Vertical Skeletal Relationships Research Articles

Risk factors for gingival invagination: A retrospective study.

This study aimed to identify the risk factors for gingival invagination during orthodontic treatment after premolar extraction. The medical records of 135 patients who had undergone interdental space closure after premolar extraction were collected, and cone beam computed tomography was performed to determine the presence of gingival invagination. The risk factors were examined using mixed-effects models and generalized propensity score weighting (GPSW) to develop a predictive model. Univariate analysis revealed that the extraction site, buccal bone thickness 4 mm apical to the cemento-enamel junction (MB1), mid-root buccal bone thickness (MB2) and vertical skeletal relationships were related to gingival invagination (p < .05). Furthermore, a subsequent multivariable mixed-effects model analysis indicated a significantly increased risk of gingival invagination at MB1 < 1 mm (p < .001; odds ratio [ORMB1≤0.5mm] = 29.304; 95% confidence interval [CI]: 8.986-93.807; OR0.5<MB1<1mm = 22.309; 95% CI: 9.890-50.320). Row mixing model analysis performed after balancing covariates using GPSW showed that MB1 and vertical skeletal relationships were associated with gingival invagination (p < .05) with an increase in ORs. Therefore, in addition to MB1, the risk of gingival invagination is higher in hyperdivergent and normodivergent patients. During the establishment and internal validation of the predictive model, the area under the curve for all three models exceeded 0.7. The risk of gingival invagination is higher in patients with MB1 < 1 mm and in normodivergent or hyperdivergent patients.

Relationship between vertical facial morphology and dental arch measurements in class II malocclusion: a retrospective study.

To evaluate the relationship between dental arch measurements and the vertical facial pattern determined in skeletal Class II untreated patients. Lateral cephalograms and plaster models were obtained from 124 untreated female adults (average age: 17.6 ± 3.8 years). Class I (CI), Class II Division 1 (CII/1) and Class II Division 2 (CII/2) malocclusions were divided into three subgroups according to their vertical morphology as hypodivergent, normodivergent and hyperdivergent. The multivariate variance analysis (MANOVA) method was used in the comparison of measurement values according to vertical and sagittal morphology. The relationship between both A point-Nasion-B point (ANB) and Frankfurt-mandibular plane (FMA) angles and dental arch measurements was examined by Pearson correlation analysis. The significance level was received as p < 0.05. While vertical morphology has a statistically significant effect on mandibular arch length, sagittal morphology affects maxillary arch depth. The parameters influenced by both morphologies are maxillary and mandibular arch length, as well as maxillary intermolar width. The mandibular arch length was significantly shorter in hyperdivergent-CII-2 malocclusion (50.5 ± 7.4 mm). Larger values were obtained in both mandibular arch length and maxillary arch depth measurements in CII-1 malocclusion compared to CII-2 malocclusion. The maxillary intermolar width was significantly shorter in hypodivergent-CII-1 malocclusion (46.8 ± 3.4 mm), while it was higher in hypodivergent-CI malocclusion (51.1 ± 3.4 mm). The maxillary arch length was the lowest in hyperdivergent-CI malocclusion (63.1 ± 13.3 mm) and the highest in hypodivergent-CI malocclusion (72.8 ± 7.6 mm). Additionally, a positive but weak correlation was found between ANB and FMA angles. Dental arch measurements have been found to be affected by both vertical facial morphology and skeletal sagittal relationship. A positive correlation was found between ANB and FMA angles.

The accuracy of photographic soft-tissue profile analysis to determine Class II and vertical skeletal relationships in children.

Lateral cephalometric analysis (LCA) is the reference standard for identifying common skeletal relationships in orthodontics, such as Cl II and hyperdivergent skeletal discrepancies, but it entails radiation exposure. Therefore, photographic soft-tissue profile analysis (PSPA) could be a useful alternative for these diagnoses, particularly for paediatric patients. This study aims to estimate the accuracy of PSPA for determining common skeletal discrepancies in children. Cephalometric radiographs and profile photographs of a consecutive series of 100 children (8.0-17.6 years old) made on the same day were included. The validity of PSPA was verified against comparable LCA. First, by assessing the Pearson correlation and then estimating the sensitivity, specificity, receiver operating characteristic (ROC) curves and area under the curve (AUC) in sample A (n = 50). After external validation in a new sample B (n = 50), the ROC-AUC, diagnostic odds ratio, best cut-off points and discriminative validity were assessed in the total sample. Interrater reliability was estimated using the intraclass correlation coefficient, the standard error of measurement and Bland-Altman plots. The measurement properties of the PSPA angles A'N'B', Gl'-Sn-Pog, N'-Sn-Pog', and N'-Tra-Me' were valid (ROC-AUC > 0.7) and reliable (ICCs > 0.92). The angles A'N'B', Gl'-Sn-Pog', and N'-Sn-Pog', with the respective cut-off points ≥7.7', ≥12.8', and ≤163.5', were accurate values for determining Cl II discrepancy. The N'-Tra-Me'-angle (≥63') was an accurate estimate for a hyperdivergent discrepancy. These validated PSPA angles could be used in clinical settings as a minimally invasive diagnostic tool to screen children suspected of having skeletal Cl II and hyperdivergent discrepancies.

Three-dimensional phenotype characteristics of skeletal class III malocclusion in adult Chinese: a principal component analysis-based cluster analysis.

Skeletal class III malocclusion has a diverse and complicated aetiology involving environmental and genetic factors. It is critical to correctly classify and define this malocclusion to be diagnosed and treated on a clinically sound basis. Thus, this study aimed to provide reliable and detailed measurements in a large ethnically homogeneous sample of Chinese adults to generate an adequate phenotypic clustering model to identify and describe the skeletal variation present in skeletal class III malocclusion. This is a retrospective cross-sectional study in which 500 pre-treatments cone-beam computed tomography (CBCT) scans of patients with skeletal class III malocclusion (250 males and 250 females) were selected following specific selection criteria. Seventy-six linear, angular, and ratios measurements were three-dimensionally analysed using InVivo 6.0.3 software. These measurements were categorised into 47 skeletal, 18 dentoalveolar, and 11 soft tissue variables. Multivariate reduction methods: principal component analyses and cluster analyses were used to present the most common phenotypic groupings of skeletal class III malocclusion in Han ethnic group of Chinese adults. The principal component analysis revealed eight principal components accounted for 72.9% of the overall variation of the data produced from the seventy-six variables. The first four principal components accounted for 53.37% of the total variations. They explained the most variation in data and consisted mainly of anteroposterior and vertical skeletal relationships. The cluster analysis identified four phenotypes of skeletal class III malocclusion: C1, 34%; C2, 11.4%; C3, 26.4%; and C4, 28.2%. Based on three-dimensional analyses, four skeletal class III malocclusion distinct phenotypic variations were defined in a large sample of the adult Chinese population, showing the occurrence of phenotypic variation between identified clusters in the same ethnic group. These findings might serve as a foundation for accurate diagnosis and treatment planning of each cluster and future genetic studies to determine the causative gene(s) of each cluster.

Evaluation of miniscrew-assisted rapid palatal expansion success by comparing width of circummaxillary sutures before expansion in adult male patients.

To investigate the relationship between circummaxillary sutures and miniscrew-assisted rapid palatal expansion (MARPE) success in adult male patients and to evaluate the correlation between the width of the sutures and the maxilla expansion ratio. This retrospective study comprised 40 adult male patients treated with MARPE divided into a separation group (N = 20, mean age, 21.9 years) consisting of subjects with midpalatal suture opening and a nonseparation group (N = 20, mean age, 21.7 years) consisting of subjects with no midpalatal suture opening. Cone-beam computed tomography images were obtained before MARPE expansion for both groups and after expansion for the separation group. Vertical and horizontal skeletal relationships, palate length, and widths of 10 circummaxillary sutures before expansion were compared. The correlation between maxilla expansion ratio (jackscrew expansion to maxillary expansion ratio) and circummaxillary suture widths was also analyzed in the separation group. There were no significant differences in age, vertical and horizontal skeletal relationships, and palate length between the two groups. Zygomaticomaxillary, pterygomaxillary, midpalatal, and transverse palatine sutures showed significantly greater width in the separation group (P < .05). The zygomaticomaxillary suture showed the greatest difference (Δ = 0.36 mm) between the groups. The zygomaticomaxillary and pterygomaxillary sutures showed significant positive correlation with the maxilla expansion ratio (P < .01). In adult male patients, greater circummaxillary suture widths before MARPE expansion, especially zygomaticomaxillary and pterygomaxillary sutures, resulted in a better chance of successful suture separation and more maxillary expansion.

Tissue Expander Followed by Autogenous Bone Graft Versus Autogenous Bone Graft Alone for Mandibular Reconstruction: Quantitative Assessment.

The use of a tissue expander in maxillofacial intraoral tissue reconstruction is a developing approach, which provide adequate tissue coverage and aesthetics. The purpose of this study was to quantitatively compare the use of a soft tissue expander in conjunction with autogenous bone graft with bone graft alone for the repair of the mandible's anterior region. The study comprised 24 patients with bone defects in the anterior mandibular region. Patients were divided into 2 groups at random. In group I, expander with bone graft was used, whereas in group II, bone graft was used alone. Volumetric measures of the grafted area was performed using CBCT, and cephalometric evaluations of the anteroposterior and vertical skeletal relationship, as well as the soft tissue profile were recoded. A comparison was made between the 2 groups 6 and 24 months after surgery with P ≤ 0.05 considered significant. The mean difference in grafted bone volume between the 2 groups was 1.95cm 3 , indicating a significant difference between the 2 groups ( P = 0.05) with superior group I results. The soft tissue profile of group I demonstrated a considerable improvement and stability of the lower lip, the labiomental sulcus, and the thickness of the soft tissue Pogonion compared with group II. The use of a tissue expander in conjunction with a bone graft resulted in a better soft tissue profile, making it a favored approach in maxillofacial reconstruction.

Dento-Skeletal Abnormalities in School-aged Children in Iran: A Cross-Sectional Study

Aim: The aim of this study was to evaluate skeleto-dental abnormalities in 9-11-year-old school children, in Tehran, Iran. Materials and Methods: In this population-based cross-sectional descriptive study, a random cluster sampling was done among 19 school districts. A total of 1,429 socioeconomically and ethnically diverse Iranian schoolchildren, aged 9-11 years were studied. A brief questionnaire including background information such as gender and age was completed by the parents. Clinical examinations included the evaluation of sagittal and vertical skeletal relationship, Facial form (facial index), and the presence of significant asymmetry. Results: There were 758 males and 671 females with the mean age of 10 years±8 months. According to the sagittal skeletal relationship, the most prevalent type was convex (63%) that presenting the skeletal Cl II jaw relation; followed by straight (32.9%); and then concave (4.1%). In the vertical skeletal relationship, 73.9% of the children had an average facial relationship, 18.4 % had a long face pattern; and 7.8% had a short face pattern. Regarding facial form in the frontal view, the most common was the average form (79.3%); followed by narrow (14%); and broad (6.7%). The prevalence of significant facial asymmetry was 15.2%. Conclusion: The prevalence of dento-skeletal abnormalities were high. The majority of the Iranian schoolchildren, aged 9-11 years, had at least one dento-skeletal abnormality, even though it is commonly preventable.

Effects of fixed twin-block and forsus fatigue resistant device on mandibular third molar angulation – A comparative study

INTRODUCTION: Fixed functional appliances such as fixed twin-block (FTB) and forsus fatigue resistant device (FRD) improve Class II skeletal relationships by increasing the length of the mandible, which subsequently leads to an increase in the retromolar space. This would bring about a positional and angular change in the mandibular third molar. These appliances also produce forward movement of the mandibular buccal segments, which has also been cited as an important factor providing space and therefore improving the angulation and eruption potential of the third molars. OBJECTIVE: To evaluate and compare the effects of FTB and forsus FRD treatment on mandibular third molar angulation. MATERIALS AND METHODS: Pretreatment and posttreatment lateral cephalograms and orthopantomograms of 25 patients with Class II division 1 malocclusion treated with FTB were compared with those of 25 patients treated with forsus FRD. Sagittal and vertical skeletal relationships and mandibular length were assessed on lateral cephalogram, whereas linear parameters such as retromolar space; space width ratio (SWR); distance of Xi point from the distal surface of the lower second molar; and angular parameters such as α, β, and ϒ; and gonial angles were measured using orthopantomograms. Intragroup comparison was done using paired t-test, while unpaired t-test was done for intergroup comparison of the observed changes. RESULTS: Mandibular length increased significantly in the FTB group, whereas mesialization of the mandibular dentition was significantly high in the FRD group. Both groups showed a significant increase in retromolar space, SWR, Xi point to 7 distance, α angle, and a decrease in β angle. These changes were significantly more pronounced in the FTB group. CONCLUSION: There was a significant improvement in the third molar angulation following treatment with fixed functional appliances, which was comparatively more in the FTB group than that in the FRD group, owing to an increase in mandibular length.

Mandibular symphysis dimensions in different sagittal and vertical skeletal relationships.

BackgroundThe aim of this cross-sectional study was to compare the dimensions of mandibular symphysis (MS) between gender and the different sagittal and vertical skeletal relationships.Material and MethodsPre-treatment records of orthodontic patients were divided according to gender, sagittal (Class I, II and III) and vertical (decreased, average and increased mandibular plane [MP] angle) skeletal relationships. Measurements of MS parameters were performed on lateral cephalograms using IMAGEJ software. Comparisons between MS parameters and gender and the different skeletal relationships was performed using multifactorial and one-way ANOVA, and independent sample t-tests.ResultsA total of 104 records (25 males and 79 females) fulfilled the inclusion criteria. Males had significantly greater MS surface area, dentoalveolar length, skeletal symphysis length, total symphysis length, vertical symphysis dimension and symphysis convexity (p < 0.05). Skeletal Class II patients had significantly greater dentoalveolar and skeletal symphysis lengths while Class III had greater chin length, vertical symphysis dimension and symphysis convexity (p < 0.05). Patients with decreased vertical dimension had greater skeletal symphysis length (p = 0.026) and those with an average vertical relationship had greater chin length (p < 0.001).ConclusionsThe morphology of the mandibular symphysis is affected by gender, sagittal and vertical skeletal patterns. Males had increased mandibular symphysis surface area and linear dimensions. Class II patients had greater dentoalveolar length. Chin length was greater in patients with an average MP angle.

Modified SEC III protocol: vertical control related to patients' compliance with the chincup.

To compare the short-term outcomes of modified SEC III protocol in growing patients in relation to their compliance with the chincup, matching them with an untreated Class III control group (CG). Thirty-four patients (mean age of 8.6 ± 1.2 years) with Class III dentoskeletal malocclusion treated with the modified SEC III protocol and divided into group 1 (G1, 18 subjects), reporting good compliance and group 2 (G2, 16 subjects) not compliant with the chincup. The records were analysed before treatment (T1) and after the orthopaedic phase (T2), with an interval period of about 1.3 ± 0.5 years. The CG consisted of 16 untreated subjects with Class III dentoskeletal malocclusion (mean age of 8.3 ± 1.4 years). The statistical comparisons among the three groups were performed with ANOVA with Tukey's post hoc tests. Both G1 and G2, compared with CG, presented significant improvements in the sagittal skeletal relationships (ANB +2.5° and +2.5°, Wits +4.2° and +3.0°, respectively). G1 exhibited a significant more favourable control of vertical skeletal relationships when compared to G2 (Palatal Pl.-Mandibular Pl. -2.0°) that were associated with a statistically significant reduction of the gonial angle (ArGoMe -1.7°). Limitations of the study were its retrospective nature and the lack of evaluation of the long-term outcomes. Both groups of treated patients showed favourable sagittal skeletal improvement compared with controls. The use of chincup in patients with good compliance produced significantly greater control of the skeletal vertical dimensions compared with patients not compliant with the chincup.

Cephalometric norms for Sri Lankan Sinhalese adolescents with Class I malocclusion

Context: Comprehensive cephalometric analysis plays a significant role in orthodontic diagnosis and treatment planing and variety of cephalometric standards have been developed for different populations. It is important to develop standard cephalometric norms for different populations. Aims: The aim of this study was to develop cephalometric standards for Sri Lankan Sinhalese adolescents with Class I malocclusion and to test the hypothesis that there are racial differences in cephalometric measurements between Sri Lankan and Caucasian norms. Setting and Design: Cross sectional , hospital based, descriptive study. Materials and Methods: Lateral cephalograms were obtained from 33 males (aged 15.7 ± 1.99 years) and 42 females (aged 15.6 ± 2.29 years). Inclusion criteria were healthy individuals with normal growth and development, straight facial profile, average vertical facial proportions, full complement of dentition (excluding third molars), normal overjet and overbite, Class I incisor, canine and molar relationship, and no crossbite in the anterior/posterior region. Eight angular and four linear measurements were analyzed in skeletal, dental, and soft-tissue assessment. Statistical Analysis Used: Statistical analysis was performed using the statistical software R 3.5.0. Results: In the dentoalveolar assessment, the Sri Lankan subjects had a significantly proclined upper (UI to N-A = 23.28) and lower incisor (LI to N-B = 6.56 mm and 28.3) inclinations compared with the Caucasian norms. In the assessment of soft-tissue profile, both upper (1.66 ± 2.7mm) and lower lip (2.8 ± 2.6mm) protrusions were slightly increased than the norms of the Steiner analysis, and these findings were clinically significant. There were no apparent differences in relation to anteroposterior and vertical skeletal relationship when compared with Caucasian norms. Conclusions: The results of the present study suggested that Sri Lankan Sinhalese adolescents with Class I occlusion are likely to present greater incisor proclination than Caucasians. Key Messages: The present study suggested that Sri Lankan Sinhalese adolescents are likely to present greater incisor proclination than Caucasians in Class 1 malocclusion.

Comparison of anterior mandibular alveolar thickness and height in young adults with different sagittal and vertical skeletal relationships: A CBCT Study

Alveolar bone surrounding mandibular incisors dictates the range of buccolingual inclination that can be achieved with treatment. The objective of this study was to evaluate the mandibular anterior alveolar thickness and height in individuals with different sagittal and vertical skeletal relationships. Cone beam computed tomography scans of 53 individuals (22 males and 31 females; mean age 21.19±3.7 years) were classified into 3 groups according to the sagittal skeletal relationship (class I, class II, and class III) and the vertical growth pattern (hyperdivergent, normodivergent, and hypodivergent). The alveolar thickness and height of both mandibular central incisors were measured. Group comparisons were performed with analysis of variance and post hoc Scheffé tests. Multiple linear regression was applied to evaluate the influence of all variables on the alveolar conditions. Alveolar thickness and height showed no significant differences among the class I, II and III groups (6 and 7mm regardless of the sagittal group, P>0.05). The middle and lower alveolar thicknesses were significantly smaller in hyperdivergent (5.76mm and 6.34mm) and normodivergent (6.29mm and 7.40mm) than hypodivergent individuals (6.63mm and 8.27mm respectively). The lingual alveolar height was smaller in hyperdivergent (6.04mm) than hypodivergent individuals (7.93mm) (P=0.029, 95%CI: 0.15-3.63) and the lingual bone height was smaller in hypodivergent (3.24mm) than hyperdivergent individuals (5.06mm) (P=0.029, 95%CI: 0.15-3.48). Multiple linear regression indicated a significant influence of the root length on the alveolar thickness and height. The sagittal skeletal relationship showed no influence on the alveolar thickness or height, even if dental compensation was present. Hyperdivergent individuals showed smaller alveolar thicknesses and heights than hypodivergent individuals.

Cephalometric outcomes of a new orthopaedic appliance for Class III malocclusion treatment.

To evaluate dental and skeletal effects of a new orthopaedic appliance for the treatment of Class III malocclusion in growing patients. This retrospective cephalometric study was performed on a sample of 18 patients with a skeletal Class III malocclusion (4 males; 14 females; mean age 8.8 ± 1.5 years) treated with the Pushing Splints 3 (PS3) protocol. The control group consisted of 18 subjects (5 males; 13 females; mean age 9.1 ± 1.8 years) selected from a database of subjects with untreated Class III malocclusion. The cephalometric analysis was performed at the beginning (T0) and the end of the orthopaedic therapy (T1). Significant differences between the treated and control groups were assessed with independent samples t-test (P < 0.05). In the PS3 group, the post-treatment cephalometric values showed a forward displacement of the maxilla, resulting in a statistically significant increase of the SNA angle. ANPg and Wits appraisal improved significantly compared with the control group. Lingual inclination of mandibular incisors and buccal inclination of the upper incisors were significantly increased in comparison with the control group. No significant differences were recorded for backward mandibular rotation. This study presents a short-term evaluation of the treatment and the use of a historical control group. The PS3 was effective for the treatment of Class III malocclusion in growing patients, with favourable maxillary advancement and control of the vertical skeletal relationships.

Orthognathic Surgery Treatment Need in a Turkish Adult Population: A Retrospective Study.

Objectives: Limited information exists on orthognathic procedures and respective dentofacial deformities in Turkey. This retrospective study assessed the orthognathic surgery procedures in two universities, using the Index of Orthognathic Functional Treatment Need (IOFTN), and compared the IOFTN grades according to gender as well as sagittal and vertical skeletal relationships. Material and Methods: Records of 200 consecutive patients (120 females, 80 males, mean age = 23.4 (SD: 5.4) years) who received orthognathic treatment (2014–2018) were analyzed. Sagittal (ANB angle) and vertical skeletal type (GoGnSN angle), osteotomies, and IOFTN scores were recorded. Results: Class III, II, and I malocclusions formed 69%, 17.5%, and 13.5% of the samples, respectively. Class III skeletal relationships (69%) and high-angle cases (64%) were the most prevalent (p < 0.05). IOFTN scores were unevenly distributed among genders (p < 0.05) and the prevalent scores were 5.3 (40.5%), 4.3 (15.5%), 5.4 (13%), and 5.2 (7.5%), with 94% scoring 4 or 5 (great and very great functional need). Bimaxillary osteotomies were the most prevalent (55%), followed by LeFort I (32%), and 26% had genioplasty. Conclusion: IOFTN is a reliable tool to identify patients in need of orthognathic surgery. Class III malocclusions and Class III sagittal skeletal relationships were more common in this sample. Comparatively, a higher number of patients had genioplasty as a part of their treatment.

Long-term evaluation of rapid maxillary expansion and bite-block therapy in open bite growing subjects: A controlled clinical study.

To evaluate the long-term effects of rapid maxillary expansion (RME) and posterior bite block (BB) in prepubertal subjects with dentoskeletal open bite. The treatment group (TG) comprised 16 subjects (14 girls, 2 boys) with dentoskeletal open bite with a mean age of 8.1 ± 1.1 years treated with RME and BB. Three consecutive lateral cephalograms were available before treatment (T1), at the end of the active treatment with the RME and BB (T2), and at a follow-up observation at least 4 years after the completion of treatment (T3). The TG was compared with a control group (CG) of 16 subjects (14 girls, 2 boys) matched for sex, age, and vertical skeletal pattern. An independent sample t-test was used to compare the T1 to T3, T1 to T2, and T2 to T3 cephalometric changes between the TG and the CG. In the long term, the TG showed a significantly greater increase in overbite (+1.8 mm), reduced extrusion of maxillary and mandibular molars (-3.3 mm), and, consequently, a significant decrease in facial divergence (-2.8°) when compared with untreated subjects. The RME and BB protocol led to successful and stable recovery of positive overbite in 100% of the patients considered. Correction of open bite was associated with reduced extrusion of maxillary and mandibular molars with a significant improvement in vertical skeletal relationships when compared with the CG.

Heritability of the airway structure and head posture using twin study.

Inherited traits of obstructive sleep apnoea (OSA) may have link to the heritability of the airway anatomy. The aim of this study was to investigate heritability of the airway anatomy by comparing skeletal and soft tissue features of Korean monozygotic twins (MZ) and dizygotic twins (DZ). In total, 72 participants (mean age, 41.5±5.9years; 40 males, 32 females) including 48 MZ (24 pairs) and 24 DZ (12 pairs) with same sex were participated. The craniofacial, craniovertebral, hyoideal and pharyngeal parameters were measured using lateral cephalograms. The genetic analysis was performed using Falconer's method. High heritability was detected in the hyoid position and inclination of the cervical column. The velopharyngeal and hypopharyngeal dimensions showed higher heritability compared to those of the nasopharynx and oropharynx. The body mass index (BMI) had interactions with the nasopharyngeal and hypopharyngeal dimensions and length of the tongue and soft palate. The mandibular growth had correlations with the nasopharyngeal and hypopharyngeal dimensions. The vertical skeletal relationships appeared to have interaction with the nasopharyngeal, velopharyngeal and hypopharyngeal dimensions, as well as length of the tongue and soft palate. A forwarded inclination of the cervical columns was seen in connections with BMI and the nasopharyngeal and hypopharyngeal dimensions. The airway structures and head postures seemed to be under strong genetic controls. The airway dimensions had associations with BMI, head postures and skeletal structures which showed high heritability. Forwarded head postures would be physiological adaptations of compromised airway adequacy by increased BMI and retrognathia.

Dentoskeletal features in mixed dentition children with displaced maxillary canines in a southern Italian population.

To analyse the prevalence and the distribution of displaced, buccal/palatal maxillary canines, and the association with sagittal and vertical skeletal relationships in a southern Italian population. Consecutive records of patients were examined. Inclusion criteria were: age 7-12 years, 1-2 cervical vertebral maturation (CVM) stage, initial dental casts, intraoral photographs, panoramic, lateral and periapical radiographs. Subjects with at least one canine in Lindauer II, III or IV sector and/or &#945; angle >31&#176; were included in displaced maxillary canine (DMC) group, whereas those with both canines in sector I and &#945; angle &#8804;31&#176; were used as control group (CTR). According to canine bulges and/or x-ray examinations, DMC were then divided in palatal and buccal displaced canines (PDC/BDC). Sagittal and vertical skeletal relationships were evaluated using ANB and SN/GoMe angles. Chi-square tests were performed to compare the prevalence rates of skeletal features. The sample consisted of 123 children, 40 DMC and 83 CTR. The DMC group included 11 PDC and 29 BDC subjects. The M:F ratio was 1:3 in PDC and BDC, 1:1 in CTR group. The unilateral-to-bilateral ratio was 1:1 and 3:1 in PDC and BDC subjects. The most common sector combination regarding unilateral and bilateral displacements was "II" and "II,II". PDC occurred more in Class I and in hyperdivergents, whereas BDC in Class I or II and in normodivergents. DMC occurred more often in females than in males. BDC was more common than PDC and unilateral displacements occurred more frequently than bilateral ones. No significant correlation with skeletal features was observed.

Early correction of class II division 1 by the modified fixed lingual mandibular growth modificator

Objective: The aim of this study was to assess the skeletal and dental changes of Class II division 1 malocclusion corrected by Modified Fixed Lingual Mandibular Growth Modificator (MFLMGM). Materials and Method: This study was conducted on a sample of 15 patients, which they presented with CL II division 1 malocclusion. Overjet was ≥ 8mm. Age ranges from 9-12 year. The maxilla was protruded and the mandible was retruded. Results: The results showed that the maxillary growth was not significantly affected by MFLMGM treatment while the mandible was advanced. The overjet reduction was 7mm, and overbite reduction was 2.2mm. A reduction of 2.9o in ANB was largely due to an increase of 2.3o in SNB, slight non-significant increase in posterior facial height (S-GO) was 1.4mm. The changes in the other vertical skeletal relationships were negligible. Conclusion: Modified Fixed Lingual Mandibular Growth Modificator (MFLMGM) was successful in treatment cases of severe overjet skeletal Class II division 1 malocclusions. MFLMGM can control degree of severe overjet in treatment of skeletal Class II division 1 malocclusion by Gurin lock. Distal movement of upper molars were an important required in correction of molar relationship. Keywords: Fixed functional appliances, Class II correction, Mandibular advancement

Full Mouth Rehabilitation of an Ectodermal Dysplasia Patient with Hypodontia and Reduced Vertical Dimension Using Metal Ceramic Restorations: A Case Report

Oral rehabilitation of the hypohidrotic ectodermal dysplasia (HED) patient is recommended to improve both the sagittal and vertical skeletal relationship as well as to provide improvements in esthetics, speech, and masticatory efficiency. It has also proven to boost the self-esteem of the patient. This clinical report describes the full mouth reha- bilitation of a HED patient who was clinically monitored for a period of 3 months to evaluate her adaptability to the new increased vertical dimension at occlusion achieved with the help of an overlay removable partial denture (ORPD) for a period of 3 weeks, and provisional restoration for an additional period of 3 months to determine esthetic and functional outcome with provisional restoration, which was followed by the placement of final definitive prosthesis, designed based on shortened dental arch (SDA) scheme, which eliminates the need for invasive implant surgeries. The occlusal cant was corrected by a conservative approach using the macroesthetic elements of smile design, which helps to establish the occlusal plane in a simple and reliable technique.

Dental prosthetic rehabilitation of a child with ectodermal dysplasia: A case report

Ectodermal dysplasias (EDs) form a part of the complex group of rare congenital diseases, primarily observed as a result of the abnormal development of embryonic ectodermal derivatives. A 5-year-old male child reported to the Department of Pedodontics and Preventive Dentistry, with the typical features of hypohidrotic ectodermal dysplasia (HED), i.e., diff usely sparse hair, eyelashes and eyebrows, subsequent problems with thermoregulation and dry skin. The facial profi le showed a prominent forehead, sunken nasal bridge (“saddle nose”), and everted lips. Oral prosthetic rehabilitation was planned for the child to improve both the vertical and sagittal skeletal relationship, additionally providing better esthetics, improved speech, and masticatory function. The case report thus presents the early prosthetic oral rehabilitation of a young boy with HED associated with severe anodontia in the primary dentition.