Dental and alveolar arch widths in normal occlusion, class II division 1 and class II division 2

Basal and dentoalveolar transverse parameters in different sagittal and vertical malocclusions in adults: a comparative study

OBJECTIVE

This study sought to three-dimensionally (3D) evaluate the maxillomandibular basal bone and dentoalveolar widths using cone-beam computed tomography (CBCT) scans in adult Chinese populations with different vertical and sagittal facial skeletal patterns whilst no apparent posterior dental crossbite.

MATERIALS AND METHODS

The retrospective cross-sectional comparative study enrolled CBCT images of 259 adult patients (125 males and 134 females). The subjects were divided into the hyperdivergent(n = 82), hypodivergent(n = 88), and normodivergent(n = 89) groups based on the Jarabak ratio (S-GO/N-Me), which were further divided into three subgroups of skeletal Class I, II and III, based on both the ANB angle and AF-BF parameters. ANOVA was used to analyze the extracted data of the studied groups. The intra- and inter-observer reliability was analyzed using the intra-class correlation coefficient (ICC).

RESULTS

In all three vertical facial skeletal patterns, the skeletal Class II had significantly smaller mandibular basal bone width compared to skeletal Class I and Class III, both at the first molar and first premolar levels. The skeletal Class III seemed to have smaller maxillary basal bone width compared to skeletal Class I and Class II malocclusions; however, a significant difference was found only in the normodivergent pattern. As for the dentoalveolar compensation, it was most notable that in the hypodivergent growth pattern, the skeletal Class II had significantly smaller maxillary dentoalveolar width compared to the Class I and Class III groups, both at the first molar and first premolar levels.

CONCLUSIONS

Based on the sample in the present study, skeletal Class II has the narrowest mandibular basal bone regardless of the vertical facial skeletal pattern.

CLINICAL RELEVANCE

For Chinese adults with no apparent transverse discrepancy, the maxillomandibular basal bone and dentoalveolar widths are revealed in specific categories based on different vertical and sagittal facial skeletal patterns. In diagnosis and treatment planning, particular attention should be paid to skeletal Class II for possibly existing mandibular narrowing.

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

Background

To evaluate the relationship between dental arch measurements and the vertical facial pattern determined in skeletal Class II untreated patients.

Methods

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.

Results

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.

Conclusion

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.

Impact of the prefabricated forms of NiTi archwires on orthodontic forces delivered to the mandibular dental arch

BACKGROUND

Although preformed archwires with a variety of arch forms are currently commercially available, the effects of variation in the shape of these archwires on the orthodontic force at each tooth are not well understood. Therefore, we evaluated the forces delivered by various types of commercially available preformed nickel-titanium alloy (NiTi) archwires in a simulated mandibular dental arch.

METHODS

Sixty-three types of 0.019 × 0.025-inch preformed NiTi archwires from 15 manufactures were selected for analysis. The intercanine width (ICW) and intermolar width (IMW) of each archwire were measured at the mean canine and first molar depths of 30 untreated subjects with normal occlusions. Each archwire was placed in a multi-sensor measurement system simulating the mandibular dental arch of subjects with normal occlusions, and orthodontic forces in the facial-lingual direction at the central incisors, canines, and first molars were measured. Correlations between the ICW, IMW, and ICW/IMW ratio of archwires and the delivered forces were analyzed. The archwires were classified into the following four groups according to the ICW and IMW: Control group, ICW and IMW are within the means ± standard deviations of the normal ranges; Ovoid group, narrow ICW and IMW; Tapered group, narrow ICW; and Square group, narrow IMW. The forces were compared among these groups for each tooth.

RESULTS

Significant correlations between the measured archwire width and force to each tooth were found, except between IMW and forces at the central incisors and canines. Significant differences in the forces were found among all groups, except between the Ovoid and Tapered groups at all teeth and between the Ovoid/Tapered and Control groups at the first molar. Significantly greater orthodontic forces in the facial direction were delivered at the central incisors by the archwires in the Ovoid and Tapered groups when compared with the archwires in the other groups.

CONCLUSION

These findings suggest that there is a possible risk of a clinically significant level of unfavorable orthodontic force being delivered to the mandibular incisors in labial inclination when using a preformed archwire with an ICW that is narrower than the dental arch.

Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding

Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-year-old patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

Three-dimensional assessment of craniofacial asymmetry in children with transverse maxillary deficiency after rapid maxillary expansion: A prospective study

OBJECTIVE

The aim of this study was to evaluate craniofacial asymmetry in children with transverse maxillary deficiency, with or without functional unilateral posterior crossbite (UPC), before and after rapid maxillary expansion (RME).

SETTING AND SAMPLE POPULATION

A sample of 51 children with cone beam computed tomography scans obtained before RME (T1) and a year after RME (T2).

MATERIAL AND METHODS

This prospective study consisted of 2 groups: 25 children with functional UPC (6.77 ± 1.5 years) and 26 children without UPC (7.41 ± 1.31 years). Linear and angular measurements were obtained from zygomatic, maxilla, glenoid fossa and mandible, using original and mirrored 3D overlapped models. All right and left side comparisons in both groups and intergroups asymmetries were compared using MANOVA and t test for independent samples, respectively, statistically significant at P < .05.

RESULTS

The UPC group showed no side differences, but mandibular horizontal rotation at T1, and this asymmetry was improved in T2. The non-UPC group showed at baseline significant lateral asymmetry in orbitale, position of palatine foramen, respectively, in average 2.95 mm and 1.16 mm, and 0.49 mm of average asymmetry in condylar height. The glenoid fossa was symmetric in both groups at T1 and T2.

CONCLUSIONS

Children with transverse maxillary deficiency showed slight morphological asymmetry, located in the mandible position in cases of UPC, and in the orbital and maxillary regions in cases without UPC. One year after RME, patients improved their craniofacial asymmetry, with significant changes in the mandible and correction of the mandibular rotation in patients who presented UPC.

Three-dimensional analysis of dental arch forms in Italian population

BACKGROUND

The aim of this study was the comparison of male and female upper and lower dental arch form in untreated Italian patients by 3D analysis, to find differences in shape, in transversal and longitudinal diameters between sexes, and to give a representative set of population's dental arch to clinicians in order to provide suitable orthodontic treatment.

METHODS

The sample consisted of 3D scans of dental casts deriving from 104 Italian untreated patients (Male = 35, Female = 69) in permanent dentition. An evaluation of the arch form was performed by angular and linear values on every patient using a 3D software (SolidWorks®). A Student's two-tailed t test was used to determine if the differences in measurements between the male and female groups were significant and the level of significance was set at P < 0.05.

RESULTS

Statistically significant differences in upper and lower transversal and longitudinal diameters were found. Male arch widths were significantly larger than those of females. Male intercanine, intermolar, and interpremolar diameters were significantly greater than females. Dental arch depth was significantly smaller in the female group. Anterior upper dental arch form was flatter, wider, and less sharp in the female group.

CONCLUSIONS

Basing on the anatomical arches differences found between sexes concerning Italian patients, it is suggested to have regard to each patient pre-treatment arch form, width, and depth during orthodontic treatment according to gender.

Evaluation of arch width among Class I normal occlusion, Class II Division 1, Class II Division 2, and Class III malocclusion in Indian population

Objective:

To test the hypothesis that there is no difference between Class I (CI) normal occlusion, Class II division 1 (CIId1) and CII division 2 (CIId2), and Class III (CIII) malocclusion with respect to arch widths, width of the maxillary and mandibular arches, gender dimorphism within groups, and gender comparisons.

Materials and Methods:

Samples of 40 CI subjects, 40 CIId1 subjects, 40 CIId2 subjects, and 34 CIII subjects were studied. All subjects were Indians with no history of orthodontic treatment. An analysis of variance and Duncan's test statistically compared the groups and genders.

Results:

CIId1 malocclusion showed the narrowest maxillary arch compared with the other types of malocclusions. CIII malocclusion showed largest mandibular arch than other types of malocclusions. Gender dimorphism is more commonly seen in CI normal occlusion than other types of malocclusions. Gender dimorphism is not observed in CIId1 group. Gender comparisons revealed arch width differences between different types of malocclusions more pronounced in males than in females. The maxillary/mandibular intermolar width difference is positive for CI normal occlusion and negative for CIId1, CIId2, and CIII malocclusions, which suggested, the presence of crossbite tendency in CII and CIII malocclusions.

Conclusion:

The hypothesis is rejected by the findings of this study.

Archform comparisons between skeletal class II and III malocclusions

The purpose of this cross-sectional research was to explore the relationship of the mandibular dental and basal bone archforms between severe Skeletal Class II (SC2) and Skeletal Class III (SC3) malocclusions. We also compared intercanine and intermolar widths in these two malocclusion types. Thirty-three virtual pretreatment mandibular models (Skeletal Class III group) and Thirty-five Skeletal Class II group pretreatment models were created with a laser scanning system. FA (the midpoint of the facial axis of the clinical crown)and WALA points (the most prominent point on the soft-tissue ridge)were employed to produce dental and basal bone archforms, respectively. Gained scatter diagrams of the samples were processed by nonlinear regression analysis via SPSS 17.0. The mandibular dental and basal bone intercanine and intermolar widths were significantly greater in the Skeletal Class III group compared to the Skeletal Class II group. In both groups, a moderate correlation existed between dental and basal bone arch widths in the canine region, and a high correlation existed between dental and basal bone arch widths in the molar region. The coefficient of correlation of the Skeletal Class III group was greater than the Skeletal Class II group. Fourth degree, even order power functions were used as best-fit functions to fit the scatter plots. The radius of curvature was larger in Skeletal Class III malocclusions compared to Skeletal Class II malocclusions (r_WALA3>r_WALA2>r_FA3>r_FA2). In conclusion, mandibular dental and basal intercanine and intermolar widths were significantly different between the two groups. Compared with Skeletal Class II subjects, the mandibular archform was more flat for Skeletal Class III subjects.