclusions. The enrolled cases were subdivided based on SN/MP angle, FH/MP angle, Y-axis/FH angle, gonial angle, and LAFH/TAFH, into high angle (hyperdivergent), low angle (hypodivergent), and average (normodivergent) cases according to Aboul-Azm and colleagues. Each case had to have a minimum of three of the five parameters indicating its pattern of growth, DR angle was constructed by using three skeletal points; C (center of condyle where the angle located), M (center of premaxilla), and G (center of symphysis of mandible), the measured data were led to the computer and statistically analyzed using the Statistical Package for Social Sciences software, version 24. Quantitative data were expressed using range (minimum and maximum), mean, and SD. Significance of the obtained results was judged at P value less than 0.05. Results There is a strong correlation between the conventional parameters and DR angle. The cutoff point of the DR angle below 28° indicates a horizontal growth pattern, between 28.5 and 32.5° indicates an average growth pattern, and above 32.5° indicates a vertical skeletal growth pattern. Conclusion The DR angle is a reliable parameter in assessing vertical skeletal growth pattern with minimal cephalometric landmarks that easily and accurately located.

Radiographic Estimation of Association between Condylar Morphology, Ramal Height, and Mandibular Plane Angle in Various Growth Patterns in District Solan Population in Himachal Pradesh

Introduction: In young adults, the mandibular condyle plays an essential role in the stability of long-term orthodontic and orthognathic treatments. Its morphology varies significantly between individuals and is associated with age, sex, facial type, occlusal force, functional load, malocclusion type, and right and left sides. Aim: The aim of the study was to estimate the association between morphology of condyle, ramus height, and mandibular plane (MP) angle in young adult patients with various vertical skeletal growth patterns. Materials and Methods: The present study was conducted on 90 pretreatment panoramic radiographs of subjects aged between 17 and 21 year of age; the patients were divided into three groups as hypodivergent, normodiveregent, and hyperdivergent with 30 subjects in each group on the basis of Sella-Nasion-MP angle. Various parameters were measured to record the condyle morphology, ramus height, and mandibular angle for all the groups. Results: The intergroup comparisons showed that hypodivergent group has statistically significantly greater values compared to those in the hyperdivergent group. A statistically significant difference was detected between the normodivergent and hypodivergent groups only in the condylar area measurements Conclusion: The condylar height was greater in patient with Class I malocclusion. The condylar height width and other perimeters were greater in males than females.

Three-Dimensional Assessment of Temporomandibular Joint Morphology and Facial Asymmetry in Individuals with Different Vertical Skeletal Growth Patterns.

The aim of the current study was to investigate, by means of Cone-Beam Computed Tomography (CBCT), condyle−fossa relationship, temporomandibular joint (TMJ) morphology and facial asymmetry in subjects with different vertical skeletal growth patterns. CBCT of 56 patients (112 TMJs) were categorized into three groups according to the mandibular plane angle (MP): Hypodivergent (MP ≤ 23°), Normodivergent (23° < MP < 30°), and Hyperdivergent (MP ≥ 30°). TMJ spaces, width and depth of the condyle and thickness of the fossa were measured. Horizontal and vertical measurements were used to assess facial asymmetry. One-way Analysis of Variance (ANOVA) and post-hoc Turkey tests were computed for the between-groups comparison. Statistical significance was set at p < 0.05. Larger anterior joint space and smaller condylar dimensions (medio-lateral diameter and medio-lateral thickness) were observed in the hyperdivergent group compared to the normodivergent and hypodivergent groups. Right condylar distances to midsagittal plane were significantly larger than left distances in all the three groups. A vertical pattern of growth in healthy individuals seems to be associated with condylar position and dimension, while facial asymmetry values do not differ among different vertical groups.

DYNAMIC SMILE EVALUATION IN ALL THREE SKELETAL PATTERNS

OBJECTIVES: To compare the different smile variables amongst patients with varying vertical skeletal patterns, and to find whether there is a correlation between the dynamic contributing factors and the vertical smile parameters. METHODS: This cross-sectional study was conducted at department of Orthodontics, Nishtar Institute of Dentistry, Multan, Pakistan from 01-10-2020 to 01-04-2021. The posed smiles of 120 participants, aging 15-25 years, having well-aligned dental arches were videotaped for objective measurements and comparisons with their underlying vertical skeletal growth patterns. RESULTS: The evaluation of smile parameters showed a significantly decreased inter-labial gap in patients with skeletal low angle in males (8.92±3.6mm) and females (9.44±2.58 mm) [p&lt;0.004]. Upper lip length was significantly decreased in low angle (16.23±1.59 mm) cases for males as compared to vertically high (18.57±1.47 mm) and normal angle (18.24±2.08 mm) cases. Inter commissural width was increased significantly in the low angle cases (63.39±8.14 mm) when compared with the high angle cases (58.24±5.44 mm) in females. Maximal Incisal Display was significantly increased in high angle cases (9.03±1.31 mm) p&lt;0.001 as compared to the low angle cases (7.64±1.98 mm). A 65.8% (n=79) of the sample showed a flat smile arc with 26.7% (n=32) having consonant smiles while 7.5% (n=9) showed a reverse smile arc. CONCLUSION: Smile dynamics are influenced by underlying skeletal patterns. Individuals with skeletally high angles showed an increased incisal display and an increased upper lip elevation upon smiling. While the low angle patterns displayed a decreased inter-labial gap and majority showed a flat smile arc.

Association of crossbite with vertical skeletal growth patterns: A retrospective study.

Crossbite is a type of malocclusion in which teeth are positioned more buccally or lingually than their corresponding opposing tooth in the upper or lower dental arch, resulting in a lateral mismatch of the teeth in the dental arches. Crossbite can be unilateral or bilateral, and it can be anterior or posterior. The link between crossbite and skeletal growth pattern remains uncertain. The current study aimed to find the prevalence of crossbite in subjects visiting a private dental hospital and evaluate if there is any association between crossbite and skeletal growth pattern. Data required for the study were procured from the dental information archiving software. The data were sorted and entered into an Excel spreadsheet. IBM SPSS software version 23 was used to conduct the statistical analysis. Graphs and tables were used to interpret the findings. the prevalence of crossbite was found to be 6.4%. Subjects with horizontal growth pattern commonly had crossbite, but no statistical significance (P = 0.07), standard deviation (1.011), was noted. There was no statistically significant association between different skeletal growth patterns however subjects with horizontal growth pattern reported more commonly with crossbite.

Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects.

The aim of the present work was to study the sequence of skeletal maturation in the various anteroposterior and vertical skeletal growth patterns and to detect whether differences existed between them. Cephalograms of 861 growing and adolescent female patients were traced to categorize the subjects into 9skeletal patterns. Each subject was assigned askeletal maturational stage. Analysis of variance (ANOVA) followed by Bonferroni test were used to detect differences in the onset of the three growth stages (prepubertal, pubertal and postpubertal) between the 9groups. The same statistical methods were used to detect differences between the mean ages at the three growth stages within each group. No statistically significant differences were found between the mean ages of pubertal and postpubertal growth stages between the 9skeletal patterns. However, classIII growers had asignificantly earlier onset of prepubertal growth (10.25 ± 1.56years) when compared to that of classII high angle cases (11.11 ± 1.67years; P < 0.01). Also, significant differences were found between the mean ages at the three growth stages within the groups. Amap was created defining the sequence of skeletal maturation for each skeletal growth pattern. This map defines clinically relevant differences in the starting time points and the optimum intervals of growth modification for each skeletal growth pattern.

A Comparison of Craniofacial Characteristics between Two Different Adult Populations with Class II Malocclusion-A Cross-Sectional Retrospective Study.

Simple SummaryOne of the most common orthodontic problems, Class II malocclusion, may lead to an increased risk of dentoalveolar trauma, psychosocial issues, and a possible compromised quality of life. Oftentimes clinicians use normative standard values to which each patient is compared to identify deviations from the norm, in order to determine a patient-specific treatment plan. Large inter-individual and inter-ethnic variability, however, is sometimes not considered. In our study, we compared the cephalometric characteristics between two different ethnic groups (South Indian and Vietnamese) with the phenotype of Class II malocclusion in the hope of better understanding this variation and its implications in treatment planning to achieve satisfactory outcomes.The dental, skeletal, and soft-tissue characteristics of a particular malocclusion can differ based on ethnicity, race, age, sex and geographical location with Class II malocclusion being one of the most prevalent malocclusions encountered in orthodontic clinical practice. The broad understanding of the characteristics of vertical skeletal and dental parameters in patients with Class II malocclusion can help clinicians to identify patterns and variations in the expression of this phenotype for better treatment outcomes. Hence, we compared the craniofacial characteristics of skeletal and dental Class II malocclusion traits from Indian and Vietnamese individuals to analyze the vertical skeletal and dental patterns in both population groups. The sample comprised of lateral cephalograms from 100 young adults with Class II malocclusion, of which fifty (25 males and 25 females) were from South India and the other 50 age- and sex-matched adults from Vietnam. The lateral cephalometric radiographs were digitized into anonymous image files and were traced and assessed for 16 vertical skeletal and dental parameters. The ANB angle was greater in males (+1.4 deg; p < 0.001) and females (+1.9 deg; p < 0.001) in the South Indian population. The Vietnamese males had a larger mandibular plane angle, articular angle, anterior facial height and lower anterior facial height compared to the Indian males. The Vietnamese females had larger mandibular plane and articular angles compared to the Indian females. The skeletal class II malocclusion was more severe in the South Indian compared to the Vietnamese adults. The Vietnamese sample showed a generalized tendency towards a more vertical skeletal growth pattern and in males this pattern seemed to be due to the dentoalveolar component. The Vietnamese females showed a tendency towards a vertical growth pattern, but without apparent contribution by the dentoalveolar component.

Analyzing the contribution of the dental components and abnormal habits in the development of dental open bite in growing children: A cross sectional study

Dental Open bite malocclusion could be caused by either aberrant dental development or abnormal oral habits. Aim: The current study aimed at analyzing the causative factors of dental open bite in a group of growing female subjects having normal vertical growth pattern. Materials and methods: Dental measurements were performed on lateral cephalometric radiographs and study models of 176 growing females with an age range of 9-12 years and average vertical skeletal growth pattern. They were divided into 2 equal groups; group 1 consisted of subjects with dental open bite and group 2 consisted of subjects with normal overbite. The existence of oral habits was also recorded for each patient in the 2 groups Results: The flattened curve of Spee and the proclination of the upper incisors were statistically higher in the open bite group. The ratios of occurrence of thumb sucking, tongue thrusting and mouth breathing habits in the open bite group were statistically higher than in the control group. Conclusions: The flattened curve of Spee, and the proclination of upper incisors, together with some oral habits should be cautiously addressed by the orthodontic clinician during the treatment planning process of open bite malocclusions. This could help in resolving the causative factor of the malocclusion.

3D Evaluation of the Relationship between Different Vertical Growth Patterns and Cranial Base Angulations

Objective This study aimed to compare cranial base angulations in subjects with high-angle, low-angle, and normal-angle vertical growth patterns using cone beam computed tomography (CBCT). Design This study is a retrospective clinical research. Settings This study was carried out at the Dentistry Faculty of Eskisehir Osmangazi University. Participants According to skeletal vertical face growth patterns, 78 subjects (48 females and 30 males, average age: 13.19 ± 1.73 years) were divided equally into three groups: high angle, low angle, and normal angle groups. Main Outcome Measures Cephalometric images were derived from CBCT, and patients were classified according to the SN-GoGn angle (sella-nasion, gonion gnathion angle). Sagittal, axial, and coronal cranial base angulations were measured in three-dimensional (3D) CBCT images. Data were analyzed using the Kolmogorov-Smirnov normality, Kruskal-Wallis, and Mann-Whitney U statistical tests. Results There were statistically significant differences between the low-angle and high-angle groups according to sagittal cranial base angulation parameters ( p = 0.01). Conversely, there were no statistically significant differences between vertical facial growth patterns according to coronal and axial cranial angle variables ( p > 0.05). Conclusion According to the study results, there were no effects of cranial base angulations in two planes (coronal and axial) on different vertical skeletal growth patterns. In the sagittal cranial base angulation parameter, the high-angle group showed greater angulation values than the low-angle group. CBCT may be helpful for evaluating, diagnosing, and predicting 3D cranial base differences.

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

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

Association between condylar position and vertical skeletal craniofacial morphology: A cone beam computed tomography study

Condylar position may play an important role in the establishment of different craniofacial morphologies. The aim of the present study was to determine the possible association between condylar position and vertical skeletal craniofacial morphology in subjects with normal sagittal skeletal pattern using CBCT. The CBCT images of 45 patients with Class I sagittal skeletal pattern were classified into three balanced groups on the basis of SN-MP angle. Each group contained 15 subjects: low angle, normal angle and high angle. The condylar position was determined for the left and right joints. Chi square test was applied to assess the association between condylar position and vertical skeletal growth pattern. The condyles were more anteriorly-positioned in patients with high angle vertical pattern than in those with normal and low angle vertical pattern. No significant differences were found in condylar position between low angle and normal angle subjects. A significant correlation between condylar position and vertical skeletal pattern was found in the present study. This relationship can be considered for predicting and establishing a proper treatment plan for temporomandibular diseases during orthodontic treatment.

Correlation between dento-skeletal characteristics and craniomandibular disorders in growing children and adolescent orthodontic patients: retrospective case-control study.

The aim of this retrospective case-control study was to identify, in a group of growing children and adolescents affected by malocclusion, specific dento-skeletal characteristics which could be correlated to the onset, in the above-mentioned subjects, of craniomandibular disorders (CMD). Among the patients treated at the Paedodontics and Orthodontics department of Bari Dental School, we recruited a group of patients with malocclusion and symptoms of temporomandibular disorders, as an experimental group. We considered as controls those patients who, match-paired to their skeletal class depending on the ANB angle, did not show any CMD sign or symptom. Of the 128 examined patients, 15 showed signs and/or symptoms of CMD (11.7%). When compared to 15 patients non-affected by CMD, we could not detect statistically significant differences in both skeletal and occlusal characteristics. It is still interesting to notice how in CMD patients, characteristics of skeletal hyperdivergence are often to be found. The present study seems to confirm that in growing children and adolescents, the presence of signs and/or symptoms of CMD is not associable to a specific vertical skeletal growth pattern or to other specific occlusal characteristics.

Reliability of Investigating Vertical Skeletal Growth Pattern Using OPG and Lateral Cephalogram: - A Comparative Study

Reliability of Investigating Vertical Skeletal Growth Pattern Using OPG and Lateral Cephalogram: - A Comparative Study

Dental maturation in short and long facial types. Is there a difference

The purpose of this investigation was to study the relationship between vertical skeletal growth pattern and dental maturation in children with long or short anterior facial height. The sample consisted of the records of 312 Dutch children (153 boys and 159 girls, aged 9-12.9 years, with a mean chronological age of 11.3 years). The subjects were selected according to their lower anterior facial height as a percentage of the total facial height. Two groups, one with long and the other with short anterior facial height, were formed for further comparison. Dental age, according to Demirjian's dental maturity score, was determined for each subject. The power of the study was 79% (2-sided test) and 87% (1-sided test). There was no statistically significant difference in dental age score between the two extreme groups. The subjects with short anterior facial height demonstrated a slight tendency toward more advanced dental age. The difference in dental age between long and short facial types is not big enough to be clinically relevant.

Influence of vertical growth pattern on faciolingual inclinations and treatment mechanics

Control of faciolingual tooth inclinations is obtained by using rectangular wire with third-order bends and standard edgewise brackets or by using a straight wire in a preadjusted appliance system. Ideal faciolingual inclinations have been determined previously by measuring facial surface contours relative to coronal long axes. This study evaluates faciolingual inclinations based on occlusal table inclinations relative to occlusal planes. The samples compared include untreated ideal occlusions and malocclusions in three different vertical skeletal growth patterns. Faciolingual inclinations of first molars and central incisors were measured relative to the occlusal plane and to selected cephalometric angular measurements. Statistical comparisons between groups revealed significant differences in the inclinations of the upper incisor relative to the occlusal plane (U1-OP) and the inclination of the occlusal plane relative to sella nasion (OP-SN). No statistically significant intergroup differences were found in the inclination of the lower incisor relative to the occlusal plane (L1-OP) or in the faciolingual inclinations of the maxillary and mandibular first molars. On the basis of the large intergroup differences in the mean angle between the occlusal plane and sella nasion (OP-SN), the use of straight-wire appliance therapy is discussed in terms of the potential for creating differential moments. Because differential moments may facilitate or hinder treatment goals, the practitioner must know the biomechanical sequelae resulting from occlusal plane-sella nasion variations, which differ from normative values when preadjusted brackets are used.