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Sandoval C, Díaz A, Manríquez G. Assessing cervical spine and craniofacial morphology in Class II and Class III malocclusions: A geometric morphometric approach. Cranio 2024; 42:450-460. [PMID: 34623215 DOI: 10.1080/08869634.2021.1987040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To compare craniofacial and cervical morphology between skeletal Classes II and III applying Geometric Morphometric Methods (GMM). Twenty-six cervical and craniofacial landmarks of 40 Class II and 39 Class III individuals were digitalized on lateral cephalograms. Procrustes ANOVA, generalized Procrustes, principal component analyses, and thin-plate spline function were applied to assess the pattern of shape variation of craniofacial structure and the cervical spine in relation to skeletal classes. Compared with Class III, Class II individuals presented a maxillary protrusion, mandibular retrusion, shorter mandibular corpus, posterior mandibular ramus rotation, anterior cranial base rotation, and a smaller centroid size. Furthermore, a forward and smaller cervical spine were observed. With GMM, the shape and size differences between skeletal classes can be analyzed visually and numerically.
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Affiliation(s)
| | - Alejandro Díaz
- Centre for Quantitative Analysis in Dental Anthropology (Ca2), Faculty of Dentistry, University of Chile
| | - Germán Manríquez
- Centre for Quantitative Analysis in Dental Anthropology (Ca2), Faculty of Dentistry, University of Chile
- Institute of Dental Research, Physics Group, Faculty of Dentistry, University of Chile
- Physical Anthropology Group, Faculty of Social Sciences, University of Chile, Santiago, Chile
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2
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Ogolo DE, Ajare E, Ndubuisi C, Okwuoma O, Nnama S, Ohaegbulam S. Volumetric assessment of Posterior cranial fossa in a West African population. World Neurosurg X 2024; 22:100334. [PMID: 38455251 PMCID: PMC10918262 DOI: 10.1016/j.wnsx.2024.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Posterior fossa pathologies can have potentially devastating outcomes. The volumetric capacity of this fossa, known to have ethnoregional variations, can thus be critical in determining outcomes and intervention measures and approaches to pathologies involving this region. This study aimed to evaluate the normal posterior fossa volumes within the West-African subpopulation. METHODS This was a descriptive study of all patients presenting for a cranial imaging study at the study location within a two-year period using a 1.5T MRI of this cranial region. Obtained data included the transverse and anteroposterior diameters, and the height of this fossa and the obtained data was analyzed. P values < 0.05 was statistically significant. RESULTS A total of 315 patients were recruited (165 males and 150 females). The average posterior fossa transverse diameter, anteroposterior diameter and height were 108.19 mm, 71.58 mm and 35.53 mm respectively for males, and 105.7 mm, 66.48 mm, and 34.24 mm for females respectively. The average posterior fossa volume for males (292.36 cm3) was significantly higher than for females (252.90 cm3) (p= 0.0038). The highest average posterior fossa volume was between 16-30 years for males and above 75 years for females. CONCLUSION Posterior cranial fossa volumes for the West African population is significantly higher than those obtained for other regions. In addition to being beneficial in some posterior fossa space occupying lesions, this larger volume can explain the relative rarity and sexual preferences of some posterior fossa congenital abnormalities like Chiari-1 malformation amongst the West African population.
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Affiliation(s)
- Donald E. Ogolo
- Memfys Hospital Enugu, Nigeria
- Macquarie University Hospital, Sydney, Australia
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Wright MF, Knowles RL, Cortina-Borja M, Javadpour S, Mehendale FV, Urquhart DS. Epidemiology of Robin sequence in the UK and Ireland: an active surveillance study. Arch Dis Child 2023; 108:748-753. [PMID: 37369383 DOI: 10.1136/archdischild-2023-325556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Birth prevalence of Robin sequence (RS) is commonly reported as 1 case per 8000-14 000 live births. These estimates are based on single-source case ascertainment and may miss infants who did not require hospital admission or those without overt upper airway obstruction at birth. OBJECTIVES To identify the true birth prevalence of RS with cleft palate in the UK and Ireland from a population-based birth cohort with high case ascertainment. METHODS Active surveillance of RS with cleft palate was carried out in the UK/Ireland using dual sources of case ascertainment: British Paediatric Surveillance Unit (BPSU) reporting card and nationally commissioned cleft services. Clinical data were collected from notifying clinicians at two time points. RESULTS 173 live-born infants met the surveillance case definition, giving a birth prevalence of 1 case per 5250 live births (19.1 per 100 000 (95% CI 16.2 to 21.9)), and 1:2690 in Scotland. 47% had non-isolated RS, with Stickler syndrome the most common genetic diagnosis (12% RS cases). Birth prevalence derived from the combined data sources was significantly higher than from BPSU surveillance alone. CONCLUSIONS Birth prevalence of RS in the UK/Ireland derived from active surveillance is higher than reported by epidemiological studies from several other countries, and from UK-based anomaly registries, but consistent with published retrospective data from Scotland. Dual case ascertainment sources enabled identification of cases with mild or late-onset airway obstruction that were managed without hospital admission. Studies of aetiology and equivalent well-designed epidemiological studies from other populations are needed to investigate the identified geographical variability in birth prevalence.
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Affiliation(s)
- Marie Fa Wright
- Paediatric Respiratory Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rachel L Knowles
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sheila Javadpour
- Paediatric Respiratory Medicine, Children's Health Ireland at Crumlin, Crumlin, Ireland
| | - Felicity V Mehendale
- Usher Institute, The University of Edinburgh Centre for Global Health Research, Edinburgh, UK
| | - Donald S Urquhart
- Paediatric Respiratory Medicine, Royal Hospital for Children and Young People, Edinburgh, UK
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, UK
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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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Abdalla Y, Kiliaridis S, Sonnesen L. Airway changes after fixed functional appliance treatment in children with and without morphologic deviations of the upper spine: A 3-dimensional CBCT study. Am J Orthod Dentofacial Orthop 2022; 161:791-797. [DOI: 10.1016/j.ajodo.2021.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/01/2021] [Accepted: 01/01/2021] [Indexed: 11/26/2022]
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Authors' response. Am J Orthod Dentofacial Orthop 2021; 160:338. [PMID: 34456002 DOI: 10.1016/j.ajodo.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022]
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Sivakumar A, Nalabothu P, Thanh HN, Antonarakis GS. A Comparison of Craniofacial Characteristics between Two Different Adult Populations with Class II Malocclusion-A Cross-Sectional Retrospective Study. BIOLOGY 2021; 10:biology10050438. [PMID: 34069082 PMCID: PMC8156312 DOI: 10.3390/biology10050438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/26/2021] [Accepted: 05/11/2021] [Indexed: 11/18/2022]
Abstract
Simple Summary One of the most common orthodontic problems, Class II malocclusion, may lead to an increased risk of dentoalveolar trauma, psychosocial issues, and a possible compromised quality of life. Oftentimes clinicians use normative standard values to which each patient is compared to identify deviations from the norm, in order to determine a patient-specific treatment plan. Large inter-individual and inter-ethnic variability, however, is sometimes not considered. In our study, we compared the cephalometric characteristics between two different ethnic groups (South Indian and Vietnamese) with the phenotype of Class II malocclusion in the hope of better understanding this variation and its implications in treatment planning to achieve satisfactory outcomes. Abstract The dental, skeletal, and soft-tissue characteristics of a particular malocclusion can differ based on ethnicity, race, age, sex and geographical location with Class II malocclusion being one of the most prevalent malocclusions encountered in orthodontic clinical practice. The broad understanding of the characteristics of vertical skeletal and dental parameters in patients with Class II malocclusion can help clinicians to identify patterns and variations in the expression of this phenotype for better treatment outcomes. Hence, we compared the craniofacial characteristics of skeletal and dental Class II malocclusion traits from Indian and Vietnamese individuals to analyze the vertical skeletal and dental patterns in both population groups. The sample comprised of lateral cephalograms from 100 young adults with Class II malocclusion, of which fifty (25 males and 25 females) were from South India and the other 50 age- and sex-matched adults from Vietnam. The lateral cephalometric radiographs were digitized into anonymous image files and were traced and assessed for 16 vertical skeletal and dental parameters. The ANB angle was greater in males (+1.4 deg; p < 0.001) and females (+1.9 deg; p < 0.001) in the South Indian population. The Vietnamese males had a larger mandibular plane angle, articular angle, anterior facial height and lower anterior facial height compared to the Indian males. The Vietnamese females had larger mandibular plane and articular angles compared to the Indian females. The skeletal class II malocclusion was more severe in the South Indian compared to the Vietnamese adults. The Vietnamese sample showed a generalized tendency towards a more vertical skeletal growth pattern and in males this pattern seemed to be due to the dentoalveolar component. The Vietnamese females showed a tendency towards a vertical growth pattern, but without apparent contribution by the dentoalveolar component.
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Affiliation(s)
- Arvind Sivakumar
- Department of Orthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India;
| | - Prasad Nalabothu
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Department of Paediatric Oral Health and Orthodontics, University Center for Dental Medicine UZB, 4058 Basel, Switzerland
- Correspondence: ; Tel.: +41-61-3286095
| | - Huyen Nguyen Thanh
- Department of Orthodontics, National Hospital of Odonto-Stomatology, Hanoi 111103, Vietnam;
| | - Gregory S. Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland;
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Oh E, Ahn SJ, Sonnesen L. Treatment effects of functional appliances in children with Class II malocclusion with and without morphologic deviations in the upper spine. Am J Orthod Dentofacial Orthop 2021; 160:41-49. [PMID: 33888375 DOI: 10.1016/j.ajodo.2020.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/01/2020] [Accepted: 03/01/2020] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This research aimed to compare treatment effects of functional appliances between children with and without morphologic deviations in the upper spine and analyze associations between Atlas dimensions and the short- and long-term treatment effects. METHODS Sixty-eight prepubertal or pubertal children (35 boys and 33 girls; mean age, 11.47 ± 1.39 years) treated with Class II functional appliances were included. Lateral cephalograms were taken at pretreatment (T1), postfunctional appliance treatment (T2), and after retention at postpuberty (T3). Upper spine morphology and Atlas dimensions were evaluated at T1. T1-T2 and T1-T3 lateral cephalograms were superimposed using a structural method. Changes in the jaws were compared with multiple linear regression analysis between children with and without deviations in the upper spine. Associations between the changes and Atlas dimensions were analyzed by partial correlation. RESULTS Children with morphologic deviations in the upper spine showed significantly more backward rotation of the mandible (P <0.01) and increased inclination of the jaws (P <0.05, P <0.01) from T1-T2 and significantly smaller condylar growth (P <0.01) from T1-T3 compared with children without the deviations. Atlas height was significantly associated with vertical and rotational changes in the mandible (P <0.01) from T1-T2 and condylar growth (P <0.05) from T1-T2 and T1-T3. CONCLUSIONS Morphologic deviations in the upper spine and low Atlas height were significantly associated with smaller condylar growth induced by functional appliances in the long term. Upper spine morphology and the Atlas dimension may be valuable in phenotypic differentiation in children with Class II malocclusion for optimal treatment outcome.
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Affiliation(s)
- Eunhye Oh
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sug-Joon Ahn
- Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Liselotte Sonnesen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Effects of fixed functional appliances with temporary anchorage devices on Class II malocclusion: A systematic review and meta‑analysis. J World Fed Orthod 2021; 10:59-69. [PMID: 33785320 DOI: 10.1016/j.ejwf.2021.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of fixed functional appliances (FFAs) in conjunction with temporary anchorage devices (TADs) has been proposed to enhance skeletal changes and reduce proclination of the lower incisors. OBJECTIVES To systematically investigate the skeletal and dentoalveolar effects of FFAs with TADs on Class II malocclusion in adolescents. METHODS Electronic searches of databases and manual searches of references were performed up to August 30, 2020. Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) focusing on adolescent patients treated with FFAs combining TADs were included. The modified Cochrane risk-of-bias tool (R.O.B 2.0) and ROBINS-I (Risk of Bias in Non-randomized Studies-of Interventions) Tool were used to assess the risk of bias in RCTs and CCTs, respectively. Meta-analyses of SNA, SNB, ANB, Co-Gn, SN-MP, the lower and upper incisor inclination changes were performed. Subgroup analyses and sensitivity analyses were conducted based on TAD types, FFA types, record types and types of study designs. RESULTS Ten studies were included with a sample size of 281. Meta-analyses revealed significant differences in the changes in SNB (mean difference [MD] 0.67; 95% confidence interval [CI] 0.04-1.29), ANB (MD -1.22, 95% CI -2.04 to -0.39), Co-Gn (MD 1.57; 95% CI 0.22-2.92), inclination of the lower incisors (MD -5.64, 95% CI -7.78 to -3.50)] and inclination of the upper incisors (MD -1.91; 95% CI -3.69 to -0.13). TAD types and FFA types seem to affect the treatment outcome. CONCLUSIONS Compared with FFAs alone, FFAs with TADs exhibit superior skeletal effects and reduce the inclination of the lower incisors in the short term; however, the evidence showed moderate to high risk of bias. Registration number CRD42020177611.
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Malik S, Skrobola M, Obamiyi S, Feng C, Wang Z, Rossouw PE, Michelogiannakis D. A retrospective comparison of dental and skeletal ages between African American, Caucasian, and Hispanic subjects. J Orthod Sci 2020; 9:11. [PMID: 33354537 PMCID: PMC7749452 DOI: 10.4103/jos.jos_2_20] [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: 01/05/2020] [Revised: 02/15/2020] [Accepted: 07/14/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE: To compare dental and skeletal ages among African American (AA), Caucasian (C) and Hispanic (H) subjects (chronological ages 9 to 15-years). MATERIAL AND METHODS: A total of 168 subjects (9 to 15 years old) were equally divided into AA, C, and H groups, with an equal number of males and females. Each group was divided equally into 7 chronological age-groups, ranging from 9 to 15 years. Dental age was determined from panoramic radiographs as primary, early mixed, late mixed, or permanent dentition (scored as 1-4). Skeletal age was calculated from hand-wrist radiographs using Fishman's Skeletal Maturation Index (SMI 1-11). One-way analysis of variance and Tukey's test were used to compare skeletal and dental ages among AA, C and H subjects; and AA, C and H subjects in each chronological age-group. The two-sample t-test was used to compare SMI and dental age among females and males. RESULTS: Skeletal and dental age were not significantly different between AA, C and H subjects. Mean SMI was higher in females than males; and there were no significant gender differences regarding dental age. Mean SMI and dental age were significantly different among AA, C and H subjects in the 12-year-old and 11-year-old age groups, respectively. CONCLUSIONS: Dental and skeletal maturation are fairly similar among AA, C and H subjects (aged 9 to 15 years).
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Affiliation(s)
- Shaima Malik
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, USA
| | - Mike Skrobola
- Orthodontist in Private Practice, Middletown, New York, USA
| | - Samuel Obamiyi
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, USA
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, New York, USA
| | - Zhihui Wang
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, USA
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, USA
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de Frutos-Valle L, Martin C, Alarcón JA, Palma-Fernández JC, Ortega R, Iglesias-Linares A. Sub-clustering in skeletal class III malocclusion phenotypes via principal component analysis in a southern European population. Sci Rep 2020; 10:17882. [PMID: 33087764 PMCID: PMC7578100 DOI: 10.1038/s41598-020-74488-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 09/28/2020] [Indexed: 02/08/2023] Open
Abstract
The main aim of this study was to generate an adequate sub-phenotypic clustering model of class III skeletal malocclusion in an adult population of southern European origin. The study design was conducted in two phases, a preliminary cross-sectional study and a subsequent discriminatory evaluation by main component and cluster analysis to identify differentiated skeletal sub-groups with differentiated phenotypic characteristics. Radiometric data from 699 adult patients of southern European origin were analyzed in 212 selected subjects affected by class III skeletal malocclusion. The varimax rotation was used with Kaiser normalization, to prevent variables with more explanatory capacity from affecting the rotation. A total of 21,624 radiographic measurements were obtained as part of the cluster model generation, using a total set of 55 skeletal variables for the subsequent analysis of the major component and cluster analyses. Ten main axes were generated representing 92.7% of the total variation. Three main components represented 58.5%, with particular sagittal and vertical variables acting as major descriptors. Post hoc phenotypic clustering retrieved six clusters: C1:9.9%, C2:18.9%, C3:33%, C4:3.77%, C5:16%, and C6:16%. In conclusion, phenotypic variation was found in the southern European skeletal class III population, demonstrating the existence of phenotypic variations between identified clusters in different ethnic groups.
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Affiliation(s)
- L de Frutos-Valle
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain
| | - C Martin
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain.,Craniofacial Biology Research Group, BIOCRAN, Complutense University, Plaza Ramón y Cajal, s/n, 28040, Madrid, Spain
| | - J A Alarcón
- Section of Orthodontics, Faculty of Odontology, University of Granada, Campus Universitario de Cartuja, Granada, Spain
| | - J C Palma-Fernández
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain
| | - R Ortega
- Faculty of Odontology, Complutense University, Madrid, Spain
| | - A Iglesias-Linares
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain. .,Craniofacial Biology Research Group, BIOCRAN, Complutense University, Plaza Ramón y Cajal, s/n, 28040, Madrid, Spain.
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Comparison of cervical vertebral anomalies and sella turcica bridging in different growth stages with various vertical skeletal growth patterns. Surg Radiol Anat 2020; 43:117-125. [PMID: 32914225 DOI: 10.1007/s00276-020-02566-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare cervical vertebral anomalies and sella turcica bridging (STB) in different growth stages in orthodontic patients with different vertical skeletal growth patterns. METHODS Lateral cephalometric radiographs (LCR) of 270 patients in the preadolescent, adolescent, or postadolescent periods and having low angle [LA], normal angle [NA], or high-angle [HA] vertical skeletal growth patterns were evaluated retrospectively. STB was visualized using LCRs while evaluating the deficiency of ponticulus posticus (PP) and atlas posterior arch (PAA) associated with the atlas bone. The Pearson chi-square and Fisher's exact tests were used for categorical data and one-way ANOVA for numerical data. RESULTS The prevalence of fully calcified PP and STB increased from the preadolescent (PP, 10.0%; STB, 11.1%) to the postadolescent period (PP, 24.4; STB, 21.1%); they did not differ from vertical skeletal growth patterns (p > 0.05). The prevalence of PAA deficiency is significantly higher in individuals with LA (46.7%) than with other angles (NA, 27.8%; HA, 26.7%). The vertical skeletal growth pattern was significantly related to STB in the preadolescent period and PAA in the postadolescent period. CONCLUSIONS Different anomalies during different growth periods correlate with the vertical skeletal growth pattern. It will be useful to evaluate a different anomaly according to the relevant growth period.
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Dentoskeletal and tooth-size differences between Syrian and Hungarian adolescents with Class II division 1 malocclusion: a retrospective study. BMC Res Notes 2020; 13:270. [PMID: 32493458 PMCID: PMC7268623 DOI: 10.1186/s13104-020-05115-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/26/2020] [Indexed: 11/10/2022] Open
Abstract
Objectives Malocclusion features differ across various populations and ethnicities. At this time, no data are available regarding the dentofacial differences between Syrian and European adolescents with Class II division 1 malocclusion, which is one of the most frequently treated pathologies in orthodontic practice. The present combined cephalometric and tooth-size study aimed to compare the dentoskeletal and tooth-size characteristics of Syrian and Hungarian adolescents with Class II division 1 malocclusion. Results Class II division 1 malocclusion in Hungarian adolescents was a sagittal discrepancy, while in Syrian adolescents, it was a result of excessive vertical development. Syrian adolescents had a significantly excessive vertical development when compared with Hungarian adolescents, regardless of sex (p < 0.01). Hungarian boys had significantly more protruded maxillae (p < 0.001) and less retruded mandibles (p < 0.01) when compared with Syrian boys, while Hungarian girls had significantly shorter mandibles relative to those of Syrian girls (p < 0.01). Syrian girls had significantly more protrusive lower incisors (p < 0.001), accompanied by significantly larger anterior tooth-size ratios when compared to Hungarian girls (p < 0.001). In conclusion, these findings underscore the importance of considering ethnic differences during orthodontic diagnosis and may have implications for optimizing orthodontic treatments in Syrian and Hungarian adolescents with Class II division 1 malocclusion.
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Oh E, Ahn SJ, Sonnesen L. Evaluation of growth changes induced by functional appliances in children with Class II malocclusion: Superimposition of lateral cephalograms on stable structures. Korean J Orthod 2020; 50:170-180. [PMID: 32475844 PMCID: PMC7270938 DOI: 10.4041/kjod.2020.50.3.170] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 12/26/2022] Open
Abstract
Objective To compare short- and long-term dentoalveolar, skeletal, and rotational changes evaluated by Björk’s structural method of superimposition between children with Class II malocclusion treated by functional appliances and untreated matched controls. Methods Seventy-nine prepubertal or pubertal children (mean age, 11.57 ± 1.40 years) with Class II malocclusion were included. Thirty-four children were treated using an activator with a high-pull headgear (Z-activator), while 28 were treated using an activator without a headgear (E-activator). Seventeen untreated children were included as controls. Lateral cephalograms were obtained before treatment (T1), after functional appliance treatment (T2), and after retention in the postpubertal phase (T3). Changes from T1 to T2 and T1 to T3 were compared between the treated groups and control group using multiple linear regression analysis. Results Relative to the findings in the control group at T2, the sagittal jaw relationship (subspinale-nasion-pogonion, p < 0.001), maxillary prognathism (sella-nasion-subspinale, p < 0.05), and condylar growth (p < 0.001) exhibited significant improvements in the Z- and E-activator groups, which also showed a significantly increased maxillary incisor retraction (p < 0.001) and decreased overjet (p < 0.001). Only the E-activator group exhibited significant backward rotation of the maxilla at T2 (p < 0.01). The improvements in the sagittal jaw relationship (p < 0.01) and dental relationship (p < 0.001) remained significant at T3. Condylar growth and jaw rotations were not significant at T3. Conclusions Functional appliance treatment in children with Class II malocclusion can significantly improve the sagittal jaw relationship and dental relationships in the long term.
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Affiliation(s)
- Eunhye Oh
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sug-Joon Ahn
- Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Liselotte Sonnesen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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15
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Kim JR, Jo JH, Chung JW, Park JW. Upper cervical spine abnormalities as a radiographic index in the diagnosis and treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:514-522. [PMID: 31780398 DOI: 10.1016/j.oooo.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 10/04/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the clinical characteristics and treatment outcomes of patients with temporomandibular disorders (TMD) according to the presence of upper cervical spine abnormalities and craniofacial morphology. STUDY DESIGN Clinical examinations were conducted on 43 patients with TMD. Upper cervical spine characteristics (fusion, posterior arch deficiency [PAD], and craniofacial morphology) reflecting head-and-neck posture were evaluated on lateral cephalograms. Condylar bone changes in the temporomandibular joint were evaluated by using cone beam computed tomography. Clinical characteristics and treatment outcomes after 1 year of conservative therapy were statistically analyzed between groups, according to the presence of upper cervical spine abnormalities. RESULTS Pain on neck muscle palpation was more frequent in patients with cervical fusion (P = .019) and with either fusion or PAD (P = .004) before treatment. Patients with PAD had smaller comfortable mouth opening ranges compared with those without the deficiency (P = .044) before treatment and smaller comfortable (P = .020) and maximum (P = .021) mouth opening ranges after treatment. Patients with PAD also had mouth opening limitation (P = .028) and pain on masticatory muscle palpation (P = .014) more frequently after treatment compared with patients without the deficiency. CONCLUSIONS Associations exist between upper cervical spine characteristics and treatment outcomes in patients with TMD, suggesting such parameters as a possible radiographic index in TMD diagnosis and treatment.
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Affiliation(s)
- Ji Rak Kim
- Department of Dentistry and Oral Medicine, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Jung Hwan Jo
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Jin Woo Chung
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Ji Woon Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea.
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Ethnic differences in craniofacial and upper spine morphology between European and Asian children with skeletal Class III malocclusion. Am J Orthod Dentofacial Orthop 2019; 156:502-511. [DOI: 10.1016/j.ajodo.2018.10.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 11/21/2022]
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17
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de Frutos-Valle L, Martin C, Alarcon JA, Palma-Fernandez JC, Iglesias-Linares A. Subclustering in Skeletal Class III Phenotypes of Different Ethnic Origins: A Systematic Review. J Evid Based Dent Pract 2018; 19:34-52. [PMID: 30926101 DOI: 10.1016/j.jebdp.2018.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/22/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE We aimed to systematically review articles investigating the efficiency of the clustering of skeletal class III malocclusion phenotypic subtypes of different ethnic origins as a diagnostic tool. METHODS The review protocol was structured in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and registered in Prospero (CRD42016053865). A survey of articles published up to March 2018 investigating the identification of different subgroups of skeletal class III malocclusion via cluster analysis was performed using 11 electronic databases. Any type of study design that addressed the classification of subclusters of class III malocclusion was considered. The Newcastle-Ottawa scale for cohort and cross-sectional (modified) studies was used for quality assessment. RESULTS The final selection included 7 studies that met all the criteria for eligibility (% overall agreement 0.889, free marginal kappa 0.778). All studies identified at least 3 different types of class III clusters (ranging from 3 to 14 clusters; the total variation of the prevalence of each cluster ranged from 0.2% to 36.0%). The main shared variables used to describe the more prevalent clusters in the studies included were vertical measurements (Ar-Go-Me: 117.51°-135.8°); sagittal measurements: maxilla (SNA: 75.3°-82.95°), mandible (SNB: 77.03°-85.0°). With regard to ethnicity, a mean number of 8.5 and 3.5 clusters of class III were retrieved for Asian and Caucasian population, respectively. CONCLUSIONS The total number of clusters identified varied from 3 to 14 to explain all the variability in the phenotype class III malocclusions. Although each extreme may be too simple or complex to facilitate an exhaustive but useful classification for clinical use, a classification system including 4 to 7 clusters may prove to be efficient for clinical use in conjunction with complete and meticulous subgrouping. CLINICAL SIGNIFICANCE The identification and description of a subclustering classification system may constitute an additional step toward more precise orthodontic/orthopedic diagnosis and treatment of skeletal class III malocclusion.
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Affiliation(s)
| | - Conchita Martin
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain; BIOCRAN (Craniofacial Biology) Research Group, Complutense University, Madrid, Spain.
| | - Jose Antonio Alarcon
- BIOCRAN (Craniofacial Biology) Research Group, Complutense University, Madrid, Spain; Faculty of Odontology, University of Granada, Campus Universitario de Cartuja, Granada, Spain
| | | | - Alejandro Iglesias-Linares
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain; BIOCRAN (Craniofacial Biology) Research Group, Complutense University, Madrid, Spain
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