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Yadfout A, El Aoud J, Merzouk N, Slaoui Hasnaoui J. Increasing Vertical Dimension of Occlusion (VDO): Review. Clin Cosmet Investig Dent 2024; 16:135-142. [PMID: 38770218 PMCID: PMC11104375 DOI: 10.2147/ccide.s453704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/09/2024] [Indexed: 05/22/2024] Open
Abstract
The need to increase the Vertical Dimension of Occlusion (VDO) to restore lost dental function or optimise specific dental treatments is a common occurrence in daily dental practice. The common belief that the Vertical Dimension at Rest (VDR) is fixed hinders the development of restorations with a VDO that encroaches on or surpasses the interocclusal rest space (IRS), thereby preventing potential tissue damage to the masticatory apparatus. Recent studies have shown that the mandible rest position falls within a range termed as the "comfort zone". The range of this zone may vary from one person to another and within the same person over time due to factors such as age or health status. In this review, we have concluded that a permanent increase in the VDO, once indicated, is a safe procedure for dentulous patients. However, it is important to minimise the extent of the increase to simplify the prosthodontics treatment process. An inter-incisal increase exceeding 5 mm is seldom needed. Moreover, it is important to consider the functional, aesthetic, and biological elements associated with VDO. The biological and functional environment closely related to the VDO had great adaptive capacities, which have for a historically been underestimated. Patient adaptation has been observed in dentate patients, edentulous patients, and even cases involving implant-supported prostheses. Muscle relaxation and changes in muscle length are likely the primary adaptation mechanisms, rather than the restoration of the original VDO through dentoalveolar maturation. Intervention with a fixed restoration is more predictable and results in a higher and more rapid level of adaptation. Finally, the increase should include the entire arch to prevent relapse of the VDO to its previous value, and changes in VDO should be assessed by utilising temporary diagnostic restorations for a period before implementing definitive prostheses, in order to evaluate the adaptive muscle response.
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Affiliation(s)
- Asmae Yadfout
- Department of Removable Prosthodontics, Faculty of Dentistry, Mohammed V University, Rabat, Morocco
| | - Jihane El Aoud
- Department of Removable Prosthodontics, Faculty of Dentistry, Mohammed V University, Rabat, Morocco
| | - Nadia Merzouk
- Department of Removable Prosthodontics, Faculty of Dentistry, Mohammed V University, Rabat, Morocco
| | - Jihane Slaoui Hasnaoui
- Department of Removable Prosthodontics, Faculty of Dentistry, Mohammed V University, Rabat, Morocco
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Costa Dutra LD, Guerra-Seabra EJ, Souza da Fonseca Dutra GR, Silva APD, Lucena EEDS. [Dental condiction of patients with temporomandibular dysfunction]. Rev Salud Publica (Bogota) 2023; 21:376-380. [PMID: 36753184 DOI: 10.15446/rsap.v21n3.72086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 05/25/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To evaluate the dental condition and the vertical dimension in patients with TMD, and the age and origin of the DTM. METHODS Was performed a descriptive study, observational, cross-sectional, with a sample of thirty patients with TMD, diagnosed by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). This sample was determined based on estimates the service thus a sample of convenience. The association between gender, age, vertical dimension and dental condition with TMD were verified using the chi-square statistical test with 95% confidence intervals. RESULTS It found that 26 patients were female and 4 males. Fifteen subjects presented aged below 36.5 years. How much the origin of the DTM, 19 subjects had articular disorder, and 11 muscle disorder. Has been determined that there was no statistically significant association between the independent variables with the DTM. CONCLUSION The etiological factors analyzed in isolation do not seem to influence in a unique way in the development of TMD, but may act together with other factors, because the cause is multifactorial.
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Affiliation(s)
- Laio da Costa Dutra
- LC: Cirurgião-Dentista. Ph.D. Odontologia. Universidade Estadual da Paraíba. Campina Grande, Brasil.
| | - Eduardo J Guerra-Seabra
- EG: Cirurgião-Dentista. Ph.D. Ciências da Saúde. Universidade do Estado do Rio Grande do Norte. Caicó, Brasil.
| | | | - Alexandre P da Silva
- AS: Cirurgião-Dentista. Ph.D. Saúde Coletiva. Universidade Federal do Rio Grande do Norte. Natal, Brasil.
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Ribeiro AB, Pita MS, Ribeiro AB, Garcia AR, Junqueira Zuim PR. Effect of short-term increase in occlusal vertical dimension on masticatory muscle electrical activities and pressure-to-pain threshold: A crossover clinical study. J Prosthet Dent 2021; 128:970-976. [PMID: 33678437 DOI: 10.1016/j.prosdent.2021.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Increasing the occlusal vertical dimension (OVD) is a common procedure in clinical practice. However, few studies have assessed the short-term influence of an increased OVD on the masticatory muscles. PURPOSE The purpose of this crossover clinical study was to investigate the effect of increased OVD on the electrical activity of masticatory muscles and the pressure-to-pain threshold (PPT) in asymptomatic participants. MATERIAL AND METHODS Twenty asymptomatic participants (22.7 ±2.39 years of age; 10 men, 10 women) were submitted to an increase in OVD by using interocclusal devices of different thicknesses (3- and 6-mm) for 24 hours. Masticatory muscle activity was assessed with electromyography (EMG), expressed in microvolts (μV), while the participants masticated 2 pieces of latex of different consistency (latex S and H) with and without the device. The PPT was measured with a digital algometer before and after the mastication. The results were assessed by using analysis of variance (ANOVA) and the Tukey honestly significant difference (HSD) test (α=.05). RESULTS The change of OVD did not significantly affect the electrical activity of the muscles. The latex of hard consistency (latex H) showed higher electrical activity values than the soft texture (latex S). For the working side anterior temporal muscle, a change in the PPT was detected on the day the 6-mm-device was inserted, but for the other muscles, device thickness and latex mastication did not change the PPT. CONCLUSIONS For a short time, an increase in occlusal vertical dimension did not affect the electrical activity in the masticatory muscles or pressure-to-pain threshold in asymptomatic participants.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Collaborator Professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
| | - Murillo Sucena Pita
- Post-doctoral Research Fellow, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Aline Barbosa Ribeiro
- Post-doctoral Research Fellow, Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Alício Rosalino Garcia
- Associate Professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Araçatuba, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Paulo Renato Junqueira Zuim
- Associate Professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Araçatuba, São Paulo State University - UNESP, Araçatuba, SP, Brazil
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Rosado LPL, Barbosa IS, Junqueira RB, Martins APVB, Verner FS. Morphometric analysis of the mandibular fossa in dentate and edentulous patients: A cone beam computed tomography study. J Prosthet Dent 2021; 125:758.e1-758.e7. [PMID: 33610327 DOI: 10.1016/j.prosdent.2021.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/06/2023]
Abstract
STATEMENT OF PROBLEM Mandibular fossa roof thickness and lateral inclination could be associated with the presence of bone changes in the mandibular condyle in dentate and edentulous patients. However, literature regarding the relationship between the presence and absence of teeth and the morphologic features of the temporomandibular joint is lacking. This knowledge could provide a better understanding of changes affecting the correct functioning of the stomatognathic system. PURPOSE The purpose of this clinical study was to assess the mandibular fossa roof thickness and lateral inclination in relation to sex, presence or absence of teeth, and bone changes in the mandibular condyle through cone beam computed tomography (CBCT). MATERIAL AND METHODS CBCT scans of 100 individuals (50 dentate and 50 edentulous) were evaluated in terms of mandibular fossa roof thickness and lateral inclination. Bone changes in the mandibular condyle were classified dichotomously in relation to osteophytes, erosion, sclerosis, and flattening. Differences were assessed with the Student t test, the chi-square test, and 2-way analysis of variance (ANOVA), with Tukey post hoc tests (α=.05). RESULTS Sex was not related to mandibular fossa measurements. Edentulous participants showed a higher mandibular fossa lateral inclination (P<.001) and lower roof thickness (P=.001) than dentate participants. When the association between bone changes in the mandibular condyle was evaluated in dentate and edentulous groups, only sclerosis showed a statistically significant association (P<.001). The 2-way ANOVA showed that the mandibular fossa roof thickness was lower in edentulous participants in the presence of flattening and erosion and that the mandibular fossa lateral inclination was higher in the presence of osteophytes, erosion, and sclerosis (P<.001). Among dentate participants, the mandibular fossa lateral inclination was higher in the presence of flattening (P=.024). CONCLUSIONS Mandibular fossa roof thickness and lateral inclination are not associated with sex. However, tooth absence and bone changes in the mandibular condyle are related to mandibular fossa measurements.
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Affiliation(s)
- Lucas P Lopes Rosado
- PhD Researcher, Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Izabele Sales Barbosa
- Research Associate, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
| | - Rafael Binato Junqueira
- Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil.
| | - Ana Paula Varela Brown Martins
- Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
| | - Francielle Silvestre Verner
- Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
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Oh WS, George F, Park JM. Prosthodontic treatment of a retrognathic edentulous maxilla demonstrating limited interarch distance: 3.5-year results with fixed and removable implant prostheses. J Prosthet Dent 2017; 118:251-255. [PMID: 28222867 DOI: 10.1016/j.prosdent.2016.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/06/2016] [Accepted: 10/06/2016] [Indexed: 11/25/2022]
Abstract
The prosthodontic treatment of patients with a retrognathic edentulous maxilla should consider the restoration of the lower facial profile and access for oral hygiene. This clinical report describes prosthodontic treatments of a patient with edentulism who presented with repeated fractures of the denture teeth of a maxillary implant-supported complete fixed dental prosthesis (ICFDP) and a mandibular implant-supported overdenture. Considerable plaque accumulation was noted on the ICFDP, which was replaced with an open palatal design implant-supported overdenture. However, the patient experienced difficulty managing the 2 removable prostheses. The patient's mandible was eventually restored with a milled titanium alloy framework ICFDP with metal occlusal surfaces. This combined approach of fixed and removable prostheses was stable at 3.5-year follow-up appointment, without compromising the patient's oral hygiene or comfort.
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Affiliation(s)
- Won-Suk Oh
- Clinical Professor, Department of Biologic and Materials Sciences Division of Prosthodontics, Ann Arbor, Mich
| | - Furat George
- Clinical Assistant Professor, Department of Biologic and Materials Sciences Division of Prosthodontics, Ann Arbor, Mich
| | - Ju-Mi Park
- Professor, Department of Prosthodontics, Chonbuk National University School of Dentistry, Jeonju, Republic of Korea.
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Raschke GF, Eberl P, Thompson GA, Güntsch A, Peisker A, Schultze-Mosgau S, Gomez-Dammeier M, Djedovic G, Rieger UM, Beuer F. Wearing complete dental prostheses - Effects on perioral morphology. Med Oral Patol Oral Cir Bucal 2016; 21:e413-9. [PMID: 27031069 PMCID: PMC4920453 DOI: 10.4317/medoral.21102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/15/2016] [Indexed: 12/05/2022] Open
Abstract
Background To adequately perform rehabilitation of edentulous patients by a complete removable dental prosthesis (CRDP) is from basic interest to dentists to understand the morphologic changes caused by re-establishment of a physiologic jaw relationship. Anthropometric analyses of standardized frontal view and profile photographs may help elucidate such changes. Material and Methods Photographs of 31 edentulous patients were compared in relaxed lip closure and after insertion of a CRDP in stable occlusion. 2232 anthropometric distances were raised. Eighteen anthropometric indices reflecting the perioral morphology and its integration in the vertical facial harmony were investigated. Results The intercanthal – mouth width index (p<.001), medial - lateral cutaneous upper lip height index (p=.007), lower vermilion contour index (p=.022), vermilion - total upper lip height index (p=.018), cutaneous - total upper lip height index (p=.023), upper lip - nose height index (p=.001), nose - upper face height index (p=.002), chin - mandible height index (p=.013), upper lip - mandible height index (p=.045), nose - lower face height index (p=.018), and nose - face height index (p=.029) showed significant pre- to post-treatment changes. Conclusions The investigated anthropometric indices presented reproducible results related to an increase in occlusal vertical dimension. Their application may be helpful in assessment, planning, and explanation of morphologic effects of CRDPs on the perioral and overall facial morphology, which may helps to improve the aesthetic outcome. Key words:Dentures, removable dentures, anthropometry, perioral morphology.
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Affiliation(s)
- G-F Raschke
- Department of Cranio-Maxillofacial & Plastic Surgery, Friedrich Schiller University Jena, Universitätsklinikum Jena, D-07747 Jena, Germany,
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von der Gracht I, Derks A, Haselhuhn K, Wolfart S. EMG correlations of edentulous patients with implant overdentures and fixed dental prostheses compared to conventional complete dentures and dentates: a systematic review and meta-analysis. Clin Oral Implants Res 2016; 28:765-773. [DOI: 10.1111/clr.12874] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Ina von der Gracht
- Private Practice; Stuttgart Germany
- Department of Prosthodontics and Biomaterials; Center for Implantology; Medical Faculty, University Hospital; RWTH Aachen University; Aachen Germany
| | - Andreas Derks
- Department of Prosthodontics and Biomaterials; Center for Implantology; Medical Faculty, University Hospital; RWTH Aachen University; Aachen Germany
| | | | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials; Center for Implantology; Medical Faculty, University Hospital; RWTH Aachen University; Aachen Germany
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Abdelnabi MH, Swelem AA, Al-Dharrab AA. Influence of denture adhesives on occlusion and disocclusion times. J Prosthet Dent 2016; 115:306-12. [DOI: 10.1016/j.prosdent.2015.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 07/25/2015] [Accepted: 07/28/2015] [Indexed: 11/24/2022]
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Kuć J, Sierpińska T, Gołębiewska M. The relationship between facial morphology and the structure of the alveolar part of the mandible in edentulous complete denture wearers. A preliminary study. Acta Odontol Scand 2015; 73:57-66. [PMID: 25183253 DOI: 10.3109/00016357.2014.950181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Although the effect of involutional processes that occurs in the maxilla and mandible of edentulous subjects is obvious, the problem of factors definitely determining the direction of changes still remains unsolved. This study was aimed at determining the relationship between facial morphology and the structure of the alveolar part and the body of the mandible in edentulous complete denture wearers. MATERIALS AND METHODS Twenty-five healthy edentulous Caucasian patients in the 70.5 ± 9 years of age group were examined. All patients underwent tele-X-ray examination with the presence of currently used dentures in the oral cavity. To assess morphological parameters of the facial skeleton, cephalograms were analyzed according to Ricketts and Mc Namara method. To assess the mandible morphology, the films were measured using the method of Tallgren. RESULTS The period of edentulism was found to be negatively correlated with the anterior segment of the body of the mandible within its symphysis. The parameter corresponding to the location of the first lower molar showed a directly proportional correlation with G'-Sn', G'-Me', Sn'-Me', N-Ans, N-Me, Ans-Me, Co-Gn and Co-Go. Positive correlations were found between the parameters describing contour of the alveolar part of the body of the mandible and mandibular symphysis and G'-Me', Sn'-Me', N-Me, Ans-Me describing the height of the occlusal vertical dimension. CONCLUSION The study showed a directly proportional correlation between the vertical occlusal dimension of the lower face conditioned by prosthetic rehabilitation and the height of the alveolar part in the lateral regions of the mandible.
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Affiliation(s)
- Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok , Poland
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Williams SE, Slice DE. Influence of edentulism on human orbit and zygomatic arch shape. Clin Anat 2013; 27:408-16. [PMID: 23338936 DOI: 10.1002/ca.22194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 09/21/2012] [Accepted: 09/25/2012] [Indexed: 11/09/2022]
Abstract
Edentulism, or tooth loss, seriously alters the appearance of the lower facial skeleton. The aim of this study was to determine if complete maxillary edentulism also impacts the curvature shape of the orbits and zygomatic arches in elderly adults. The study was conducted on 80 crania comprising two cross-sectional populations of elderly African- and European-Americans (60-80 years old). Forty of the crania possessed intact dentition; the remaining 40 exhibited complete edentulism with tooth socket resorption. Three-dimensional semilandmarks representing the curvature of the orbits and zygomatic arches were collected using a hand-held digitizer. Each craniofacial region's semilandmarks were aligned into a common coordinate system via generalized Procrustes superimposition. Regional variation in shape was explored via principal component analysis, multivariate analysis of variance, discriminant function analysis, cross-validation, and vector plots. Shape differences between the edentulous and dentate groups were detected in both the orbits (P = 0.0022) and zygomatic arches (P = 0.0026). Ancestry and sex differences were also identified in both regions. Orbit data correctly classified dentate crania 65% of the time and edentulous crania 72.5% of the time. Zygomatic arch data correctly classified 75% dentate and 60% of edentulous crania. The individual curves constituting each region also exhibited shape alteration with tooth loss, with the exception of the inferior zygomatic curve. Vector plots revealed patterns of superoinferior expansion, and medial and lateral recession depending on the region examined. These results suggest a relationship exists between maxillary edentulism and changes in the surrounding craniofacial structures.
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Affiliation(s)
- Shanna E Williams
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina
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Deljo E, Filipovic M, Babacic R, Grabus J. Correlation analysis of the hyoid bone position in relation to the cranial base, mandible and cervical part of vertebra with particular reference to bimaxillary relations / teleroentgenogram analysis. Acta Inform Med 2013; 20:25-31. [PMID: 23322951 PMCID: PMC3545319 DOI: 10.5455/aim.2012.20.25-31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 12/13/2011] [Indexed: 11/30/2022] Open
Abstract
Introduction: The relationship among the orofacial system and the rest of the body ,both in functional and anatomical terms was the subject of numerous scientific studies. The optimum position of the bone structures of orofacial system provides performance of intact vital functions, such as breathing or swallowing. Hyoid bone represents a link between the head and neck. Although located in the neck, hyoid bone due to its brachial origin belongs to the visceral skeleton. The purpose of the research: a) To determine the position of the hyoid bone, in relation to the cranial base, mandible and cervical part of the vertebra; b) To determine the linear measures of hyoid bone and its constituents and c) to Identify on the profile teleroengen image, whether there are differences in the position of hyoid bone depending on the saggital maxillo-mandibular relationship. The examinees and methods: 30 profile teleroengen images of patients aged 17-18 years of both sexes were used for this study. To study the position of hyoid bone depending on the saggital maxillo-mandibular relationship respondents were divided into groups based on the ANB-angle values. The first group is ortognat patients with ANBangle values, from 1 to 4°. The second group included patients with distal jaw relationship, that is, whose values of ANB-angle were greater than / or 5°. The third group consists of patients with ANB-angle value of 0 or negative. Results and Conclusion: The position of hyoid bone is not constant, but depends on the maxillo-mandibular anterior posterior relationships. Length of hyoid bones and greater horns of hyoid bone differs with respect to the sagittal malocclusion. In relation to the cranial base and maxillary bones flat position of the hyoid bone is highly correlated. A positive correlation was found with relation to the cervical vertebra, while the dependence is determined in relation to the steep mandibular plane.
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