Correlation between vertical components and skeletal Class II malocclusion in ethnic Javanese

Assessment of Frontal Sinus Volume and Cranial Base Length Based on Different Vertical Skeletal Patterns: A Cone Beam Computed Tomographic Study

Introduction Evaluating craniofacial growth is an essential component of orthodontic treatment, and it is assessed by examining the cranial base. The anterior cranial base is regarded as a stable structure, and the frontal sinus is also recognised as a contributing component in the formation of the cranial base. The frontal sinus, a cavity present in the frontal bone, displays variation in both size and shape and has an impact on the overall structure of the skull and face. This study aims to evaluate the impact of vertical skeletal pattern and gender on the volume of the frontal sinus. Materials and methodology In this study, 90 cone beam computed tomography (CBCT) scans from the record's section were included, comprising 46 males (55.44%) and 44 females (48.88%) aged 20 to 35 undergoing orthodontic treatment. The assessment involved evaluating vertical skeletal patterns using a lateral cephalogram derived from the CBCT scans, and volumetric analysis of the frontal sinus was conducted using Dolphin Imaging software (version 11.9; Dolphin Imaging and Management Solutions, Chatsworth, California). Statistical analysis was performed on the collected data using SPSS software, version 20.0 (IBM Corp., Armonk, NY). Pearson correlation, a one-way ANOVA test to determine any statistically significant differences between the means of both frontal sinus volume and cranial base length groups individually and an independent t-test to compare the sample means between the frontal sinus volume and cranial base length groups were performed. Results: A non-significant association was observed between frontal sinus volume and cranial base length in skeletal open bite (p = 0.73) and skeletal deep bite (p = 0.12) between males and females, which implies there is no substantial association between frontal sinus volume (p = 0.08) and cranial base length (p = 0.41) in the different vertical skeletal patterns.  Conclusion: Frontal sinus volume was similar in subjects with a skeletal open bite and a deep bite. Males and females did not show a difference in frontal sinus volume. Hence, it was concluded that frontal sinus volume and anterior cranial base cannot be used as parameters to predict vertical malocclusions.

Investigation of the Relationship between Sagittal Skeletal Nasal Profile Morphology and Malocclusions: A Lateral Cephalometric Film Study

The aim of this study was to evaluate the relationship between skeletal sagittal nasal profile morphology and sagittal skeletal malocclusions. Regarding lateral cephalometric films, the study was conducted in a total of 135 individuals without any prior orthodontic treatment (mean age of 17.91 ± 1.91), including 49 males (mean age 17.91 ± 1.16) and 86 females (mean age 17.78 ± 1.91 years). The groups were divided into two groups as male and female according to gender, and three groups as skeletal Class 1, Class 2, and Class 3 according to the Steiner's ANB angle. In addition, skeletal groups were compared within groups by dividing into two groups of male and female. A total of eight parameters, three skeletal sagittal angular (SNA, SNB, and ANB angles), four nasal linear (R-A, N-A, N-ANS, and N-R distances) and one nasal angular (N1-N2/N2-R angle), were measured on each cephalometric film. The arithmetic mean and standard deviation of all measured nasal parameters were calculated. For statistical analysis, independent sample t-test and one-way analysis of variance (One-Way ANOVA) were used for normally distributed data, and Mann Whitney U and Kruskal Wallis tests were used for data that did not show normal distribution. For statistical analysis, p < 0.05 was considered significant. R-A, N-A, and N-ANS linear nasal parameters differed significantly between the male and female groups, which were evaluated regardless of the skeletal groups, with a higher rate in males (p < 0.05). N-R linear nasal parameter showed a statistically significant difference between skeletal malocclusion groups, which were evaluated regardless of gender. N-R distance was found to be significantly longer in skeletal Class 3 individuals than in Class 1 and 2 individuals (p < 0.05). There was no statistically significant difference in nasal bone concavity angle in all groups (p > 0.05). R-A and N-A linear nasal parameters showed statistically significant differences between male and female sex groups in all skeletal malocclusion classes (p < 0.05). At first, results showed that males had longer measurements than females in all linear nasal parameters. Second, longer measurements were found in all linear nasal parameters in skeletal Class 3 individuals than those in skeletal Class 1 and Class 2 individuals. Third, the nasal bone concavity angle was greater in skeletal Class 2 individuals than the others.

Association of Upper Lip Morphology Characteristics with Sagittal and Vertical Skeletal Patterns: A Cross Sectional Study

Background: Upper lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery. This study is aimed to evaluate the association between upper lip characteristics (ULCs) and skeletal patterns (SPs). Methods: 2079 patients were involved and grouped by sagittal and vertical. Class I, II, and III were identified by ANB angle, while normodivergent, hyperdivergent, and hypodivergent were identified by Facial Height Index and Sum of Angles. ULCs were evaluated by superior sulcus depth, nasolabial angle, upper lip length, basic upper lip thickness, and upper lip thickness. Confounders including demography, malocclusion, upper incisors, and upper lips were adjusted by multivariate linear regression to identify the association between ULCs and SPs. Group differences were evaluated with analysis of variance and Chi-square test. Results: The mean value of ULCs and prevalence of SPs were explored in the Western China population. ULCs were significantly different in various sagittal, vertical, and combined SPs. Superior sulcus depth was negatively related to Class II, and positively related to Class III and the hypodivergent pattern after adjusted by confounders. Conclusions: ULCs significantly varied among different SPs, while only superior sulcus depth was independently associated with SPs, indicating superior sulcus depth is the only ULC that might be significantly corrected by intervention of skeletal growth.

Oral Rehabilitation Using Noninvasive Restorative Approach for Late Mixed Dentition of Preterm Birth Child with Amelogenesis Imperfecta

Preterm birth children comprise about 6% of live births around the world. It is known that premature children exhibit oral anomalies that could affect the function and/or appearance of their dentition in addition to their medical needs. A diagnosis of amelogenesis imperfecta (AI) can present a challenge for both the patient and the treating clinician. This can be more complicated in the case of child treatment, where cooperation and some of the treatment modalities for adults can not be considered. Conventional management of such children is not possible due to the ongoing process of growth and development and the ability of the child to cope with the extensive and lengthy treatment procedure. This article highlights a minimally invasive method for managing AI using adhesive and full-coverage restoration that requires no tooth preparation; this allows the structural integrity of the teeth to be maintained, along with their vitality. As a result, the child will have teeth with better function and aesthetic, to improve eating, appearance, and self-confidence.

Correlation between Dentoalveolar Heights and Vertical Skeletal Patterns in Class I Malocclusion in Ethnic Javanese

Objectives  Vertical proportions of the face are important determining factors for diagnosis and planning appropriate orthodontic treatment. Orthodontic patients have different vertical and sagittal skeletal discrepancies, as well as associated varying degrees of dentoalveolar compensations. Dentoalveolar is a functional component of the jaw; it plays a role in occlusal dynamics and forms sagittal and vertical maxilla–mandibula relationships. This study aims to analyze the relationship between dentoalveolar heights and several vertical skeletal patterns in patients with Class I malocclusion in ethnic Javanese.

Materials and Methods  The sample consisted of lateral cephalograms of 75 patients (18 samples were male, and 57 were female). Determined by inclusion and exclusion criteria, the participants were selected from an initial sample of 196 patients with skeletal Class I malocclusion (sella–nasion–A and B [ANB] = 1–4 degrees). Cephalometric analysis was performed using OrthoVision2017 digital software. This analysis measured upper anterior dental height (UADH), upper posterior dental height (UPDH), lower anterior dental height (LADH), lower posterior dental height (LPDH), ANB angle, sella–nasion and mandibular plane (SN-MP), sella–nasion and palatal plane (SN-PP), palatal plane and mandibular plane (PP-MP), Frankfort horizontal plane and mandibular plane (FH-MP), sella to gonion (S-Go), articulare to gonion (Ar-Go), nasion to menton (N-Me), nasion to anterior nasal spine (N-ANS), and anterior nasal spine to menton (ANS-Me). Pearson correlation test was used to assess correlations among all variables ( p < 0.05).

Results  Significant correlations were observed between dentoalveolar heights and SN-MP, S-Go, Ar-Go, N-Me, and ANS-Me ( p < 0.05).

Conclusions  Patients with Class I malocclusion in ethnic Javanese exhibit a significant correlation between dentoalveolar and vertical skeletal patterns. UPDH and/or LPDH have a significantly positive correlation with SN-MP, S-Go, Ar-Go, N-Me, and ANS-Me. The orthodontic correction of the decreased or increased facial height included either the extrusion or intrusion of the anterior or posterior teeth in different ways.

Factors influencing different types of malocclusion and arch form-A review

AIM

This review intends to highlight malocclusion as a multifactorial issue and review the different factors that influence different types of malocclusion and arch form.

METHODS

An online article search was performed on the factors influencing malocclusion and arch form from January 1990 through April 2020. The search was performed within the Google, Rutgers library, PubMed, MEDLINE databases via OVID using the keywords mentioned in the PubMed and MeSH headings for the English language published articles January 1990 through April 2020, which evaluated different factors that influence malocclusion and arch form.

RESULTS

Of the 300 articles found in initial search results, 31 articles met the inclusion criteria set for this review. These 31 studies were directly related to the factors that impact malocclusion and different arch forms.

CONCLUSION

Genetic inheritance, genetic mutations, age, gender, ethnicity, dental anomalies like macrodontia, congenital diseases, muscular diseases, hormone imbalance, and human behaviour are all factors that influence malocclusion and arch forms. The elements within the individual's control like behaviours can aid in preventing malocclusion. However, it seems as if the underlying reason for most of these factors indicates that malocclusion is a by-product of genetics and pathology.

The Importance of the Occlusal Plane in Predicting Better Facial Soft Tissue in Class II Malocclusion in Ethnic Javanese

Objectives  Class II malocclusion is largely due to a retrognathic mandible. Mandibular rotation is closely related to changes in the occlusal plane during growth. The problems in the occlusal plane could cause disadvantages in the soft tissue profile in Class II malocclusion, presenting treatment challenges for an orthodontist. This study aimed to investigate the importance of the occlusal plane for a better soft tissue profile in Class II malocclusion for Javanese patients.

Materials and Methods  The total number of cephalogram softcopies of patients with skeletal Class II malocclusion were selected based on ANB values (> 4 degrees), no agenesis teeth except the third molar, and all permanent teeth. The cephalograms were calculated using digital tracing by Morpheus 3D imaging. The points and areas to be analyzed on the cephalogram were predetermined. The examination was performed in a span of 1 month and performed via a statistical test using Pearson’s test and multiple regression analysis ( p < 0.05).

Results  There were significant correlation values between the angles produced by the occlusal plane to sella national, Frankfurt horizontal, mandibular plane, and Z-angle ( p < 0.05).

Conclusion  Patients with skeletal Class II malocclusion have a significant correlation between the occlusal plane and the vertical plane, thereby affecting the shape of the soft tissue profile, which causes a facial imbalance. By improving mandibular movement, the soft tissue profile can also be corrected.

A Prospective Study Comparing Adolescent and Post-Adolescent Periods Regarding Effects of Activator Appliance in Patients with Class II Mandibular Retrognathia by Using 3dMDface Analysis and Cephalometry

BACKGROUND The purpose of this prospective study was to compare adolescent and post-adolescent growth periods regarding the effectiveness of conventional activator appliance in patients with Class II mandibular retrognathia by using lateral cephalometric radiographs and three-dimensional photogrammetry (3dMDface). MATERIAL AND METHODS We enrolled 2 groups: 15 patients in the adolescent growth period and 17 patients in the post-adolescent growth period. All patients had Class II anomaly with mandibular retrognathia and were treated with conventional activator appliances. Lateral cephalometric radiographs and three-dimensional photogrammetric views were obtained at the beginning and end of the activator treatment of Class II patients. Maxillomandibular discrepancy, mandibular protrusion and lengths, convexity angles, facial heights, and dental measurements were evaluated cephalometrically. Projections of the lips and the chin and volumetric measurements of the lip and the mandibular area were assessed using three-dimensional photogrammetry. RESULTS Conventional activator therapy resulted in similar effects in both growth periods regarding improvements in the mandibular sagittal growth and maxillomandibular relationship (ANB° and the SNB° angles). Mandibular effective length was increased (Co-Gn length) and the maxillary horizontal growth was restricted (decreased SNA° angle) in both groups following the treatment. Treatment duration was significantly longer in the post-adolescent group. Increases in the projections of menton, pogonion, and sublabial points were observed in the three-dimensional photogrammetric views. Total lip volume was reduced while the mandibular volume was significantly increased in both groups. Lower gonial angle showed a greater increase in the post-adolescent group. CONCLUSIONS Correction of Class II anomaly with mandibular retrognathia was achieved with a combination of dental and skeletal changes in both growth periods. Conventional activator therapy may be an alternative treatment approach in the late growth period as it led to significant skeletal and dental changes.

Correlation Between Sex and Facial Soft Tissue Characteristics Among Young Saudi Patients with Various Orthodontic Skeletal Malocclusions

BACKGROUND There is a debate over the influence of sex on facial soft tissue physiognomies. Therefore, the present study used teleradiographs to assess and compare the soft tissue physiognomies between males and females in a sample from Saudi Arabia who have various orthodontic malocclusions. MATERIAL AND METHODS We obtained 221 lateral cephalometric radiographs taken from orthodontic clinics of patients ages 16-26 years (114 males and 107 females) living in the central and eastern regions of Saudi Arabia. OnyxCeph3TM digital software was used to analyze the dentoskeletal classification of the sample as class I (n=84), class II division 1 (n=42), class II division 2 (n=33), and class III (n=62). Burstone analysis of 6 linear measurements for facial soft tissue thickness (FSTT) was used. We used descriptive analysis and the independent-samples t test using SPSS version 25 for Windows (Chicago, IL) with p<0.05 set as the level of statistical significance. RESULTS Male patients with a class I dento-skeletal relationship showed thicker FSTT; the most significant thickness was seen near the glabella, followed by the upper/lower lip and sub-labiomental sulcus areas. Male patients with class II division 1 showed a substantial difference in FSTT at subnasal, lower lip, and sub-labiomental sulcus areas. No significant difference in FSTT was found between males and females among class II division 2 and class III patients. CONCLUSIONS These observations of significant changes in facial structures of Saudis between males and females should be of great help for diagnosis of orthodontic cases in Saudi adults.