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Mathapun J, Charoemratrote C. Is Incisor Compensation Related to Skeletal Discrepancies in Skeletal Class III? A Retrospective Cephalometric Study. Diagnostics (Basel) 2024; 14:1021. [PMID: 38786319 PMCID: PMC11119506 DOI: 10.3390/diagnostics14101021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/20/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
This study investigated compensation in skeletal Class III subjects to compare various severities of abnormal jaws. A retrospective analysis of 137 skeletal Class III cephalograms (63 males and 74 females) was conducted, with cephalometric assessments determining skeletal and dental values. The results were compared with Class I cephalograms. Incisor compensation was examined by pairing normal jaws with varied abnormal jaws, classified by severity using one standard deviation (SD). Statistical analyses included Kruskal-Wallis tests, Bonferroni tests, Spearman's correlations, and multiple linear regression. Four skeletal Class III groups were identified: OMx+PMd, RMx+OMd, OMx+OMd, and PMx+PMd (P = prognathic; O = orthognathic; R = retrognathic; Mx = maxilla; Md = mandible.). The upper central incisor (U1) showed proclination, and the lower central incisor (L1) showed retroclination across all groups except for U1 in PMx+PMd and L1 in OMx+OMd, which exhibited normal inclination. U1 exhibited limited compensation even with progressive maxillary retrognathism, while L1 showed limited compensation after one SD of mandibular prognathism. Maxilla (SNA) and jaw discrepancy (ANB) were inversely related to the U1 degree, whereas only jaw discrepancy (ANB) was positively related to the L1 degree. U1 in PMx+PMd and L1 in OMx+OMd showed no incisor compensation. U1 had limited compensation even with progressive maxillary retrognathism while L1 showed limited compensation after one SD mandibular prognathism.
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Affiliation(s)
| | - Chairat Charoemratrote
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai 90110, Thailand;
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Jeong S, Kim S, Lim SH, Yu SK. A study of correlations between cephalometric measurements in Koreans with normal occlusion by network analysis. Sci Rep 2024; 14:9660. [PMID: 38671196 PMCID: PMC11053105 DOI: 10.1038/s41598-024-60410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
Analyzing the correlation between cephalometric measurements is important for improving our understanding of the anatomy in the oral and maxillofacial region. To minimize bias resulting from the design of the input data and to establish a reference for malocclusion research, the aims of this study were to construct the input set by integrating nine cephalometric analyses and to study the correlation structure of cephalometric variables in Korean adults with normal occlusion. To analyze the complex correlation structure among 65 cephalometric variables, which were based on nine classical cephalometric analyses, network analysis was applied to data obtained from 735 adults (368 males, 367 females) aged 18-25 years with normal occlusion. The structure was better revealed through weighted network analysis and minimum spanning tree. Network analysis revealed cephalometric variable clusters and the inter- and intra-correlation structure. Some metrics were divided based on their geometric interpretation rather than their clinical significance. It was confirmed that various classical cephalometric analyses primarily focus on investigating nine anatomical features. Investigating the correlation between cephalometric variables through network analysis can significantly enhance our understanding of the anatomical characteristics in the oral and maxillofacial region, which is a crucial step in studying malocclusion using artificial intelligence.
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Affiliation(s)
- Seorin Jeong
- Department of Orthodontics, College of Dentistry, Chosun University, 7 Chosundaegil, Dong-Gu, Gwangju, South Korea
| | - Sehyun Kim
- Department of Orthodontics, College of Dentistry, Chosun University, 7 Chosundaegil, Dong-Gu, Gwangju, South Korea
| | - Sung-Hoon Lim
- Department of Orthodontics, College of Dentistry, Chosun University, 7 Chosundaegil, Dong-Gu, Gwangju, South Korea
| | - Sun-Kyoung Yu
- Department of Oral Anatomy, College of Dentistry, Chosun University, 7 Chosundaegil, Dong-Gu, Gwangju, South Korea.
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Dehesa-Santos A, Park JA, Lee SJ, Iglesias-Linares A. East Asian and Southern European craniofacial class III phenotype: two sides of the same coin? Clin Oral Investig 2024; 28:84. [PMID: 38195777 DOI: 10.1007/s00784-023-05386-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES The skeletal class III phenotype is a heterogeneous condition in populations of different ethnicities. This study aimed to analyse the joint and ethnicity-specific clustering of morphological features in skeletal class III patients of Asian and European origins. MATERIALS AND METHODS This cross-sectional study involved South Korean and Spanish participants who fulfilled the cephalometric, clinical, and ethnic-related selection criteria. Radiographic records were standardised, calibrated, and measured. A total of 54 skeletal variables were selected for varimax factorial analysis (VFA). Subsequently, a cluster analysis (CA) was performed (mixed method: k-means and hierarchical clustering). Method error and precision were assessed using ICC, Student's t-test, and the Dahlberg formula. RESULTS A total of 285 Korean and Spanish participants with skeletal class III malocclusions were analysed. After performing VFA and CA, the joint sample revealed three global clusters, and ethnicity-specific analysis revealed four Korean and five Spanish clusters. Cluster_1_global was predominantly Spanish (79.2%) and male (83.01%) and was characterised by a predominantly mesobrachycephalic pattern and a larger cranial base, maxilla, and mandible. Cluster_2_global and Cluster_3_global were mainly South Korean (73.9% and 75.6%, respectively) and depicted opposite phenotypes of mandibular projection and craniofacial pattern. CONCLUSIONS A distinct distribution of Spanish and South Korean participants was observed in the global analysis. Interethnic and interethnic differences were observed, primarily in the cranial base and maxilla size, mandible projection, and craniofacial pattern. CLINICAL RELEVANCE Accurate phenotyping, reflecting the complexity of skeletal class III phenotype across diverse populations, is critical for improving diagnostic predictability and future personalised treatment protocols.
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Affiliation(s)
- Alexandra Dehesa-Santos
- School of Dentistry, Complutense University of Madrid, Pza. Ramón y Cajal, S/N. Ciudad Universitaria, 28040, Madrid, Spain
| | - Ji-Ae Park
- Department of Orthodontics, Seoul National University School of Dentistry, 101 Daehak-Ro, Jongno-Gu, 03080, Seoul, South Korea
| | - Shin-Jae Lee
- Department of Orthodontics, Seoul National University School of Dentistry, 101 Daehak-Ro, Jongno-Gu, 03080, Seoul, South Korea
| | - Alejandro Iglesias-Linares
- School of Dentistry, Complutense University of Madrid, Pza. Ramón y Cajal, S/N. Ciudad Universitaria, 28040, Madrid, Spain.
- Craniofacial Biology and Orthodontics Research Group, School of Dentistry, BIOCRAN, Complutense University of Madrid, Pza. Ramón y Cajal, S/N. Ciudad Universitaria, 28040, Madrid, Spain.
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Passalboni C, Taverne M, Lopez R, Rotenberg M, Lauwers F, Prevost A. Characterization of labiomandibular movements induced after isolated LeFort I osteotomy in the surgical management of class III malocclusion. PLoS One 2023; 18:e0292391. [PMID: 37812623 PMCID: PMC10561870 DOI: 10.1371/journal.pone.0292391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023] Open
Abstract
INTRODUCTION Maxillary surgery alone can be proposed for the surgical management of class III malocclusion, but anticipating outcomes for the labiomental muscle complex is challenging due to the mandibular autorotation phenomenon. The objective of this study was to quantify the mandibular and labiomental movements induced by maxillary osteotomy alone in the management of class III malocclusion according to different clinical and surgical variables. METHODS The post-operative changes in mandibular and labiomental shapes were studied by geometric morphometry from the pre- and post-operative lateral cephalometric radiograph of 25 patients. The explanatory variables tested were maxillary advancement, maxillary rotation, and divergence. RESULTS Soft tissues repositioning are different from postoperative mandibular repositioning after maxillary osteotomy. Neuromuscular adjustments of mandible depend on divergence and the maxillary rotation. Labiomental response only depends on divergence. CONCLUSION The surgical procedure does not have the same bone-related and musculocutaneous effects on patients with the same class III malocclusion. It is therefore essential for surgeons to understand the effects of their procedure on musculocutaneous tissues in order to best anticipate post-operative outcomes.
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Affiliation(s)
- Chris Passalboni
- Plastic and Maxillo-facial Surgery Department, Toulouse University Hospital Center, Toulouse, France
| | - Maxime Taverne
- Craniofacial Growth and Form Laboratory, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Raphael Lopez
- Plastic and Maxillo-facial Surgery Department, Toulouse University Hospital Center, Toulouse, France
| | - Maxime Rotenberg
- Dental Faculty, Department of Orthodontics, Toulouse University Hospital Center, Toulouse, France
| | - Frédéric Lauwers
- Plastic and Maxillo-facial Surgery Department, Toulouse University Hospital Center, Toulouse, France
| | - Alice Prevost
- Plastic and Maxillo-facial Surgery Department, Toulouse University Hospital Center, Toulouse, France
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Baek SH, Hong H, Yang IH, Chung JH, Choi JY, An JS. Classification of Skeletal Phenotypes of Preadolescent Patients With Isolated Cleft Palate Using Principal Component Analysis and Cluster Analysis. J Craniofac Surg 2023; 34:2051-2055. [PMID: 37643113 DOI: 10.1097/scs.0000000000009692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/29/2023] [Indexed: 08/31/2023] Open
Abstract
This study aimed to classify the skeletal phenotypes of preadolescent patients with isolated cleft palate using principal component analysis and cluster analysis. Sixty-four preadolescent female patients with isolated cleft palate (incomplete hard palate and complete soft palate cleft group, n=51; complete cleft of the hard and soft palate group, n=13; the mean age when lateral cephalograms were taken, 7.08±0.76 y) were included. Ten angular and 2 ratio cephalometric variables were measured on a lateral cephalogram. Cluster analysis was performed using 3 representative variables obtained from principal component analysis (SN-GoMe, SNA, and SNB). The differences in the variables among the clusters were characterized using the Kruskal-Wallis test. As a result of the analysis, 6 clusters were obtained from 3 groups: the retrusive maxilla and mandible group: cluster 3 (14.1%, moderately hyperdivergent pattern), cluster 5 (17.2%, severely hyperdivergent pattern); the normal maxilla and mandible group: cluster 1 (23.4%, normodivergent pattern), cluster 4 (12.5%, moderately hyperdivergent pattern), cluster 6 (20.3%, severely hyperdivergent pattern); the normal maxilla and protrusive mandible group: cluster 2 (12.5%, normodivergent pattern). The distribution of isolated cleft palate types did not differ among the 6 clusters ( P >0.05). Two thirds of the patients (68.7%, clusters 1, 2, 4, and 6) had a normal anteroposterior position of the maxilla, while one third of the patients (31.3%, clusters 3 and 5) showed a retrusive mandible. These results indicate that isolated cleft palate patients have diverse maxillo-mandibular growth patterns compared with patients with cleft lip and palate.
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Affiliation(s)
- Seung-Hak Baek
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyunseung Hong
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ii-Hyung Yang
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jee Hyeok Chung
- Department of Plastic and Reconstructive Surgery, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Jin-Young Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jung-Sub An
- Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Alshoaibi LH, Alareqi MM, Al-Somairi MAA, Al-Tayar B, Almashraqi AA, An X, Alhammadi MS. Three-dimensional phenotype characteristics of skeletal class III malocclusion in adult Chinese: a principal component analysis-based cluster analysis. Clin Oral Investig 2023; 27:4173-4189. [PMID: 37121943 DOI: 10.1007/s00784-023-05033-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND 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. MATERIALS AND METHODS 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. RESULTS 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%. CONCLUSION 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.
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Affiliation(s)
- Lina Hassan Alshoaibi
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Mohammed Muneer Alareqi
- Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Majedh Abdo Ali Al-Somairi
- Department of Orthodontics, School & Hospital of Stomatology, China Medical University, Shenyang, China
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Barakat Al-Tayar
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
| | - Abeer A Almashraqi
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Xiaoli An
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China.
| | - Maged Sultan Alhammadi
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Yang IH, Choi JY, Baek SH. Characterization of phenotypes of skeletal Class III malocclusion in Korean adult patients treated with orthognathic surgery using cluster analysis. Angle Orthod 2022; 92:477625. [PMID: 35147668 PMCID: PMC9235389 DOI: 10.2319/081421-635.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To characterize the phenotypes of skeletal Class III malocclusion in adult patients who underwent orthognathic surgery (OGS). MATERIALS AND METHODS The sample consisted of 326 patients with Class III malocclusion treated with OGS (170 men and 156 women; mean age, 22.2 years). Using lateral cephalograms taken at initial visits, 13 angular variables and one ratio cephalometric variable were measured. Using three representative variables obtained from principal components analysis (SNA, SNB, and Björk sum), K-means cluster analysis was performed to classify the phenotypes. Statistical analysis was conducted to characterize the differences in the cephalometric variables among the clusters. RESULTS Class III phenotypes were classified into nine clusters from the following four major groups: (1) retrusive maxilla group, clusters 7 and 9 (7.1% and 5.5%; severely retrusive maxilla, normal mandible, severe and moderate hyperdivergent, respectively) and cluster 6 (9.2%; retrusive maxilla, normal mandible, normodivergent); (2) relatively protrusive mandible group, cluster 2 (20.9%; normal maxilla, normal mandible, hyperdivergent); (3) protrusive mandible group, clusters 3 and 1 (11.7% and 15.3%; normal maxilla, protrusive mandible, normodivergent and hyperdivergent, respectively) and clusters 8 and 4 (15.3% and 3.7%; normal maxilla, severe protrusive mandible, normodivergent and hypodivergent, respectively); and (4) protrusive maxilla and protrusive mandible group, cluster 5 (11.4%; protrusive maxilla, severely protrusive mandible, normodivergent). Considerations for presurgical orthodontic treatment and OGS planning were proposed based on the Class III phenotypes. CONCLUSIONS Because the anteroposterior position of the maxilla and rotation of the mandible by a patient's vertical pattern determine Class III phenotypes, these variables should be considered in diagnosis and treatment planning for patients who have skeletal Class III malocclusion.
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Tsuji K, Haruyama N, Nomura S, Murata N, Yoshizaki K, Mitsuyasu T, Nakano H, Nakamura S, Mori Y, Takahashi I. Characteristics of craniofacial morphology and factors affecting them in patients with isolated cleft palate. PeerJ 2021; 9:e11297. [PMID: 33976983 PMCID: PMC8063870 DOI: 10.7717/peerj.11297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/28/2021] [Indexed: 11/20/2022] Open
Abstract
Background Myriad maxillo-mandibular occlusal relationships are observed in patients with isolated cleft palate (ICP), unlike in patients with other cleft types, such as cleft lip and palate. Objectives This study aimed to categorise the characteristics of craniofacial morphology in patients with ICP, and investigate the clinical factors affecting these categorised morphological characteristics. Methods Thirty-six girls with ICP (age (mean ± SD): 5.36 ± 0.36 years) underwent cephalometric measurement. Their craniofacial morphology was categorised using cluster analysis. Profilograms were created and superimposed onto the standard Japanese profilograms to visualise the morphological characteristics of each group (cluster). The mean values and variations in the linear and angular measurements of each group were compared with the Japanese standards and statistically analysed using Dunnett’s test after the analysis of variance. Fisher’s exact test was used to analyse the differences between the cleft types (cleft in the hard and/or soft palate) and skills of the operating surgeons in the groups. Results Cluster analysis of craniofacial morphologies in patients with ICP resulted in the formation of three categories: the first cluster exhibited a relatively harmonious anteroposterior relationship between the maxilla and the mandible (22.2%); the second cluster exhibited crossbite owing to a significantly smaller maxilla (33.3%); and the third cluster exhibited a smaller mandible with posterior rotation showing skeletal class II malocclusion (44.4%). Differences in cleft types and surgeons were not associated with the distribution of patients in each cluster. Conclusions Patients with ICP exhibited characteristic morphological patterns, such as bimaxillary retrusion or severe mandibular retrusion, besides the anterior crossbite frequently found in patients with cleft lip and palate . Understanding the typical morphological characteristics could enable better diagnostic categorisation of patients with ICP, which may eventually improve orthodontic treatment planning.
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Affiliation(s)
- Kyoko Tsuji
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Naoto Haruyama
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Shunsuke Nomura
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Naohisa Murata
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Keigo Yoshizaki
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Takeshi Mitsuyasu
- Section of Oral and Maxillofacial Oncology, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Hiroyuki Nakano
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Seiji Nakamura
- Section of Oral and Maxillofacial Oncology, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Yoshihide Mori
- Section of Oral and Maxillofacial Surgery, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Ichiro Takahashi
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Fukuoka, Japan
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de Frutos-Valle L, Martín C, Alarcón JA, Palma-Fernández JC, Ortega R, Iglesias-Linares A. Novel Sub-Clustering of Class III Skeletal Malocclusion Phenotypes in a Southern European Population Based on Proportional Measurements. J Clin Med 2020; 9:E3048. [PMID: 32971753 PMCID: PMC7565379 DOI: 10.3390/jcm9093048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/05/2020] [Accepted: 09/16/2020] [Indexed: 01/10/2023] Open
Abstract
Current phenotypic characterizations of Class III malocclusion are influenced more by gender or ethnic origin than by raw linear skeletal measurements. The aim of the present research is to develop a Class III skeletal malocclusion sub-phenotype characterization based on proportional cranial measurements using principal component analysis and cluster analysis. Radiometric data from 212 adult subjects (115 women and 96 men) of southern European origin affected by Class III skeletal malocclusion were analyzed. A total of 120 measurements were made, 26 were proportional skeletal measurements, which were used to perform principal component analysis and subsequent cluster analysis. The remaining 94 supplementary measurements were used for a greater description of the identified clusters. Principal component analysis established eight principal components that explained 85.1% of the total variance. The first three principal components explained 51.4% of the variance and described mandibular proportions, anterior facial height proportions, and posterior-anterior cranial proportions. Cluster analysis established four phenotypic subgroups, representing 18.4% (C1), 20.75% (C2), 38.68% (C3), and 22.17% (C4) of the sample. A new sub-clustering of skeletal Class III malocclusions that avoids gender influence is provided. Our results improve clinicians' resources for Class III malocclusion and could improve the diagnostic and treatment approaches for this malocclusion.
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Affiliation(s)
- Leixuri de Frutos-Valle
- Section of Orthodontics, Faculty of Odontology, Complutense University, 28040 Madrid, Spain; (L.d.F.V.); or
| | - Conchita Martín
- Section of Orthodontics, Faculty of Odontology, Complutense University, 28040 Madrid, Spain; (L.d.F.V.); or
- BIOCRAN (Craniofacial Biology) Research Group, Complutense University, 28040 Madrid, Spain
| | - José Antonio Alarcón
- Section of Orthodontics, Faculty of Odontology, University of Granada, 18071 Granada, Spain;
- BIOCRAN (Craniofacial Biology) Research Group, Complutense University, 28040 Madrid, Spain
| | | | - Ricardo Ortega
- Section of Radiology, Faculty of Odontology, Complutense University, 28040 Madrid, Spain;
| | - Alejandro Iglesias-Linares
- Section of Orthodontics, Faculty of Odontology, Complutense University, 28040 Madrid, Spain; (L.d.F.V.); or
- BIOCRAN (Craniofacial Biology) Research Group, Complutense University, 28040 Madrid, Spain
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